Ziv Medical Center

Ziv serves the Upper Galilee and Golan Heights, providing hospital care for approximately 300,000 residents as well as soldiers and United Nations personnel.[7] Its address is on Rambam Street in Safed, also rendered Zefat, with postal code 13100; the medical center also has a medical library.[8] Its government ownership and academic affiliation with Bar-Ilan University place it within both Israel’s public hospital system and its medical education network.[1]

The hospital’s regional role encompasses routine healthcare, specialist treatment, and care for casualties of conflict.[7] In 2023 it had approximately 2,000 staff, while its services included a radiation center and a child and adolescent psychiatry department serving communities north of Haifa.[9][10] In July 2024, preparations were underway to develop Level 1 trauma capabilities, including neurosurgery and thoracic surgery, so that seriously wounded patients would not require transfer elsewhere.[11] A new surgical framework incorporating those two specialties was inaugurated in September 2025 in cooperation with Rambam.[6]

Capacity figures vary by publication and date: a Ministry of Health guide lists approximately 400 beds, while a February 2024 account gives approximately 370 inpatient beds and another 38 beds in the protected emergency department.[1][7] These figures describe the hospital at particular reporting points rather than a single consistently defined capacity total.[1][7]

The hospital’s origins lie in efforts by Safed’s Jewish community in the late nineteenth century to establish local healthcare, supported by a donation from Baron Rothschild.[4] A new building was completed in 1910 beside a large public garden and served as Safed’s Jewish hospital until the War of Independence.[4] Another historical account dates the opening of Rothschild Hospital to 1912 and describes it as an alternative to a missionary hospital across the street.[12]

During World War I, Ottoman authorities requisitioned the hospital, using it first for typhus patients and later as a military hospital.[4] After Allied forces took Safed in September 1918, the American Zionist Medical Unit spent approximately six months restoring the abandoned institution.[4] It reopened in June 1919 with assistance from the Rothschild family.[4] The restoration formed part of the medical unit’s work establishing or renewing hospital activity in five major Jewish population centers between August 1918 and June 1919.[13]

Hadassah took the hospital under its care in 1922, after which it became known as Rothschild-Hadassah Hospital or simply Hadassah.[4] During the British Mandate, its hospital, adjacent municipal clinic, and preventive services in schools together provided much of Safed’s Jewish medical infrastructure.[4] Hadassah’s hospitals followed a policy of treating people regardless of race, color, or creed, and in the 1930s the organization began transferring institutions outside Jerusalem to Jewish municipalities and Kupat Holim.[13]

Among the early physicians was Dr. Gershon, or George-Georg, Gary, remembered for treating Joseph Trumpeldor in his final hours.[4] Dr. Moshe Krieger managed the hospital for two years and treated the poet Rachel, who was hospitalized in Safed in 1921 and 1925.[4] Their friendship inspired several poems dedicated to him.[4] A special tuberculosis ward opened in 1926, reflecting the number of tuberculosis patients attracted to Safed’s climate.[4]

Dr. Pinhas Weil and his deputy, Dr. Avraham Tzafroni, led the institution from 1927 to 1948.[4] Its place in Safed extended beyond medicine: local leaders and their families received treatment, artists and writers volunteered to entertain patients, and underground organizations stored weapons there.[4] During the War of Independence, tuberculosis patients were evacuated to two guesthouses in Zikhron Ya’akov, while the Safed building became Military Hospital No. 7.[4] It treated casualties from nearby fighting and maintained a forward branch at Kibbutz Kfar Giladi.[4] The hospital served the army’s Northern Command and played a significant medical role in the north during the war.[12][13]

In 1957, the institution passed from Hadassah to the Ministry of Health and became the Government Hospital in Safed.[4] While a new hospital was being built in the southern part of the city, Prime Minister Golda Meir initiated its naming after Rebecca Sieff in 1971.[4] Sieff was a founder of WIZO and a member of the Marks family associated with Marks & Spencer.[3] The move to the new southern site took place in 1973, before the Yom Kippur War.[4][12] The former building subsequently became a rabbis’ seminary and later part of the Tzfat Academic College campus.[12]

During the 2006 Lebanon war, a rocket landed outside Rivka Ziv Hospital at approximately 11 p.m. on July 17.[14] The blast broke more than 50 windows on the northern façade and destroyed external water and gas pipes.[14] Flying glass injured a patient and a boy in a wheelchair who were on a balcony.[14] In a later opinion article, director Salman Zarka wrote that Ziv had treated more than 1,500 wounded soldiers and civilians during the war and that a missile had struck the facility.[15]

Salman Zarka became the hospital’s director in 2014, after previously heading the IDF Northern Command’s Medical Corps.[16] His tenure included continued treatment of Syrian patients, expansion of pediatric facilities, and preparations for greater trauma-care capacity.[5][11][16] By February 2024, Ziv had received approximately 170 wounded soldiers and civilians during the war then underway; by July, the reported number received from within Israel since October 7, 2023, exceeded 290.[7][11]

