New Plan For Rescue Accident Victims In Under 8 Minutes: Thailand

[MaxLee]

New plan for rescues in under 8 minutes

-- The Nation 2013-03-19

[camo007]

I was at Silom Soi 4 when a friend collapsed after arriving from a long flight. We called BNH hospital to send an ambulance as they are close. But would you believe after 25 minutes it did not arrive so a Tuk Tuk driver carried him into the Tuk Tuk and we got to the hospital in time to see the Ambulance just pulling out of the hospital... TIT

Now remember Soi 4 is like 500 meters from BNH hospital... And it was 2:00am and no traffic at all on Soi Convent!

[candypants]

Also, the Kingdom needs 1,400 to 1,500 emergency nurses to take care of patients. - why not take them from the hospitals as most of them only sit around doing nothing in their little nurses' boxes!

i suspect you haven't spent any real time in a Thai hospital, watching nurses run off their feet.

[KimoMax]

Road safety campaigns and strict road/ vehicle law enforcement

Public first aid training programmes

Pre-hospital life support training for police and emergency personnel/ motor bike paramedics/ ambulance paramedics trained in both adult and paediatric advanced life support skills

Designated trauma centres

Dedicated in-hospital trauma teams for both children and adults with full on-site diagnostic imaging and intensive care facilities

Helicopter emergency medical services staffed with one trauma doctor and paramedic (No, I haven't forgotten the pilot)

There, simple enough.

Next.

Just a FYI: A week ago in Pattaya, while driving on Central Pattaya Road in Heavy Traffic, I was passed on the Road by an Ambulance Motorcycle with Emergency Lights and Siren on. No it was not a Police Motorcycle or an imitatator. I don't know what level of Emergency Care the rider was capable of, but the Motorcycle had Saddle Bags where Emergency Equipment could be carried.

About 8 years ago, Bangkok Hospital in Bangkok did have 2 Big Motorcycles (think Kawasaki's) with Emergecny Equipment in the Saddle Bags for an Emergency Doctor to ride to an Emergency.

In 1992 some of the Western Expat Paramedics who would come to Thailand on their Breaks from the rebuilding of Kuwait and Post War proposed upgrading Bangkok and Surrounding Area Emergency Medical Services ( EMS ) workers to at least a Licensed or Certified Advanced First Aid or Emergency Medical Technician I levels with proper Ambulances, Motorcycles, Equipment, and a Dedicated Medical Helicopter. Future Training to Similar Thai level of a Paramedic was also proposed.

As a result; Thailand did give some basic upgrading of training and equipment of the Body Snatcher Ambulance's Volunteers. To this day, they still do not have proper Ambulances or equipment.

A Nationwide Emergency Ambulance Telephone number was implemented.

Bangkok General Hospital in Bangkok acquired Two Big Motorcycles with Equipment for EMS Response.

Hospital Ambulances, when available began responding also to Medical Emergencies with a Nurse.

A Helicopter Ambulance was initiated. However, the Helicopter over a short time period was often used for other purposes and Not Available.

* Note: Most times a Medical Helicopter in Bangkok and Densely Populated areas was/is Impractical. Limited Landing places was/is a big problem.

Unfortunately in Thailand: Change comes Very Slowly.

The Best course for now is to Regulate the Rescue Ambulances, Upgrade Vehicle and Equipment Standards, and Required First Aid and AdvancedTraining.

Not just a bunch of Under or Untrained persons sitting at a street corner with some Old Pick Up Truck, then Racing at break neck speeds to an Emergency.

*Foot Note: There are some Rescue Ambulaces here in Thailand that do take their Responsabilities Seriously, and DO have proper vehicles, equipment, and Personell. All on their own initiative.

A Doctor is NOT Needed on an Ambulance or Helicopter except in some rare cases. Using a Doctor is Not Necessary and a Waste of Resources. Proper Trained Personell and Proper Emergecny Training for Nurses is the Key to advancing Emergency Medical Care and Services.

