Ezrat Nashim – Emergency Medical Services

In the face of mountains of paperwork, miles of red tape, opposition and naysayers, a group of determined women defied the odds on a crusade to meet the needs of their fellow Jewish women. The result is a new development in the frum world: Ezras Nashim, the first women-only emergency medical unit, which began operations this past summer. While Ezras Nashim took more than two years to get off the ground, the organization is actually 40 years in the making. The late 1960s saw the founding of the iconic Hatzolah, a volunteer unit of Orthodox EMTs who were trained to respond to Williamsburg’s emergency medical needs.

The initiative caught on quickly, forming branches throughout the five boroughs and, eventually, in other Orthodox communities across the US, Israel, England, Switzerland, Australia and Mexico. Holocaust survivor Yitzchak Shlomo Hoffman was one of Hatzolah’s earliest forerunners and greatest advocates. Before the organization was founded, he would arrive at emergencies with oxygen and bandages and transport people to the hospital in his car—in essence, the pre-Hatzolah Hatzolah. Hoffman felt strongly that a women’s unit should be incorporated into the growing organization to assist other women in an emergency. He established an EMT course in the mid-’70s for Williamsburg women to become certified, attracting 40 attendees, including his daughter. She in turn spent the summer in Monroe and trained 70 more women. By the ’80s, Hoffman had trained 300 women as EMTs, 225 of them in Boro Park and Williamsburg, and 75 in Monroe. The women’s unit had a promising start in Monroe, working fluidly alongside the men’s.

The male volunteers did the heavyduty work, but when a call came in for the women, the women went. But the promise was short-lived; the men of Hatzolah, as well as some community members, felt that it wasn’t appropriate for women to be working alongside men, and shortly thereafter, the women’s unit was disbanded. Of the 300 women, some let go of their certifications while others used them to go on and become school and camp nurses. One woman trained students as EMTs at the school where she served as head nurse and principal. Mr. Hoffman’s daughter, who despite the setback, hadn’t let go of her dream of a Hatzolah women’s division, continued to train women for certification in Boro Park, and renewed her license every three years for 30 years. But as the years passed, no changes seemed forthcoming.

In 2009, a group of women in New Square approached the Skverer Rebbe about a troubling experience many of them had had. While in labor, they were unable to make it in time to the hospital and had given birth in the ambulance, surrounded by Hatzolah members. These men, they said, were their neighbors, people they saw frequently, and they were embarrassed about what had happened. The Skverer Rebbe decided that women should be helping women, and soon enough, New Square’s Hatzolah had a fully operational women’s division with 12 female EMTs (there are now 24). When the Brooklyn women heard about this, their dream was rekindled. The original members began organizing meetings again and making efforts to get their initiative off the ground.

They needed an attorney—preferably a woman—to help them move things forward. Ruchie Freier, a real estate attorney, answered their call. “I was intrigued,” she recalls of the first contact she received from these women, who invited her to one of their meetings, though “I didn’t know if this was a bunch of rabblerousers.” She arrived at the meeting, convinced she had the wrong address. “It was a very modest house, and an elderly chasidish man with a white beard opened the door,” she says. That man was the same Yitzchak Shlomo Hoffman, early champion of Hatzolah, who still rallied for a women’s unit alongside his daughter, who was waiting for Freier inside with the rest of the group. “These were very prim, very proper looking women,” Freier recalls, her voice still resonant with amazement. 

Freier was all for their idea to start a female branch of Hatzolah to assist women in labor and birth, but before getting on board with them, she wanted to make sure there was truly a need for it. After all, if men are local, live nearby, and are quick to respond, it would seem that what was most important was who would arrive the fastest, not their gender. “I spoke to different women,” she says, “and was horrified to hear that it’s really traumatic for those who are [in labor] and are surrounded by multiple men who are their acquaintances…With a doctor, you see him at his office, you see him at the hospital, and you never see him again. But when it’s six neighbors who you’re going to see the next day, it’s traumatic.” What she learned had a profound effect on her. “I saw all these women in distress and I kept feeling in my heart that something has to change. It can’t go on the way it’s going on right now.” She approached Hatzolah, asking them to take on a women’s division, but came up against significant opposition.

