The Indian Medical Association has prepared a draft plan to introduce emergency medical services, initially in four states, from next year, according to Dr Arul Roy, National President of the Association. He also said 2003 would be observed as the Year of Emergency Medicine. The propagation of Emergency Medicine would be taken up on a war-footing during the year, he said. He was speaking at the first International Conference on Emergency Medicine in Hyderabad on Friday.

Stressing the importance of Family Medicine and Emergency Medicine, Dr Roy said both needed greater attention by extending speciality status. The draft plan would deal with emergency in and out of hospitals and also in-between towns. It would also stress on the need to link accident-prone highways with the healthcare system.

For the effective implementation of emergency medical services, Dr Roy suggested the need for mass education, training for nursing and paramedical staff, better communication and transport facilities, like uniform emergency telephone number throughout the country and fully equipped ambulances, and a responsible media to educate the public for a change in mindset.

Referring to some speakers' remarks that India lagged behind the western countries by 30 to 35 years with regard to emergency medical services, Dr Roy said, "We will do it in the next 12 months what they have done in 35 years."

The three-day international conference has been organized by the Society for Emergency Medicine in India (SEMI), in association with Apollo Hospitals, Medical Council of India, American Academy for Emergency Medicine, American Academy for Emergency Medicine (India), Emergency International and North Shore Long Island Jewish Health System, New York. Over 500 delegates from the medical fraternity, pharmaceutical companies and government agencies are attending the conference and the workshop which began on October 23. There are also some delegates and panelists from the US, UK, Colombo and Singapore.

The discussion on Friday brought to light the woeful inadequacies in the health delivery system and the avoidable death of more than a million people every year for want of timely medical care. The conference also raised concern over emergencies created by both natural and man-made disasters.

Inaugurating the conference, Dr Kodela Sivaprasad Rao, Medical and Health Minister, Andhra Pradesh, promised to introduce post-graduate courses in Emergency Medicine in all the medical colleges in the State. The courses would start from next academic year pooling an expert faculty from various specialties.

The State Government was planning to station fully equipped ambulances and set up mini mobile emergency care hospitals at all accident-prone areas, especially along the highways. A state-level committee of doctors from both the public and private sector would study the problems involved in emergency care and arrive at solutions, the Minister said.

Sangita Reddy, Managing Director of Apollo Hospitals, said the country was poised for a new era in emergency medical care. She said the primary requirement was accessibility, both physical and financial. Creation of infrastructure alone was not enough. The people should be aware of the facilities, where to take a patient in an emergency, where to get an ambulance etc.

After SEMI was set up in the year 1999, an awareness had been created and several institutions were doing something in emergency care. She said that was not enough and called for an integrated approach to produce results. All efforts should be directed to sensetize the staff, the public, the doctors, the regulatory bodies and the MCI to play the role of life-savers.

Dr G Bhaktavatsalam, President, SEMI, wanted everyone to develop a passion for emergency medical care which can save hundreds of lives. He said it was a wonderful specialty and what was needed was an emergency system with a couple of ambulances and trained staff.

Dr Shyam Sunder, Vice-Chancellor, NTR University of Health Sciences, Vijayawada, said his university would take steps to start post-graduate courses in Emergency Medicine soon. He said in addition to the big cities, training at district level must be given equal consideration. He also called for training a core faculty and holding national examination on the subject.

Dr George Abraham, President, American Academy of Emergency Medicine, India, said though 1,70,000 people died of accidents every year, the authorities had neglected this sector. He said while 60 % of the ambulances carried dead bodies, the remaining carried staff to their offices. He stressed the need for fully equipped ambulances instead of "mortuary vehicles."

Dr K Hari Prasad, Organising Secretary of the conference, was confident that post-graduate courses would be started by next year to coincide with the Year of Emergency Medicine as declared by IMA. He called for public-private hospital partnership for quality emergency services. He said the situation in the major cities had improved to a great extent. Though the number of accidents had gone up, the number of deaths had come down. Emergency care did not cost anything, what was needed was a change of mindset to help in an emergency.

Dr Suresh David, Chief of Emergency Services, CMC, Vellore, lamented the road blocks created by the Medical Council of India. He said half of the post-graduate degrees had not been recognized by MCI. He said the situation in trauma care had changed with Apollo taking the lead. Now trauma and emergency cases were being admitted in hospitals. Doctors must have real concern on emergency cases, he said.

Dr Mabel Vasnaik of St John's Medical College, Bangalore, stressed the need for recognizing emergency medicine as a speciality by the Medical Council of India. It should be introduced as a course of study at the under-graduate and post-graduate levels, she said.

In the next two days, the participants would discuss issues such as disaster management, pre-hospital care, EM in rural India, and various problems that needed immediate attention. Winding up the first day's discussions, Dr Hari Prasad said, "Let us show our concern and do our work while waiting for MCI recognition."