To save a superhero

Traumatising: First responders to accident scenes often go without counselling
Traumatising: First responders to accident scenes often go without counselling

Have you ever stopped to think about the emotional trauma paramedics and fire-fighters suffer with each incident they attend to? To most, these people are superheroes who boldly and fearlessly walk into alarming situations. From personal experience, Mmegi Staff Writer, MOMPATI TLHANKANE finds that even the superheroes need help

Recently, my colleague and I were travelling from Molepolole to Gaborone where we had just covered a beMOBILE Premiership game in which Mochudi Centre Chiefs were crowned champions.

After crossing the Mmanoko Bridge, we stopped to pick up a hitchhiker.  The hiker was a woman and with the sun setting, we felt she would be vulnerable to criminals. A few cars passed as she quickly hurried across to our car.  

We rejoined the road after she was safely inside the car, but no more than 30 seconds later, we heard the jarring sound of screeching car tyres.


Moving quickly past three cars, we arrived at the scene of a horrific accident. The scene was fresh and we were among the first on site.

A pungent smell of smoke and oil hung in the air as we approached the scene where it appeared two vehicles had been involved in a head-on collision.

 A man was desperately struggling to get out through a car window and was crying in agony. We immediately attended to  him to help him out of the wreckage.  We then placed him on the ground.

Our attention shifted to the other victims whom we were eager to reach, in case the engine caught fire.

The man we had already rescued was in his early 20s and he was bleeding from the nose and eyes. His legs appeared broken as they were facing backwards and he was slowly losing consciousness.

We moved onto the next person who was the driver.  He was stuck in the car and we could not extricate him from his side as the door had caved in. As he cried out in pain, we used the passenger door to pull him out. 

As more people arrived on the scene, I decided to go back to the man we had first responded to.  He was still lying there helplessly on the ground.  He was now bleeding from the ears and mouth.

His eyes were not blinking and he could not move a muscle, but he was still breathing.  I could not stand the sight anymore and I went back to our own vehicle, as people began gathering around the scene like a swarm of bees on a honeycomb.

My colleague had his camera and he began snapping away, before we headed back.

On the way, I kept looking around like a young gazelle that had just lost its mother to the lions of the wilderness.

Within the roots of my unsettled mind was that little fear suggesting that the same thing might happen to us on the way to Gaborone.

I prayed silently that we would arrive safely. Emotions gathered and I found myself gasping for oxygen. I could sense that my colleague was traumatised as well as he was now driving more cautiously than ever before.

I needed something to erase the images I had just seen at the wreckage. I could not handle them.

Recent research has shown that common occurrences like car accidents and natural disasters can trigger emotional trauma.  A stressful event or situation creates psychological trauma when it overwhelms the individual’s ability to cope, and leaves that person fearing death.

A research analysis of peer-reviewed literature from 1990 to 2010 revealed the effectiveness of Psychological First Aid (PFA) as a disaster intervention tool.

According to the analysis, the term PFA first appeared in the military during World War II as a debriefing tool.

“PFA has become a critical dimension of response to the needs of those who are acutely stressed due to a disaster or emergency situation,” the analysis reads. “PFA is a vital first step in ensuring basic care, comfort, and support. Moreover, PFA is being taught in every chapter of the Red Cross in the United States, where at least 50 percent of volunteers have received this training.” PFA, however, does not appear to be offered locally.

Botswana Red Cross Society first aid instructor, Pilot Khohliwe said the organisation does not provide psychological aid for its paramedics. 

“If they develop a problem that is when we find a way to deal with it,” he said.

He said field workers in the disaster management team are the ones who witness traumatising scenes.

“They are the first responders so they are bound to be affected,” he said.  Khohliwe said the traumatising incidents could eat away at paramedics for the rest of their lives, if they are not attended to.

“As a first aid instructor and paramedic, we always attend to accidents and natural disasters so we need that psychological first aid,” he said.

“Paramedics often get traumatised after attending to the victims of severe accidents and most of them do not open up about these experiences.”

Former American Red Cross volunteer, Dr Didi Biorn, who was part of the first responders to the September 11 terror attacks in America, said emergency responders have realised that in times of disasters they also have to cater for the psychological effects.

“During the September 11 attacks people were concerned about what was going to happen.  People asked whether this was a once-off attack and this created so much uncertainty followed by stress,” she said.  “What we did as the American Red Cross was to provide psychological first aid and ensure that people realised that whatever they were experiencing was a normal reaction. Biorn said even though she was not at Ground Zero – the actual site of the demolished Twin Towers - she realised that fire-fighters were traumatised by what they had seen. Most of them, she said, did not want to open up.  A clinical psychologist by profession, Biorn runs an organisation called Afro Botho, which provides a service called ‘Heal the healer’ aimed at first responders. According to the psychologist, in times of disaster, it is expected that people will be afraid and unsettled.

“In times of disasters, these are normal reactions to an abnormal situation. Our biggest role is to normalise people’s reactions so that they can be at ease,” she said.  “We do not provide psych aid for the victims only but also for the first responders.

“Fire-fighters, paramedics and the police are the ones who attend to accidents, but this becomes a problem when someone dies in their hands.”

According to Biorn, people who do not receive help may end up developing post-traumatic-stress-disorder.  “These traumatic incidents make people become hyper vigilant. Paramedics for example are people who work under extreme situations, but saving lives is what drives them.

However, when they fail to save lives it affects them to the extent that it haunts them,” she said.

Through Afro Botho, Biorn intends to revive what she learnt in America. “I am currently training social workers so that we can send them to help whenever a life-threatening situation arises.”

For his part, Emergency Assist 991 operations manager, Adiel Jacobs said they provide psychological first aid in excruciating circumstances like tragic accidents.

“If they have attended to a traumatising accident, we provide a debriefing afterwards,” he said.

“During the debriefing we get together to discuss what we saw and everyone gets to talk.

“We ask them to share their experiences and also ask whether they need counselling. We do not force our paramedics to undergo counselling. They have the right to choose and all we can do is to encourage them.” Jacobs said the doctors give paramedics time off if they have been diagnosed with PTSD.  “For those who are not ready, we tell them that counselling is always available when they need it. That is standard procedure.”

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