Kelly R. Yamamoto Fuentes is a Honolulu paramedic.

By Kelly R. Yamamoto Fuentes

The state of Hawai'i has a long history of providing excellent pre-hospital medical care. We are looked upon as leaders in emergency medical services and currently provide a wide spectrum of advanced emergency procedures and are literally the extension of the emergency-room physician.

During this last legislative session, we worked diligently on a bill — now before Gov. Lingle — that would allow paramedics the opportunity to retire after 25 years of service. Of the four first-responding agencies — HPD, HFD, Ocean Safety and EMS — we are the only frontline personnel who do not receive this retirement option.

The Employee Retirement System provides this benefit to those whose jobs have proven to be "high risk." We have inundated the Legislature with testimonies from our peers, our administration, our union, colleagues in the medical field and other first-responding agencies. They have shared personal experiences and observations to prove that EMS workers put their lives on the line every time they go out to save one.

The public has been led to believe (thanks to bad journalism and lack of appropriate PR) that EMS simply transports patients to the hospital after all the dangerous work has been done. This is hardly the case. EMTs are frontline first-responders who are at risk for physical injury, exposure to hazardous materials and infectious disease like HIV, SARS, TB, hepatitis, meningitis, etc.

Furthermore, in a world constantly on alert for terrorist attacks, EMS has prepared a strike team and mobile laboratory and has trained all of its personnel to deal with biological, chemical and nuclear weapons of mass destruction. Although WMDs are of great concern and have truly changed the flavor of EMS, it is really the everyday challenges that put EMS in the high-risk category. The epidemic use of ice alone has increased our exposure to shootings, stabbings, physical violence, increased traffic collisions and outright threat to our lives.

We do not have the advantage of pulling emergency service resources from neighboring states, as did New York in 9-11. Should our airports and harbors be deemed inaccessible, the present EMS system will be tasked with managing the community needs alone.

Emergency medical service is an arduous line of work. It's fast-paced, emotionally charged, and physically and intellectually demanding.

Because of the realities of life, many paramedics are opting to move on to more lucrative positions, opportunities that provide more livable salaries, benefits, working conditions and career opportunities. The attrition rate within the organization is high. We have lost about 80 medics in the past 4 1/2 years (total of fewer than 200 personnel). At the same time, we find it is becoming more and more difficult to attract young, bright individuals because of some of the same reasons that people leave. This retirement option is one small way to retain our experienced medics and hopefully aid in attracting potential ones.

Furthermore, it gives paramedics a graceful means to "hang up the stethoscope" when the wears of the profession become too difficult. Unlike the police and fire departments, military and other organizations, paramedics in Hawai'i do not have a career ladder to retreat to when the rigors of the field and the realities of aging keep us from doing our best.

We hope this measure will initiate the repairing and rebuilding of the infrastructure of EMS. The needs of our community are growing rapidly, but the workforce and resources for EMS have not.