O'ahu may be without 24-hour emergency medical flight coverage come September, which is when the temporary agreement with the National Guard to provide helicopters is set to expire. Add to that our growing population on O'ahu. It's clear that the need for more ambulances has affected emergency response times.

These are prime examples why Hawai'i's emergency medical services are at a critical juncture. If not addressed, the health and public safety of our residents will be jeopardized; they may be already.

During my campaign for office, a group of supporters and I were canvassing a Mililani neighborhood when one of the volunteers ventured off on her own and was viciously mauled by a dog. During times like this, minutes seem like hours, but it took a distressing amount of time for the ambulance to arrive.

After the incident, I felt terrible that someone had put their life in danger while doing something on my behalf and I seriously considered pulling out of the race. But when I decided to continue my campaign, I made a pledge to do something about the issue of response time for emergency services.

The problem is straightforward. Emergency Medical Services, O'ahu's public ambulance service under the city administration, is underfunded. I realize that many government programs have had to operate without adequate funding, but the consequences for this program to be underfunded could truly be a matter of life or death.

Every year, EMS receives over 66,000 calls for emergencies and injuries, with over 40,000 of these patients needing transport to a hospital. There are only 18 "rigs" or ambulances to cover all of O'ahu. As our population grows, the number of calls will increase and the need for more ambulances should be apparent.

During the 2006 legislative session, I requested $1.2 million to increase ambulance service to better cover the Mililani and Waipi'o Gentry communities. This appropriation would have paid for one ambulance, 16 peak hours a day, 365 days a year. The request was strongly supported by the community and EMS, but the Department of Health opposed it. Ultimately, the funding was not approved.

The need grows every year. And I will reintroduce this request next session. If we don't give EMS more resources to better cover the island, we are going to see a dangerous deterioration in emergency response time. Paramedics are stretched to the limit. They receive more emergency calls than they can handle. Fortunately, EMS works closely and cooperatively with the Honolulu Fire Department, which is why you will often see HFD first on the scene until EMS arrives.

Last week, I did a ride-along with the Waipahu emergency medical services team. I had intended to observe for three hours, but ended up staying for six. What I saw not only fortified my position about the serious need for more ambulances, but it opened my eyes to the incredible job these paramedics perform under extremely stressful conditions.

Paramedics and emergency medical technicians are professionally trained to handle all types of emergencies, including traumas, but it is their level of concern for every patient that is inspiring. They attend to the injured as if they were treating and transporting a member of their own family. While doing their job, they witness the worst of what can happen to a person through accidents, injuries, disasters and crimes, yet they are required to balance the highest level of efficiency with the deepest level of human compassion. These people deserve our thanks and our support in helping them do their work.

Many people, fortunately, have never had to call an ambulance for themselves or a loved one. Once that happens, however, you come to appreciate how every minute counts and that the lack of funding for emergency services just doesn't seem to justify the loss of a life.

The fact that O'ahu residents are getting excellent care is due to the emergency personnel who work with speed. But even these heroes admit that they are stretched too thin. We must prepare for the day when a mass casualty incident will hit our island. Securing permanent medevac flight service and beefing up our ambulance fleet should be two of O'ahu's highest priorities.

Democrat Ryan Yamane represents House District 37 (Wai pi'o, Mililani). He wrote this commentary for The Advertiser.