I spent most of my childhood in California, on the coast, in a region where the headlands and beaches alike can be treacherous. I learned how to distinguish crumbly, dangerous headlands from more solid rock, how to traverse the cliffs carefully to get to the beach, and when it wasn’t safe to do so at all. I learned how to watch the ocean, how to get a sense of it. I learned, in short, how to protect myself around the ocean, and even I run a risk, just like other people who have spent the bulk of our lives here: A misplaced hand or foot, an unpredicted wave, a cliff that crumbles when it wasn’t supposed to.
These things are even more difficult for people who are not from here, because even when provided with a quick orientation, they don’t benefit from years of tactile experience. They don’t know what it feels like when soil crumbles under their feet, how to tell the difference between shades of difference in the color and texture of rocks, how to count wave patterns, how to assess the movements of water in a seemingly safe bay or nook of water.
There are a lot of cliff and beach strandings in California annually, including residents and visitors alike, though they are heavily weighted towards visitors. They are hikers who wanted to explore, they are divers who thought a beach would be safe, they are people who thought they were safe but fell or stumbled. There are all sorts of reasons why people get into trouble on the California coast, and in all of those cases, emergency services are ethically and legally bound to respond. That can include fire departments, law enforcement, the Coast Guard.
In a minor case, maybe it’s possible to sweep up with a boat, or for someone to rappel down a cliff face to help people back up. In major cases, though, way more people and equipment are needed to safely rescue someone who has been stranded. That can include multiple boats, helicopters, specially trained personnel. It can require hours and hours, including overtime, and including volunteers, especially in rural California, where sufficient qualified individuals aren’t available, or where fire departments and many first responders are entirely volunteer (receiving small stipends per call, but these don’t act as real compensation).
For rural communities, these responses can be extremely expensive, dragging down resources that are already tight, and they may tie first responders up, forcing them to triage — do they focus on the cliff rescue, or the house fire? Do they pull people off the cliff rescue to handle a medical aid call, or hope that a request for mutual aid will reach a neighbouring fire district in time? (A growing number of medical aid calls across the US are handled by fire departments, not by ambulances, due to funding cuts.)
In other words, when people get stranded, it costs, big time. And generally speaking, once they are pulled up to safety and assessed for injuries, they’re either whisked off to hospital for treatment (as they should be) or let go and allowed to resume their lives (as they should be). But is it fair to expect communities to bear the burden of cost for these situations? I’m not entirely sure, and it’s something I struggle with. I categorically believe that all people who are stranded and in need of help should be rescued, no matter how they ended up that way; we have a duty of care to other humans and we can dissect how and why a situation happened after the fact.
Some communities do bill, at least partially, for costs — for example, the ride in a helicopter may be billed. But it can be hard to quantify expenses like stipends and overtime for people who show up to support the rescue effort. There can also be public resistance to the notion, especially when it’s an innocent situation where the victim really wasn’t to blame.
It’s not appropriate to withhold rescue, just like medical treatment, on the basis of ability to pay. We must live in a culture where people who are in need receive aid, rather than being beholden to finance, with some being helped while others are not. But once the drama is over and the clouds have cleared, what are we left with? In an ideal world, no one would ever have to pay for medical care, because we would have universal health care and this would be a nonissue. And in an ideal world, no one would have to pay for a cliff or beach rescue, because we would have sufficient funding to support emergency services and they would be able to absorb the cost of purchasing and maintaining equipment, training people, paying for their presence, handling overtime costs, and so on — and they would have sufficient personnel to handle multiple crises at once, rather than having to divide their attention.
But we don’t live in that world. We rely on people with insurance as well as cash patients to subsidise care for patients who cannot, because in the short term, health care now is more important than ideals, and I’d rather see people getting care than get into high minded conversations about how we really shouldn’t live in a culture where the quality of care, and access to same, is predicated on wealth: In the moment, we need people to get treatment, and then we can step back and have the conversation.
Similarly, emergency services now sometimes struggle with the cost of rescue operations, because they don’t receive sufficient funding and they’re bound to respond to emergencies. So maybe, perhaps, those who can pay should be obligated to do so, billed for the expenses of those who came to their rescue, in order to pay for those who cannot afford the expense, but still deserve the same duty of care.
Image: Marine Headlands, Michael Fraley, Flickr