Deep beneath the Israeli port city of Haifa lies a facility few would expect: a fully operational, blast-resistant hospital converted from an underground car park. The Sammy Ofer Fortified Underground Emergency Hospital can be created within 72 hours: a 1,200-bed trauma centre complete with operating theatres, a maternity ward and three weeks of stockpiled medical supplies.

Built in the wake of the 2006 Israel-Hezbollah war, it is part of the Rambam Medical Centre, just 45 kilometres from the Lebanese border. Designed with future conflict in mind, it has oxygen taps, electricity and water system and independent power and air filtration. It is completely secure and fully connected, ensuring that, as a hospital, it can function even under sustained missile attack or in the event of a communications blackout.

This readiness was tested and proven this year. The hospital was fully activated during Iranian missile strikes on northern Israel in June, receiving wounded civilians as well as patients from above-ground medical centres who needed to be moved underground for safety. Surgery and even caesarean sections were performed safely below ground.

The hospital’s emergency teams operated uninterrupted amid air raid sirens and communications outages, and children of employees were sheltered in the hospital’s fortified daycare centre. The facility functioned just as intended, offering uninterrupted care when the surface became unsafe. This reaffirmed the strategic foresight behind the dual-use design.

Australia should consider Israel’s approach to dual-use infrastructure—facilities that serve civilian purposes in peacetime and other, critical functions during crises. As we confront growing strategic uncertainty, more frequent and severe natural disasters and global supply chain volatility, we need to think differently about how infrastructure supports national resilience.

Israel’s model is rooted in necessity. With little land and constant threat of conflict, its urban and national planners have developed a culture that prioritises survivability and flexibility. Civil defence considerations are embedded into building codes, public health infrastructure, transport systems and even residential buildings, many of which must have fortified rooms or shelters.

This is about integrated systems thinking—linking logistics, planning and operational continuity under the assumption that crisis is inevitable, not hypothetical.

Australia does not face the same immediate military threats. Our geographic isolation provides a buffer, making us feel less needful of hardened civilian infrastructure.

However, recent years have revealed how vulnerable we remain to many risks—for example, the Black Summer bushfires of 2019 and 2020, floods, the Covid-19 pandemic, supply chain shocks and cyber threats. Australians are experiencing a series of continuous and cascading crises that are exposing gaps in our infrastructure preparedness, adaptability and redundancy. These challenges, coupled with rising strategic instability in the Indo-Pacific, should prompt a re-evaluation of the assumptions that underpin our preparedness.

There are scattered examples of dual-use thinking in Australia. During Covid-19, facilities such as a dormant workers camp in Howard Springs were converted into quarantine facilities. In areas prone to fire and flood, some emergency coordination centres have been built with hardened structures and independent electricity supply. Yet these are typically the result of ad-hoc adaptation, not deliberate design.

Infrastructure planning remains fragmented across federal, state and local governments, making a collective approach difficult. Building codes and national standards rarely require infrastructure to be designed with resilience or dual use in mind. Defence and civilian infrastructure systems are developed and operated in parallel, with minimal joint planning or coordinated investment. The lack of clear governance frameworks or incentives for dual-use capability means that Australia often relies on short-term fixes rather than structural readiness.

In practice, this means hospitals lack surge capacity, critical logistics hubs are vulnerable to disruption, and communities are left exposed when disaster strikes. If we want to avoid repeating the same cycle of unpreparedness, we must embed resilience into the infrastructure lifecycle—from planning and funding through to design, construction and operation.

That doesn’t mean every car park must be a bunker. But it does mean reimagining hospitals, schools, ports, airports and logistics precincts as assets that can serve multiple roles in a crisis. It means planning for continuity, not just capacity. Infrastructure must be able to operate under degraded conditions—whether due to cyberattack, natural disaster or strategic coercion.

Adopting this mindset requires more than technical adjustments; it demands political will, cross-sector coordination and a shift in how we value infrastructure. We need to treat it as a pillar of self-reliance. This involves new design standards, integrated risk assessments that include national security considerations and shared investment models between government and industry. It also requires fostering a culture of foresight within planning institutions—in which resilience is seen as a core design principle, not an optional extra.

Israel’s underground hospital is more than an engineering feat. Its activation in 2025 under live missile fire is proof that infrastructure built with strategic intent can protect lives and sustain essential services in crisis. It’s a symbol of the kind of thinking Australia now needs. The threats we face may be different, but the need to think ahead is just as urgent. In an era where the next crisis may look nothing like the last, the infrastructure that sustains us must be capable of adapting when it matters most.