Duncan McConnell MBA(Exec), MCOM, GradCertAmbMgt, DipHlthSc(Amb) DipInfoTech, FIML, AFCHSM, CHM, MAP
Foundational Paramedicine Program Director / Senior Lecturer
Clinical Director Mongolian Emergency Services and Disaster Management Program
Academic Lead Maldivian Paramedic Education Program
School of Medicine – Griffith University
Advanced Care Paramedic II Extended Scope of Practice (ESoP) LARU
Queensland Ambulance Service
Griffith Health Centre (G40) 5.14
Gold Coast Campus, QLD, 4222
Telephone: 07 5678 0886
Email: duncan.mcconnell@griffith.edu.au

Community Paramedicine in Developing Countries

Prehospital care in developing countries is often viewed upon as limited or scarce at best. The primary advice given to anyone who travels to a developing country is ensure you have good travel insurance and try not to hurt yourself.
But what if we could take lessons learned from years of prehospital care development in developed countries and work with the Ministries of Health within developing countries to establish a sustainable and internationally recognised prehospital delivery model based on the needs of their health care system?

Duncan is currently engaged in this development with the Ministry of Health in Mongolia, which is supported by the World Health Organisation (WHO) and with the Ministry of Health the Republic of the Maldives. Two very different countries, but both with very similar challenges and priorities. The use of community paramedicine within Maldives new National Ambulance Service (NAS), provides a holistic use of the response matrix, that will enable them to bridge the gap of acute and non-acute services, as well as relieve current strains on the already struggling Atoll Health Services.

The use of community paramedicine within Mongolia presents a very different challenge to that of the Maldives. The ambulance response here is physician run, however this is becoming unsustainable due to training and higher paying opportunities within the medical profession. The focus here is on the transition over to a more sustainable and staffed ambulance module, standardisation across education, governance and training, and enabling a smooth transition of community paramedicine based on the current physician response already in place.
But how do we staff a community paramedic within a developing country? With both countries presenting different paramedic staffing models that range from ground up paramedic development to nursing and physician responses, development of a suite of postgraduate education programs which can be delivered via blended learning approach, so far has appeared to be a viable and sustainable ongoing solution for this level of community paramedic.

Generalised paramedic development training has been designed to start from Ambulance Drivers, right the way up to Paramedic, Community Paramedic and Critical Care / Flight Paramedic, with each of these levels complementing the training and development from the previous one. A complete suite of “paramedic development pathway programs”. Although these developments are very new in their application and implementation, applying the needs required for each specific developing country’s health system, has already started to provide improvements in patient care delivery and outcomes across both countries.