Problems we have to deal with in the scene of an accident

It is not easy to be a first aider in our country. The law does not protect us, as for example if there is case like you have to move a person from a car on fire (emergency rescue) the victim might sue you later because of permanent paralysis, in such cases we are not protected.

Additionally, the infrastructures that should help us are almost non-existent or inadequate: there are hardly any emergency call centers and very few ambulances. Therefore, there is a lack of people between the first responders and the health facilities that can receive the victims. This increases the pressure on first responders tremendously, but it is the reality in our country. Many more efforts should be made to optimize these structures in the future.

What is particularly challenging is that there are always people at the scene of an accident who are watching and not helping. For the first responders, such bystanders are an additional stressor. As you can see in Figure 1, they are either inactive or increase the pressure on the rescuers by shouting various things.  “Hey, sir, that’s not the way to do it,” “Hey, do you want him to die? Wait for the authorities,” “You’re wasting time. You should take him to the hospital right now”…. Certain people even become aggressive, especially when the victim succumbs to his injuries.

As first aid instructors it is our main task to raise awareness of our country-fellows on the attitude of helping and to explain what should be done and how to act in case of emergency.

Picture 1 : Accident happened in 2022, in the most accident prone road in Madagascar (NR 2). You can see how many persons take action or stand by. Source: facebook.

Some tips to be prepared

In our training courses, we talk and exchange a lot with our trainee first aiders. We spend a lot of time for the first part of the training. This is very important, as we explain why they should help in emergencies. They must understand that as it is the base for becoming a first responder. We make them aware of the importance of first aid action as every life is precious and can be saved through simple measures. We inform them of possible situations they may find themselves in. It is not to discourage them but to prepare them for real cases. We teach them how to deal with difficult emergency situation.

How do I act in an emergency?

The teaching techniques and methods we use are varied. At some point in the training, sometimes in the middle, learners are confronted with an almost real emergency situation. This is a staged game kind of a role play which has been secretly planned with one or a few participants.

Indeed, without knowing that it was a game, normally around one third of our trainees starts to help. Though – like it might happen in real life – some were the bad grumbling bystanders. Others were also passive, being engulfed by stress. Within this part in our training, we emphasize the importance of action and the problems with inaction. At the end of the role play, we discuss about what happened, what role each of them played and why. It helps our participants to reflect and learn from their own behavior in an emergency situation. (picture 2).

Something else, I was really surprised about all the young trendy and connected people from big cities that we trained. They all had great phones, but none of them knew how to add their emergency contacts, nor complete their medical information. Accidents do not warn. Here, in one way, we insist on anticipation, we ask them to set their phone up as a homework: if something happens to me, how will my loved ones know? In another way, we teach what to look for in the phone of the victims.

As a first aid instructor in a developing country, we adapt our training to the real situations of our community (culture, lifestyle, habits…). We teach how to face to different situations, we discuss about what to do and what not, we raise awareness, but above all we encourage our young people to take action.

Again: Accident don’t give warnings. Be prepared – always!


Picture 2 : Photo taken after learners understood that they were in a role play.