Edited March 19, 2013 by KimoMax

[belg]

good luck in this country nobody gives priority when they hear a siren

[KimoMax]

good luck in this country nobody gives priority when they hear a siren

Per the Thai Motor Vehicle Department and on their Driver Training and Tests; A driver is "Required" to pull over to the shoulder and Stop when approached by an Emergecny Vehicle with Lights and Siren.

I just renewed my Thai Driver License a month ago and saw the requirment on study material and test.

Lack of Enforcement by those that should be taking care of this Simple issue.

Edited March 19, 2013 by KimoMax

[GentlemanJim]

The current problem is that untrained 'responders' are used to ferry accident victims to hospital. I saw an accident and went to render first aid, A guy on a bike actually had a helmet on but appeared that he may have a broken leg (s). I stabalized him, got him to refrain from trying to get up and move and said wait for the ambulance to come. A truck appeared quickly with two guys who jumped out ran over and much to my protestations took the guys helmet off, grabbed his arms and legs and picked him up and threw him on the back of the truck, then rushed off. I imagine many many people arrive at hospital with injuries much worse than they sustained in any crash, simply caused by brute manhandling by untrained responders. I have also been told of some much more troublesome tales of terror, the truth of which I cannot establish, but a 'responder' told me that a certain group of responders on another turf took advantage of the fact that they received more money for recovering a dead body than a live one and that in the back of trucks, people had held there fingers over the mouth and nose of badly injured people to ensure they arrived with a corpse. The idea makes me truly shudder, but I stress I have nothing other than the story of the responder to go on.

This country has a long way to go before it can make improvements. One thing is the mafia monopoly held by the Doctors on anything medical. You cannot even run first aid courses along the lines you would receive from St Johns etc unless it is a Doctor running it and in my experience in the UK, Doctors were not always the most adept at running emergency first aid courses/first responder courses.

[chickenslegs]

Ahh the body snatchers, one of my favorite parts of Thailand.

If you thought they were charitable foundations, you would be

very very wrong.. Serious money is involved , which explains the gun

battles these " foundations" have had over territory. These people

need to all be given the boot, and then put in real ambulances with

real equipment with staff with real training. Given the mind boggling

accident rate here in Thailand, this could be a real lifesaver.

But there's no profit in saving lives.

[market trader]

Let me tell you about 2 recent incidents I was witness to up here in Chiang Mai..The first took place at Chiang Mai Ram a private hospital here. One of the hospitals ambulances pulled up to the ER room. Within seconds 2 nurses jumped out and orderlies started to remove a stretcher. The patient was fully hooked up to IV and oxygen. A few seconds later I saw thatthe patient was being attended to by a doctor. Incident number 2 was an accident near my home. A car ran into a lady on a motorcycle.Just by looking at the victim you could see she was critically injured. Within 10 minutes the police and the pick up truck arrived. The 3 guys in the pick up put the victim on a canvas stretcher and without even checking what and where her injuries were put her into the pick up truck and left.

[TackyToo]

Reduce the time of arrival of an ambulance? Make it mandatory everyone wears a necklace with ATM card plus PIN hanging around his neck.

[comserve]

It may be better to tackle the root cause of the accidents:

bad drivers,

inconsiderate drivers,

unlicenced drivers, drunk drivers,

overloaded vehicles,

slow elderly trucks

Police should put drivers off the road rather than give them a fine (with a receipt) which means they can still drive that day with immunity.

[rescuemt]

Sawatdee khrap to one and all. This is my first post on the TV forum
so please be gentle with me . I'm one of only a small handful
of farangs who are registered members of rescue foundations here in the
LOS. I read through the replies to this news article and they motivated
me to finally join TV after years as a lurker and post my two satangs
worth. I'd like to address several points made in previous comments from
an insider's perspective. As you certainly know, conditions or
experiences in one part of this country do not apply to the nation as a whole
and may not even be consistent from town to town, so please keep that in
mind. I'm speaking only from my personal experience (18 years
in-country) and do not claim that my situation is the norm by any
means. With that said, here is my perspective on four issues brought up
in previous posts:

1) Training: As of 2012, all active, registered members of rescue
foundations were required by a new mandate from EMIT to receive training to the
First Responder level (30 Hours). Training was provided free of charge
and followed an international curriculum taught by instructors with at least an
EMT level certification or higher and most were R.N. nurses who work in the
E.R./E.D. This training is in addition to the training all members
receive from their respective foundations - ours is a 2-day program done at the
HQ in Bangkok taught by E.R. physicians. I have assisted in training on several of
these courses and can attest that the curriculum and instruction was
professional and the students very dedicated and serious about improving their EMS skills.

