Global Warning for EMS

An Interview with Tony Walker,
CEO, Ambulance Victoria.
Published in Ambulance Today,
Spring 2020, Issue 1, Volume 17,
Global Warning and the Burning Issues at the Core of Prehospital Trauma Care

As the world looked on in disbelief at the devastating Australian bush fires earlier this year, the Emergency Response teams were working day and night to reduce casualties amidst extremely challenging circumstances.

Tony Walker, CEO at Ambulance Victoria, gives us an insight into what effects the fires had on the Australian Ambulance Services and how the effects of climate change are shaping Ambulance Victoria’s response systems.

Harry Squire (H.S): Tony, working within EMS can be challenging at the best of times. How did the bush fires in Australia effect the ambulance service?

Tony Walker (T.W): The scale and intensity of the recent bush fires in Victoria was unprecedented, and their impact on our people and operations significant.

Ambulance Victoria’s Emergency Operations Centre coordinated a state-wide ambulance response.

The fires burned an area equivalent to two thirds of the UK. Entire towns were lost. Smoke turned day into night.

The remoteness of some impacted communities meant our teams were managing a challenging logistical and operational environment on a daily basis.

We had local crews in the fire-effected areas and, as need increased, dispatched extra paramedics to these areas where they worked along-side government-funded medical officers and an Australian Defence Force medical team to ensure we had adequate coverage on the ground.

We were heavily involved in the relocation of vulnerable community members from local hospitals and aged care facilities, and as people were being evacuated by the Navy we provided the facilities of our Air Ambulance base back in Melbourne.

As smoke from the fires blanketed our larger cities and air quality plummeted to hazardous levels, we saw a 51% spike in calls for help for breathing problems in one night.

Many of those patients were taken to hospital, putting enormous strain on emergency departments.

Ensuring the safety of our staff was paramount. A number of ambulance crews were isolated in their communities, and there were other areas in which we couldn’t respond to emergency calls because fires made them inaccessible.

In the course of caring for their communities, some of our people lost their own families’ homes to the fires.

I’ve since spent time in some of the worst hit parts of Victoria, including the coastal town of Mallacoota where you saw in media reports the thousands of holiday makers evacuated to the beach.

I spoke to many of our people who have been at the heart of emergency and recovery efforts. Particularly for fire fighters, most of whom are volunteers, but also for my people, it’s been a long and difficult summer.

And I do feel a deep personal obligation to care for them. We created a special Bush re Support package to make available extra psychological support services and financial relief. Over 200 staff have utilised the scheme.

H.S: Bush fires in Australia clearly aren’t anything new, and it does seem to me like the response was well orchestrated and efficient, however, with extreme weather cases like this seemingly becoming more frequent, are you worried for the future?

T.W: There’s no question that climate change-induced extreme weather events are becoming more frequent and more intense. The science has been forecasting this for three decades.

Personally, of course I am concerned for the world my generation is leaving to my children. My daughter Lucy is only four years old. I am grandfather to two-year-old Ella, and have another grandchild on the way.

Outside of the Mallacoota branch

I think this summer’s fires sheeted home to most Australians the impact of a warming world in a way that melting glaciers and stranded polar bears had not.

At Ambulance Victoria, our vision is to transition over the next five years to 100% renewable energy, reducing our emissions by 27%.

As you’d anticipate, carbon emissions from our fleet are a significant contributor to our carbon footprint, but we are not shying away from that challenge.

H.S: It’s a good point, I think we are all guilty at some level of feeling far-removed from the impacts of climate change, but when it hits on a personal level — it hits hard.

Are the Australian ambulance services prepared for another event like this? And do you think any lessons have been learned from this year?

Paramedics at Mallacoota

T.W: Extreme heat, thunderstorm asthma, prolonged drought, fires, floods — extreme weather events are coming down the road to challenge and change us at Ambulance Victoria.

Emergency services here learned a lot from the Black Saturday fires in 2009 when 173 people perished. As a consequence, this summer many lives were saved thanks to the public’s and emergency services’ greater understanding of the threat level and how to respond.

We learned a lot in 2016 when we experienced the world’s largest and most catastrophic epidemic of thunderstorm asthma.

Over a period of 30 hours, there was a 67.2% increase in respiratory-related emergencies. People died, ten people. It’s inevitable that we’ll be challenged again.

We need to be ahead. To future-proof our service, we need to think smarter, not bigger. We need to do things in more efficient and innovative ways.

Technology is enabling us to re-imagine and transform our service. We’re working proactively and in partnership with communities to build their capacity to respond to health emergencies.

Being ahead means that we will be in a position to manage extreme weather events on top of the significant demand drivers like mental health and an aging population that are the daily reality in a modern ambulance service.

H.S: It is certainly a challenging time for EMS, especially in Australia, but it does seem Ambulance Victoria are managing these challenges well and planning for an inevitably more challenging future.

Is there a message you would like to give in general to the people in Australia involved in the emergency services?

T.W: There has never been a more challenging and rewarding time to be an emergency services professional.

H.S: Thank you for your time and insights, Tony. I think I speak for most people when I say the response to the bush fires by the Emergency Services in Australia has been incredible, and it certainly sounds like you’re geared up for climate-related response.

Personally, with this becoming a global issue, I think that there is a lot to learn from the work that Ambulance Victoria has been doing and is planning to do in the future and it will be interesting to see how things develop in the coming years.

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