Think Globally and Act Locally in '10

By Jim Sideras

In the realm of EMS, one of the largest global issues in the past few months has revolved around the H1N1 virus and how to immunize mass groups of people. It has taken on increased importance with a shortage of the vaccine. According to the CDC, H1N1 in the United States has caused 10,000 deaths, hospitalized more than 212,000 people, and sickened more 50 million people by mid-November. A full sixth of the U.S. population has been ill due to the disease, and another wave of the virus is expected in early February.

On the local level, communities mobilized resources to vaccinate thousands against the disease. This often required having dozens of staff members to immunize people, and many cities have ongoing immunization centers. Some communities have sought out fire/EMS departments to take part in this immunization process. Their expertise in large scale operations, use of the National Incident Management System (NIMS), and leadership make them a natural fit to organize any event.

This involvement raises the level of credibility of our service and gives us the opportunity to showcase the many unique abilities we possess. However, some organizations have taken the stance that H1N1 immunizations are "not an EMS or fire-related issue." Those with this attitude fail to understand the concept of "thinking globally and acting locally."

They truly miss the point and the mission of their organization and the valuable leadership they can provide. H1N1 is very likely a precursor to the next pandemic. Those who failed to learn from the SARS epidemic and now H1N1 will likely not be prepared to help their communities for the next one. That next outbreak could be even worse. Leadership, experience and training are always in short supply during any crisis. We need to step up and assume those roles in our communities, or face being relegated to the sidelines while others lead the way.

"Think globally and act locally" needs to be part of the thought process of every leader. The new mindset of fire/EMS leaders needs to be that every person saved with our help is the justification for our existence and not a title for glory.

"Think globally and act locally" has been a buzz phrase for years — and it holds particular relevance to both firefighting and EMS operations of today.
From a fire service perspective, we can break things down further, to the two perspectives of national and local. From a national perspective, almost half of the LODDs in the United States are caused by cardiovascular incidents every year and 2009 has continued the trend.

Imagine if half of the deployed combat soldiers were dying from cardiac arrests. There would be public outcry at the poor physical condition of our soldiers. If the military generals were suffering heart attacks while leading soldiers, the media would be full of stories about the lack of stamina in our military. Yet, firefighters dying from cardiac arrests is almost deemed acceptable.

Firefighters and Chief Officers are just like soldiers entering combat. Both face high stress and physically demanding situations. They must be prepared mentally and physically for the challenge. We also cannot use the excuse that many of the cardiac arrests in the fire service involve volunteers. As with the military analogy, a large percentage of deployed combat soldiers are not career soldiers but rather from the National Guard. All soldiers, both regular and guard, enlisted and generals, meet the same physical and medical standards.

The solution? Chiefs must act locally to ensure their "soldiers," both career and volunteers, are physically ready to survive the challenges of firefighting. We know the bigger picture of the national statistics. But to address the problem, work must begin at the local level, with your department. Failure to do so will result in continued unnecessary line-of-duty deaths.