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New Direction for Rural Survivability

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Isolated by miles of prairie,„Greeley„County is located along the western edge of„Kansas, where its 1,365 residents are accustomed to doing for themselves and making the best of what they have. Their healthcare system (including its all-volunteer„EMS service) has been the county_s only growth industry over the past two decades.

To offset years of drought and less-than-fruitful harvests, this rural„Kansas farming community developed an innovative and lucrative healthcare system. In the wake of 9/11, a new business began operating in 2006 to produce disaster response and decontamination trailers. The new operation brings full-time jobs to the area and is likely to bolster its volunteer responder ranks.

For generations, the close-knit community's primary source of income was the summer wheat harvest. But like every agricultural community,„Greeley„County has always been at the mercy of the weather. Many area rescue personnel are farmers, and their financial success literally rides on stewardship of the land, plus luck with the notorious„Kansas weather. Thirty seconds of hail, for example, can destroy a year_s crop. Consistently poor yields trickle through the community and businesses close, forcing some ambulance service volunteers to leave the community for relative financial stability in a different industry.

Several successive years of bad harvests -- plus the resulting hemorrhage of area residents to greener pastures elsewhere -- led to a "community survival meeting" three years ago.

"We had to make decisions," says Chris Baber, service director for Greeley County Ambulance Service (GCAS). "We_ve got to create our community's success from within. We_ve got to be glad we're here in the first place."

Greeley„Countyalready had two things working in its favor: A spirit of volunteerism, and a strong hospital and clinic system. Greeley County Health Services has been the county's only growth industry over the past two decades. The county's hospital is located in the county seat of Tribune and employs 128 people, some of whom also volunteer for GCAS.

GCAS averages 120 calls per year (including standbys and out-of-town transfers). Like many volunteer„EMS agencies, GCAS struggles to maintain its roster, currently listing more than 20 people. Responding to calls is especially difficult for personnel during the workday, whether they farm or work in town. A transfer to the closest higher-acuity hospital in Garden City can tie up crews for at least six hours.

With the development of Response Systems LLC, the community will have 15 additional full-time jobs and a good possibility of more„EMS volunteers. Personnel will be encouraged to receive EMS training and allowed to take ambulance responses in„Greeley„County during regular work hours, says Todd Burch, CEO of GCHS and a managing partner of Response Systems.

"This company would keep medicine in the mainstream," Burch says. "It reinforces medicine as the mainstream in„Greeley„County, and gets more people interested in it. I hope people would see„EMS as an entryway into the medical field. And if we create 15 more jobs, we'll potentially increase the population, which will help the economy and maybe get more volunteers."

The Response Systems trailers are fitted with catch-tanks for contaminated water and have ramps for non-ambulatory patients. The trailer is large enough for MCI decontamination, but small enough to be towed by a pickup truck to a hospital entrance, where it can be made ready for use in a little as three minutes. In addition to producing decon trailers (so far they've sold 18 to„Kansas services), Response Systems will be manufacturing additional decon materials in the near future, Burch says.

Burch developed the trailers with the assistance of fellow Response Systems managing partner Robert Moser, M.D., whose family practice is based in Tribune. A native of„Greeley„County, Moser returned to practice medicine when he learned it was listed as a critically underserved area. He arrived in 1991 and has since spearheaded expansion of the healthcare system serving Greeley and its northern neighbor,„Wallace„County, with the hospital and outreach clinics. He's also the medical director for GCAS.

"We've got great local support of our healthcare system," Moser says. "This is also about our survival as a community. Small towns are dealing with a turnover and with an aging population. Our children are leaving, and they aren't coming back. Anything we can do to increase our numbers and give people reasons to stay will help our survivability."

Response Systems recently was contracted to assist with evacuations for„Louisiana„State„University's eight healthcare facilities, and has a patent pending on vehicles designed to transport multiple, spineboarded patients. The bus-size evac vehicles are fitted with O and electricity for medical equipment, says Randy Cardonell, director of operations and training for Response Systems. An EMT-I and longtime volunteer for GCAS, Cardonell recently joined the company full-time.„

"We have fewer people but the same number of jobs that need to be done," Cardonell says. "Even people who are not involved with„EMS play a role in [ambulance] calls, because they have to cover for people who need to leave their jobs. That is a fact of life, here."

Rural communities. like those in„Greeley„County. rely on a fierce work ethic that has become second-nature to those who live there. Nothing is taken for granted, and almost everyone in the community wears multiple hats. In addition to her duties as GCAS director, Chris Baber is a full-time teacher at the K-12 Greeley County School and also is the school's driver education instructor, cheerleading sponsor and CPR instructor.

She also lives on a farm, and July's wheat harvest is "an intense time of year," Baber says. "From before„sunup„ until midnight, we're working. This is the only payday that wheat farmers get all year."

Volunteers with GCAS coordinate with each other during wheat harvest, taking call for responders who would otherwise need to dash from either a combine or wheat truck to take a call. In turn, farmers take calls during the winter. Randy Cardonell's son and daughter are also EMTs and are among several college students who return to Tribune during school breaks to take„EMS call so GCAS regulars can have a break.

"No matter what size the community is,„EMS has to provide service 24/7," Baber says. "One way or another, things get handled."

After years of poor to fair harvests,„Greeley„County farmers finally had a good harvest this summer. By all accounts, this year's harvest, which is just completed, was a "bin buster", Cardonell says. "The community is very upbeat about it. We hadn't seen it in such a long time and we are very, very thankful."

Despite a rough start this year with several blizzards (one of which buried half of the GCAS ambulance barn beneath a huge snow drift), Greeley County missed the brunt of severe weather that laid waste to the Kansas communities of Greensburg and Ellinwood (from tornadoes in May), southeast Kansas (from floods in July) and northeast Kansas (from a crop-killing April freeze).

Every county resident is connected in some way to agriculture, and it was a harvest-related incident in 1973 that led to the formation of„Greeley„County's ambulance service. After two residents were killed in a grain truck collision, local physician Willard Werner pushed for an ambulance and basic first-aid class. Modern„EMS was in its infancy, and the first members of GCAS used what they had: Their first ambulance was Dr. Werner's station wagon, and they used closet doors as spineboards.

With generous support from the community, the service now has several BLS ambulances, a solid facility -- with a training room and office -- in which to house them and a service roster that includes multiple generations of„Greeley„County responders. Thanks to a strong community education program, hundreds of area residents (a sizeable percentage of the population) are trained in first-aid and CPR.

Courtney McCainhas worked as a paramedic and an air medical dispatcher in„Kansas and„Texas. She is now a freelance journalist focusing on public safety issues. Contact her via e-mail at„kemsnews@everestkc.net.

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