CORPUS CHRISTI, Texas -- One day last August, Irene Delgado's neighbor in the Fiesta Ranch colonia complained of chest pain.
"He treats me like I was his daughter and he was saying, 'M'hija, I'm dying,' " Delgado said.
The neighbor's wife had already called 911. A few minutes later, Delgado did the same. Then she called a constable, Jack Caughman, stationed in nearby Bishop.
Caughman also got on the phone and called dispatchers. And he called again.
About 40 minutes later, an ambulance dispatched from Alice, 40 miles away, arrived to take Delgado's neighbor to the hospital in Corpus Christi.
The neighbor survived, but his ordeal remains a stark reminder of how long residents in rural parts of Nueces County can wait for ambulance service. The national standard for ambulance response is eight minutes, but many areas of the county are so isolated from ambulance services that meeting that response time is not possible.
The problem is most acute in the southwest portion of Nueces County. Some emergency workers say it has worsened in recent years.
Bishop, a city of 3,211, has not had dedicated ambulance service for about two years since a private ambulance company closed. For now, the town and the surrounding community rely on a patchwork of nearby -- and not so nearby -- ambulance companies.
"Basically, whoever we can get to come out is who we get," Caughman said. "Our average wait right now is close to 20 minutes."
Caughman has no shortage of examples, like the time he waited an hour for an ambulance with an accident victim who had a broken arm. Eventually Caughman called in a helicopter. It wasn't a life-threatening situation, the kind that would qualify for a helicopter transport to the hospital, but every ground ambulance in the region was in use.
Bishop's mayor, chief of police and fire chief have tried to get another ambulance company to come in, but the town doesn't have money to pay for an ambulance service and there aren't enough service calls to lure one.
Area mayors and fire chiefs have met sporadically in the past six months to address the concerns of rural citizens. Nueces County commissioners also have been briefed on the subject, but say it's a problem that is difficult to solve without adequate funds.
"We recognize there is a void," said County Commissioner Betty Jean Longoria. "One of the problems is you don't have a tax base. There's nothing but farmland down there and it has a low valuation."
There are five rural emergency service districts that levy taxes to provide fire service to areas of Nueces County. Two of the districts, covering the Bluntzer community and Annaville, provide ambulance service. The five districts do not cover the entire county.
Bill Roberts, the Nueces County emergency management coordinator, said the most likely short-term fix involves teaching volunteer first responders how to stabilize patients until an ambulance arrives. But he said it would take a long time for emergency service districts to provide an ambulance service. He said it isn't uncommon for residents, especially those near Bishop, to call emergency responders in Kleberg or Jim Wells counties directly, rather than calling 911.
Ask just about any emergency responder what they do if they're called to an emergency in an area that doesn't have regular service; the answer is the same.
"If you need us, we'll go," said Mickey Flores, battalions chief from EMS at the Corpus Christi Fire Department.
And Roberts said there hasn't been a case of an ambulance refusing service, but it isn't uncommon for all of them to be busy.
And travel to the county can strain the resources of city services -- though in some cases the county hospital district pays the city $250 for an ambulance run.
"It's a really difficult situation for us in the city," said Corpus Christi Fire Chief Richard Hooks. "We go out in the county, and we always have. Our first choice is to find out what kind of call it is and find a closer ambulance."When you live in a city with metro-size services, you have the benefit of having a paramedic on site within five minutes."