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Alternatives to E Mergency M Edical S Ervices ALTERNATIVES TO E MERGENCY M EDICAL S ERVICES the rosehip medic collective Alternatives to EMS Rosehip Medic Collective May 2011 version1.0 Table of Contents Introductions About Us 2 Why “Alternatives to EMS”? 4 A Brief History of EMS 5 Acknowledgments Tried and Existing Alternatives EGYHOP 15 Special thanks to the Institute for Anarchist Street Medics 17 Studies for their recognition, grant funding and Common Ground Health Clinic 19 continued support. We’d like to thank the Mutual CAHOOTS 20 Aid Street Medics for organizing the Street Medic Individuals/Unaffi liated Networks 21 Conference, which was an incredible opportunity Hatz alah and Faith-based EMS 22 for learning and networking. We’d also like the thank everyone who interviewed with and guided Our Thoughts us, Whitebird/CAHOOTS for taking us on an amaz- ing tour, and the many people who helped us edit this document. EMS Safety and Police 24 Horizontal Infrastructure/Tiered System 34 Patient Oriented Care 38 Additionally, we’d like to thank the members of the Black Cross Health Collective who have acted Conclusions as mentors to The Rosehips since our wide-eyed beginnings. Visions for the Future 44 Further Reading 48 Introductions - cartoons by Steve Berry EMT-P 1 About The Rosehips About the Authors The Rosehip Medic Collective is a group of volunteer While organized by Rosehip as a whole, this Street Medics and health care activists in and around document is the work of four authors, and we feel it’s Portland, Oregon. We provide fi rst aid and emergency important to locate ourselves in the landscape of privilege care at protests, direct actions, and other sites of and oppression. Between the four of us, all are white, resistance and struggle. We also train other Street Medics some of us are hella queer and trans, and all of us identify and put on community wellness trainings. We believe strongly with anti-authoritarian traditions. We come in democratizing health care knowledge and skills, in from varying academic and class backgrounds, and the reducing our community’s dependence on corporate ways we collected and organized infortmation for this medicine, and that strong networks of support and zine are heavily infl uenced by our training in history, care are essential to building a sustainable, long-term antrhopology, feminist studies, and medical care. movement for collective liberatioWn. We are working to Much of our theory relies on the fi rst-hand create one facet of the healthy and diverse infrastructure experiences of ourselves and our peers, including many we see as necessary if we are to build another world. interviews from within local and North American Street Our group includes EMTs, Wilderness First Responders, Medic social networks. Content from these interviews herbalists, and more. are presented throughout the zine and more background In summer of 2009, members of our collective att ended is given for these sources in the “Tried and Existing a discussion facilitated by Rose City Copwatch (also of Alternatives” section. Portland) about their “Alternatives to Police” zine. While Our research focuses on the EMS traditions with reading and discussing their project, we refl ected on our which we ourselves are most familiar: EMS as it has work as Street Medics and care providers, and on how developed in the United States. What we are critiquing here we interact with police and Emergency Medical Services is a system intricately tied to the state and industrialized (EMS) during emergencies. This led to discussions of medicine. There are many other kinds of care, and it is alternatives to state and corporate EMS, critical analyses not within the scope of this project to explore them all. of our experiences, and att empts to understand our roles What we can do is off er our critique, ideas and hope, and in community well-being. Inspired by the “Alternatives make space for collective dreaming about what liberatory to Police” zine, we embarked on this project. models do and what liberatory models can exist. After beginning our research, we became aware of and applied for funding from the Institute for Anarchist Studies, hoping for help with this large undertaking. The $500 grant we won has allowed us to travel for interviews around the Northwest and to Ohio, for the Mutual Aid Street Medics-sponsored Street Medic Conference (Summer 2010). The grant also allowed us to dream big in terms of printing and distribution. 2 3 Why “Alternatives to EMS”? A Brief History of EMS As communities in Portland and elsewhere deal with Emergency Medical Services are systems intended the ongoing realities of police violence, discussions and to provide prehospital care and transport for injured and projects have emerged to work towards accountable, non- ill patients. While many traditions of healing exist and oppressive, and community-driven alternatives to police deal with the incidence of traumatic injury and illness, forces. This work has connections with progressive, we have focused here on those which produced EMS transformative and revolutionary social justice projects systems in the United States, most of Europe, and other such as those for prison abolition and support for areas aff ected by US and European imperialism. While houseless communities. As we see it, this fl urry of activity the need for such systems today may seem obvious, less around policing is one of many interconnected struggles than 50 years ago prehospital medicine in the United and aspirations. So while we dream of and start to build States was almost exclusively the domain of soldiers and alternatives to institutions like the police, we cannot stop undertakers (and hearses the convenient predecessors there. to today’s ambulances). Examining the rapid rise of As EMTs, fi rst responders, street medics, and other contemporary EMS in the United States and much of the care providers, we believe that eff orts to create radical global North is useful in explaining both its functions alternatives need to also include emergency medicine and place within institutions of medicine and emergency and wellness care. If we are serious about seeking ways response (police, fi re, disaster management). to reform or abolish institutions for law enforcement and The role of batt lefi eld medic is one of the earliest and incarceration, we must also critically address the broader longest documented roots of this kind of care, with several realm of state- and corporate administered health and independent lineages from before the European middle safety. At the intersection of healthcare and emergency ages up through today. In Europe, Napoleon Bonaparte’s management, Emergency Medical Services (EMS) are chief surgeon designed a “fl ying ambulance” (carriage) frequently left treating those least served by other medical system of medics that would treat and then gather up institutions—while further enforcing gender, race, class, injured soldiers. Similar principles were implemented for political, and physical/mental ability categories on people cholera epidemics in Great Britain and eventually spread experiencing emergencies and chronic illness. throughout Europe and to the United States. Several late This zine will examine the history of modern EMS, 19th century physicians, disturbed by the lack of care on examine some of its strengths and weaknesses, and increasingly bloody batt lefi elds, advocated for protection discuss actual and possible alternatives that might bett er of captured and wounded soldiers, non-combatants, meet communities’ needs. Ultimately, we hope to broaden and medical providers. These eff orts led to the Geneva discussions of community alternatives to systems of Convention and the International Red Cross and Red domination to include health, wellness, and safety and to Crescent Society. provide a starting place for developing real communities Radicals in pre-revolutionary Russia also recognized of care. the need for support infrastructure, with vast numbers of political dissidents imprisoned by the tsarist government. 4 5 In the early 1900s the social-democrat infl uenced Political along distinct paths according to circumstance and need. Red Cross and the Anarchist Red Cross (later “Anarchist In some urban centers, a handful of fi re departments and Black Cross,” to avoid confusion) formed to provide food urgent care hospitals began trial “paramedic” programs, and medical care to political prisoners and revolutionaries.1 which went beyond basic care and transport to include After the Bolshevik Revolution, the Anarchist Black Cross administration of medications and specialized care for spread across Europe and the United States, largely due severe injury and illness. to heavy repression and forced emigration of anarchists Meanwhile, amid the Cold War’s entrenched confl icts from the Soviet Union. Although ABC (and the prisoners in Korea and Vietnam, resources and training allocated they supported) eventually vanished from the USSR, to U.S. military medics continued to increase, with chapters in Spain, Italy, the United States, and Germany more advanced protocols and equipment coming into continued supporting (and sometimes evacuating) wider use, including tiered medical response, advanced radicals. techniques (eg. intravenous therapy and minor surgery), Through the course of the World Wars, increasingly and helicopter ambulances. So successful were these brutal weapons demanded greater sophistication improvements (and so poor their domestic analogs) that in equipment and training, including integration of in 1966, the National
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