Prehospital care is an essential part of the continuum of health care yet also an often overlooked component. This is provided by emergency medical services (EMS) responders, who serve as the initial health care providers. They provide prehospital care through careful triage, initial evaluation and treatment and immediate transfer of patients to the appropriate health care facility, where definitive care is ultimately provided. Prehospital care plays a critical role in the treatment of emergencies and acute life-threatening conditions and yet the lack of available and accessible prehospital care in many areas in our country is an unfortunate reality many Filipinos have to face everyday. This was clearly evident in the documentary “Ambulansyang de Paa”, where patients in Sitio Dyandang and Villa Pag-asa are unable to access the healthcare they need. The documentary showed just how people residing in GIDAs need to walk for hours on treacherous roads just to be able to visit a local health center. The 3 to 4 hour travel is not something that a person experiencing an emergency would be able to survive and even in the slimmest chance that they do, the health center they arrived at might not even have a doctor present or the center may have a shortage of the necessary equipment and medications to address the patient’s condition.
Emergencies and acute illnesses often require immediate resuscitation and stabilization that cannot be provided without an adequate prehospital care system. In order for us to be able to achieve better outcomes for Filipinos experiencing health emergencies and acute illnesses, effort must be exerted into building a reliable prehospital care system across the country. The documentary reveals many of the flaws of our healthcare system that requires correcting before we are able to provide the best care for our patients. Ideally, “ambulansyang de paa” should no longer be a thing in our country. Instead, these should be replaced with fully-equipped ambulances and well-trained EMS providers that are able to respond to emergencies. The documentary also shows how other social determinants have a big impact on the healthcare (or lack thereof) that patients receive. Lack of paved roads, out of pocket spending and lack of health education are some of the other determinants that further hinder access to immediate healthcare. Political will and allotting an appropriate budget to address these are necessary for us to be able to leave stories like those seen in the documentary in the past. Addressing these underlying issues and determinants are a prerequisite for us to be able to provide better care, especially to the emergency patients who need immediate access the most.