Deep beneath the Israeli port city of Haifa lies an extraordinary testament to strategic foresight and resilience: the Sammy Ofer Fortified Underground Emergency Hospital. Nestled within the Rambam Medical Centre, this fully operational, blast-resistant hospital was engineered as a rapid-conversion facility from an underground car park to a 2,000-bed trauma centre, including operating theatres and maternity wards, within 72 hours. The hospital is uniquely equipped with oxygen taps, independent power and air filtration systems, water supply, and robust communications to ensure it can maintain uninterrupted medical services amid missile attacks, chemical threats, or communications blackouts.
The hospital’s genesis followed lessons learned during the 2006 Israel-Hezbollah conflict, and it embodies Israel’s resolute approach to integrating civil defence and infrastructure planning. With thick reinforced concrete walls of up to 40 centimetres, advanced air filtration capable of countering chemical and biological hazards, and hardened design to withstand missile strikes, this facility represents the world’s largest underground hospital dedicated to continuous operation in wartime emergencies. Its rapid deployment capability was last demonstrated in June 2025 when the hospital was fully activated during Iranian missile strikes on northern Israel. Patients from vulnerable above-ground medical centres were moved underground, where surgeries and caesarean sections proceeded uninterrupted amid air raid sirens and intermittent communications outages. Even employees’ children were safeguarded in a fortified daycare centre on-site, reaffirming the facility’s design intent to sustain essential services under attack.
Israel’s preparedness model is rooted in stark necessity, given its geopolitical realities and limited landmass. Urban planning incorporates civil defence as a cornerstone: from residential buildings with mandated shelters to public health infrastructure, all designed with dual-use functionality. This systemic approach anticipates crisis as inevitable, embedding flexibility and survivability into the operational lifelines of the nation.
Australia, by contrast, benefits from geographic isolation that historically lowered the perception of immediate military threats. Yet evolving strategic instability in the Indo-Pacific, coupled with a recent string of disruptive crises including the devastating Black Summer bushfires, floods, the COVID-19 pandemic, and cascading supply chain shocks, expose gaps in our national infrastructure’s resilience and adaptability. The ad-hoc nature of Australia’s dual-use infrastructure efforts—such as the conversion of a workers’ camp in Howard Springs into a quarantine facility during the pandemic, or emergency coordination centres with independent power—illustrates a lack of integrated, purposeful design in infrastructure planning.
Fragmentation across federal, state, and local government responsibilities further complicates coordinated resilience-building. Existing building codes and national standards seldom mandate resilience or dual-use capabilities; defence and civilian infrastructure systems often operate in siloes, leading to vulnerabilities across the supply chain, hospitals, and logistics hubs. The result is infrastructure ill-prepared for surges in demand or operation under degraded conditions, whether caused by natural disasters, cyberattacks, or strategic coercion.
Embedding resilience into Australia’s infrastructure lifecycle—spanning planning, funding, design, construction, and operation—requires more than incremental adjustments. It demands a paradigm shift toward integrated systems thinking, recognising infrastructure as a pillar of national self-reliance. This entails developing governance frameworks that incentivise dual-use design, fostering cross-sector collaboration, and adopting new design standards that incorporate comprehensive risk assessments including national security considerations.
Israel’s underground hospital is more than an engineering marvel; its activation during real-time missile attacks is powerful proof that infrastructure built with strategic intent can save lives and sustain critical services in crisis. For Australia and other nations facing complex and uncertain threats of different natures, the lesson is clear: infrastructure must be conceived not solely for capacity but for continuity, capable of adapting when it matters most.
In an era where future crises may differ radically from the past, from climate disasters to geopolitical conflict and cyber warfare, the infrastructure that underpins society must likewise evolve. Learning from Israel’s hardened peace-time readiness approach could seed the development of Australian facilities that serve civilian roles in peace but can be swiftly transformed to critical lifelines in crisis, ultimately enhancing national resilience in an unpredictable world.
Source: Noah Wire Services
