Millions of rural Americans are struggling with a lack of emergency medical services. It is mainly because many ambulance services have shut down due to financial constraints, shortage of resources and skilled people, reported NBC news.

Most of the rural communities consider fire and police as more important and essential than emergency services. So, the emergency services usually do not receive any funding from the state legislature. Other states pitch in, but the funding is not enough to cover the cost of an ambulance and a standby crew to attend to 911 calls. The majority of emergency medical services in rural areas are run with the help of volunteers.

But the volunteers rarely get paid for their services and they have to look for full-time jobs to support their lives and family. In order to become an emergency medical technician (EMT), an individual will have to dedicate several hours of his time and is a costly affair to climb the ladder to become a paramedic.

While an EMT requires at least 40 hours of training, an emergency medical responder (EMR) needs an additional 16 hours of training every two years.

To work as an EMR in North Dakota, for instance, a person needs to spend 50 to 60 hours to learn how to drive an ambulance and assisting with CPR and first aid. An unpaid volunteer will have to $600 for such classes.

Still, many people from rural areas volunteer for emergency medical services. "Can you imagine sitting in a place and dialing 911 and not having anybody show up?" Steven Maershbecker, squad leader of the Hebron ambulance service, told NBC News. "That’s very difficult for me to sit back and try to accept."

Many of the medical services in rural areas struggle with shortage of manpower as the younger population in these areas move to urban areas looking for jobs, leaving behind the older population alone. These elderly people require 911 services most of the time for medical emergencies like heart attack and stroke.

"As the population in these communities shrinks, you’ve got a finite pool of people who are willing to volunteer," Wayne Denny, chief of Idaho’s Bureau of Emergency Medical Services and Preparedness, said.

This is not just the story of Idaho alone. Every other neighboring village has the same story to say.  A volunteer paramedic Erick Hartse also shared a similar story.

"We’ve been relying on volunteers to be the backbone in EMS for a long time, and unfortunately, that needs to change," he said. "Could you imagine being a volunteer doctor? It’s unfathomable."

Ambulance In this photo, an ambulance transporting a patient is reflected in the window of another ambulance at Ronald Reagan UCLA Medical Center in Los Angeles, Oct. 9, 2008. Photo: David McNew/Getty Images