Registered F.R. trucks now have special stickers listing their truck number's registry and expiration

date to alleviate any doubt. These same stickers are required on all hospital ambulances as
well - one is a blue and white round "star of life" decal and the second
is a long, rectangular red or blue decal (bumper-sticker style) that has the
First Responder Registration number hand written with a paint pen. If you
come across a truck with these decals, I'd say you're in good hands. That
said, my own truck doesn't display these decals as my level of training is EMT
so I have to display in Thai and English that I'm certified to that level
instead as the EMIT does not yet train rescue groups to that level but
it's in the long-term plan. However, there are now EMT boot camps here in
Thailand similar to those in the US where rescue officers can train at their own expense

on their own time; this has become very popular as Thais are keen to improve their status within the
groups. Yes, there are still too many trucks out there with untrained
people - usually in very small towns with no "Big 3" foundation
groups or hospital services but they are being weeded out and forced
to join up with one of the "Big 3" and get the mandatory training or
else face sanctions.

2) Response Time: This new mandate for an under 8 minute response time
is sorely needed, imho. Hospital ambulances are (under)staffed by
E.R./E.D. nurses and EMTs who are working with patients up until they hear a
radio call out. They have to constantly keep an ear on the radio - often
located in another room outside the E.R. - and then have to stop whatever
they're working on (not easy to do when you're in the middle of suturing a
wound) and head outside to the ambulance then go through the dispatch protocol checklists
advising their mileage on the vehicle at time of departure, etc. then checking
times of dispatch, departure, and arrival at the scene. Foundation rescue
trucks, on the other hand, have a much quicker response time as we are already
in our trucks on standby when the calls go out and can leave as soon as we are
dispatched. The majority of calls we arrive on scene, treat and package
the patient for transport, and get them to the E.R. before the ambulance even
arrives on scene and many times before they even leave the hospital. So,
we try to coordinate as best as possible with others responding to the scene so
that everyone knows the status of the call and they can cancel their ambulance
call out and not waste any time. A call for an under-8 on scene time may
not be practical in many instances, but it's good that the hospital staff have
a goal to shoot for and try their best to get on scene as quickly as
possible. The more trained hands we have on scene, the better. We
work in BLS (basic life support) and do not run IV lines, so having the
hospital bus on the scene is great for those most serious injuries which
require intravenous medications such as morphine, etc. That said, anyone
familiar with EMS knows about the "golden
hour" and thus the response time to the scene and on to the E.R. is
critical. Now we just need to get the public to understand what lights
and sirens mean and how to give right-of-way to our emergency vehicles - this
is a huge issue and one I'm not sure how to address other than public education
campaigns which Thailand isn't known for doing. To those of you in Bangkok, God help you.

3) Rescue Foundations: In Thailand, there are three national
rescue groups: Ruamkatanyu Foundation, Por Tek Tung, and Sawang. Aside
from the "Big 3", there are several smaller rescue groups that are independently
run organizations - too many to list here. Unfortunately, like everything
in life, a few bad apples spoil the bunch as they say. Yes, there are
many areas of improvement that need to be addressed; again, too many to list
and discuss here. What I can say, though, is that the men and women (and
yes, even their children!) who volunteer their personal time and money to
assist the public are some of the best people you will find anywhere on this
planet. The general public (and expat farangs, in particular) have no
idea what we face in this line of work or even what we do. Responding to
motor vehicle accidents or other injury/trauma calls is our mainstay, but we
also assist the local P.D. on domestic disturbances, fights, and any other
nasty call they need help with (we can even make arrests as well as authorized
by the local constabulary). We catch snakes and other dangerous animals,
respond with the F.D. to any fire calls, take 'crazy' street people into
custody and transport them to mental institutions, and of course do ALL the
work involving any deceased persons such as taking fingerprints, notifying the
next of kin, etc. Traffic control, assisting stranded motorists, locating
lost/missing persons, and helping convoys and motorcades are also examples of
the work we do each and every day, 24/7 free of charge with no expectation of
reimbursement or even thanks.

