For all the reasons life in a rural place like Tarkio, Missouri, can feel simple, all the space can make responding to emergencies at a moment's notice complicated.
"Our transport times can be as long as two hours," said Gene Bradley.
For Bradley, reaching anyone in crisis is the stress that comes with the job of being an ambulance district chief. He leads the Atchison-Holt Ambulance District.
“Not only do the seconds matter, but we have a lot of distance to get to a hospital," Bradley said.
What worries him now goes far beyond the vast area of Northwest Missouri he’s responsible for.
"Never crossed our minds that this would be something that would greatly affect our ability to do our mission,” he said.
He hasn’t had one of his four ambulances in months. He has a loaner while he waits for his truck in the shop.
“That truck left us the first of April, and we still don’t have it back," Bradley said. "It's scheduled to come back to us in October.”
The massive hold-up is because of one of the tiniest parts built into the large chassis—the frame behind the cab.
“The microchip to what, I understand, is the brain that's in the computer that makes everything work,” Bradley explained. “They can have the whole truck and have them ready to go but not have that chip to put in there and the truck won’t start or run.”
The pandemic caused issues that forced some factories to close or cut microchip production.
Ford, which makes around 70% of the chassis used in ambulances, had to shut down production earlier this year.
“Right now, I would say ambulance production in the second half of this year is down 30-50%," said Mark Van Arnam of the American Ambulance Association.
The American Ambulance Association says districts across the country, both large and small, are feeling the impact of the shortage at a time when calls for help in the pandemic aren’t slowing down.
The organization wants the federal government to make ambulances a priority to receive the delayed parts that are also used in buses and RVs.
"You have an already bad situation where these people are on the frontlines and they’re trying to provide health care and it’s aggravated by a short supply of the number one commodity to be in the ambulance business and that's an ambulance," Van Arnam said.
"Where it worries me is if I’m transporting a patient on the interstate, and we take folks to Lincoln and Omaha, Nebraska, which is a two-hour transport, 100 miles, if we break down on that truck on the interstate, our closest backup help could be 30 or 40 minutes away,” Bradley explained.
Experts hope the chip shortage will be over by the end of the year, but the supply chain might not be on track until the end of 2022.
Bradley also says he’s down more than three paramedics, but whether it be a shortage of microchips or manpower, the resources he does have, are on the road around the clock, because in this line of work, a call to respond carries a responsibility to a code he holds close.
“We live by three core values in this service, calm their fears, ease their pain, and provide hope," Bradley said.