bring first aid to more people, many Red Cross and Red Crescent
Societies are focusing on simple life-saving skills. It’s
not about textbooks and certificates. It’s about empowering
communities with the confidence to act.
“The last time you showed me this I was too weak to
blow up the chest,” says a quiet, middle-aged woman — let’s
call her Mary — as she kneels tentatively on the carpet
next to a lifeless first-aid mannequin. Mary is living in
a rehabilitation centre in Bedford, United Kingdom, fighting
to overcome alcohol addiction.
A Red Cross trainer, Dan Sheridan, has come to this two-storey
brick house to teach the second of two brief first-aid courses
to Mary and three other residents, in the familiarity of
their temporary home. Sheridan structures the course as a
conversation rather than a lesson, asking questions, making
jokes and encouraging them at every step. “There you
go, relax, it’s not so hard,” he coaches.
Mary bends over, pinches the mannequin’s nose and
breathes into its mouth. When the chest rises, she smiles
in relief. These days she spends most of her time learning
to heal herself. Today, she has acquired the skills to save
“That’s great,” says Sheridan. “See,
you can do it.”
A civic duty
First-aid has been at the core of the Red Cross Red Crescent
Movement ever since Henry Dunant organized civilians to help
injured soldiers after the battle of Solferino in 1859. It’s
more than a skill — it’s an act of humanity.
Given without discrimination, it helps empower communities
to take greater care of their own survival and well-being.
It’s a responsibility of global citizenship and an
essential element for safe and resilient communities.
“First-aid training is a key activity for us,” says
Nehal Hefny of the Egyptian Red Crescent Society, noting
that there is a real desire for training at the community
level because, very often, city or state emergency services
cannot respond quickly enough in many parts of the country. “The
training is one of our main activities and it’s very
Whether it’s inner-city Cairo, a remote village in
Myanmar, the favelas of Brazil or a London suburb, first-aid
training offers people the chance to take life-saving action
and demonstrate humanitarian values in their own community.
In places where there is little or no access to emergency
services, there is a real hunger for basic life-saving skills. “People
are often really looking for the skills to be able to prevent
and respond to emergencies by themselves,” says Eric
Bernes, a first-aid specialist for the ICRC.
“Everyone has the potential to save lives,” adds
Grace Lo, a first-aid specialist for the IFRC.
Reaching out to vulnerable communities, she says, is key
to attaining the goal of ‘First Aid for All’,
the theme of 2010’s World First Aid Day, planned by
the Red Cross Red Crescent for 11 September. To mark the
occasion, the IFRC has published an advocacy report following
up National Society first-aid training efforts around the
Still, in many parts of the world — in both high-
and low-income countries — first-aid training needs
to be brought to many more people and communities. In many
high-income countries in Europe, for example, the public
often views first aid as an optional skill. Those who have
taken a course in the past might think they have paid their
dues, even if they cannot remember a thing today (studies
show that ideally, a person should have a refresher course
every 6 to 12 months).
Diane Issard, manager of the European Reference Centre for
First Aid Education, says that to ensure help is within reach
at all times, at least 30 per cent of the population should
know first aid. And yet, a recent IFRC advocacy report shows
that even in Europe, there are great disparities. In Norway,
for example, 95 per cent of the population knows basic first-aid
techniques, while in Hungary, less than 1 per cent of the
public is trained.
Part of the reason is legislation. When a government requires
citizens to learn first aid at school, makes it a condition
for obtaining a driving licence or requires it at the workplace,
the numbers automatically go up. Unfortunately, many governments
often don’t see first aid as a political priority.
School curricula are already overloaded. Driving licences
are costly enough. This point of view overlooks the fact
that first aid can save not only lives but money, by reducing
the cost of medical treatment.
One country that is moving toward requiring first-aid training
is Ghana, where traffic accidents are a leading cause of
fatalities: more than 1,600 annually. With the support of
national authorities, the Ghana Red Cross Society is working
to expand a programme in eastern Ghana that has already offered
first aid training to more than 3,000 licence applicants.
The victory is not without challenges — the most immediate
one being a lack of mannequins, a costly investment for developing
countries. “Now that we have the mandate,” says
Kofi Addo, the Ghana Red Cross Society’s acting secretary
general, “we must demonstrate the capacity to deliver.”
In China, some provinces oblige people to undergo Red Cross
training before obtaining their driving licences. On the
other hand, there is little public encouragement for learning
first-aid skills and no mandatory requirement for high-risk
industries. With support from national lottery funds, the
Red Cross Society of China has been working in recent years
to improve quality, standardize courses throughout the country
and communicate the importance of first aid to the public
Tuvalu Red Cross instructor Matakina Simii, 31, teaches first
aid to new volunteers with the help of a local police officer
during a weekend training session on the Pacific island
volunteer from the Mozambique Red Cross Society helps with
first aid and advice on proper use of water to residents
of the Chacalane camp.
But first-aid training is not just about learning technical
skills. It’s about giving the public the confidence
to act. Even when people are trained in first aid, they sometimes
hesitate. Some are afraid of blood or of catching diseases.
Many are concerned about lawsuits, despite the fact that
legal judgements in such cases are extremely rare. Nonetheless,
worries about making a mistake often lead to the so-called
bystander effect, whereby everybody counts on somebody else
to act. That is unfortunate — even a clumsily performed
cardiac massage can save a life, whereas no action at all
is certain to end in death.
As a result, a number of National Societies are coming to
the same conclusion, that teaching complicated first-aid
manoeuvres puts people off. In the Netherlands, fewer than
2 per cent of the population has learned first aid, because
for years the public was offered only one type of course,
which lasted 32 hours and was expensive.