4) Money: There are so many misconceptions and misunderstandings regarding
this issue it makes me ill. One of the biggest is that there is "Big
Money" to be had in this line of work. Ah.... no. The only
money we make is a small stipend paid by the county hospital to help pay our
fuel costs - at the moment THB 350 per incident (not per patient) - and to
qualify for that payment we have to log our times through the radio
dispatcher which is not always feasible and complete a bunch of paperwork
after the call which is then submitted to Bangkok and, if approved, we get a
payment within 3-4 months later. As a result of this system, the majority
of our calls we do not apply for the 350 Baht reimbursement as it is too
difficult and time consuming. Our equipment costs (we are very well
equipped in my group - all trucks have spinal immobilization equipment, oxygen
and airway apparatus, splints, full medic kits with everything you'd find in an
ambulance, Kendrick Extrication devices, and one truck - the boss - carries a
full set of Hurst extrication tools - the "Jaws of Life"), fuel, vehicles,
uniforms, - you name it - is all paid for out of our own pockets. We have
no sponsors, no support, no kick-backs, zilch, zero. The only way our
guys can make some small money is to provide hearse services to
transport bodies from the morgue to the Wat for cremation - many people live
and work far from their homes in the countryside and thus the need to move
bodies around the country. Even so, this money barely covers the fuel
costs and time spent driving there and back so one is not likely to get rich
doing this service. The infighting between groups comes not from the big
money to be had but rather from the problem of working in certain districts and
zones. Each local group of responders has a very specific area we run
calls to. The problems arise when another neighboring group jumps a call
and responds into an area that is not in their 'jurisdiction'. This
creates a huge amount of problems as the call jumpers do not officially report
on the radio what they're up to so we have no idea that another team is already
on the scene - we're running code-3 lights and sirens to get there only to find
that, upon arrival, another group has already worked the call and are en-route
to the hospital. Fortunately for my situation, our local police chief only
authorized our group to respond to calls in our city limits - any outsiders can
be subject to arrest. However, for larger cities there is the need to
alternate days - odd days one group and even the other - or some similar
compromise to divide the city into zones/districts. Regardless, the
majority of the time things work pretty smoothly considering so many variables
that can and will go wrong.

So, in a nutshell, that's a glimpse into the EMS situation here in Thailand from a
(farang) insider's perspective. Please try and keep an open mind when it
comes to these foundations - the people involved are doing this service for
their fellow citizens with no expectation of thanks, payment, or even
respect. It's done out of the goodness of their hearts (and collecting
some 'naam jaii') and their ability to face chaos and life-threatening danger
in the face when others look or run the other way. The EMS system here in
Thailand is still in its infancy and has a long way to go, but where else on the planet
do you have such great people willing to take up the slack and lend a helping
hand to someone in distress??? Certainly not in my home country, that's
for sure. Kudos to the Thais for their gracious service to humanity; I'm
very lucky and proud to be a part of such a wonderful group of people and put
my life on the line for them every day without hesitation or reservation.
Should you have any questions about these topics, please post a reply and I'll
be happy to help out where I can.

Chok dee!!

Edited March 23, 2013 by rescuemt

[EyesWideOpen]

Thanks rescuemt for your informative post. But it still does not address the fundamental issue of money. If no money is involved, why on god's green earth would foundations fight over bodies? I personally always use the Follow The Money system to figure out mysterious Asia....

