Lacking EMTs, an Aging Maine Turns to Immigrants

SOUTH PORTLAND, Me. — Jolly Ntirumenyerwa ran her fingers over the stethoscope that she had slung around her neck. It was a comforting connection to her career as a physician in her home country, the Democratic Republic of Congo, where she worked in emergency medicine.

Her credentials did not transfer when she moved to the United States in 2012, and she could not work as a doctor. So, she took jobs as a health aide in an assisted living facility.

Now, thanks to an unusual program that is training immigrants to become emergency medical technicians, she is preparing to make better use of her medical background and, she hopes, work her way up to becoming a physician assistant if not, someday, a doctor.

“I want to do what I was trained to do,” Ms. Ntirumenyerwa, 37, said the other day as she took a break from her E.M.T. class, being conducted in a cavernous ambulance bay at Southern Maine Community College. “I put in a lot of years training to be a physician, and I don’t want to throw them away.”

But the program goes beyond helping Ms. Ntirumenyerwa (pronounced t-roo-may-YAY-rwa) achieve her personal career goals. It is also helping to address some serious problems in Maine.

One is a shortage of E.M.T.s. Another is a shortage of a work force in general, particularly of young people who can help sustain the state economically as its population ages. Maine is the nation’s oldest state, with the highest median age and the highest concentration of baby boomers, and its birthrate is dropping; in 2016, just two of its 16 counties had more births than deaths.

Economists regard Maine’s rapidly aging population as a demographic tsunami that has severe implications for the state’s labor pool, health care system and overall socioeconomic well-being. But the state can grow, they say, with more international immigration — though that may become more difficult under the Trump administration.

Thanks mainly to a small influx of immigrants, the state’s population inched up last year by about 2,000 people over 2015, despite the anti-immigrant sentiments expressed by Gov. Paul R. LePage. But the state recorded 1,300 more deaths than births, a downward trend in which Maine and West Virginia lead the nation. Like other graying states in New England, Maine is struggling to keep its young people living and working here.

“This program is a win-win-win,” said David Zahn, chairman of the global languages department at the community college, which started the program.

He said he basically put two and two together. Surveys showed that employers, especially municipal and private ambulance services, needed more E.M.T.s; other surveys showed that many immigrants in the Portland area are underemployed and have medical backgrounds.

When the E.M.T. course for immigrants was announced, three times as many people applied as could be accommodated.

The first class is small, with 13 participants. But to Dana Connors, the president of the Maine State Chamber of Commerce, the program is a big step in the right direction. “It may be a small number, but it looms large in message and significance,” Mr. Connors said. The program, he said, illustrates what opportunities exist “when we recognize immigrants as part of our solution.”

Many of those opportunities are in health care. As residents live longer, the need for health care workers — and E.M.T.s — is only increasing.

The E.M.T. shortage stems in part from the low pay — $10.50 an hour for an entry-level job, a result of low federal reimbursement rates, said Robert Russell, the chief executive of North East Mobile Health Services, a private medical transport company in nearby Scarborough. In addition, he said, training involves a major commitment of time. This course requires eight hours a week for 16 weeks.

Mr. Russell said his company would interview the immigrants who successfully completed the course. He said he was grateful to have an expanded pool of applicants, especially people who are multilingual (Ms. Ntirumenyerwa, for example, speaks French, Lingala and Swahili, in addition to English) and who can bridge cultural divides. “It’s a huge added benefit,” he said, when employees reflect the customers they are serving.

Paul Froman, the course instructor, said that he did not vary the program for the immigrants, and that they must pass the same tests and meet the same requirements for licensing as American-born participants. But because of their medical backgrounds, he said, the immigrants “are informed, and you can get a lot deeper.”

David Ngandu, 33, who was also a doctor in the Democratic Republic of Congo and is taking the E.M.T. course, said that in some ways, it was easier to treat patients here than in Africa because of the availability of equipment and supplies.

“For example,” he said, “oxygen is very expensive in the Congo. I knew what needed to be done, but I didn’t always have the equipment.”

The course is financed by a work force development grant of $29,000 through the Maine Community College System and additional support from the John T. Gorman Foundation, which helps disadvantaged people in Maine. Most of the immigrants cannot pay for the course on their own.

While many work force development programs help immigrants learn English, Mr. Zahn said, this is the first of which he is aware that teaches English in the context of E.M.T. training, with participants learning high-level terminology and a higher level of English than those in, say, the food services industry.

“Because of their extensive medical backgrounds, we’ll have people on ambulances who have a higher level of skill” than some other newly minted E.M.T.s, Mr. Zahn said.

And, he added, the program might help restore an underemployed immigrant’s sense of dignity.

“They are doctors,” he said. “And they’re cleaning toilets? We’re taking advantage of their skills and getting them back into their own arena.”

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