[Hospital under fire--take home message from one war]

Future conflicts in our region will no longer be limited to clashes between opposing armies. Unlike past wars, which by and large did not target places of worship and hospitals, such structures will not be immune from attack in the "total wars" of the future, nor will the civilian population be spared. Hospitals may be hit by enemy fire and must, therefore, be ready to work under adverse conditions and emergency situations. This article describes the accumulated experience of our hospital as a confrontation Line medical facility for over 30 years, sustaining direct hits with injuries to people and damage to buildings. Lessons from those confrontations, particularly the second Lebanon war, are discussed and recommendations to other hospitals formulated, essentially highlighting the following: The need to protect the hospital's physical structures in order to guarantee the safety of patients, staff and visitors in the event of conventionaL or non-conventional war. The provision of protected transportation for the staff and in-hospitaL day-camps and dormitories for their children in order to bolster the presence of the staff on board and enable them to work unperturbed. Preparation of the hospital for work under fire, drafting emergency procedures that are custom-tailored to the needs of the hospital, particularly the evacuation of patients from vulnerable wards to protected areas, and drilling the entire staff regularly and methodically.