From a New York Times article on the bodysnatchers...

http://www.nytimes.com/2002/01/29/news/29iht-bodies_ed3_.html

"Competition over bodies has occasionally proved intense enough for rival groups to resort to violence. The police once fired warning shots to stop 40 Por Tek Tung collectors armed with wooden clubs and hammers from fighting six collectors from a rival group.

Mr. Niroot took part in one of the most famous confrontations, in which half a dozen body snatchers were hospitalized after fighting over a motorcyclist's body."

Edited March 24, 2013 by EyesWideOpen

[sirchai]

"If we could get to the patients within eight minutes, we could save [many] lives and also reduce the cost of treatment while rescuing them,"

What a bunch of bullshit that is.Laws in Germany say that a) an ambulance fully equipped, an emergency doctor with experience must be at any place in Germany within 15 minutes, even in the middle of nowhere.

But helicopters make it possible to save thousands of lives a year. Considering the Thai rescue system and their poor equipment, plus not much medical knowledge makes it impossible to be at an accident in time.

This article is just another "we would like to, but we know that we're not capable doing so" small talk. Similar to the education system. And the clone and and and and and. ...( would be easy to write additional 10,000 more words)

The hub of dreams that never come true. But considering their high speed train plans, they should have a hospital each kilometer next to the railway. Aeeh better 2 km away, flying trains could easily damage their image......

[Steely Dan]

I just read, recently, where hospitals were paying ambulance services to bring patients to them. God help you if you get stuck in traffic going to the farther hopital because it pays a larger bounty.

edited to add: someone should invent a Motorclyle Ambulance that could get through traffic quickly.

It's worse than you could ever imagine - There are periodic confrontations between rival ambulance teams, which on at least one occasion has resulted in shots being fired.

[zydeco]

Back in the US, a 911 call usually got me an ambulance, a firetruck, and a police cruiser to my house within five or six minutes. Of course, about a month later, the bill from the city for around $850 would arrive in the mail, which would be attached to the $3000-4000 emergency room fee at the hospital, which was within a ten minute ride. Other fees for the hospital stays, you can only imagine. Lesson: you get what you pay for. And the only way emergency services will improve in Bangkok/Thailand is for a lot of (corruption free) money to be pumped in to the system. And that ain't gonna happen. You just need to deal with the reality that a serious accident that back in the US would have set you back a couple of hundred thousand is simply going to cost you your life in Thailand. That's the deal you make when you move here.

[I Like Thai]

I was at Silom Soi 4 when a friend collapsed after arriving from a long flight. We called BNH hospital to send an ambulance as they are close. But would you believe after 25 minutes it did not arrive so a Tuk Tuk driver carried him into the Tuk Tuk and we got to the hospital in time to see the Ambulance just pulling out of the hospital... TIT

Now remember Soi 4 is like 500 meters from BNH hospital... And it was 2:00am and no traffic at all on Soi Convent!

Why would you wait 25 minutes at the side of the road with a very ill friend, when the hospital is only 500 metres away. This story is made up.

[ginjag]

I was at Silom Soi 4 when a friend collapsed after arriving from a long flight. We called BNH hospital to send an ambulance as they are close. But would you believe after 25 minutes it did not arrive so a Tuk Tuk driver carried him into the Tuk Tuk and we got to the hospital in time to see the Ambulance just pulling out of the hospital... TIT

Now remember Soi 4 is like 500 meters from BNH hospital... And it was 2:00am and no traffic at all on Soi Convent!

Why would you wait 25 minutes at the side of the road with a very ill friend, when the hospital is only 500 metres away. This story is made up.

Sometimes you wait the 1st 15 mins thinking they are sure to come then a bit longer before panic sets in, 25 mins is a long time BUT the guy was maybe disabled himself, and many Thais would pass by laughing as some do because they couldn't understand English, I cannot understand why there was not an offer of help.

[ginjag]

I was at Silom Soi 4 when a friend collapsed after arriving from a long flight. We called BNH hospital to send an ambulance as they are close. But would you believe after 25 minutes it did not arrive so a Tuk Tuk driver carried him into the Tuk Tuk and we got to the hospital in time to see the Ambulance just pulling out of the hospital... TIT

Now remember Soi 4 is like 500 meters from BNH hospital... And it was 2:00am and no traffic at all on Soi Convent!

