CUAJINIQUIL, Costa Rica - In a place where bicycle-powered transportation is the norm and a hammock sways in the soft breeze at every home, the “Pura Vida” relaxed lifestyle permeates all aspects of life; except when it comes to the immediate need for emergency medical care.
Three New Mexico Army National Guard medics spent three days sharing emergency medical response tactics, techniques and best practices with 34 Costa Rican first responders from four agencies at the Murcielago Fuerza Policia training site here. Fuerza Publica (Police Officers), Fronteras (Border Patrol Officers), Servicio Vigilancia de Aerea (Air Surveillance) and Guardacostas (Coast Guardsmen), attended the Subject Matter Expert Exchange (SMEE) of information which included some classroom instruction but saw the majority of time spent conducting hands-on practical exercises.
Since 2006, the New Mexico National Guard and Costa Rica have enjoyed the opportunity to share information about a variety of topics as part of the U.S. Southern Command’s State Partnership Program. The program partners states and nations in order to provide a comprehensive platform for exchanging ideas and information specific to the nations’ needs. Costa Rica does not have a military, but it does have multiple law enforcement agencies that are often the first responders to the scene of an accident or a natural disaster.
The SMEE conducted Sept. 1-3, 2015, focused on medical first aid response by the law enforcement officials in the case of misfortunes such as vehicle accidents, but specifically on responding to natural disasters like earthquakes. According to the synopsis for the SMEE, Costa Rica requested the subject matter experts in first aid in order to improve the skills of their law enforcement personnel throughout the country. The focus is to provide hands-on information to the police, border patrol and coast guard in order for them to be able to provide medical assistance to the public or provide first aid to their colleagues while countering illicit drug trafficking or any other potential injury-producing activities.
Sgt. 1st Class David Muniz, the noncommissioned officer in charge of the SMEE and medical NCOIC of the 515th Regiment (Regional Training Institute), created a schedule of events designed to share as much immediate first response information as possible in the short amount of time. He began with identifying the anatomy of the human body with the help of 3D images on slides written in Spanish, the primary language in Costa Rica. Staff Sgt. Heriberto Magallanes, a medical readiness noncommissioned officer with the New Mexico National Guard’s Medical Detachment, assisted with all aspects of sharing the medical knowledge as well as the invaluable resource of being the translator between the two languages.
“I find it great to get to interact with another nation and to share first aid and (combat lifesaver skills) which some of them just don’t have,” said Magallanes. “It’s pretty challenging because some of the Spanish we use in New Mexico is different in Costa Rica. Medical terms are different and a bit more challenging simply because of the topic.”
Even though the regional dialects differed slightly, the Costa Rican participants were constantly engaged and absorbing all the information presented to them. Coast Guardsman Randy Moya Palacios said through an interpreter, “The course went great. The instructors were well-prepared. It was a great time working with the other agencies which a lot of times we don’t get to do.”
Moya Palacios went on to say that the most valuable information he garnered from the course was how to use the clothes and supplies available as the medical kits may not be close enough when they are needed. He said, “When supplies are not available, I use what is there.” Moya Palacios said the instructors helped give him some more ideas of what to use in situations where improvisation may be necessary.
Moya Palacios and his fellow classmates were given ample time to experiment with the limited supplies the New Mexico Guardsmen brought with them and were presented with multiple methods for using what they have on hand. For example, Sgt. 1st Class Greg Holmes also of the Medical Detachment, and one of the fellow medics sharing his decades of expertise, showed the first responders how to use the button hole on their uniform coat’s sleeve to attach to the uppermost button on the column in order to improvise a sling when no other cloth may be available.
Holmes also demonstrated the proper way to stabilize the head and neck of an injured patient while another responder turns the patient onto their back in order to assess injuries or to move to a more comfortable position while awaiting further medical care. Under the watchful eyes of Holmes, Muniz and Magallenes, the Guardacostas, Fuerzas Publicas and the officers working for Fronteras practiced the skills over and over again before being given four mass casualty scenarios to wade through.
Dara Chavarria Hernandez, Servicio Nacional de Guardacostas, has served for more than seven years and has attended numerous first aid programs of instruction. She said, through an interpreter, that they all have some basic knowledge of rescue, first aid and CPR but this course helped them in the case of larger emergencies. “In the event of a natural disaster, we’ll be the first ones called to help the country regardless if it’s Coast Guard specific,” Chavarria Hernandez said. “It’s very important to continue the next level of this course in emergency medicine.”
The Costa Rican first responders spent the three days learning how to assess victim’s injuries, basic first aid, medical evacuation, and various methods for providing immediate medical care. The culminating event was a simulated earthquake disaster with dozens of casualties displaying a gamut of injuries. This crafted event was held in the classroom with desks thrown askew pinning civilians, live exposed electrical wires hanging from the ceiling, frantic casualties calling for help but fighting it off as soon as first responders reached them. The scene was chaotic and loud and tumultuous with the New Mexico medics tossing simulated pieces of collapsing building at the rescuers while forcing them to run a maze of overturned debris to the single exit before a countdown to total destruction upped the fatality count.
On hand to witness the law enforcement officials from the three services respond calmly while under immense pressure were the Ministry of Public Security - Murcielago Academy Sub-director, Ronald Meza; U.S. Embassy Costa Rica - Deputy Chief of Mission, Robin Matthewman; U.S. Embassy Costa Rica - Office of Defense Representative, U.S. Coast Guard Cmdr. Brady C. Downs; Costa Rica Coast Guard, Puerto Mora Station - Comandante Lady Martinez; and Costa Rica Air Surveillance Director - Coronel Oldemar Medal Madrigal.
Following the mass casualty exercises and a thorough discussion on the course, the 34 law enforcement professionals conducted a graduation ceremony on the beach of the Murcielago training site. Remarks made during the ceremony by the officials echoed what the participants annotated as positive aspects of the exchange. They said that those serving in this capacity are the first line of response to injured citizens and gaining additional knowledge on how to properly and expeditiously assess and treat patients is a service to them.
As with most courses of instruction, the New Mexico National Guard medics have much more knowledge to share than the time allotted. Future exchanges hope to focus on jungle first aid and additional methods for buddy care. This is in line with what Fronteras officer Victor Zamora Cruz wants to see in the next course. Through an interpreter, he said he wants to work more with emergency-style triage, casting and splinting limbs, responding to snake bites and lacerations due to the jungle environment they patrol by foot daily.
Muniz summed up the course saying it was an overall success. “This particular course was good because the majority are the Border Patrol who are out in the middle of nowhere by themselves,” he said. “They are motivated. I really felt like they are taking as much of it in as possible because they know they actually need it.”
The rich legacy of New Mexico National Guard and Costa Rica’s State Partnership Program allows for pinpointing the areas of greatest need for the sharing of tactics and techniques. As they remain partner nations and work together, this bond will grow and continue to serve both entities.