In 2005, the Netherlands Red Cross finally received the
right to teach first aid and decided to rethink the entire
process. “Some National Societies focus on issuing
first-aid certificates,” says first-aid specialist
Patrick Logister. “But even in countries where 80
or 90 per cent of the public is certified, if nobody helps,
or is taught effective techniques, the effect is non-existent.” The
Dutch have chopped down the course length, put more focus
on target groups such as young parents and are trying to
encourage a propensity to act by educating the public that
lawsuits should not deter anyone from trying to provide life-saving
In Argentina, the Red Cross is also striving to improve
and simplify instruction methods, after realizing that most
of what they teach is forgotten after one year. “First
aid was always taught like school, with manuals like textbooks,” says
Martin Roth, an anaesthesiologist and long-time Red Cross
volunteer. “The teacher gives a lesson and you practise.
That may be good for kids, but adults have another way of
The National Society worked with an adult education expert,
who suggested a case-study approach, with abbreviated content,
small discussion groups and lots of practice. “We’re
focusing on the most elemental, vital things, so they can
be remembered,” says Roth.
Dan Sheridan agrees. “These people don’t want
to be lectured or preached at,” he says. “The
trainer as a font of knowledge — that just creates
a barrier. Make it safe and familiar, tell them, ‘You
already have the answers, guys, just bring it out’.”
The goal is to make first aid accessible to all, including
the most vulnerable members of society. The Italian Red Cross
and the Hellenic Red Cross in Greece are training blind people
to prevent and deal with domestic accidents, the Finnish
Red Cross trains elderly people and youth at risk, the Armenian
Red Cross Society has a programme for remote communities,
the French Red Cross has worked with young people in inner
cities, the Netherlands Red Cross is developing a programme
for Muslim communities, the Russian Red Cross Society trains
factory workers and some Chinese Red Cross branches train
migrant workers. For its part, the British Red Cross has
been giving more attention to empowering people with physical
and mental disabilities.
In Afghanistan, the ICRC provides first-aid training to
all parties in the conflict, as well as supporting the Afghan
Red Crescent Society in the delivery of first aid services
and training to civil society members such as taxi drivers,
who often take the injured to hospital. “Taxi drivers
tell us that first-aid skills are really important for them,” says
Bijan Frederic Farnoudi, the ICRC’s communications
officer in Kabul. “They can’t evacuate a person
to the hospital in the normal time frame of two hours, but
need to take complicated, indirect routes, so the journey
may take up to seven hours. Those extra hours are often the
difference between life and death.”
In conflict zones, or in areas with chronic violence, such
as the favelas of Rio de Janeiro or Cité du Soleil
in Port-au-Prince, Haiti, first aid is also a means to make
a connection, to open a dialogue with key players and combatants
and create a certain “humanitarian space”, says
“It’s much more than a bandage,” he says,
adding that those who provide first aid in dangerous situations
are also setting the highest example of humanitarian values
in action. “Yes, the first-aid givers are saving lives.
But just as importantly, they are restoring a sense of confidence
and hope — especially when you have a situation of
violence, whether it’s war, gangs, banditry or whatever.
Acting in these situations creates a level of hope that people
are not only destructive but can also act to help each other.
“It really is the DNA of the Movement,” he says
of first aid. “Since Solferino, it’s remained
an extraordinary vehicle. A hallmark of the Movement that
nowadays needs to be really reinforced.”
Opening the door
First aid can also become an entry point towards developing
people’s trust and clearing a path to more sensitive
issues. In Ireland, a community-based health and first-aid
programme was introduced in 2009 in Dublin’s Wheatfield
prison, a medium- to high-security facility and home to 450
male prisoners, many of whom are long-term inmates. The project,
a partnership between the Irish Red Cross, the prison’s
healthcare division and the city of Dublin’s vocational
education committee, started as a way to avoid bringing the
H1N1 epidemic into the penitentiary.
Twelve prisoners were chosen to participate as Red Cross
volunteers and receive first-aid education with relevant
health awareness. They took classes two hours a week, then
passed on what they had learned to the rest of the prisoners.
It seemed to work: a neighbouring prison had several cases
of swine flu, but there was not a single one at Wheatfield.
But Graham Betts-Symonds, the prison’s healthcare
and nursing manager, was most struck by the transformation
in the volunteers who participated. “While some [prisoners]
had behavioural difficulties in the past, they appear to
have completely changed as Red Cross volunteers,” he
says. Perhaps the most amazing result was the response to
a mass HIV testing project in June 2010, after first-aid
courses highlighted HIV awareness as a key health issue.
In the days leading up to the tests, the volunteers passed
out leaflets, encouraged other prisoners to go and talked
openly about the virus. The turnout exceeded all expectations.
A survey was held during the tests and the prisoners’ responses
proved that, without peer support, many would not have bothered
“If medical people came around, prisoners would go
back into cells,” wrote one. “RC guys 1,000
per cent better doing this than staff doing it,” noted
“Makes you more on the ball about HIV/AIDS , especially
about unprotected sex,” said a third.
And one prisoner wrote: “Thank God it’s being
Amy Serafin is
a freelance writer based in Paris.
want to be lectured
or preached at. The
trainer as a font of
knowledge — that
just creates a
first- aid trainer
for the British
Volunteers with the Brazilian Red Cross, along with the ICRC, offer free first-aid
services and training to residents of Rio de Janeiro’s favelas, where
health and emergency services are largely unavailable.