They stood by their position that working alongside women was inappropriate, and that the women’s branch would delay the men’s response time. Others  argued that women simply weren’t qualified for the job. Says Freier, “I realized, as I was doing my research, that the fire department has female EMTs and all the volunteer ambulance companies also have women EMTs. The people who are big players in the world of EMS are all women. The head of NY’s regional EMS council is a woman. The top lawyer in EMS Albany is a woman. EMT cards are issued and signed by a woman. So many women play a key role in New York in emergency medicine. Surely we women would be great at it too.” Still, she could see that Hatzolah had a point. It would not work for women to join the men’s Hatzolah. But what would work would be a separate, women’s-only EMT unit devoted solely to assisting other women.

The project would need a director—ideally, someone well-versed in the legalities of getting such an organization off the ground. Originally, she had only planned to help them, but by now, Freier was invested. She decided to join them, and stepped up as their director. As their representative, Freier went with her husband to the Skverer Rebbe on a number of occasions with shailohs regarding Skver’s Hatzolah women’s division, and the group’s effort to form their own division in Brooklyn. “The Rebbe was incredibly supportive,” she says. “He said it was a wonderful thing, and that theirs was successful.” He gave the aspiring women a brachah, though Freier and her compatriots were still unsure how they were going to make it happen. She maneuvered through the political routes on the local, state and federal levels, contacting everyone from the health department, the mayor’s department, and the IRS. “We had to deal with every level of government to get this organization started,” she says. She consulted lawyers to help get licensing, and the other women on the team worked alongside her to establish a system of operations, recruiting women and getting classes running.

As director, Freier would become certified as an EMT in order to avoid malpractice (she brought her mother along for the training). Meanwhile, she changed her law practice, hiring help in the office to accommodate the time she was putting into building Ezras Nashim. “The siyata dishmaya that we hit every single day was incredibly amazing, how things started falling into place,” she says. Not that it was easy. “It’s a very big town,” Freier explains. “There were so many issues on so many levels. It took a year to get the insurance.” Bureaucracy, paperwork and certifications aside, there was also the issue of expenses to fund the purchase of equipment (including oxygen tanks, defibrillators and EpiPens), as well as the $1,500 certification course that each woman is required to take, plus the cost of insurance for each individual EMT. While some women EMTs do drive, the ones who don’t for reasons of tznius required transportation; for this purpose, the organization leased a “fly-car,” with the required flashing lights and sirens, that is parked with a volunteer driver at the home or office of whoever is on call. As they are currently not licensed to transport, they did not acquire their own ambulance, which also would have been prohibitively expensive. Instead, they have contracted with a local reputable ambulance service, which is family-run for over 50 years. (However, when the topic of purchasing an ambulance for Ezras Nashim in the future came up, one EMT put in her vote for a pink one.) They purchased a dispatch system that operated via telephone to prevent their calls from being scanned, and struggled to find a hospital that would grant them privileges.

“It was a major, major research project,” Freier says. “I have two drawers filled with files.” As an organization comprised of wives and mothers, it was inevitable that their progress would be in fits and starts. “Many volunteers would be excited in the beginning, but they wouldn’t make it to the finish line.” Be it demands at home, life changes or other circumstances, many women simply could not keep up the commitment. “We have learned to expect a coming and a going of our members,” Freier explains. “We have to always have a membership beyond just the core who make it through the course and stay dedicated.” Between schedules and communication issues (some members don’t regularly use email), just getting the group together for a meeting can be a challenge.

