Responding to the Call in Colombia

Juan Cardona has responded to emergency calls with the Coral Springs (FL) Fire Department for 18 years, most recently as the EMS division chief. For the past three years, he also has been responding to a different call: training firefighters and paramedics in his homeland of Colombia.

In 2012, using his vacation time, Cardona began the initiative in his hometown of Palmira. It now is a nationwide effort and has the support of the Colombia Direction of the Fire Service, based in Bogota. Cardona also has developed a relationship with the country’s fire service director, German Andres Miranda.

In February Cardona was named an honorary captain of the Colombia Fire Service and now is recognized as an official instructor.

“I can now deliver training in any area related to both the fire service and EMS, and students receive educational credit,” Cardona says. “We issue accreditation certificates to anyone who completes the courses.”

Cardona was born and raised in Colombia, coming to the United States in 1992.

“I didn’t have a set career path, so I started as a hotel security guard,” Cardona says. “I became the natural liaison between the rescue crews or paramedics and patients. I had been interested in medicine when I was a kid, so I decided to become a paramedic and eventually a firefighter.”

The Coral Springs Fire Department has the only fire department-based fire academy in the state: the Coral Springs Regional Institute of Public Safety.

“A few years ago, we had a contingent from South America here,” Cardona says. “During one of the classes, I met the fire captain of my hometown. He asked me to come down to his department. I showed up at Palmira’s fire department, and they had a huge reception for me. They had the press in a separate room, and I found myself in the middle of something that hadn’t even started yet. I spent the entire day with the department, teaching and learning. After that I’ve been there three or four times a year.”

This year Cardona garnered his fire department’s support, and now members of his department help with the training.

“I see a huge need for prehospital care in South America,” Cardona says. “Those guys are really good at the fire skills. They seem to have people trained well for that. But I see a lot craving for prehospital care. I personally do mostly medical training, but now, with the academy and department on board, we have more than 300 instructors from the area teaching everything. We have resources for almost all aspects of fire and medical services to be taught.”

Yet there have been challenges. In 2012 Colombian lawmakers passed a law mandating that mayors and governors throughout the country provide funding to implement and improve training, equipment and services.

Cardona says many of the 40,000 firefighters in Colombia are volunteers, with just a few of the larger fire departments receiving full funding from the government. He says volunteers may receive some benefits, such as stipends for travel, but otherwise there is no money.

“I want to help those who don’t have funding, the ones where the firefighters have to provide their own gear, such as their own helmets,” Cardona says.

Cardona has collected used fire and medical equipment as one way to help.

“On one of my trips, I was going to teach CPR and basic life support,” Cardona says. “A friend had a friend with a set of manikins in Orlando. I drove to Orlando from Palm Beach; the man opened his garage, put the manikins in my trunk, I thanked him, and I drove back home. I took them down to Colombia and was able to train with them and then donate them.”

Cardona also brings gifts to the students.

“One guy rode on his mini motorcycle for nine hours straight to take my class,” Cardona says. “That’s commitment! Another guy lives in an area with a lot of guerilla activity. He showed me a picture of his dad’s tombstone. It was the eighth anniversary of his dad’s death, and he said he should have been with his family, but he wanted to take my class. When the class finished, I called him up, gave him a t-shirt as a gift and explained why to the class. You’ve never seen two grown men cry like that.”

Cardona says the fire and EMS service is starkly different in Colombia from what Americans expect.

“They respond to emergencies but contract out to transport patients by ambulance,” Cardona says. “They don’t have the response-time standards like we do. They’ll get there when they get there. They are medically trained but cannot do most procedures because they do not have a medical director. If someone is bleeding out, they can put a tourniquet on it, but they can’t start an IV unless they can get a doctor on the phone to authorize it.”

Cardona says the main issue is a lack of funding from the government. He says Palmira, for example, has 300,000 people but just one station. He says some areas may have three or four ambulances and fire trucks, but only one is available because they do not have money to fill the gas tanks.

“Even though the 2012 law forces mayors and governors to provide funding, they don’t,” Cardona says. “There is a lot of corruption in South America, especially in Colombia. When I go to the towns, I have the press there, and the politicians come out. I give them their 15 minutes, and then, in front of the media, I put them on the spot. I remind them they are obligated to provide the funding. I’ve made a few enemies, but I also have seen progress where some are receiving the funding.”

Still, when the funds are not forthcoming, the departments have to get creative.

“One department owns two water tankers,” Cardona says. “The fire department delivers water to the farms around the area just to make some money. Another one will have a police blockade and ask motorists to show their emergency kits. If they don’t have one, the fire department will sell them. Or they will offer their services for mass-gathering events for a fee.”

Cardona says he is encouraged, however. He says that because of his relationship with the national fire service director, the government recently awarded about $20,000 for training, which can provide approximately six classes a year.

“It tells me somebody is actually listening,” Cardona says. “Also, there usually are 3–5 in a class of 20 who have the knowledge, and I’ve started a list so they can become paid instructors in the future. The idea since the beginning was that I would help them help themselves. I tell them it’s their obligation to go back to their departments and ask questions of their leaders. They have to ask why they don’t have the level of funding required and why they don’t guarantee response times. I can see my students’ minds going, How do I do that? It doesn’t occur to them that they can challenge their managers. We teach them how to ask the questions to get the proper funding, training and equipment.”

He says he is amazed at how the efforts have spread throughout Colombia. Officials in Costa Rica, Ecuador, Chile and Mexico have contacted him, but he is reluctant to expand.

“I started with a desire to only help my hometown,” Cardona says. “And I have a job and a family. I will give advice to anyone who wants to start in another country. I’ve gathered a lot of materials in Spanish and have translated PowerPoints, presentations, etc., that can be used. I wouldn’t mind helping others start a program in another country.”

Susan E. Sagarra is a writer, editor and book author based in St. Louis, MO.