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Emergency Medical Services in the UAE: PTSD Proposal

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Updated: May 20th, 2022

The United Arab Emirates (UAE) has been experiencing rapid growth in paramedic services over the last few years. However, such services are at their initial stages of growth and thus the level of operation and delivery cannot be compared to that of developed countries, especially the United States (US) and Europe. Conventionally, the Dubai Corporation for Ambulance Services (DCAS) has been relying on experienced expatriates with background training in emergency and paramedic services to accomplish its mandate. However, this workforce is not enough to meet the current demands in the market.

For instance, in 2015, the DCAS could not offer advanced paramedic services, which allow patients to enjoy sophisticated care interventions and appropriate drug therapies, due to staffing shortages. According to DCAS Advanced paramedic project, in 2015, the DCAS had only 740 paramedics and medics with Emiratis forming a paltry 6.3 per cent of this workforce.

The ambulance was introduced in Dubai in 1977 to offer various services, but they were given different names depending on the departments being served. Some of the departments included the Department of Health & Medical Services and the Dubai Police. However, the services were unified through the Local Act, which facilitated the creation of the DCAS to offer ambulance assistance to Dubai residents. The DCAS was formed under the Act Law No. 15 of 2010 issued under the decree of His Highness the Ruler of Dubai (DCAS Main Website). Therefore, DCAS is the officially designated government agency that is tasked with providing ambulance services to the Dubai Emirate region (DCAS Main Website).

Posttraumatic Stress Disorder (PTSD) is one of the common mental health conditions affecting millions of individuals across the world. This disorder is a huge social, economic and health burden to its patients, thus affecting the entire society (Buljan, 2015). The impacts of PTSD are multifaceted, affecting individuals, family members, communities and health care systems. In addition, PTSD is associated with high morbidity and mortality rates together with the associated physical, occupational and social disabilities (McFarlane, 2010; Coughlin, 2011; Vieweg, 2007; Kessler, 2000). According to Marciniak et al. (2004), the high costs of care associated with PTSD are overwhelming and they can bankrupt individuals and families.

This disorder also puts excessive pressure on healthcare resources and facilities, which might affect the quality of services offered to other patients (Marshall et al., 2014; Elhai, North and Frueh, 2005; Erbes et al., 2007). Socially, individuals suffering from PTSD experience poor relationships with family members, friends and society coupled with absenteeism at work (Fineberg et al., 2013). Consequently, due to missed workdays, affected individuals have lower income and occupational success, as compared to their healthy counterparts (Kessler, 2000; Iversen et al., 2008). In case students are involved, they miss classes and, thus, their educational performance is affected significantly.

The high prevalence of PTSD and other mental sickness comorbidities has been established through numerous studies, but the relationship between these disorders is unclear (Ferry, 2008). The available research shows that individuals suffering from PTSD are highly likely to develop other mental disorders including anxiety, depression, major depressive disorder and substance abuse among other related conditions (Kessler, 2000; Brewin et al., 1996; Vermetten & Lanius, 2012; APA, 2013).

According to McFarlane (1989), PTSD patients might have more than one diagnosis. In addition, the risk of substance abuse is increased by multiple factors among individuals suffering from this disorder (Breslau et al., 2003; Reed et al., 2007) and major depression (Breslau et al., 2000). Brady et al. (2004) posit that around 40 per cent of PTSD patients are reported to suffer from substance abuse. Therefore, the high prevalence rates of mental disorders and substance abuse among individuals suffering from PTSD is worrying, which necessitates the need for a comprehensive study on this topic. In addition, given that emergency paramedics are highly predisposed to PTSD, it means that patients being served may not receive the best care hence poor care outcomes and quality of life.

PTSD prevalence rates among rescue and emergency workers are comparatively higher (range from 10 per cent to 20 per cent) as compared to the general population, where rates are between 5 per cent and 10 per cent (Neria et al., 2007). As mentioned earlier, extensive PTSD research focusing on emergency workers is lacking even in developed regions, such as the US, Australia and some European countries.

This realisation underscores the need to conduct a study dedicated to assessing the effects of trauma among rescue workers, namely, in areas that have not been covered in the available literature, especially the UAE. Such studies would play a central role in enhancing the welfare and health of emergency workers in the region. The approach towards the treatment of PTSD among such individuals would improve significantly, as it would be evidence-based. In addition, research on this topic would establish the relationship between PTSD and other mental health conditions among paramedics in the UAE.

Emergency Medical Service (EMS) is a relatively new concept in the UAE and empirical research on this field is limited. To the researcher’s knowledge, there are currently no studies exploring the perception of EMS personnel working in the UAE regarding what works or what could be considered to mitigate the effects of posttraumatic stress in the workplace and how they manage or deal with critical stress incidences. It is also worth noting that although there is an improved awareness in mental health in the UAE (refer to this study: Dubai mental health study highlights a shift in attitudes; reference), there are few interventions that fit the context of the country when it comes to high-risk occupations.

Paramedics form a significant part of high-risk populations that are predisposed to PTSD due to their nature of work whereby they are exposed to trauma. The current studies have not focused on healthcare providers because patients have been the major point of concern for researchers. Previous studies conducted in the UAE have mainly focused on students’ perception of mental health therapy by examining their behaviours toward mental health treatment (reference). In addition, many available studies seek to assess the prevalence of stress and burnout among emergency healthcare workers. For example, a study conducted in 2017 examined the prevalence of stress and burnout among emergency healthcare professionals in the Arab world, but it did not include the emergency professionals working in the UAE (reference).

Other studies were conducted in Western countries, such as Canada, Australia, and the US. However, results from these countries may not be extrapolated into the UAE because set-ups are different (reference). For instance, the psychosocial issues experienced in the US and Europe might vary significantly from those dealt with in the UAE.

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IvyPanda. 2022. "Emergency Medical Services in the UAE: PTSD." May 20, 2022. https://ivypanda.com/essays/emergency-medical-services-in-the-uae-ptsd/.

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IvyPanda. (2022) 'Emergency Medical Services in the UAE: PTSD'. 20 May.

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