A crisis continues in rural America, where population decline and busy schedules are eating away at vital ambulance and emergency services.

As reported in today’s Herald, emergency medical technicians and emergency medical responders are in great need throughout the region and state.

“We are in major need of EMTs,” said Sarah Vaith of McVille, N.D.

“We are in desperate need of EMRs,” said Betty Pelletier, of Pembina.

Kelly Dollinger, president of the North Dakota Emergency Medical Association, is especially blunt: “If your family is in a car accident and no ambulance shows up, what are you going to do?”

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The obvious answer: Suffer. And it could happen at greater frequency as the crisis widens.

It’s a multifaceted problem.

Most small towns rely on volunteer crews to answer the call when emergencies happen. One problem is that when these crews show up, it’s often to deal with a friend or neighbor, which must be a traumatizing experience. Furthermore, for most of these EMTs, the hours are long and the pay – when there is pay – isn’t great.

Adding to the difficulties experienced by these EMTs is an unfortunate Catch 22: Since crews are stretched so thin, and since the state requires ambulance services to meet certain staffing requirements, many volunteers believe that if they quit or retire, it could end local services.

That’s a heavy burden for these people, who are heroes in every sense of the word.

What to do?

There’s no easy solution. Bolstering pay with state money could potentially help, but not necessarily, according to Vaith, who heads emergency service in Michigan and McVille.

“You can have all the money in the world, but that only puts a Band-Aid on it,” she said. “The community has to decide what they want for their ambulance service.”

That’s easier said than done. A sometimes grueling schedule that has traumatic work conditions and low pay doesn’t make for the best help-wanted ad. It’s exacerbated by a drastic population decline in many rural areas.

One easy fix is for businesses in rural communities to universally commit to allowing workers to take unexpected leave to fill this void.

Also, communities should consider higher levies to better pay those who answer the call to become EMTs and EMRs.

For those who cannot make the commitment, there are other ways to help. Some small towns, for instance, would allow community members to volunteer to help wash and maintain ambulances and other equipment, or even babysit for crew members when they answer emergency calls.

The state must continue to find perks and benefits for EMTs. An example came last year, when the state’s voters approved a plan to allow emergency responders free access into state parks. That measure passed 64 percent to 36 percent. However, our concern is that although it passed, more than 112,000 North Dakotans voted against it.

To us, that suggests an alarming lack of understanding and empathy about this shocking and potentially life-altering crisis in rural America.