On Wednesday night a Hamas barrage of almost 200 rockets was launched at southern Israel. In addition to the powerful response by the IDF, civilian volunteers went into action, helping victims wounded in body and soul – saving lives under fire.

Yaakov Bar Yochai, a 39-year old father of five is a volunteer United Hatzalah medic in Sderot. United Hatzalah’s success is due to its local volunteers who can and do arrive at a medical emergency within minutes, much faster than a conventional ambulance. In the case of of Bar Yochai, this meant that the same missiles that harmed his neighbors also threatened him and his family.

Bar Yochai was in the shower preparing to attend a social event in the nearby town of Netivot when the first red alert sirens sounded on Wednesday evening. He gathered his family in their shelter and as the all-clear announcement sounded, he left his home to treat the wounded.

“I knew that I was the closest medic to the missile strike because I heard it land in the next street over,” Bar Yochai told Breaking Israel News. “The United Hatzalah operator informed me that there were wounded so I jumped on my motorcycle and was there in seconds. I began to treat a man in his 50’s who was hit by shrapnel and was bleeding heavily from his arm. I put a tourniquet on it and by the time the ambulance arrived, there were already more sirens. I spent the entire night, until four in the morning, riding from one incident to another. Of course, there were sirens all the time.”

“There were a lot of rockets and mortars from Gaza but there were also a lot of explosions from the Iron Dome. We are less than half a mile from the border with Gaza so we also heard the explosions from the IDF response. All this is very frightening,” Bar Yochai explained. “Many of the calls involved shock with no physical injuries. We treat this as well. Every person reacts differently. Some people can handle it. Other people scream uncontrollably. Others freeze and become entirely unresponsive and catatonic. Some, who have been through many attacks suddenly break. We need to respond to everything.”

Bar Yochai woke early for morning prayers but at ten, the sirens went off again as more rockets fell.

“I guess this sounds like I was full of bravery or something, but that isn’t the case,” Bar Yochai said. “The truth is that the entire time, I was concentrating on what needed to be done. This is how they train us. But while I was out last night, my children were calling me on the phone to make sure I was okay.”

Bar Yochai has lived under the threat of rockets from Gaza for many years but his understanding of the source of the conflict is highly focused.

“I don’t, God forbid, hate the Gazans,” he said. “They are people, just like me and my family. I do hate Hamas. Hamas tries to hit cities with its rockets. Hamas wants to kill our people. Hamas even considers it a victory when it forces the IDF to react in such a way that endangers Palestinians. This is what I hate.”

In addition to medics, United Hatzalah also sent out members of their psychotrauma unit to treat victims of the attack.

“Last night in Sderot, there were a lot of children affected by the first attack,” Miriam Ballin, head of United Hatzalah’s psychotrauma unit told Breaking Israel News. “No matter how many times this happens, no matter how much you prepare and practice, your body fills with adrenaline and fear. There is no way you can prepare for an actual rocket landing near you.

Ballin made aliyah to Israel from the U.S. with her physician husband six years ago. Her decision to establish a psychotrauma program for United Hatzalah came from a personal experience. One day, while walking in the street, she was struck by a motorcycle. Ballin was not seriously injured but when she returned to the scene of the accident to thank the people who had helped her, she understood that they had been deeply affected by witnessing the accident. As a social worker, Ballin was familiar with PTSD. She saw that it was not being addressed so she decided to help United Hatzalah establish a psychotrauma program.

“Treating psychotrauma is essential to medical first responders,” Ballin explained. “United Hatzalah created a team of mental health work professionals. Our 250 volunteers deal with psychological first-aid every day. Our main focus is suicide, sudden infant death syndrome, and victims of terrorism. We also train medics in psychological first aid. This also helps them better function as medics.”

“When the dispatcher receives a call that is flagged as highly traumatic, we get a call. Our closest responder is sent to the scene and our average response time is 12 minutes. Last night in Sderot, our responders went out to medical calls that turned out to be emotional issues. This includes chest pains without any physical indications of heart problems or difficulty breathing. These can be the result of psychotrauma.”

“The United Hatzalah psychotrauma unit is for psychological first-aid and does not interfere with the governmental organizations that are in place, coping with long-term effects of rocket attacks and terrorism. We respond to the call and stabilize that person.

Just as physical injuries can be internal, the same is true for psychotrauma.

“Many times, we arrive at a scene and the people who are really traumatized aren’t identified as being affected. It isn’t always the person who is screaming who is the most traumatized. Sometimes, a person can become dissociative and will be overlooked. Some people say that they are fine after the attack but will develop PTSD down the line. We help identify those people who are at-risk. There is also a strong inclination to try to suppress powerful reactions to psychotrauma. It is uncomfortable to watch someone having a powerful reaction to psychotrauma, so the natural reaction is to suppress or ignore it. In fact, every reaction is a healthy reaction to an abnormal situation.”

United Hatzalah’s psychotrauma program also focuses on collateral victims.

“We also decided it was important to train medics in psychotrauma to lower the likelihood that the medics would develop PTSD from their work” Ballin said. “There is a trauma clinic and hotline for our medics. This support is crucial for volunteers more than for professionals. A volunteer has to jump out of his life into a crisis and then jump right back in to his life.

“Of course, when a rocket falls there is a lot of damage and injury, physical and psychological,” Ballin said. “But the real damage is caused by living under the constant threat of rocket attack, never knowing when a rocket will fall.”