Emergency: partying tourists keep Ibiza's ambulances busy

Eleven years have passed, but Ibiza still remembers the case of the young Italian who, after a night out, lost an arm in an accident when he was travelling in the back seat of a car with half his body sticking out of the window. The injured man, who was intoxicated, did not realise what had happened until the police stopped the vehicle, which, after hitting a fence, continued on for a further four kilometres.

Although striking, it is just one of the many episodes that emergency teams on the island face on a daily basis. The challenge is posed by the large nightlife centres, which threaten to overwhelm the ambulance service due to the number of incidents they record during the high season. These are giant discotheques, which bring together thousands of tourists - some with a capacity of between 5,000 and 10,000 people - and which generate emergency situations that must be dealt with by the already collapsed public health network.

The jewel of the Mediterranean welcomed more than 3.6 million tourists last year, many of them attracted by its popular nightlife, a sector that continues to grow. To its extensive and consolidated network, with clubs such as Es Paradís, Edén, Lío, Ibiza Rocks, Amnesia, Chinois, Destino, Ushuaïa and Hï, which attract thousands of people every season, has been added this year [UNVRS], a 'hyperclub' with a capacity for nearly 10,000 people, the largest in the world. To complete the leisure offer, numerous beach clubs are scattered along the Ibizan coastline, such as Blue Marlin, Nikki Beach, Nassau, O Beach and Playa Soleil, among others.

The rise of these huge entertainment venues has a direct impact on the public emergency services. According to the USAE union, the urgent transfers requested from the discotheques are overloading the resources destined to attend to the island's 160,000 permanent residents. Workers at the public company in charge of ambulances, GSAIB, warn that emergency calls related to club-goers have become so frequent that the service cannot cope with the demand.

One in three transfers are requested by the clubs, according to USAE data. "Sometimes we go to the same club three or four times in the same night," says José Manuel Maroto, the union's representative. "There are places where we have to go to pick up a drunk person every day," he adds. The requests come in the early hours of the morning and are usually related to excessive alcohol intake, but above all to drug use.

Clubbing in Ibiza is not cheap. Entrance fees can reach 100 euros and drinks can cost up to 25 euros, which, according to Maroto, encourages the use of experimental drugs, because they are "a cheaper alternative". The island's lively nightlife and relaxed image have for years been linked to the use of narcotics and, despite being illegal, "all kinds are consumed", which has aggravated the crisis. So much so that every year, before the start of summer, health workers try to predict what the "fashionable" substances of the season will be, in order to have the appropriate treatment.

Regulations require nightclubs to have medical staff, such as nurses and emergency personnel. However, according to USAE, the same requirement does not apply to private ambulances. This situation means that, in the event of an emergency, transfers are left to the public system, which is stretched to the limit.

The discotheques, for their part, comply with the current regulations. However, the union criticises the fact that the requirements are not proportionate to the risk. An example is sporting events, which are generally attended by a healthy and physically fit audience. In these cases, and even for gatherings of just 300 people, the presence of an ambulance with advanced life support is required. On the other hand, in clubs with thousands of attendees, where alcohol and drug consumption is "very high", only the presence of a medical team is required. Of all the discotheques on the island, DC10 is the only one that has its own service for emergency transfers.

"It is unfair that nightclubs, which earn millions of euros a year, are passing this problem on to the public health system," said Maroto. "In the end, the residents pay the bill with their taxes," he added. And what is worse, it is the residents themselves who suffer the consequences of the transfers generated by nightlife. Because, the professionals point out, the calls they receive from the clubs are usually "priority alerts", as the patient is often unconscious and there is a risk that he or she could suffer a cardiac arrest or even die. This is why the assistance requested by the island's residents is often relegated to the back burner and is attended to after a long wait.

This is corroborated by Ibizans, who complain that the emergency services fail to respond to their calls. Maroto makes no secret of this and admits that, on occasions, "we fail to attend, for example, to an elderly man who has fallen at home and suffers a possible hip fracture". "We delay it in order to attend to the most urgent call first, which often comes from the clubs," he said.

Dealing with emergency calls made by discotheques is not always easy. According to the workers, they are often particularly complicated situations due to the seriousness of the patient, and also because of the environment of drug abuse in which they occur, which can lead to moments of conflict. "On many occasions we have to restrain the people we attend to as a precaution: we have to put up with assaults and very dangerous situations."

Although it has intensified in recent times, the precariousness of the service goes back a long way. The unions have been denouncing for years that services are provided in poor conditions. There are few ambulances and their lack of maintenance aggravates the situation.

"Many have broken air conditioning and we are going to stop using them, because there is no shade to park them in and the temperature is unbearable. You can't work in them and you can't see patients in them. Two vehicles have already broken down, and there are no backups," Maroto concluded.