Why would you wait 25 minutes at the side of the road with a very ill friend, when the hospital is only 500 metres away. This story is made up.

Sometimes you wait the 1st 15 mins thinking they are sure to come then a bit longer before panic sets in, 25 mins is a long time BUT the guy was maybe disabled himself, and many Thais would pass by laughing as some do because they couldn't understand English, I cannot understand why there was not an offer of help.

My answer to this thread is easy --why swallow this stupid story and publish it... I have in mind national parks---farm areas-- BKK traffic---work and school leaving times---Idiots that put the story to the press and the same foe the thread; And that also goes to me for answering. similar thread re----thck particles in Chiang Mai.

The spokesperson with any grey matter would say----We are trying our best to cut down the rescue times in accident cases--- it would be more credible. come on THE Nation pressure for better press reports from whoever.

Edited March 24, 2013 by ginjag

[ginjag]

Is there a problem with the EDIT in a reply. I have this problem many times, it says edit--then when I try I cannot it will not accept the curser, and it says at the bottom save the changes--that I cannot correct ???

[cheeryble]

Thanks for a heartening post rescuemt.....keep up the good work.

[ginjag]

Sawatdee khrap to one and all. This is my first post on the TV forum

so please be gentle with me . I'm one of only a small handful

of farangs who are registered members of rescue foundations here in the

LOS. I read through the replies to this news article and they motivated

me to finally join TV after years as a lurker and post my two satangs

worth. I'd like to address several points made in previous comments from

an insider's perspective. As you certainly know, conditions or

experiences in one part of this country do not apply to the nation as a whole

and may not even be consistent from town to town, so please keep that in

mind. I'm speaking only from my personal experience (18 years

in-country) and do not claim that my situation is the norm by any

means. With that said, here is my perspective on four issues brought up

in previous posts:

1) Training: As of 2012, all active, registered members of rescue

foundations were required by a new mandate from EMIT to receive training to the

First Responder level (30 Hours). Training was provided free of charge

and followed an international curriculum taught by instructors with at least an

EMT level certification or higher and most were R.N. nurses who work in the

E.R./E.D. This training is in addition to the training all members

receive from their respective foundations - ours is a 2-day program done at the

HQ in Bangkok taught by E.R. physicians. I have assisted in training on several of

these courses and can attest that the curriculum and instruction was

professional and the students very dedicated and serious about improving their EMS skills.

Registered F.R. trucks now have special stickers listing their truck number's registry and expiration

date to alleviate any doubt. These same stickers are required on all hospital ambulances as

well - one is a blue and white round "star of life" decal and the second

is a long, rectangular red or blue decal (bumper-sticker style) that has the

First Responder Registration number hand written with a paint pen. If you

come across a truck with these decals, I'd say you're in good hands. That

said, my own truck doesn't display these decals as my level of training is EMT

so I have to display in Thai and English that I'm certified to that level

instead as the EMIT does not yet train rescue groups to that level but

it's in the long-term plan. However, there are now EMT boot camps here in

Thailand similar to those in the US where rescue officers can train at their own expense

on their own time; this has become very popular as Thais are keen to improve their status within the

groups. Yes, there are still too many trucks out there with untrained

people - usually in very small towns with no "Big 3" foundation

groups or hospital services but they are being weeded out and forced

to join up with one of the "Big 3" and get the mandatory training or

else face sanctions.

