▲ The HH-65C - Dolphin is used as an air ambulance helicopter all over the world. Photo courtesy US Coast Guard
On July 13, a 66-year-old Jeju haenyeo (woman diver) was diving in the sea when she began to suffer from severe chest pains and was rushed to a local hospital. She was diagnosed with a myocardial rupture which required an immediate operation, but the hospital said that it didn’t have the proper equipment for the surgery.
Her family desperately needed to transport her to Seoul, but it wasn’t until the next day that she was finally able to be flown to the capital by airplane. Unfortunately, she died in mid-air shortly before the plane landed at Gimpo Airport in Seoul. Her death devastated her family and has prompted many other patients’ families and lawmakers to call for a thorough review of Jeju Island’s emergency medical system.
For patients facing life-threatening situations on the island and a consequent need for evacuation to the mainland, there are currently two modes of air transport to Seoul; first, a limited number of commercial airplanes are able to accommodate stretchers. The other is the 911 air ambulance helicopters which are flown in from Gyeonggi province upon request.
These special helicopters, which take under two hours to rush patients to Seoul, have been a life-saver for four patients on Jeju so far this year. The problem is that they are not always immediately available as the helicopters cover the entire country for life-saving emergency rescues. Already there have been 120 other patients who were in need of emergency transport but had to wait for commercial airplanes with stretcher facilities, reflecting the absolute need for Jeju Island to have its own air medical helicopter on call.
The commercial plane stretcher service is also limited. In the case of Korean Air, only 71 aircraft out of 126 provide this service while for Asiana Airlines, a dedicated stretcher section is available only on five planes out of 66 aircraft. None of the budget carriers have this system in place. Very often, it is hard to secure a spot in the dedicated stretcher section during weekends or during the peak holiday seasons. And even if the airline stretcher is available, it takes at least four to five hours for the plane’s interior to be modified. For patients with life and death emergencies, these long hours could mean the difference between life and death.
Jeju is one of only two of Korea’s 16 regions which does not own an emergency medical helicopter. The island’s medical service falls short of the highest standards in the country because of Jeju’s isolation, a reason many in the healthcare industry and government officials consider to be vital in lobbying for an efficient air ambulance system. However, the Jeju provincial government’s three-year efforts to secure such an emergency evacuation procedure have stalled because of budget issues.
One air ambulance helicopter equipped with cutting edge medical equipment costs between 18 to 24 billion won, a price tag the Jeju provincial government seemingly cannot afford. The plan to rent an air ambulance instead of buying one was also under discussion last year, but didn’t go through for the same financial reason. Given the fact that the annual cost for operating the 911 emergency system on Jeju amounts to 1.6 billion won, it seems implausible that Jeju would spend more money on renting such an expensive air ambulance helicopter.
The tragic death of the haeyneo is merely one example which proves how vulnerable Jeju’s emergency medical system is. The need for a multi-purpose rescue helicopter has been strongly advocated by Kim Jae Yoon, a Democratic Party lawmaker in Seogwipo City. In a Sept. 5 forum held with the Korean Coast Guard, he asserted that Jeju should be the first place to receive such a helicopter from the central government, citing Jeju’s geographical location. Lee Sun Hwa, a member of Jeju’s local council, also pointed out that Jeju’s emergency service requires extensive innovations.
“The Jeju government hasn’t even signed any agreement with airliners which mandates rules regarding the emergency air transport,” Lee said, stressing that immediate action should be taken by the local authorities.
However, there are medical experts who claim that lawmakers should prioritize the improvement of Jeju’s medical infrastructure over the purchase or rental of an air ambulance helicopter. In a sense, the urgent need for the air ambulance helicopter to transport patients to bigger cities is proof that Jeju’s medical infrastructure is very weak.
The Ministry of Health and Welfare, which evaluated four emergency medical centers on Jeju (Jeju National University Hospital, Halla Hospital, Hanmaeum Hospital, and Joongang Hospital), found that the current number of emergency medical technicians and paramedics amounts to only 40 percent of the required number. Furthermore, no Emergency Medical Information Center operates in Jeju, which could result in disastrous consequences for those in need of immediate medical advice. Far from being sophisticated, or state of the art, the local emergency medical service has been characterized as outmoded or ineffective. For example the Jeju Fire Station sends fire crews with only two weeks of formal medical training to fire scenes with no emergency medical technicians.
In truth, the island is a beautiful and clean place, which lends itself to a peaceful and healthy lifestyle. That’s in part why Jeju is increasingly becoming known as the island of longevity. The reputation, however, will become tainted unless the integrated emergency medical system is properly developed and implemented.
Government officials tend to approach this issue from a cost perspective when the real bottom line is that Jeju Island needs a safer environment. We have to learn to stop saying, “We can't” when it comes to saving people’s lives.
ⓒ Jeju Weekly 2009 (http://www.jejuweekly.com)
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