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by Fathima Razik Cader

Apropos to the articles on this programme which appeared on the 8th, 22nd and 29th April, respectively the citizens of Colombo in particular, and those in other parts of the country, eventually will be able to see the Emergency and Rescue Service in action.

And no doubt, for a while, most people on the streets are going to stop whatever they are doing and watch the scene that will unfold when the Emergency and Rescue teams actually live up to their name - i.e. respond to an emergency call and rescue a trauma victim. A dire and long-felt need, the major players in this important exercise are working according to plan and making steady progress.

For a start, Chief Fire Officer, Fire Department, J. Kannangara, said that 89 suitably qualified men have been selected with the majority of them having successfully got through Biology (as a subject) at the Advanced Level exams. On the 15th July, 2003, they began basic training in fire fighting followed by an intensive training programme for six weeks. Thereafter, 30 of them will be chosen to follow training as para-medics. Training for the recruits will also be conducted at the Headquarters of the Fire Department in addition to the Dockyard, the Airport and the Refineries at Kolonnawa and Sapugaskande. Such training will include fighting an outbreak of fire on a ship, an aircraft or oil refinery.

The programme also has rescue operations as lifeguards and will therefore put these trainees through appropriate training to function in that capacity as well. J. Kannangara, the Fire Chief and the training officers at the Fire Department will have their hands full, as a result. The 'icing off the cake' is that these young men with A' Level qualifications are ensured of a permanent job but with a proviso - that they perform well throughout their training. Those who do not achieve the required standards will (sadly) be discontinued.

Taking over from the Fire Chief will be Dr. Anil Jasinghe, Director, Accident Service and Dr. Shirani Hapuarachchi, Consultant Anaesthetist, Neuro Surgical Unit of the National Hospital of Sri Lanka. Dr. Shirani Hapuarachchi said that at the very outset, the recruits will be taught the basics of physiology followed by first-aid. She was very emphatic that the recruits should be thorough on human anatomy so as to deal with accident victims effectively. "That way the victim can be treated correctly so as to prevent further damage to the injury already sustained" she avers.

We certainly do not disagree with that statement. Also important is the manner in which a patient is handled whilst being transported to hospital. Currently, many accident victims suffer added trauma to the injury already sustained in the process of being transported to hospital. The need to give oxygen (depending on the type of injury), why first-aid is necessary, the reassurance to the injured (if conscious) are all part of the comprehensive training that the para-medics will be going through before being put on the job.

Dr. Anil Jasinghe said that the curriculum for the programme has been drawn up based on the London Ambulance Service in the UK. This will no doubt be a paradigm shift in conducting this whole exercise. For after all, precious lives of those injured in an accident are in the balance and the measures such as those being drawn up are certainly worthy of mention. As a matter of routine, Dr. Jasinghe sees many accident victims daily.

"It is a matter of regret that presently, 60% of primary evacuations from the scene of the accident are done in three-wheelers and this has got to stop" asserts Dr. Jasinghe. 25% of the total admissions to the Accident Service at the National Hospital are caused by road traffic accidents. Dr. Jasinghe adds that empirical evidence reveals that around one-third of the trauma deaths could be averted if there is an effective and timely pre-hospital care in place. Further, complications too could be reduced if such care in rendered to an accident victim. "The objective therefore is - either reduce morbidity or reduce mortality" summed up Dr. Jasinghe.

The Traffic Police, according to SSP Alfred Wijewardena, is ready to play an important role in this whole exercise. "My staff has undergone the necessary training and we are awaiting the call to link up with the rest of the team," said Wijewardena. "However, we need to get our officers into the act prior to actually responding to an alarm call by having a series of mock exercises" added Wijewardena. One can therefore see that the plan of action is being followed and the birth of the Emergency and Rescue Service is certainly on the cards.

Yet another vital link is the Telecommunications Regulatory Commission (TRC), which has to provide the 3 digit number to the Alarm Centre at the Fire Department and the Traffic Police Department. In this context, Prasanna Kumara Wickramaarachchi, Consultant to the TRC, said that this issue is being addressed and sooner rather than later, the approval should be granted and thereafter, the connection to the local area authority will be made. Similarly, in the future too, when this programme expands to other parts of the country, the short-code connections to the local authorities of those areas will be made. This will enable anyone to easily dial the three digit numbers and be connected promptly to report an accident. Presently, getting through to the Police, the Fire Department or the hospital can be a tedious exercise. This facility provided by the TRC will be an absolute boon and will no doubt contribute immensely towards saving many a life.

His Worship the Mayor, Prasanna Gunawardena and Dr. Pradeep Kariyawasam, Chief MOH of the Colombo Municipal Council are also diligently working towards the overall success of this exercise. Towards this end, the Mayor has been taking a personal interest in ensuring that the all-important ambulances, geared for such an exercise are obtained. As reported in the introductory article (8th April), the Mayor has pledged the funds for the import of four ambulances for the Emergency and Rescue Service.

Dr. Kariyawasam, when contacted, said that the ambulances with the state-of-the-art equipment and costing around Rs. 5mn each, will be bought once the tender procedures are through, Dr. Kariyawasam added that initially, this service will be confined to road traffic accidents and will later on be extended to cover other types of traumas - e.g. injury on account of a fall or a burn injury in the home. He emphasized the need of a coordinated service with all the major players getting into the act simultaneously. On being questioned as to when this service will get off the ground, Dr. Kariyawasam confidently replied, "early next year".

Finally, the National Road Safety Secretariat (NRSS) of the Ministry of Transport, Highways and Civil Aviation and SweRoad, the Swedish consultancy firm will come in to complete the picture. Kurt Fahleson, Resident Representative, SweRoad, reiterated that the overall programme should have many trial runs prior to being officially launched.

"All the disciplines, (the Fire Department housing the Alarm Centre and the ambulances with the para-medics, the Traffic Police and the hospital) have to be coordinated and we have the expertise, the practical training and the know-how to do this", said Fahleson. "Swedish expert on this subject, Sven Loden, was in Sri Lanka during the initial planning stage of this programme and he will be back to see that everything is in place" added Fahleson.

Sri Lanka and her citizens are fortunate that even at this stage, an Emergency and Rescue Service is being planned meticulously with no loose ends left because the Colombo Municipal Council and its Fire Department, the Traffic Police, the Accident Service of the NHSL, the Telecommunications Regulatory Authority, the National Road Safety Secretariat and SweRoad, have thought it fit to devote so much of time, energy, knowledge and resources - especially financial, towards a most touching cause and worthy of praise by every citizen - that of saving precious human lives.

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