During the 2007 ESPN X-GAMES in Los Angeles, CA, Australian skateboarder Jake Brown had a freefall of over forty feet off the backside of the mega ramp, landing on little more than the hard plywood floor. As he lay motionless for several minutes, viewers across the world all gasped the same thing: “Oh no, is he dead?”

Despite the well-known risks involved in competitive action sports – and particularly in the mega ramp event – there wasn’t a single trained emergency medical provider on scene at the Staples Center that night. Not one. Against all medical protocols, Jake Brown literally picked himself up off the ground, lifted his arms to the crowd in beaten triumph, and walked off the stage. It was nothing short of miraculous. Fortunately, when an ambulance outside the main arena finally met him, he was only a few minutes’ away from some of the world’s most advanced trauma care – just in case the miracle was too good to be true.

ECU_Montanita_Ambulance

© TrekMedics.org


The Inertia

The Stress of Fun
Traumatic injuries are a natural byproduct of sports and physical exercise, and they are particularly common in action sports. Surfing, however, includes a far wider range of traumatic injuries than most other action sports. From the small abrasions on the soles of your feet to the complete inundation of your lungs before drowning, anyone who’s ever put a board under their arm knows that surfing is really about taking it on the head – over and over again.

Another thing surfers know better than most athletes is the need to travel – to go walkabout, to trek long and far in search of perfect, empty waves. Steep cliffs, narrow trails, and long barren stretches on remote islands are just a few of the physical hazards that literally come with the territory. No matter how far you have to travel to find a good wave, risk always seems to be just around the corner.

For the vast majority of us who surf in heavily populated areas – including North America, Australasia, Europe and South Africa – we are fortunate to enjoy the luxury of the 24-7 emergency medical services (EMS) safety net. Surfers are aware of this safety net, and know their role in the emergency medical response chain quite well: Generally speaking, surfers in these countries know that if you can get the injured to the beach, help is not too far away. And if word is relayed to the beach quick enough, help will already be there when you get back on shore.

Photo: TrekMedics.org

“You are at such risk of dying from an injury while traveling in developing countries that a seatbelt will likely do more to save your life than a malaria pill.” Photo: TrekMedics.org

Injuries: A Global (and Neglected) Epidemic
In developing countries, however, emergency medical care doesn’t quite work this way; more often than not, the safety net simply doesn’t exist. Any surfer who has ever traveled to a developing country is likely aware that if good times go bad, generally speaking, you’re pretty much on your own. It’s just you and your buddies, and when bad things do happen, it usually doesn’t take long to realize that the best hope for finding help is the local fishermen. Whatever is available will do. Let’s just get to a hospital.

The sad truth is that for the local fishermen and their families, this is how life is every day: No ambulance is coming any time soon, and just like the surfer who doesn’t think much about medical emergencies until they happen, it’s likely that the fishermen don’t know what to do in case of an emergency either, simply because of the lack in basic training. Emergency care is very much preventive care: injuries can destabilize and conditions will deteriorate. A wound left untreated becomes infected; a broken bone left unset becomes a permanent disability; a wound bleeds out needlessly and someone dies. That’s life without 911.

By simply existing in a developing country, your chances of suffering a fatal injury are exponentially higher. According to the World Health Organization, developing countries suffer over 90 percent of the world’s road traffic fatalities despite owning a bit over half of the world’s registered vehicles. And that’s just the roads – on your way to the beach, from the airport. In short, you are at such risk of dying from an injury while traveling in developing countries that a seatbelt will likely do more to save your life than a malaria pill.

Strengthen What Exists
Fortunately, things don’t have to be this way. Neither for surfers, nor for the local fishermen. There is a way to make surfing safer everywhere by improving local capacity, and in ways that will expand the sport in a socially responsible fashion. Here’s how:

In order to respond to an emergency effectively, you need three things: someone who knows what to do, a way to contact them, and a way to transport the patient when they get there. Think back to the last time you heard about somebody getting a limb sliced open by a fin, and the answer was probably instinctual: “I don’t know how I did it, I just remembered hearing that a tourniquet would stop the bleeding, so I tied it on tight and we got to the shore.” This is another way of saying, “The community taught me, I did most basic thing I could, and I found better care.”

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