HGH EMS Rescue says Burning Man ‘lessons’ will be invaluable moving forward

Counter cultural festival has chosen a new medical provider for the event that becomes the state’s 4th largest city for a week every August


WINNEMUCCA, Nev. — “We wouldn’t trade our experience with Burning Man for anything.”

That was HGH EMS Rescue Chief Pat Songer’s statement last week after his agency was notified that their four-year contract providing medical care at the annual counter-culture festival has been terminated.

Songer said it’s those “lessons learned” that will stay with the agency long after memories of the dust, dehydration—and even death—fade away.

Humboldt General Hospital began providing medical care at Burning Man in 2011 in its Rampart medical facility (image courtesy HGH EMS).
Humboldt General Hospital began providing medical care at Burning Man in 2011 in its Rampart medical facility (image courtesy HGH EMS).

The art festival in Nevada's Black Rock Desert gathers 70,000 people each Labor Day weekend, making the makeshift city Nevada’s fourth largest for one week.

“It was a challenge providing medical to over 450 community members each day,” said Songer, “but it was an exhilarating challenge and one that we are immensely grateful for.”

Humboldt General Hospital began providing medical care at Burning Man in 2011. Each year, Songer said his agency tweaked their contractual relationship with their host to compensate for increased numbers of participants and the associated risks of hosting one of the country’s largest mass gatherings in one of the world’s most remote and austere locations.

This year didn’t seem different except Songer said some safety concerns identified by his staff in 2014 needed clarification, so in February, the agency exercised their 180-day right to cancel their contract.

That happened in a meeting with Burning Man officials and the entire group agreed to move forward, intent on renegotiating a new contract that, among other things, would allow for at least one more EMS agency to provide backup in case festival numbers surged again, like they did in 2012.

“We just wanted to continue that same level of preparedness,” said Songer. “After all, this is a large-scale event with the potential for an MCI in the middle of nowhere. I think some people forget the potential for disaster there.”

Still, the two parties tended to disagree on Humboldt General Hospital’s role: was the agency simply an event contractor or were they a public safety agency with all the associated risks and responsibilities?

Last week, when Burning Man officials announced they were negotiating a contract with CrowdRX, a large-scale event contractor, Songer said he got his answer.

“I think that was really the crux of our concerns,” he said. “When we came to this event, we saw it as an extension of our hospital. We were going to provide hospital-level care, even if it was in the middle of one of the world’s most remote locations.”

He continued, “We weren’t there as an event contractor, we were there as a medical provider in the Black Rock Desert—a fully operational, gold star-staffed medical facility.”

Songer added, “I think as the event evolved and our expectations for safety continued to escalate, philosophically and operationally, we found ourselves on opposite sides of the coin.”

The agency was certainly planning to complete its initial five-year commitment, said Songer, and hoped to see that relationship continue beyond.

Apparently, so did many others, including officials from local, state and federal governments, hospitals and even law enforcement.

“There is safety concern out there,” Songer explained. “When Nevada is investing so much to hold an event of this magnitude here, you want there to be some long-term good that comes from that collaboration.”

In other words, explained Songer, “you don’t want an out-of-state event contractor to simply take the money and run.”

Songer said that concern focuses on the differences between a Nevada medical provider that becomes a long-term asset to the state as it grows its present and future medical network, versus an out-of-state contractor that operates on a temporary medical license for seven days and then leaves.

“Sure, you can issue that temporary license,” said Songer, “but what we’re hearing is worry about the long-term. When your hospital or your Nevada ambulance company provides those services, there is an investment there, an investment of time, experience, equipment, manpower and you come out more prepared—way more equipped for Nevada—than you went in.”

When you bring in a temporary contractor, that goes away. You’re not empowering a medical network across the state, you’re simply funding an out-of-state business. I think that’s the worry.”

With HGH out of the medical mix, and REMSA before that, Nevada’s medical network has definitely lost a one-of-a-kind training ground.

That being said, Songer said he is proud of what HGH EMS Rescue brought to the festival during his medical tenure including, according to Burning Man officials during early April, his agency’s ability to “shine a spotlight on safety.”

Other successes came with the agency’s partner relations, which Songer said were critical to his agency’s success at the event and in the future through the many mutual aid agreements forged during the festival.

Songer also expressed gratitude for the opportunity to learn the complexities of mass casualty incidents—not only the ins and outs of staging such a massive medical operation, but also in learning to “trust other agencies that you only know for one week each year.”

He praised the “once-in-a-lifetime chance” to assemble and work with a world-class medical team saying, “these weren’t contractors who go from event to event, these were medical practitioners at the top of their respective fields; they were there to practice medicine.”

Perhaps the agency’s greatest accomplishment on the Black Rock, however, was creating and adapting a system to the needs of the patients—fully in line with Humboldt General Hospital’s mission of “being helpful and caring for those in need.”

“These people wanted to stay on the playa,” he said of each year’s Burners. “They had invested a lot in terms of their time and money to get there and our job was to keep them there.”

Songer added, “It’s no different than what we do at our community hospital. We have invested millions and millions of dollars to allow people to get their care right here at home.

“When we went to the Black Rock, that model did not change, so we had to create a system that would allow patients to get the majority of their care ‘at home’ on the playa.”

Songer said there are those who will see the severed contract as a black mark for the rural EMS agency.

“We don’t,” he said.

“Burning Man did not define who we are; we defined the systems that made Burning Man’s medical an incredible model across the world,” he said.

Now, said Songer, HGH EMS Rescue will take that model and continue to adapt it to the other special events it oversees each year, including the increasingly popular music festival “Night in the Country” as well as the up-and-coming “Further Future” festival, 45 minutes outside of Las Vegas.

Of course, the model remains the core of HGH EMS Rescue’s delivery of pre-hospital care across 10,000 square miles, parts of two states and three counties.

“We had an excellent run with Burning Man,” said Songer, “and now all those resources, that knowledge and those experiences come home to our community.”

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