Emergency Medicine (lack of) the great equalizer

I have not really read much about the effectiveness of emergency medicine in India. One of the great equalizers in India is that if you happen to be in a car crash on one of its bucolic highways the chances of you surviving it is pretty much providential be you the a rich man or a poor man. All the money in the world will not help you at that instant when you really need professional medical help. There were over 98,000 road accident deaths in the year 2005 in India. You can find more sobering details about killer Indian roads (for once I agree which such crass hyperbole)

What really prompted me to touch of this issue are two simultaneous publication that show the problem and also offer a solution. That should get health policy wonks thinking about this issue. The first is this sad story that I read.

For 45 minutes, a biker and a pedestrian lay injured and bleeding on the highway near Mulund; traffic cops tried to flag down vehicles but nobody stopped to take them to hospital. Source

And then there was this story in the recent issue of the TIME magazine.

On São Paulo's chaotic streets, ambulances often can't get through the traffic to an accident scene. Hence the motorbike medic.

And these medicos are firefighters who take 240 hours of first-aid education and two week course on motorcycles skills and maintenance. Not to be snarky but can you imagine what an MBBS kid from Pune would be like? A god/goddess amongst these Sao Paolo firefighting medicos? Why Pune, coz everyone is born riding a two wheeler in that city.

But that comment should get you thinking about the possibilities of such a service in major metros in India. After all if we can have putatively deadly motorcycle riding commandos to stop crime in Mumbai, imagine what REAL service can be provided by similarly trained medicos on motorbikes in the same city.

At the risk of sounding like an insta-punditz, I think its quite feasible. There is no dearth for MBBS docs and there is no dearth of motorcycles in India and especially in Mumbai. Rather than trying to train firefighters who are way to busy rescuing folks from crashed buildings it is better to use someone who is professionally trained in the fundamentals of medicine to take over the task of emergency medicine.

The idea is the get "just the bare amount" of care to those who really need it the most in the time that its needed the most. Its really not that costly to implement something like this. Sure the insta-critics will wonder if such a project is sustainable, I think it is, there are more people dying or getting hurt on Indian roads (specially Metro roads) than there are D-company men running around. Heck even a D-company man who gets hurt in an "encounter" needs to be sewed up (or so I would naively assume)

If you ask me the pandu in the Mumbai story did more than what was expected of him. This is a direct quote from the Sao Paolo story...think about it

......(the) firefighters have become the go-to guys when accidents occur, perhaps because the country's health service is in disarray and the police are among the nation's least esteemed public servants.