Trek Medics International is a nonprofit organization dedicated to developing Emergency Medical Services (EMS) in under served countries. I asked the founder, Jason Friesen, BA, NREMT-P, to share with Everyday EMS Tips the importance of EMS system development in developing countries and reasons EMS professionals should participate in the efforts of organizations like Trek Medics International.
Jason has written a thoughtful article about the importance of EMS abroad. After reading his article visit Trek Medicals International to learn how you can get involved.
Introduction
It might not be far from the truth in saying that our perspective on a career in EMS may have strayed significantly from the scenes that we once envisioned while in EMT school. After awhile, the less appealing realities of EMS in the developed world may begin to take hold, and it becomes a common occurrence for people to burn out on the job as a result of everything but the blood and guts, or the wear and tear of high-stress calls. Taking time to participate in an EMS system outside one’s own country may help to “recalibrate” us as prehospital providers, where we’re involved with communities who both value our services, and benefit from their intended purpose.
As was described in a 2002 report by the World Health Organization, “Injury is one of the leading causes of mortality and morbidity worldwide. The burden that injuries place upon societies is particularly large in countries with limited resources.” More specifically, road traffic injuries are the second leading cause of death worldwide for people aged 5-29 years, and the third leading cause for people aged 30-44 years (Table 1). Coupled with other categories like self-inflicted injuries, interpersonal violence, burns, drowning, and war, the WHO estimated that injury is responsible for approximately 5 million deaths each year[1], which is the equivalent of 27 Jumbo Jet crashes every day for a year.
Taken from a practical standpoint, these are the types of emergencies that a basic EMS system should be most effective in responding to. However, according to a recent survey published by the WHO’s Department of Violence and Injury Prevention (VIP), 134 of the 178 participating countries/areas reported the existence of a formal prehospital care system[2]. While this number may seem surprisingly high at first glance, it is important to understand that what qualifies as a “formal prehospital care system” is often left open to interpretation. In Zimbabwe, for example, a grant supplied by UNICEF in 2004 to the country’s prehospital care system provided nine ox-drawn ambulances to help alleviate the growing problem of maternal mortality.
In short, the majority of EMS systems worldwide suffer from scarce resources and inadequate services. And while there are myriad organizations dedicated to medical assistance worldwide, the vast majority of this assistance is largely relegated to hospital/clinical efforts or disaster relief. EMS-related efforts, however, are seemingly non-existent. This provides a unique opportunity for us, as prehospital providers, to offer training and support in an equally important discipline.
But when attempting to understand how we can affect positive, long-term change in under served countries and communities, it is important to understand three basic principles:
1) as mentioned, traumatic injury is listed among the top causes of death worldwide,
2) EMS is most effective when its fundamental tenets are applied to traumatic, life-threatening injuries sustained in the prehospital setting, and
3) the benefits of existing healthcare facilities can not be fully realized unless basic, yet effective prehospital care is provided.
With these three principles in mind there a number of positive changes that we can both offer to others, as well as to ourselves.
Helping Others
By involving ourselves in developing EMS abroad, including both training and prevention programs, we can affect positive change in foreign populations by:
• Diminishing the economic and societal burdens of premature death and disability
• Empowering communities to continue on a road towards self-reliance
• Enabling sustainable development
• Encouraging self-confidence, while renewing a sense of both hope and self-determination within the community
Helping Ourselves
By committing to involve ourselves in the development of EMS abroad, we can affect positive change within ourselves by:
• Creating an opportunity to identify with other societies and ideologies
• Working to encourage a positive opinion of our own communities and ideologies
• Diminishing an “Us and Them” mentality by creating new relationships and working towards common goals
• Giving of ourselves
Conclusion
Getting back to a place where our services are called upon in situations when they’re truly needed, (as opposed to when they’re convenient), as well as employing the endless hours of training we’ve undergone in a setting where they’re productively used on a consistent basis, might very well offer a much needed second wind. As one paramedic said after a short time spent volunteering with medics in Tijuana, Mexico, “That’s why I got into EMS.”
And while any of the aforementioned reasons might be enough to inspire you to get involved as an individual, one of the greatest advantages of giving back by participating in EMS abroad might be from an organizational perspective. Each year more and more EMS agencies are working to set up “Sister Services”, where they pledge to engage in a long-term relationship with another EMS system abroad. From skills and prevention training to providing much needed equipment and supplies, as well as making new friendships and adding to a greater sense of camaraderie between prehospital providers, these relationships can do a lot to bolster morale, stave off burnout, and provide incentives for employees to continue on an invaluable service.
Jason Friesen works full-time as a paramedic in San Diego, California. He has spent several years living and working in Europe and Central America. Presently, Jason also works as a Paramedic instructor, Medical Spanish instructor, and is a contributing author for the Journal of Emergency Medical Services (JEMS). In his free time, Jason enjoys writing, surfing and traveling.