2) Response Time: This new mandate for an under 8 minute response time

is sorely needed, imho. Hospital ambulances are (under)staffed by

E.R./E.D. nurses and EMTs who are working with patients up until they hear a

radio call out. They have to constantly keep an ear on the radio - often

located in another room outside the E.R. - and then have to stop whatever

they're working on (not easy to do when you're in the middle of suturing a

wound) and head outside to the ambulance then go through the dispatch protocol checklists

advising their mileage on the vehicle at time of departure, etc. then checking

times of dispatch, departure, and arrival at the scene. Foundation rescue

trucks, on the other hand, have a much quicker response time as we are already

in our trucks on standby when the calls go out and can leave as soon as we are

dispatched. The majority of calls we arrive on scene, treat and package

the patient for transport, and get them to the E.R. before the ambulance even

arrives on scene and many times before they even leave the hospital. So,

we try to coordinate as best as possible with others responding to the scene so

that everyone knows the status of the call and they can cancel their ambulance

call out and not waste any time. A call for an under-8 on scene time may

not be practical in many instances, but it's good that the hospital staff have

a goal to shoot for and try their best to get on scene as quickly as

possible. The more trained hands we have on scene, the better. We

work in BLS (basic life support) and do not run IV lines, so having the

hospital bus on the scene is great for those most serious injuries which

require intravenous medications such as morphine, etc. That said, anyone

familiar with EMS knows about the "golden

hour" and thus the response time to the scene and on to the E.R. is

critical. Now we just need to get the public to understand what lights

and sirens mean and how to give right-of-way to our emergency vehicles - this

is a huge issue and one I'm not sure how to address other than public education

campaigns which Thailand isn't known for doing. To those of you in Bangkok, God help you.

3) Rescue Foundations: In Thailand, there are three national

rescue groups: Ruamkatanyu Foundation, Por Tek Tung, and Sawang. Aside

from the "Big 3", there are several smaller rescue groups that are independently

run organizations - too many to list here. Unfortunately, like everything

in life, a few bad apples spoil the bunch as they say. Yes, there are

many areas of improvement that need to be addressed; again, too many to list

and discuss here. What I can say, though, is that the men and women (and

yes, even their children!) who volunteer their personal time and money to

assist the public are some of the best people you will find anywhere on this

planet. The general public (and expat farangs, in particular) have no

idea what we face in this line of work or even what we do. Responding to

motor vehicle accidents or other injury/trauma calls is our mainstay, but we

also assist the local P.D. on domestic disturbances, fights, and any other

nasty call they need help with (we can even make arrests as well as authorized

by the local constabulary). We catch snakes and other dangerous animals,

respond with the F.D. to any fire calls, take 'crazy' street people into

custody and transport them to mental institutions, and of course do ALL the

work involving any deceased persons such as taking fingerprints, notifying the

next of kin, etc. Traffic control, assisting stranded motorists, locating

lost/missing persons, and helping convoys and motorcades are also examples of

the work we do each and every day, 24/7 free of charge with no expectation of

reimbursement or even thanks.

