Aberhonddu in Cymru

“Normans”. Fearfully, Arwyn gazes south towards Pen y Fan. Unmistakeably, a fire is burning up there on the summit of the region’s highest mountain. It’s a signal. A warning by his fellow countrymen to the inhabitants of Aberhonddu to get to safety because the English are attacking.

For many years, the legendary English King William the Conqueror has been attempting to drive away the Celts and bring Wales under his control. So far, without success. The Welsh wilderness is simply too rugged, the climate too hostile, and the inhabitants are all too familiar with the mountains, valleys and caverns where they can hide – if warned in good time.
By the beacons on the summits surrounding Aberhonddu. “Brecon”, as they are called in non-Welsh.

Today, the mountain range we are passing through with our yellow rescue vehicle of the Welsh Ambulance Service is called the “Brecon Beacons”. The beacons, however, have been out for centuries. They have been replaced with two-way radios and mobile phones. For Manon Ludlam, these are indispensable: “Time and again, hikers underestimate the weather in the Beacons. It can get really cold here in no time.”

The 33-year-old knows the mountains like the back of her hand, she grew up here. “My father was a nature lover. He was a hiking and mountain guide. I spent all my free time outdoors. That leaves its mark. And it is probably the reason why I became a mountain rescuer.” In her “everyday life”, Manon is a paramedic. Out of conviction. “I see this quite often. Young people leaving the Beacons to move to the big cities. The old people stay because this here…” She points through the windscreen. Meandering hills, wild, rugged, barren. “This is their home. But in the case of an emergency, the children are hundreds of miles away in London, Birmingham or Edinburgh. And the parents have no-one to rely on but themselves.”

It’s a close-knit community. The Welsh in general. In the 2001 census, most Welsh classified themselves as being “British, white”. But 15 percent simply wrote “Welsh” onto the form, although this option did not actually exist. That is why you should never refer to Wales as “England” if you are in the company of Welsh people. It is not very well received. I speak from experience when I say it will cost you at least one round for the whole pub.

People tend to look out for one another here, especially in places like the Beacons. This is necessary. Because help is normally not around the corner. The closest neighbour lives several hundred metres away as the crow flies, the nearest doctor is several kilometres away. “These conditions are not ideal for us from the rescue service. Often we must take long detours because the emergency location cannot otherwise be reached by rescue transport vehicle. Of course, we also have volunteer first responders, but they are faced with the same challenges we are.” While first responders in Germany cover an area of around 50 km², which is about the size of Lake Ammer, a first responder in Wales must cover an area of at least ten times the size. “While rescue helicopters are, of course, a welcome alternative, you should also keep in mind that the weather in Wales is even worse than the weather in England. Often the helicopter cannot fly due to bad weather.”

But the doctor is in the helicopter. Just like in other European countries, he is not on board the ambulance. But while only a doctor may declare someone dead in, for example, Germany, paramedics in the UK have more decision-making authority. “That is absolutely essential. If there are several patients that need to be dealt with it is important that we can perform triage on site. With the limited personnel we have, this is a must.” This is due to cutbacks in the British health system – something that many colleagues in other countries are probably also familiar with. “This is especially evident in the hospitals. It is hard to imagine, but on some days the rescue vehicles congest in front of the hospitals’ accident and emergency units. Sometimes, they are stuck there for hours! With patients on board! And while the teams are waiting in front of the hospital, dispatch is receiving new emergency calls. But who are they supposed to send if the ambulances are still in use?” Good question.

How much overtime has she worked, I ask Manon. “No idea.” Did she stop counting? “Never really started. Why would I be doing that? It doesn’t change a thing to know that I could theoretically take off 28 weeks in a row and not let a single day of leave go by unused. People would still get ill and need help.” I decide not to ask “why”. I can see the reply in her eyes. And as if she could read my mind she says “I simply like doing my bit to help someone else get well again. I think it’s important that we look after one another.”

Manon’s colleagues also treat each other like family. This is particularly evident in delicate situations such as the resuscitation of a patient with circulatory arrest. In Wales, resuscitation is already carried out according to the “Pit Stop” principle. During this procedure, one person acts as a kind of supervisor and positions himself at the patient’s feet with a checklist, giving precise instructions on what needs to be done when. The advantage: those helping the patient only need to focus on one task. Changes to the cardiac massage, rescue breathing or defibrillation are announced by the supervisor.

“Of course we know all the procedures by heart, but it makes things easier if you can focus on a single task without worrying about forgetting or overlooking something.” Especially at the end of a long shift. Stress needs to be relieved. “S and M – sofa and mountains. That’s what I do for relaxation. Either on the couch with a glass of red wine or out in nature. The most important thing is that Bohdi is with me.” – “Your boyfriend?” I ask. “My best friend. A black Labrador.”