EMS Corner

This year I am granted a Sabbatical from my institution, The College of Southern Nevada. A sabbatical (from the Latin “sabbaticus,”) is a rest from work, or a break, often lasting up to a year. In recent times, “sabbatical” has come to mean any extended absence in the career of an individual in order to achieve something.

The concept is to study onsite the emergency infrastructure within the Bac Liêu province of the Socialist Republic of Vietnam. When developing an undertaking of this magnitude, (planning, proposal, travel, research, and reporting etc.), and making  research goals a reality involves much more than anticipated and end-results proved to be nothing but a disappointment.

In site selection, Bac Liêu Province was chosen for several reasons. This province is located in the far south of Vietnam and has both rural and urban areas. The area has a vast divergent population of approximately 800,000 spread out over 810 square miles. This is south of Ho Chi Min City (Saigon) along the Sea of Japan.

Emergency infrastructure is a generalized concept to include police, fire, and EMS services. This is to include all efforts regarding notification, dispatch and interagency coordination between serving bodies. In the end, it comes down to (what we in the States consider “essential” services) offering very little in the socialist environment with police presence at every turn. This is NOT socialist “bashing” but a severe reality check when confronted with the lack of services offered to a generally indigent population.

When inquiring about notifications of emergencies, I was often met with puzzled looks but did manage to find out that instead of 911, they use a simple #113, #114, and #115 for police, fire, and EMS, respectively. Satisfied that the need for simple versus complex notification numbers was overcome, I inquired about where these calls are routed to (in a broad attempt to find a “central dispatch”) and attempt to locate a local call center. On first breath, we are told that all requests for emergency service are routed to the central government in Hanoi. The central government then determines severity, actual location (there is no enhanced 911 or the like for immediate location information), and then sends the required service.

After interviewing several doctors, this is apparently not the case for EMS, which routes calls for assistance to the local hospital. There appears to be no consistency and the police were often not helpful. According to the local population, many services are simply not available. Police respond only when they feel like it, ambulance respond only in the urban areas with no response in outlying rural areas and most of the local population do not even know have a fire department. When asked about the location of the fire department, most locals respond “we do not have that here.”

Fire Service

Despite local denial of the existence of a fire department, I was able to locate a single fire station (there was only one!) near other government buildings (which are prolific). With the assistance of a Vietnamese local (thanks to “JoJo” for her help) and my Chicago Fire Department retirement badge, we were allowed to “inspect” the station. One issue that stood out was that the supervisor in charge was a ranking policeman. We were allowed to photograph the equipment and the firefighters, but were cautioned to not take pictures of the policemen. The brothers (all male) were more than happy to show us their apparatus, six pumpers in all, and appear well trained and professional. One even dazzled us with his speed in donning his air-pack. The apparatus equipment is dated, Japanese in origin and lacking any type of aerial ladders or towers despite many structures exceeding six stories. Other equipment included standard deuce and a half canvas jacketed hose (no other size was noted) and adjustable flow fog and straight tip nozzles.  Some tools for B&E and salvage were also noted. Hard suction from street fireplugs (they are minimal in number) seem to be the standard with some mention of lake drafting. Protective gear is minimal, consisting of simple plastic helmets, “rain coat” style turn-outs and short rubber boots. 

When inquiring about numbers of necessary responses in a year, we were informed that in Bac Liêu there have only been 15 fires. I inquired “Fifteen this year?” I was told “No, 15 in the entire history of Bac Liêu.” The province is 70 years old. Now whether this is Socialist Party rhetoric or actual fact, locals confirm that fires are almost unheard of. My local translator claims she has only seen two fires her whole life (24 years), neither of which were attended to by fire companies. Incredulous as it may seem, coupled with the nonexistence of building codes (almost all structures are concrete, with no frame construction at all) and strange 220v wiring strung haphazardly everywhere, Bac Liêu seems to be, for the most part, fire free.

EMS

As an EMS professional weaned on TV’s “Emergency” in the 1970s and a boomer who could have served in the Vietnam conflict, I was excited to see how the profession has evolved in Vietnam versus the profound growth and changes that have occurred in the American EMS. I could almost cry at the lack of professional EMS. Ambulance workers have no medical training and only get a license to drive. The ambulances are all hospital based and run with a doctor or nurse who leaves the hospital. The rigs consist of standard Type II, van style commercial passenger conversions where they simply remove one side of seats and replaced them with some cabinetry and a stretcher. The only equipment I could find on this particular apparatus was an ‘H’ tank size oxygen cylinder, with a used O2 humidifier and several oxygen delivery devices.  Also found was an outdated suction device that was so dusty that I cannot imagine when it was last used but it was an old Laerdal (LSU) device that I had never seen. That was it.  No trauma supplies, no linen (the gurney was bare), no nothing. Quarters for the crews would make any EMS professional in America shudder. The room provided was approximately 8 foot x 8 foot with three bunks, a hammock, desk and computer station. I was told that similar rigs and quarters exist at each of the other locations and that some private services exist at private clinics. One can really gain perspective on waving the banner that EMS is prepared to “do anything with nothing.”

Law Enforcement

Police services, while prolific in numbers, remain a military (versus ‘paramilitary’) establishment. We were cautioned on more than one occasion to not “bother” the police. Our experience with the fire department supervision by the police and their close watch on us when visiting the fire service station was practically enough to scare us off.

We managed to find out that Bac Liêu has three branches of law enforcement. “Local” jurisdiction is divided into eight districts headed by a captain, and each district is divided into 10 wards. This authority handles all of the small incidents. Bac Liêu city police handle the medium size incidents and provincial police handle the large scale problems. While my contacts spanned local, high-level city police officers, all the way to middle-level Vietnamese FBI equivalent personnel, we were unable to make much progress in trying to unlock the “police mysteries.” We received polite comments, plenty of smiles and clear and firm denials to see, tour and photograph police officers or related facilities.

Vietnam is a country lost in the past. With emergency services that do not even meet the U.S. standards of the 1950s (there were not many of them then.), Vietnam does not seem to want more. The people, while very poor (especially in the rural village areas),  appear content and happy. It was difficult to find anything other than happiness when talking to the local population.  While no services exist in the rural villages, the mostly agrarian and fishing economy is growing at an enormous pace and manufacturing is on the rise.

We want to thank all the dedicated Vietnamese emergency personnel who greeted us, welcoming us into their place of work, and making us feel at ease. In the face of the overwhelming adversity of a socialist economy, there are still dedicated professionals who stand ready to answer the next alarm.