4) Money: There are so many misconceptions and misunderstandings regarding

this issue it makes me ill. One of the biggest is that there is "Big

Money" to be had in this line of work. Ah.... no. The only

money we make is a small stipend paid by the county hospital to help pay our

fuel costs - at the moment THB 350 per incident (not per patient) - and to

qualify for that payment we have to log our times through the radio

dispatcher which is not always feasible and complete a bunch of paperwork

after the call which is then submitted to Bangkok and, if approved, we get a

payment within 3-4 months later. As a result of this system, the majority

of our calls we do not apply for the 350 Baht reimbursement as it is too

difficult and time consuming. Our equipment costs (we are very well

equipped in my group - all trucks have spinal immobilization equipment, oxygen

and airway apparatus, splints, full medic kits with everything you'd find in an

ambulance, Kendrick Extrication devices, and one truck - the boss - carries a

full set of Hurst extrication tools - the "Jaws of Life"), fuel, vehicles,

uniforms, - you name it - is all paid for out of our own pockets. We have

no sponsors, no support, no kick-backs, zilch, zero. The only way our

guys can make some small money is to provide hearse services to

transport bodies from the morgue to the Wat for cremation - many people live

and work far from their homes in the countryside and thus the need to move

bodies around the country. Even so, this money barely covers the fuel

costs and time spent driving there and back so one is not likely to get rich

doing this service. The infighting between groups comes not from the big

money to be had but rather from the problem of working in certain districts and

zones. Each local group of responders has a very specific area we run

calls to. The problems arise when another neighboring group jumps a call

and responds into an area that is not in their 'jurisdiction'. This

creates a huge amount of problems as the call jumpers do not officially report

on the radio what they're up to so we have no idea that another team is already

on the scene - we're running code-3 lights and sirens to get there only to find

that, upon arrival, another group has already worked the call and are en-route

to the hospital. Fortunately for my situation, our local police chief only

authorized our group to respond to calls in our city limits - any outsiders can

be subject to arrest. However, for larger cities there is the need to

alternate days - odd days one group and even the other - or some similar

compromise to divide the city into zones/districts. Regardless, the

majority of the time things work pretty smoothly considering so many variables

that can and will go wrong.

So, in a nutshell, that's a glimpse into the EMS situation here in Thailand from a

(farang) insider's perspective. Please try and keep an open mind when it

comes to these foundations - the people involved are doing this service for

their fellow citizens with no expectation of thanks, payment, or even

respect. It's done out of the goodness of their hearts (and collecting

some 'naam jaii') and their ability to face chaos and life-threatening danger

in the face when others look or run the other way. The EMS system here in

Thailand is still in its infancy and has a long way to go, but where else on the planet

do you have such great people willing to take up the slack and lend a helping

hand to someone in distress??? Certainly not in my home country, that's

for sure. Kudos to the Thais for their gracious service to humanity; I'm

very lucky and proud to be a part of such a wonderful group of people and put

my life on the line for them every day without hesitation or reservation.

Should you have any questions about these topics, please post a reply and I'll

be happy to help out where I can.

Chok dee!!

Fair post just about stayed awake long enough to finish reading it---reply good but at my age no more saga's

Edited March 24, 2013 by ginjag

[rescuemt]

Thanks rescuemt for your informative post. But it still does not address the fundamental issue of money. If no money is involved, why on god's green earth would foundations fight over bodies? I personally always use the Follow The Money system to figure out mysterious Asia....

From a New York Times article on the bodysnatchers...

http://www.nytimes.com/2002/01/29/news/29iht-bodies_ed3_.html

"Competition over bodies has occasionally proved intense enough for rival groups to resort to violence. The police once fired warning shots to stop 40 Por Tek Tung collectors armed with wooden clubs and hammers from fighting six collectors from a rival group.

Mr. Niroot took part in one of the most famous confrontations, in which half a dozen body snatchers were hospitalized after fighting over a motorcyclist's body."

Thanks for your reply. All I can say is... why do high schools here have violent fights with their 'rivals'?? It's the same mentality. When I first joined my rescue organization, I had the same thoughts and questions as to why there is infighting when we're doing the same job. Well, the answer is very complex and, believe me, has nothing to do with money and everything to do with Thai mentality and culture. It's more of an one-upmanship situation where we feel our team is superior - we're better equipped, better trained, better at this or that kind of thing. And, as I mentioned in my first post, the main problem is that we have our own jurisdictions or 'turf' if you will, to patrol and respond to. I hate to admit it, but it even gets to me sometimes when I'm sitting around bored to death for hours waiting for a call then when I do get dispatched and head that way balls-to-the-wall code-3 only to show up at the scene and someone else is there already (not part of my team) working the accident, I get very, very defensive and agitated: who are they? where are they from? what are they doing responding to my call? this is not their jurisdiction! (you get the idea). This happens even within the same foundation. The neighboring town to mine have a problem jumping our calls lately and I must say it's a very contentious issue and has everyone involved complaining and arguing. This is where the conflict arises from and makes for some very nasty problems. Fortunately, this doesn't happen very often and when it does the team leaders can usually 'clear' the situation and placate everyone involved and we go about our business as usual. The media LOVE to report on such things, though, and blow it out of proportion. TIT.

P.S. I wish the (foreign) media would stop with this "body snatcher" crap. It's very demeaning and the cuteness of the term has long worn off by now.

Edited March 24, 2013 by rescuemt