Often it takes a lot of phone calls and regular mail to get everyone into one room at the same time. They also had to contend with the naysayers who were certain that the venture was doomed to failure. Although they kept it under wraps in the beginning stages, the Ezras Nashim idea went public in 2012. The negative response was overwhelming. One blogger said, “Women can call Ezras Nashim for the latest kugel recipe,” while another called Ezras Nashim “a waste of precious funds that should…be used differently.” The pushback was strong enough that the group went to rebbeim for their blessings and support. Freier traveled with her husband to Eretz Yisrael, where she met with gedolim such as Rav Aharon Leib Shteinman, shlita, Rav Chaim Kanievsky, shlita and Rav Yitchak Zilberstein, shlita, who said “it was a wonderful chesed, chesed she’ein kamohu, and gave their brachos.” In the States, Freier approached the Karlsburger Rav of Boro Park; Rabbi Shimon Gertner, dayan from Monsey; and the renowned Rabbi Gavriel Zinner from Boro Park, who spoke with the Skverer Rebbe in person about it.

“Daas Torah was backing us, but to make it work, we had to prove that we were a capable body of women who could make this happen.” And indeed, there was a lot to prove. “Everyone kept saying, ‘it’s never gonna happen, never gonna happen,’” Freier says. “I said, ‘If Hashem wants it to happen, it’s going to happen.’” Freier and her 50 volunteers trudged forward, getting advanced training in neonatal resuscitation and shadowing doctors in the ER and on the OB floors at two different hospitals. Eventually, Hatzolah too stepped back into a neutral position, neither promoting nor opposing Ezras Nashim. The organization launched on June 17th,and is now operating 24 hours a day, Monday through Thursday. They respond to calls ranging from labor to trauma. Come the end of Sukkos, however, they are expanding to 24/7 operations. “This is a huge step for us,” Freier says. “It means we’ve come full circle.” Before they start, however, they are working with their rabbanim, including Rabbi Shimon Gertner, on a halachah shiur that will prepare the members for use of the equipment, the dispatching system, and operations protocol on Shabbos and Yom Tov.  Along with Ezras Nashim’s work in the field, they also provide EMT training for women given by women in Boro Park, in a setting geared to accommodate frum women (classes are offered every Sunday from 6-10 p.m. from September to May, with the state exam in June). Ezras Nashim is drawing new trainees daily, and the organization continues to grow. They currently have more than 30 EMTs (though scheduling conflicts don’t allow all of them to serve at present) as well as about a dozen dispatchers.

While the original plan was to exclusively help women in labor, by law, the members of Ezras Nashim were required to learn how to handle any emergency. Now they are getting all different types of calls, serving Boro Park and nearby Kensington and Bensonhurst—though they’re hoping that demand will enable them to expand to other Brooklyn communities, as well as the Five Towns, Monsey and Monroe. Freier is also working with communities in Israel like Kiryat Sefer, which is beyond the green line, to help them get their own women’s EMT corps off the ground. So compelling is their story that frum documentarian Paula Eiselt of Queens, NY is making a film about them. As time passes, Freier continues to be inspired by the women who have joined as volunteers, despite the struggle to make Ezras Nashim a reality. “It’s an incredible experience, all these women coming together from all walks of life. We’re all united in this particular cause.” Ezras Nashim’s volunteers include mothers, grandmothers, nurses, doulas, office workers and stay-at home mothers.

The dedication of these women, who make themselves available around the clock, doesn’t surprise Freier. “I’ve been around the block a lot; frum women are the hardest-working, busiest creations that Hashem has put down on this Earth. We are the akeres habayis. It was Yocheved and Miriam who were running around delivering babies. In the history of klal Yisrael, this is what we did. In the shtetlach in Europe, when a woman went into labor, you ran and called the midwife.” It’s this universal cause of women helping women that has cemented such a diverse body of volunteers together. “What could be more basic and unifying than women giving birth?” Ezras Nashim exists today thanks to the efforts of many dedicated women who held on to their passion for 40 years before seeing it become a reality. It also took the dedication of one determined lawyer who turned her life over to do what she believed was right —though she’s quick to underplay her role in the project: “I’m just the cement that’s bringing all these bricks together. I couldn’t possibly do it without these incredible women who are working together with me.” And yet, Freier can’t deny the personal satisfaction she feels from making Ezras Nashim a reality.

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