Islandgirl,
For an example of a "boy who cried wolf" situation just look at the situation on the night of the accident. After the crash a boat was called which transported the patient and he survived. That boat could have been called in the first place and two deaths avoided. The helicopter was not required to save a life, but that was how it was almost always presented to me while I was flying there.
Anyway, there has only been a helicopter based at SXM since 2001. What was being done in case of medical emergencies before that time?