MEDINA, Miguel Andrei C.

2016-00448
Reflection Paper on WHO ECSA Framework
Prompt: Reflect on the WHO Emergency Care Systems Framework and list 5 things that can be
improved in our pre-hospital care systems.
1. Better information dissemination regarding the emergency hotlines available in the
Philippines. After reading the given handouts on the WHO ECSA Framework, I immediately
asked my dad if he knew what the emergency number here in the Philippines was. He replied that
he didn’t think we had one. I proceeded to privately message a trusted friend on facebook, and
ask if she knew – she didn’t. This was when I decided to google, and found out, to my surprise,
that the Philippines did have a working 911, along with a few other emergency hotlines. This was
good, but considering that none of the people I had asked, nor myself, were aware of these
hotlines, it would be best that information regarding these hotlines be made more public and
mainstream in the media. It also didn’t help that in my medical school rotations, the only hotline
ever mentioned was 117, which turned out to be the PNP hotline; others such as 143 (Red Cross)
or the main 911 were never mentioned. Worse, 911 was assumed to be a myth only available in
the United States.
2. Better education of the masses to improve bystanders response to emergencies. It is
good that we already have laws protecting bystanders intervening in emergencies (The Good
Samaritan Act of 2017), but I think that it is concerning that most bystanders are not properly
trained or knowledgeable about potential life-saving interventions. Yes, we have NSTP/ROTC
and other similar programs in high school or college, but speaking as someone who has went
through these programs, they were of low-quality and were taught in such big groups that it
discouraged actual, practical learnings. I propose that teaching our youth about things like CPR,
the Heimlich manuever, and bleeding management is extremely important and should be given a
greater focus in basic education – one that would warrant close, hands-on teaching, with proper
assessment and learning outcomes – rather than what we currently have now, which are mass
demonstrations which encourage familiarity and awareness but not the skills and knowledge that
could actually save a life. Education about the emergency hotlines should also be done, as
mentioned in my first point.
3. Better traffic management. It is good that most drivers on the road know better than to get in
the way of an ambulance – I can speak from experience having seen my parents drive me around
growing up. However, it is all-too-familiar to see ambulances stuck in traffic, unable to reach the
hospital promptly. I propose that a better system be put in place as these situations may worsen
patient outcomes because of delayed treatment. Coordination with MMDA can definitely be
improved.
4. Better resources and equipment. While ambulances are fine, we could always do with more.
In addition, these ambulances should be equipped with the necessary tools to maximize patient
health outcomes. Further, I have yet to see helicopter ambulances here in the Philippines. It might
be time to modernize, especially since, as mentioned in point number 3, traffic is a recurring
problem in this country. These would also be able to benefit those who live in far-flung
areas/islands far from hospitals.
5. Stronger primary health care system. This goes without saying, as even if traffic
management is solved, and appropriate equipment/vehicles are in place, those who live far from
cities or even hospitals in general would have limited access to proper pre-hospital care. As
seen in Ambulansyang-de-Paa, the lack of roads and proper infrastructure, along with problems
in manpower and resources in the health centers would represent a major point of improvement
in improving pre-hospital outcomes. Further, aside from being accessible, urgent care should be
free!