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HAIFA, ISRAEL — With the Syrian civil war threatening almost daily to spill over the border into Israel, there is a quiet tension in the air at Rambam Health Care Campus.

Northern Israel’s largest hospital was at the heart of a month-long Hezbollah rocket barrage during the bloody 2006 conflict with the Lebanese militia and would undoubtedly be in the thick of action again if the Syrian regime or its Hezbollah allies turned their weapons south.

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“Today it’s very peaceful, but tomorrow or the next day, someone could start shooting,” said Shimon Reisner, a cardiologist and Rambam’s deputy director. “You never know. We are used to that, we live with that.”

Unlike 2006, however, the Mediterranean-seaside hospital believes it will be more than ready if it comes under attack once more.

The close calls seven years ago have given rise to an extraordinary construction project: the world’s largest, fortified underground hospital, three below-grade storeys — 20,000 square metres — that can be rapidly converted into a full-service general hospital with room for 2,000 beds.