EL SALVADOR—In El Salvador, the fragile health care system has little to no functioning emergency medical services, and the local police are often the first to arrive on the scene of an emergency. With one murder occurring, on average, every hour and more than 6,600 homicides in 2015 (the year of our visit), the violence in El Salvador has quickly led the country into a full-scale humanitarian crisis.

In collaboration with the U.S. Department of State, NYC Medics developed and delivered a specialized training for police officers in El Salvador, who have been working to quell a surge in gang-related violence and homicides. The training custom-developed for them by NYC Medics focused on core content from the Tactical Emergency Casualty Care (TECC) curriculum, and was tailored to fit the knowledge and skill level of Salvadorian police officers and the unique threats and actual violence they routinely experience.

One participant in one of NYC Medics’ training workshops shared a story about the need for ongoing emergency training in the region. “I had a situation where a person was run over by a vehicle and had an arm completely broken and lacerated, and also had head trauma with bleeding,” he said. “There were other people hurt, soldiers and other police. But I had no other alternative but to put these people in a litter (large street garbage receptacle) and load them into a patrol car and take them to the hospital.”

The goals of NYC Medics’ training in El Salvador were three-fold: 1) to train and/or reinforce officer knowledge and skill necessary to protect themselves, their partners and civilians in a direct or indirect threat environment, regardless of who is injured or the injuries sustained; 2) train officers to medically address significant trauma related to injuries sustained under fire or while a potential threat may still exist, and 3) provide care to self, partner, and/or civilians who sustain a traumatic injury. Over the course of NYC Medics’ three-day training workshops, 30 officers representing every barrio throughout the country were trained in Tactical Trauma Intervention.