IN Pakistan where healthcare resources and services are frequently overwhelmed and under-resourced, pre-hospital emergency care is perhaps needed now more than ever.
Whether it is a road traffic accident, cardiac arrest, maternal condition or disaster, the early minutes following an emergency are critical. Well-prepared and well-performing dispatchers can save lives and diminish long-term disabilities and medical load to hospitals with timely, effective and coherent response in this “golden hour”.
Fortunately, Pakistan has a fantastically effective emergency service that has always served it excellently and with distinction: Rescue 1122. As a public health researcher and the director Violence, Injury Prevention & Disability (VIPD) Unit at the Health Services Academy (HSA) I have had the opportunity to work closely with the system and have seen firsthand the immense work done by it.
The Value of Pre-hospital Care: “Pre-hospital care” means treatment and support given to patients before arriving at a hospital for emergency care. It is not only a question of getting people there — it’s also about being able to offer potentially life-saving interventions on the spot. The provision of early intervention measures such as to stabilize patients with head injuries, to control bleeding, to help childbirth in maternal emergencies, and to conduct CPR in cardiac instances is critically important for pre-hospital care. This system is very well established in high-income countries. In low- and middle-income countries — like Pakistan — it is nascent yet full of promise. Closing this divide has the potential to revolutionize patient outcomes, mortality and morbidity and provide improved protection in emergencies and disasters.
Rescue 1122: A National Asset: Rescue 1122, formed in 2004, has become one of South Asia’s most efficient and reliable emergency services. With trained paramedics, ambulances, motorbike responders and fire rescue units the service covers almost every district of Punjab and some other provinces. It’s not about having vehicles or any infrastructure; it’s the educated way the training is being conducted, the management and the will of the people that makes Rescue 1122 so much different. Their dedicated professionalism and compassionate rapidity of response gives hope to those most in need. From road accidents to house fires, from trauma cases to natural calamities – Rescue 1122 is usually first on the scene. Their work is an essential, if sometimes invisible, lifeline that deserves more visibility, recognition and support.
VIPD–1122 Collaboration: Bridging Research and Practice: Acknowledging the importance of pre-hospital care, the Violence, Injury Prevention & Disability (VIPD) Unit at the Health Services Academy has collaborated with Rescue 1122 to help support the development of emergency response systems through research, training and advocacy. Our continued collaboration has worked in the following areas: Process Mapping Observing SOPs and Ground Realities of 1122 to understand Work Flows/Challenges. Training Strengthening: Assistance in development of simulation-based modules on trauma, maternal health emergency and disaster response. Analysis: Analyze emergency data to determine trends, chokepoints and policy opportunities.
Community Awareness: It involves developing of community education programs on road safety, first aid and activating early emergency system. We hope that efforts across the partnership will contribute to raising the overall standard of care delivered by EMS providers, and more widely to shaping national policy for EMS.
Why This Matters for Pakistan: Pakistan has a triple burden of diseases which includes emerging non-communicable diseases (NSD), communicable diseases (OTHERS) and a significant burden of injury and trauma. Thousands of lives are lost each year due to road traffic injuries and preventable deaths due to delayed access to emergency maternal and cardiac care persist.
Regrettably, pre-hospital care is still a neglected stepchild in our health system. It is not well integrated in health planning and in many places is not considered an essential service. Focusing on what works and communicating widely the positive impact of services such as Rescue 1122, the argument can be made for more investment, policy priority and public involvement. With Rescue 1122, we aim to create Pakistan’s first national injury and emergency response data platform, an indispensable asset for real-time analysis and long term planning.
A Call for Support and Recognition: Pre-hospital care should be considered as a public good of primary importance for the national policy-makers, health workers and community leaders. I also call upon development-partners and global health agencies to contribute for strengthening the capacity of emergency medical services throughout Pakistan. The VIPD–1122 partnership is a model for what can be accomplished when academics and frontline services join forces. With your dedication and shared belief that no life should be lost to delayed response, we can do it.
—The writer is PhD, FRSPH, MSPH, MPhil, MSc, Assistant Professor, Health Services Academy (HSA), Director, Violence, Injury Prevention & Disability (VIPD) Unit.