Ziv’s patients and workforce reflect the northern region’s Jewish, Muslim Arab, Christian, Circassian, Druze, and Bedouin communities.[7] In July 2024, Zarka described staff from these communities working together while the hospital prepared for a possible wider conflict.[11] The hospital’s catchment includes the Upper Galilee and Golan Heights, while its child and adolescent psychiatric services extend across areas north of Haifa.[7][10]

The populations reached by particular services differ substantially.[2][10] Child and adolescent psychiatry works with schools and families through community clinics, whereas the Syrian-war trauma cohort examined in a 2016 study was predominantly young and male.[2][10] Of those first 100 Syrian-war patients, 94 were male, 17 were younger than 18, and 52 were in their twenties.[2] These figures describe that study cohort, not the hospital’s overall patient population.[2]

The Beit Ida Child Health Center opened in 2016 as a reinforced pediatric facility incorporating emergency, intensive-care, inpatient, and outpatient services, together with specialty departments including diabetes care.[5] Its 6,000-square-meter building took five months to construct and cost approximately 100 million shekels.[5] About two-thirds of the funding came from the state, with donations supplying the remainder.[5]

At the time of its opening, Ziv’s pediatric emergency room treated approximately 14,000 patients annually, and its children’s clinics treated around 24,000 children each year.[5] The pediatric inpatient ward had 16 rooms and 31 beds, providing approximately 10,000 hospital days annually.[5] The new pediatric intensive-care unit had four beds, double its previous capacity.[5]

The child and adolescent psychiatry department’s “greenhouse” program operates clinics in Safed, the Golan Heights, Kiryat Shmona, and Maghar.[10] Children attend weekly sessions close to home, while staff coordinate with their families and schools.[10] In 2023, the program had operated for 13 years and worked with approximately 88 schools; the department’s services treated more than 2,000 children annually.[10]

Psychiatric inpatient capacity remained constrained in 2023: the existing unit had 15 beds, and at times as many as 20 children needing admission could not be accommodated.[10] Ziv was working to open a second 15-bed inpatient unit, while it already operated two ambulatory centers, one for eating disorders and another for other psychiatric conditions.[10] The department occupied a building dating to 1926, separate from the main campus.[10] A proposed campus building envisaged two inpatient units of 22 beds each and two ambulatory clinics with 22 places each; these were plans rather than completed facilities in the 2023 account.[10]

Oncology development also remained incomplete in 2023.[9] A radiation center had been established, but Ziv did not yet have a separate inpatient oncology ward.[9] Four oncology beds were located within internal medicine, and the hospital was awaiting Ministry of Health approval for a dedicated ward.[9]

In February 2024, plans to develop Ziv as a trauma super-center included additional trauma capacity and services such as neurosurgery, thoracic surgery, fertility treatment, and a hyperbaric chamber.[7] By May 2025, a neurosurgery department had opened, two hyperbaric chambers had been delivered, and thoracic surgery was expected to begin shortly.[17] In September 2025, neurosurgery and thoracic surgery units were inaugurated within a new surgical service framework developed with Rambam.[6] The units were dedicated to four soldiers killed in the Iron Swords War.[6]

In May 2025, Ziv was also launching a national healthcare drone program.[17] Its operational drones were intended to carry medical supplies and blood products to emergency locations that were difficult to reach and to collect environmental samples remotely, including water samples.[17]

In February 2013, seven seriously wounded Syrians arrived at Israel’s border, and Salman Zarka arranged their transfer to Ziv.[16] All survived and returned to Syria ten days later.[16] A military field hospital was established near the border in March 2013 following consultation with government officials, but closed approximately a year and a half later.[16] Most Syrian injuries were orthopedic and could await treatment in civilian facilities, reducing the need for the field hospital.[16]

A peer-reviewed study published in 2016 examined Ziv’s first 100 Syrian-war patients using trauma-registry and electronic patient-record data, with ethics committee approval.[2] Gunshot wounds accounted for 50 patients and blast injuries for 29.[2] Two patients with multiple trauma died, eight were transferred for specialist care, and 90 returned from Ziv to Syria after discharge.[2] Treatment was free at the point of care, and hospital protocols were adapted to address both the acute and chronic clinical and social effects of civil war.[2]

The work required complex reconstructive treatment.[18] One case described in 2017 involved an external fixation device stabilizing a reconstructed elbow, with later hinge release planned for physical therapy and a skin graft still required.[18] Such devices cost approximately $2,000–$3,000 and were not returned by Syrian patients unable to come back for follow-up, leaving the hospital to absorb their cost.[18] One doctor directed care from admission through discharge, coordinating surgery, subsequent procedures, and rehabilitation.[18]

