This post has been self-published on Youth Ki Awaaz by Sanjay Mucharla. Just like them, anyone can publish on Youth Ki Awaaz.

Have You Heard Of The App That Dispatches First-Responders To Emergencies In India?

Sudipta was riding his bike at around 10:30 PM in Bhubaneswar when, all of a sudden, an ox ran across the road. Upon swerving his vehicle, he lost balance and fell off his vehicle which caused a fracture on his right hand and a bleeding wound on his head.

Emergencies are not a rarity in our country. Statistics show that an estimated 300,000 emergency cases, medical and non-medical, are recorded in the country every day, with 9.5 percent of the population being affected by an emergency annually. Of these, 80 per cent are medical emergencies. India has about severe 480,000 road accidents every year, and 33 percent of these are fatal, according to a 2016 report by the government’s Transport Research Wing. 

In the US, only 2% of accident victims die. This difference in survival is mainly because of the lack of access to quality treatment in the first or “golden hour” of the accident. As a rule, 80 percent of deaths in medical emergencies occurs during the first hour.

In 2004, 10% (4,000 people) of all who died in India annually, lost their lives because of untreated or badly treated injuries according to a report by the National Human Rights Commission.

While most people assume that road accidents make for the most ambulance calls, it is, in fact, cardiac arrests that lead to more medical emergencies in India. According to the Accident-Statistical Year Book 2016, India has just a one per cent success rate in preventing deaths or permanent disability in the event of a cardiac arrest, another important category of emergency victims. In contrast, the success rate in the US was five to six per cent as far back as the early 1980s.

The Existing Emergency Medical Services (EMS) In The Country

India’s EMS is largely ambulance driven. And that’s a big problem because ambulances are not cost-effective. 

Running an ambulance-heavy EMS is expensive, and is not very effective in saving lives, in an emergency, in low-income countries like ours, as only several dozen ambulances serving a population of 10,000 will have the potential to save lives. After deployment, which happens after an ambulance is available, the wait stretches for 15-40 minutes for the dying victim in an urban area. In rural India, things are much worse.

The Indian Emergency Journal in its August 2005 issue states, “Twelve percent of institutions in the trauma care sector have no access to ambulances. Only fifty per cent of the available ambulance services possess the acute care facilities needed to keep an accident victim alive during transportation, and only four per cent of personnel staffing these services have certified formal training”.

Loads of people cite the high costs of First-Responder training as a barrier to initiate First-Responder programs in our country, but studies show a different reality. 

Contrary to what people think, training lay responders and paramedics can be relatively cost-effective as compared to the cost of ambulatory services as a study conducted in Turkey found that ambulance vehicle costs were the leading component of capital costs in EMS (Altintas, Bilir, and Tuleylioglu 1999). The cost per ambulance trip was US$163, and the cost per patient transported was US$180.

First -Responders: People Powered Emergency Care

These above numbers are saddening especially when simple life-saving techniques can be used to prevent lives in such emergencies. Multiple studies have shown that lives of 50% of the victims can be saved by helping them in the first hour, also called as the “golden” hour.

A First-Responder is a lay-person who receives basic first-aid care training and volunteers to respond to appropriate medical emergencies while an ambulance is en route. In several countries, people are actively recruited to provide first aid and initiate pre-hospital emergency care. A growing body of literature supports this low-cost, effective practice to save vulnerable lives. Having a network of medically trained volunteers in each city can make a world of a difference in a country like India, where countless lives are lost on the way to a hospital or while awaiting medical help.

One such organisation in India providing a one-stop healthcare platform for anybody who requires help in an emergency is G1 Health. First-Response is one of the crucial parts of this ecosystem, which provides first aid to patients of cardiac, ‘neuro’, obstetric, accident and trauma patients until professional or ambulatory help is available. The immediate aim of this program is to train over one lakh citizens in basic life-saving skills, starting with Hyderabad.

In the second part of the story mentioned in the beginning, Sudipta who was injured from the accident, immediately raised an emergency through the G1 app on his mobile to alert nearby First-Responders, and ambulances in order to get help. Ramakant, a First-Responder, who was nearby received a notification on his First-Responder App. Ramakant accepted the request and via GPS directions, arrived at the incident spot where Sudipta was, and then performed first-aid on Sudipta to stop the bleeding from the wounds. Since there were no ambulances nearby, Sudipta was taken to the nearest hospital in a fire station jeep.

This is one among many incidents which shows the power of an integrated emergency care ecosystem made possible by mobile-enabled technology. In another story, a police officer in Hyderabad trained on First-Response stepped forward to help an accident victim in need of help and provided first-aid by stopping the bleeding and cleaning the wounds.

The vision of the First-Responder program is to make India emergency ready by creating a network of First-Responders capable of providing basic life support in case of common emergencies like cardiac arrest, stroke, delivery-related emergencies, and road accident trauma cases before an ambulance arrives.

There is no doubt that a community First-Responder driven EMS will see many lives getting saved through prompt action by lay First-Responders. It’s about time that all players in the Indian healthcare space step up to give our people this chance at saving precious lives.

This article is an extract of the white paper ‘Scattered Saviours: Why First-Responders are the Future of the Indian Emergency Care Management System?’ which can be downloaded for free here.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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