TEL AVIV \u2014 The main nerve center for Israel\u2019s primary emergency service<\/a> could resemble any dispatch hub in any American city \u2014 a hive of uniformed first-responders surrounded by ceiling-height monitors and an expanse of computers.<\/p>\n But Magen David Adom\u2019s<\/a> dispatch unit in Ramla, about 12 miles southeast of Tel Aviv, is more than 100 feet underground, safeguarded by thick walls and a sophisticated respirator system capable of providing clean air in case of conventional and nonconventional attacks.<\/p>\n \u201cYou wouldn\u2019t imagine any other emergency services, civilian emergency services, in the world working in a shelter. But for us, this is a need, a basic need,\u201d said Uri Shacham, MDA\u2019s deputy director and chief of staff. The MDA\u2019s role, he said, <\/strong>was \u201cto make sure that no matter what happens outside, no matter how challenging the situation, this brain actually continues to function.\u201d<\/p>\n When NBC News visited the facility Tuesday, the mood seemed busy but relaxed as about a dozen uniformed dispatchers handled phone calls and plotted routes for emergency vehicles on an array of screens.<\/p>\n Soon enough, phones blared with news of incoming projectiles from Iran. The alert seemed to arrive on civilian phones just as quickly as it came to the attention of the dispatchers.<\/p>\n Within minutes, a dispatcher\u2019s screen showed green ovals indicating the likely destination of the missiles. <\/p>\n At first, two or three covered most of the greater Tel Aviv area, Israel\u2019s largest metropolitan region covering around 586 square miles and home to more than 3.9 million residents. <\/p>\n As the missiles approached, the ovals turned orange then red and fragmented into more than a dozen smaller ovals as software narrowed down their likely paths.<\/p>\n A separate screen showed a city map and the location of what the system had identified as potential fallen debris or a missile impact. <\/p>\n The map showed ambulances already on their way to the site, though the dispatcher never picked up the phone because the information traveled automatically from the military through the dispatcher and on to nearby ambulances and motorcycle medics.<\/p>\n \u201cIn the past, if I would receive the call of a burning house due to a missile fall, they would have to call me and say, listen, there is a fire, send your ambulance,\u201d Shachem said. \u201cNow we work on the same computerized system. And once they put in their system \u2014 a fire in Tel Aviv in this location because of a suspected missile hit \u2014 it will automatically be sent to Magen David Adom, sparing time, sparing any info detail that is lost during translation.\u201d<\/p>\n The highly sophisticated system seems to stretch the limits of just how far human error can be reduced.<\/p>\n Yet, on the sharp end of all that inhuman infallibility, there are still paramedics like Itai Orion, who counts himself lucky for not yet having been called out to the scene of a missile strike.<\/p>\n![\"Uri](\"https:\/\/media-cldnry.s-nbcnews.com\/image\/upload\/t_fit-760w,f_auto,q_auto:best\/rockcms\/2026-03\/260304-Uri-Shacham-rs-2218dd.jpg\")
<\/picture>![\"Dispatchers](\"https:\/\/media-cldnry.s-nbcnews.com\/image\/upload\/t_fit-760w,f_auto,q_auto:best\/rockcms\/2026-03\/260304-Magen-David-Adom-2-rs-47ea8c.jpg\")
<\/picture>![\"An](\"https:\/\/media-cldnry.s-nbcnews.com\/image\/upload\/t_fit-760w,f_auto,q_auto:best\/rockcms\/2026-03\/260304-ambulance-bus-4-rs-64f5be.jpg\")
<\/picture>![\"Itai](\"https:\/\/media-cldnry.s-nbcnews.com\/image\/upload\/t_fit-760w,f_auto,q_auto:best\/rockcms\/2026-03\/260304-Itai-Orion-rs-6780c2.jpg\")
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