This
story is a throwback to my service in the Dominican Republic, but on the
anniversary of our very first week of providing emergency medical care with the
Paramedic team in Manzanillo, I thought it fitting to document our process in
the annals of history. Enjoy!
One sunny afternoon, I was sitting with my neighbors
drinking coffee in our plastic chairs trying to catch a breeze. I had been
in site for nearly six months and felt that I had a pretty good grasp on the dynamics
of the place. The hospital administrator rolled up to our growing street
gathering and took his place in the low-back plastic chair on the corner.
“Bea,” he said to me, “I need a favor. We need an ambulance for the hospital,
can you get us one?”
Fast forward to nearly two years later, and I never did get
that hospital administrator his ambulance, but what we did do together as a
community was create an emergency medical system staffed by local first
responders who use a basic mobile phone software to provide pre-hospital care
to emergencies in my site of Manzanillo in the northwest corner of the
Dominican Republic. But let’s back up!
After that fateful conversation I had that afternoon with
the hospital administrator, fondly known as Papito, I started investigating the
idea of an ambulance donation. I did a Google search and sent a mass email to
friends and family back home. I also sent many emails to organizations I read
about online and one finally took the bait! Little did I know, this connection
would turn into a full-blown emergency response system project (and
subsequently sour me at the idea of ambulance donations as legitimate forms of
aid). I heard back from Trek Medics International, an organization dedicated to
“improving emergency medical care anywhere.” And so I began a series of intense
conversations with the Executive Director, Jason, who pushed me for more
specific answers to my “can you donate an ambulance” question. As it turned
out, when I dug a little deeper within my community, I teased out from the
hospital administrator that what we really needed was a collaborative solution
to the actual problem of inadequate pre-hospital care and a lack of reliable
inter-facility transfer capacity.
So, I’d found the jackpot organization that could help me
tackle this – now what? After a series of conversations between community
members, we unanimously agreed to invite Trek Medics to send a team down to investigate
the possibility of starting a pilot program. One thing led to another and the
big boss, Jason, decided that Manzanillo was the perfect place to launch their
newly developed Beacon technology (essentially a way to crowd-source
transportation and medical attention, like emergency Uber). Working under the
supervision of the local fire department, we gathered recruits who had to
interview, study, train, and perform simulations for several weeks before we
allowed them to “graduate” as community first responders. Simultaneously,
I was training local dispatchers and working with the fire chief, Ramoncito, to
give the fire station a central role in the new service as
dispatchers of local emergencies.
The team of responders (fondly referring to themselves
as “paramedicos”) also had to prove themselves as reliable partners with
real skin in the game. For example, they initially offered to
help the local civil defense during Holy Week and stationed
themselves for service at the beach when the holiday crowds flocked to
Manzanillo’s beaches. There they encountered a number of patients with
problems ranging from wounds to dehydration and intoxication.
While no serious patients were treated (thankfully), their simple presence on
scene proved to be a small, but critical first step in
their growth: it showed the community that the response team was more
than just a good idea, it built their confianza (trust) in our new service exponentially.
Then, we had to start giving our responders bigger tests so
that we knew we could safely grow. This included: handling
simultaneous emergencies; ensuring that a sufficient number of
available first responders were distributed equally as the coverage area
expanded; training our team members as instructors in order to
train neighboring communities, introducing a new version of the Beacon
software funded by Google, and learning to use newly minted motorcycle
ambulances the organization donated to our local fire station. And on and on it
went...one good idea snowballing into a thousand more - all community-driven to
make a well-oiled emergency medical system.
There is still so much to do, but for something that started
as a simple conversation over much-too-sugary coffee, it is now the primary
method for emergency transport in my rural community. Today, six months from the
date I finished my service in the Dominican Republic and have moved on to a
similar Peace Corps Response position in Panama, we still have a fully
functioning emergency medical service in Manzanillo and have expanded (with
help from USAID and other generous organizations) to the entire province.
Locals are the crux of the organization and run the entire operation. This was
a project that never would have functioned without a vested community interest
(especially as I knew nothing about first aid myself before it started!). Key
community members were part of every decision and the driving force excited
about this organizations entry into Manzanillo. After initial contact with Trek Medics, I became a critical community organizer, but I was never the
driving force. As Jason reminded
me various times throughout the process, “We can’t want it more than they do.
They have to be a part of every step.” A very valuable life
lesson, indeed, especially in the realm of international development.
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