Paramedic Service Short of Minorities

A horrific crash. Two children dead. Two parents who spoke only Spanish.

Jorge Vasquez, a paramedic in training with New Castle County, remembers the April 4 crash because he was the only person in Christiana Hospital's emergency room who spoke Spanish. He was asked to translate the tragic news to the parents.

"It was so hard to do, but I learned how to do it," he said. "I was fortunate to be there and to be able to help. Let me tell you, it changed me a lot."

Vasquez, a native of Colombia, is the only Hispanic paramedic in Delaware's three counties, and one of only nine minority paramedics in the state.

Minorities make up less than 4 percent of all paramedic staffs.

The lack of diversity is a problem that officials in all three counties are struggling with, working to overcome a historically low level of involvement in the field in minority communities and a national shortage of qualified applicants of any race, gender or ethnicity.

New Castle County has five minority paramedics on a staff of 103. County Executive Chris Coons said he's painfully aware of the problem those numbers pose in a county that is 27 percent nonwhite.

"Of all the units of county government, this is the one that stands out the most as not being representative of the community," he said.

Kent County has three minority paramedics on its 35-person staff. In Sussex County, there is only one, a black person, on a staff of 110.

"I would walk on glass to change that," said Glenn Luedtke, director of Sussex County Emergency Medical Services. The nonwhite population is 26.4 percent in Kent County and 19.3 percent in Sussex County.

Leaders from all three counties said they want their paramedic staffs to reflect the racial makeup of the communities they serve. They recognize that paramedics often must help frightened, confused patients who need someone they can relate to. It's particularly important with Delaware's sizable Spanish-speaking population.

"I think it's fundamentally unfair and rotten that not enough minorities are included," said New Castle County Councilman Jea P. Street, of Wilmington. "Secondly, I think medically it's important that there be representation so folks who get sick and need services can look up and have a relationship with the person that's treating them. They should be given the opportunity to have a level of comfort."

A national problem

The problem is not unique to Delaware.

A 2005 survey by the National Registry of Emergency Medical Technicians showed 76 percent of qualified paramedics are white.

Experts attribute the low number of minority paramedics to inadequate recruitment and a decades-old tradition of paramedics coming out of the ranks of volunteer fire and ambulance companies, which have long struggled with a lack of diversity.

"Minorities have not been courted at an early age," said Greg Lord, a member of the board of directors of the National Association of Emergency Medical Technicians, a professional organization representing EMTs and paramedics, who are trained to administer drugs and deliver life support.

"You don't even get any awareness in the minority community that this is a field they can go into," Lord said.

Vasquez said many of the Hispanic patients he encounters do not understand that his job is to take care of them.

"It's a very young profession, so people don't always understand who you are when you come to the door," he said. "I tell them that I am the bridge between the doctor and their house."

County officials are working to try to improve their recruitment of minorities, said Lawrence Tan, chief of New Castle County's Emergency Medical Services, one of the five minorities on the staff.

"The division absolutely has a goal that we would like to reflect the demographic of the community we serve, but anybody that we are bringing into the service must be able to take care of the patients," Tan said.

All three counties accept paramedics who complete a two-year program at Delaware Technical & Community College, and also hire paramedics who are nationally certified.

The rigorous Delaware Tech program begins with allied health classes and labs such as anatomy and physiology, and includes clinical rotations in different departments of a hospital. The final phase is a field internship responding to real emergencies. There is an entrance exam to the program.

There were no minorities in May's graduating class, but New Castle County has three minority paramedics in next year's class, and two in the class after that.

To improve the demographics, New Castle County has begun a campaign to recruit paramedics of color. Coons last year assembled the Emergency Services Corps, a group of about a dozen volunteers. One of their responsibilities is to visit high schools, civic groups and other community organizations to recruit.

By May, they had been able to get 600 people to fill out cards expressing interest in volunteer fire and emergency medical service, but county officials don't know how many will follow up.

"The positive summary is that they are engaging in outreach to a far wider place," Coons said. "This is a focused, sustained effort that we intend to continue for several years. It's the only way I can see that we are going to save volunteer fire service and promote recruitment for paramedics, and so far the results are good."

Street said he's never seen the volunteers recruit at the Hilltop Lutheran Neighborhood Center in Wilmington, where he is executive director. The center serves a large minority clientele.

"The recruitment is superfluous at best," Street said. "It's one of the last good-old-boy networks that I'm determined to break. It's been exclusive for an extended and long period of time, and there's no excuse for it."

Colin Faulkner, director of public safety for Kent County, said he never stops advertising for paramedics in newspapers, online and at schools across the country that offer paramedicine programs. The county has no outreach program targeted to minorities.

In Sussex County, Luedtke is discouraged by minority outreach efforts.

"When we recruit from out of state, from Pennsylvania, Virginia and Washington, D.C., you stand in front of these groups and all you see is a sea of white faces," he said. "We all have the same problem. We can't seem to find an answer. For whatever reason, we are not an attractive profession."

A 'dirty' job

Paramedics said the field also suffers from a high burnout rate and limited earning potential. The average starting pay in Delaware is $35,000, with top pay nearing $60,000.

"EMS is an extraordinarily dirty job, and I mean that literally," Lord said. "If you work in any urban or suburban system, not a day goes by that you don't get splattered with somebody's blood, you don't get vomited on or have to fight with a patient. You do as much work as the cops do or a paid firefighter for a lot less money."

And it's a dangerous job, Faulkner said.

"It's a good job to have, an excellent, professional job. I have people who work here who have bachelor's and master's degrees," Faulkner said. "But it's not an easy job. You see people at their very best, and you see people at their very worst."

Public safety officials note a general decline in interest in the fields of firefighting, policing and paramedicine because potential job applicants don't see themselves doing the work for the long haul.

Others, especially would-be paramedics, never make it through the testing and training.

Tan says Vasquez is an example of a paramedic with promise, regardless of his ethnicity.

Vasquez holds a degree in international business, but he left a job as a senior credit analyst to become a police officer because he wanted to connect with people in need. But Vasquez, who has permanent residency status, was disqualified from the police academy because he was not a U.S. citizen. That disqualification led him to the paramedic program at Delaware Tech.

It's a choice he said he doesn't regret.

"Sometimes patients think they are abusing me, but I tell them no. I love to do this," he said. "This is way better than I thought it would be. The challenge is great. There's so much to do."

Contact Angie Basiouny at 324-2796 or abasiouny@delawareonline.com.