Man From Matunga

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October 16, 2006

Injured? You must go to Sion

This was published in today's Mumbai Mirror.

A certain percentage of reader feed-back has always focused on the frivolousness of my writing. “I am sick of your rasam-idli. Do you know the plight of those who have been scammed by the South Indian Co-op Bank? Can’t you write about them?” And so on and so forth. Apart from the fact that what I write about is really nobody’s business, it is amazing how presumptuous people can get.

Having said that, when my dear friend Nobs Roy mailed me some stuff about Emergency Medical Services (EMS) in Mumbai (or rather the lack of), I thought I could use this opportunity to get serious.

Question: If you were to get seriously injured in a road-traffic accident, where would your best chances of survival lie?
a. Public hospital (Sion, KEM, etc)
b. Private hospital (Hinduja, Lilavati, etc)
The answer is (a). The public hospitals have round the clock services including emergency diagnostic and blood facilities, easy handling of police and legal inquiries and no risk of being denied treatment due to non-payment of bills. Virtually all specialties required to handle emergency care (orthopedic surgeons, general surgeons, neurosurgeons, anesthetists, radiologists) are available at all times. And among the public hospitals, Sion has perhaps the best EMS, simply because of the vision of the previous deans and surgeons who worked hard to make the EMS a well-oiled machine.

The problem in Mumbai, unfortunately, is of reaching the EMS services. A common medical fraternity joke is that the only difference between an ambulance and a hearse, is its color. In a city choked with vehicles and the complete absence of civic sense, it is virtually impossible for ambulances to reach any hospital in time. And even if ambulances are given way or are allowed to break signals, it is not uncommon to find a couple of cars behind the ambulance availing of this advantage as well! And so, the study conducted by Arvind Vatkar, Poonam Vaishnav, Pragnya Supe, Ritam Chowdhury and Sandeep Patil, found that only a third of emergency cases were brought in by ambulances. The rest came in police vans, taxis, private vehicles and some even on stretchers by foot.

It is a pity that a country that is supposed to be the next superpower and a city that is the financial capital of that country does not even have a basic EMS for the public. There is no single number to call and no coordinating authority to work with. If a person reaches the hospital in time, it is usually due to the timely arrival of a complete stranger, either the police or a passerby. And contrary to popular belief, the police were actually able to rescue people in about a quarter of accidents and then transported the victims in police vans to the hospital.

With the virtual absence of any kind of civic training in first-aid as well as trained paramedics (even if an ambulance manages to come to you, it is actually just a transportation mode with no trained personnel to handle accidents), about half of the victims receive no first aid on the way and the other receive inappropriate care, which is even worse.

Despite all this, the EMS at Sion Hospital does a great job. And though, as with most things in our daily lives, the authorities are completely useless in terms of providing pre-hospital care during accidents, it is a public Municipal hospital that provides perhaps the best accident care, if you manage to get to it…alive.

Posted by bhavinj at October 16, 2006 10:19 AM

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Posted by: shoby at November 9, 2006 10:23 PM

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