In the video “Ambulansyang-de-paa”, one problem that can be noted is this nation’s non-functioning pre-hospital care especially in the rural, far-reaching areas. First and foremost, the people of Bayan ng Banson and Villa Pag-asa have poor public health knowledge about diseases such as tuberculosis and cannot identify emergent and urgent cases that need a hospital visit and confinement such as severe malnutrition and dehydration. Another problem would be the roads to the nearest health center and hospital were hours away and only accessible by foot for those who live in Banson. It was commendable that the community resort to bayanihan by transporting an ill member via duyan, but it was mentioned that several members have died while traveling because it would take at least 4 hours with dump truck road travel to get to the nearest health center; 8 hours by foot if they weren’t able to reach the dump truck cut off time. It was also a problem that only one doctor is assigned to the health center who cannot be at the post 24 hours a day, 7 days a week.
Literature suggests that a well-functioning pre-hospital care system--- such as improved bystander response, dispatch, provider response, patient transport, and transport care--- has significantly reduced preventable trauma deaths from serious injuries, reduced mortality and morbidity, and reduced injury severity. There were also several studies which reported that it was cost-effective to have a system of trained laypersons (such as the barangay health worker in the video) and paramedics to avert mortality. Pre-hospital care should include evidence-based strategies, prioritized and tailored to each community. It should institute basic and inexpensive strategies and interventions that can minimize the probability of death or disability, and should be simple, sustainable, and efficient.
References
Bashiri, A., Savareh, B. A., & Ghazisaeedi, M. (2019). Promotion of prehospital emergency care through clinical decision support systems: opportunities and challenges. Clinical and experimental emergency medicine, 6(4), 288.
Husum, H., Gilbert, M., Wisborg, T., Van Heng, Y., & Murad, M. (2003). Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. Journal of Trauma and Acute Care Surgery, 54(6), 1188-1196.
Thind, A., Hsia, R., Mabweijano, J., Hicks, E. R., Zakariah, A., & Mock, C. N. (2015). Prehospital and emergency care. Essential surgery: disease control priorities. 3rd edn. Washington DC: World Bank, 245-62.