Medical staff often did not know whether Syrian patients were civilians or fighters, and patients did not always disclose previous injuries, allergies, or medical histories.[18] Identities were protected because disclosure could endanger patients and their families.[18] Stays ranged from a few days to several months, with rare cases lasting more than a year, and patients received the same standard of care as Israelis.[16]

The program extended beyond war surgery.[18] In 2017, a free one-day pediatric clinic operated every three weeks, bringing children from the border by bus with a parent.[18] It provided routine checkups and treatment for more complicated conditions, with some children remaining for further care.[18] Specialist examinations included cardiology, ear, nose and throat care, orthopedics, and ophthalmology.[19] Injured Syrian patients were not charged, with expenses covered by the Israeli government, Ziv, and individual contributions.[18]

Psychological needs shaped treatment as well.[19] After treating a wounded mother and daughter together, pediatrician Michael Harari emphasized reuniting relatives and reducing physical pain as part of addressing trauma.[19] The child initially would not leave her blanket or eat, illustrating the importance of family contact during recovery.[19] Medical clown Johnny Havis also helped visiting children laugh and dance.[19]

A 2018 account recorded more than 1,500 Syrian hospitalizations at Ziv, totaling 12,310 inpatient days, without specifying the exact period covered.[19] In May 2025, Zarka gave a total of 1,500 Syrian patients and wounded people treated at Ziv between 2013 and 2018, distinguishing that figure from 4,600 treated jointly by Ziv and a military hospital.[17]

The humanitarian work received recognition in the United States.[20][21] During congressional remarks on December 17, 2015, Representative Scott Garrett quoted an unnamed Ziv doctor describing Israeli medical teams’ compassion as “planting the seeds of peace.”[20] In a Senate speech on May 17, 2018, Senator Ted Cruz stated that Ziv had provided more than $8 million in free care to Syrians wounded in the civil war, without specifying the period covered.[21]

Beit Ida was designed to continue pediatric care during emergencies.[5] Its reinforced concrete walls were 30 centimeters thick, with the north-facing wall twice as thick, and it incorporated shock doors, iron windows, and a nuclear, biological, and chemical air filter.[5] Its second floor could become a 100-bed hospitalization ward in an emergency.[5]

Protection across the wider campus was uneven in February 2024.[7] The main inpatient building, opened in 1973, was not protected against missiles or earthquakes, while some newer areas had protective structures or steel reinforcement.[7] The trauma unit had four beds, with two more available in an emergency, and critical departments had protection under various approved standards.[7] In a May 2025 interview, Zarka said the hospital’s 400-bed routine capacity fell to about 200 beds in wartime, with only about a quarter of normal activity conducted underground.[17]

By July 2024, preparations for potential isolation during a wider conflict included stockpiling food, medication, and oxygen sufficient for several days.[11] Staff were expected to be ready to remain at the hospital and work 12-hour shifts.[11] These preparations accompanied plans for expanded trauma services and reduced reliance on transferring serious casualties to other hospitals.[11]

A cyberattack on Ziv’s computer systems was detected in late November 2023.[22] Israel’s National Cyber Directorate attributed it to Agrius, associated with Iran’s Ministry of Intelligence, with involvement by Hezbollah’s Lebanese Cedar unit.[22] A joint investigation involving the directorate, IDF, and Israel Security Agency limited the attack and prevented disruption of hospital operations and civilian medical care.[22][23] Hackers claimed to have stolen 300,000 patient records and later published records online.[22]

An archival photograph associated with Ziv Medical Center and Safed Hospital depicts a wall sculpture by Marcel Janco and Itche Mambush.[24] The record also links the hospital with a school of nursing, while architectural archival material is cataloged under both “Ziv Medical Center, Safed” and “School of Nursing at the Ziv Medical Center, Safed.”[24][25]

The former Rothschild Hospital building preserves another strand of the institution’s history.[12] Its courtyard contains a memorial stone for head nurse Tova Bat Moshe Pestrovsky, and its later uses included a rabbis’ seminary and incorporation into the Tzfat Academic College campus.[12] The hospital’s earlier cultural connections also include Rachel’s stays in Safed and the poems inspired by her friendship with Dr. Moshe Krieger.[4]

Published totals for Syrian patients differ substantially.[16][18] Two accounts issued in September and October 2017 gave figures of more than 2,000 and more than 800, respectively, without explaining the difference.[18][26] A 2019 account gave roughly 5,000, whereas Zarka’s 2025 interview distinguished 1,500 treated at Ziv from 4,600 treated jointly by Ziv and a military hospital.[16][17] These totals should not be combined into a single cumulative count.[16][17]

The cyberattack’s organizational attribution represents the finding of Israeli security authorities, while the widely reported figure of 300,000 stolen patient records originated as a hacker claim.[22] Separately, the $8 million humanitarian-care figure came from a Senate speech that did not identify its period or supporting documentation.[21]