JULIE KNIPE BROWN
Reprinted with Permission, Philadelphia Daily News
Each month, paramedic Dawn Garrow drives to the local dollar store, and pulls $5 to $10 from her wallet to buy bottles of disinfectant spray with bleach.
The disinfectant isn't for herself, but for you - the citizens of Philadelphia.
Garrow is assigned to Medic 13, the busiest and possibly bloodiest, paramedic unit in the city, handling 8,000 calls a year in some of the worst neighborhoods of North Philadelphia.
Call volume is so high and the pressure to respond at lightning speed so fierce, that medics say they often barrel from call to call with little time to sanitize their equipment or mop up the blood rolling around inside their rigs.
Dispatchers constantly press them to return to service, even if the squad has been exposed to a particularly bloody and possibly contaminated call. Those who take 30 minutes or more between calls have been threatened with reprimands.
"I love my job, and there isn't anything I'd rather do," said Garrow. "But the city doesn't care if you have blood all over everything, they want you back on the street."
So Garrow squirts as she goes - if she has the time, which she admits, she often doesn't.
Paramedics, like firefighters, say the truth is the city doesn't give them time to sanitize their equipment, their rigs or themselves - time that they say is necessary to protect the citizens they serve from also being exposed to blood-borne pathogens.
The International Association of Firefighters believes that Philadelphia is one of the worst cities in protecting its firefighters and medics from job-related illnesses, injuries and disease.
And, they say, it's probably one of the reasons that the city's firefighters and medics seem to have a high rate of hepatitis C, a potentially fatal disease that is transmitted through direct contact with blood.
"The issue with this epidemic that everyone seems to be missing is that the city has high numbers because they have failed to protect its firefighters and paramedics," said Rich Duffy, health and safety director of the Washington-based IAFF.
The Philadelphia Fire Department, including Fire Commissioner Harold Hairston, did not respond to requests by the Daily News for information about its infectious disease control efforts.
The city, until recently, didn't even have an infectious disease control officer, and the one assigned now is a human resource director who isn't trained for the job, said George Casey, president of the Philadelphia Fire Fighters Union, Local 22.
Even now, in the wake of the hepatitis C crisis, Casey said the education program the fire department has recently conducted is more an exercise in exonerating the city from fault than educating and training firefighters to protect themselves and the public from blood-borne pathogens and disease.
And even now, there's little support for those on the front lines who are exposed to blood, said Jim Lucy, president of the city's paramedic association.
"It's a very serious problem. The city has a double standard. They want us to take precautions, but they don't want to give us the time to do it. For us to go out of service to clean blood off ourselves or our ambulances is a very big deal. They ask us questions and it's like we're accused of doing something wrong when all you're doing is your job and trying to protect yourself, your family and the public, " he said.
Equipment is also a problem. The city gives paramedics a diaper wipe-like product for cleanup, but the product was abandoned long ago by cities like New York because it doesn't contain adequate disinfecting solvents.
"There are times we order things and we don't get them, Lucy said. "Last month it was oxygen masks. The city didn't have any, and our union had to get involved before we finally got them."
A letter was recently mailed out by the Fire Department administration notfiying medics who took 30 minutes or more between calls that they were "slowing" the city down and warning them that they could be reprimanded.
Part of the problem, Lucy said, stems from the fact that the fire department is still being run like a fire department even though three quarters of its calls are medical runs.
"The system needs a whole new adjustment. You have people in charge who do not understand paramedics. We need more squads, better equipment and the time to completely clean the squads every single day," Lucy said
