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At least 19 per cent of professional football leagues do not have a heart-starting defibrillator at every match, according to research by world players union FIFPro.

Eleven of 58 FIFPro member unions said the device was not required at games in their countries or rules were frequently overlooked. Eight unions said authorities could not immediately provide the necessary information.

Cameroon player Patrick Ekeng collapsed earlier this month while playing for Dinamo Bucharest and was pronounced dead after being taken to hospital. In Romania, it’s not obligatory for clubs to provide a defibrillator.

“You are putting the life of athletes at risk if you do not have this piece of equipment,” FIFPro Chief Medical Officer Vincent Gouttebarge said. “It is relatively new in some countries but football should try to introduce it everywhere as a matter of urgency.”

Gouttebarge said all clubs should also have a well-trained emergency doctor and an emergency plan at every training and competition venue.

Emilian Hulubei, President of Romanian players union AFAN, said some clubs in the country have a history of skimping on medical costs. More than a dozen teams in the first two divisions are in financial administration. It costs 100 euros an hour to hire a fully-equipped ambulance with a defibrillator in Romania. A new defibrillator typically costs 1,000 euros.

According to FIFPro member unions, a defibrillator is not mandatory in the leagues of Croatia, Ecuador, Guatemala, Malta, Namibia, Paraguay, Romania and Venezuela. In Cyprus, it is compulsory in the first division but not the second. In Montenegro, lower-league games do not have an equipped ambulance.

In India’s I-League, clubs put the lives of players at risk by obtaining exemptions from authorities allowing them to go ahead with games without the mandatory medical equipment, according to Indian players union FPAI.

Matches in the league are not supposed to go ahead unless a fully-equipped ambulance is on standby but sometimes the vehicles are little more than a car with a red cross painted on the side, FPAI officials said.

Following Ekeng’s death, Romania’s football federation said it will buy the heart-starting device for all clubs, according to media reports. Paraguay’s football authorities expect all first-division clubs to have them by the end of the year, the FAP union said. At the moment only three of 12 top-flight Paraguayan clubs have them.

FIFPro General Secretary Theo van Seggelen said he wants to see the same standard of first aid for all professional footballers.

“We are disturbed some leagues do not seem to treat medical care as a priority,” Van Seggelen said. “It is clear players in some countries have less chance of surviving a cardiac arrest.”

Picture above: Dinamo Bucharest fans display a banner of Patrick Ekeng at the Romanian Cup final following his death.

Picture below: Patrick Ekeng in action for Cameroon in the Under-20 World Cup in 2009.