Connect with us In 2014, Andrew Hodgetts left a paramedic career in Victoria with a set of keys, an empty bank account and a mandate to start an ambulance service on Espiritu Santo, Vanuatu's largest island. There was no funding for equipment or vehicles. That came later through cold-calling ambulance commissioners, a chance conversation at a trade stall that filled his car boot with donated gear, and an unsolicited vehicle donation from Queensland Ambulance Service. In this episode, Hamish McLean talks with Andrew about what it actually took to build ProMedical Santo from nothing: recruiting and training two Ni-Vanuatu nurses as the service's first paramedics, funding operations through business sponsorship and a subscription model, and the slower, harder job of teaching a community what an ambulance is and why they should call one rather than load a patient into the back of a ute. The conversation moves from the practical (no street names, no central dispatch, directions given by mango tree) to the systemic: why Andrew now believes importing a high-income paramedic model into a low-resource setting was, in his own words, naive; how a near-mutiny over cutting CPR from a first-aid course taught him that "what works" and "what the community needs" aren't always the same question; and why his PhD research into community first responder programmes has led him to conclude that context - culture, infrastructure, geography, trust in the profession - has to shape the model, not the other way around. The episode closes on a comparison that speaks directly to EMS Global's work in Mongolia: what happens when first-responder models designed for dense, road-connected populations meet nomadic, geographically dispersed communities — and why the answer isn't always more training, but a different question altogether. In this episode How a volunteering trip turned into founding a new ambulance station on SantoFunding a charity ambulance service door-to-door: sponsorship tiers, raffles and a free fuel deal that kept the service runningTraining two Ni-Vanuatu nurses as the service's first paramedicsTeaching a community what "call an ambulance" means and why visibility mattered as much as clinical capabilityThe Village First Aid Responder (VIFA) programme, and the community pushback that changed Andrew's approach to CPR trainingWhy he now questions transplanting a paramedic-level, high-income model into a low-resource contextThe gap between prehospital and hospital-level care, and what happens when an ambulance service outpaces the system it delivers intoAeromedical retrieval without air traffic control, on grass runways, at duskWhat his PhD research into community first responder models is finding and why most existing programmes are taught in isolation from the wider health systemParallels with nomadic, dispersed communities in MongoliaAbout the guest Andrew Hodgetts is a Victorian-trained paramedic who founded ProMedical Santo, a charity ambulance service on Espiritu Santo, Vanuatu, in 2014, supported through the Australian Volunteers for International Development (AVID) programme. He is now a PhD candidate researching how community first responder programmes can be integrated into established health systems in low- and middle-income countries. For video podcasts visit: https://www.youtube.com/@ems-global2048/podcasts Our website: https://emsglobalfoundation.org/ This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit emsglobalfoundation.substack.com
