Dial 108: India's emergency response number has saved 1.5 mn lives so far

The service, currently available in 16 states and two union territories, employs 47,000 people and attends 80,000 calls daily

Our own version of 911, which attends calls for help on health, natural disasters or law-and-order emergencies, has been operational for the past 12 years. All that a distressed person has to do is to dial '108' on phone to have the situation addressed. This isn't currently a centralised service available all over India, but is offered in public-private partnership under an initiative of GVK-Emergency Medical Research Institute. 

The reach 

With 47,000 employees, the service is spread over 16 states and two union territories (Diu & Daman and Dadra-Nagar Haveli). A 24-hour helpline has been set up in each of these domains under a state head, who reports to the regional director. GVK-EMRI sets up services based on tenders floated by state governments or, if it is nominated, it is invited by state governments to establish an emergency response network. 

With the help of this initiative, which is equipped with life support systems contained in advanced and basic ambulances, over 45 million cases have been attended to, and over 1.5 million lives have been saved. India’s own emergency service may be world's largest in terms of the population it serves. “We attend 80,000 calls daily and touch a population of 800 million,” says K Krishnam Raju, Director, GVK-EMRI. 

Ambulances 

The GVK–EMRI-promoted initiative been operating quietly the past twelve years and has slowly added a repertoire of services, such as boat ambulances (in Assam, Uttarakhand and Gujarat), bike ambulances and those that cater to specific conditions such as heart and child delivery. What's more, GVK–EMRI also addresses non-health emergencies such as natural catastrophes and women in distress. The ambulance service was started by Satyam and was subsequently taken over by GVK group and placed under its foundation as Emergency Medical Research Institute (EMRI). 

Currently, it is the world’s largest Emergency medical service provider with a fleet size of over 13,000 operational ambulances. This fleet includes 6,600 emergency medical service ambulances that function as ICUs on wheels, 5,166 basic life-support ambulances, including those that carry patients who cannot reach a hospital without special support, and 798 advanced life-support ambulances. “We run mobile medical units as well” says Raju.

The service also runs 5,071 vehicles for Janani Sishu Suraksha Karyakram (JSSK), an ambulance service for pregnant women, newly-delivered mothers and infants through toll-free numbers, 102 and 104. Another toll-free number, 181, is essentially a helpline in Uttar Pradesh and Gujarat for women in distress. Some states have animal care ambulances as well.

Operations 

GVK-EMRI has set up 32 call centres across partner states with a state-of-the-art command centre in Hyderabad. The command centre has integrated telephony and GIS-enabled computer-aided integration of ambulances, using GPS devices. 

The service is offered in partnership with various state governments, both through tender and by nomination, as in the case in Tamil Nadu, Karnataka, Goa and Gujarat. Once a call is received, the patient or victim is taken to the nearest government hospital. No patient shifted or refused treatment in such a hospital, unless it is unable to provide required care. In such cases, the patient may be moved to another private hospital. 

Depending on the level of sophistication, each ambulance (Force and Tata) may cost anything between Rs 1.3 million and Rs 3 million. Eighty-five per cent of the cost of the vehicle is borne by the government while 15 per cent is undertaken by GVK-EMRI. 

Training the army of emergency responders 

Every '108' ambulance is manned by a trained emergency medical technician (EMT) and a trained pilot (driver). Apart from educating and informing the people in the community and responding to emergency calls, the service has also created a cadre of EMS-trained doctors and nurses to continue the EMS care delivery so that chances of survival improve for anyone in an emergency situation. GVK-EMRI’s state-of-the-art Emergency Medicine and Learning Centre (EMLC) is a centre of excellence in EMS education that has so far trained nearly 400,000 health care personnel on various aspects to ensure capacity building in EMS education in India as a precursor to increasing survival rates. 

So far, GVK-EMRI has trained 99,838 EMTs, 96,749 pilots, 13,188 doctors, 56,144 nurses, 45,269 first responders, 76,814 personnel in American Heart Association/International Trauma and Life Support (AHA/ITLS) courses and 8,215 personnel on other EMS Skills. Over 90 full-time certified instructors conduct global certification programmes regularly. 

GVK-EMRI and Stanford School of Medicine have, since 2007. jointly collaborated in instructor development, paramedic education, district hospital physician training, online medical research and pre-hospital emergency care protocols. It is also recognised as an International Training Centre (ITC) by global bodies. 
 

The Sri Lanka foray 

  

GVK-EMRI was chosen as operator by the Government of Sri Lanka to run the Emergency Ambulance Service with a toll-free number ‘1990’ in public-private partnership under the Indo–Sri Lanka Friendship Scheme. The programme was granted assistance of about $22.8 million by the Government of India. This includes $7.6 million for the first phase consisting of 88 ambulances in the country's southern and western provinces, launched on July 28, 2016 in Colombo. The remaining $15.2 million is for the ongoing second phase of a nationwide expansion involving deployment of 209 ambulances covering all districts in Sri Lanka. 

As many as 500 EMTs and pilots, 55 emergency response officers and 10 emergency response centre physicians have been trained so far by the GVK-EMRI EMLC Team for the Sri Lankan 1990 Suwa Seriya Emergency Response Service Project. Further training of over 600 people is on the cards. The service is being expanded in all of Sri Lanka. 

Migration to 112 

The Government of India wants to migrate all emergency services to one number -- 112. All distress calls relating to domestic abuse, violence, police, health, mother-and-child distress calls, fire and other emergencies will come to this number. ”We have no issue in migrating to the (new) service, though initially, people may find it difficult to associate the number 112 with emergency response,” says Raju. 

The big roadblock is the permission required by the telecom company to ascertain the GPS location of the origin of the call, to enable the emergency service provider to respond. “Uttar Pradesh maybe the first state to work towards giving this permission,” says Raju.