PRIME CONCERN
14
HARYANA
TRAUMA CARE
Haryana has one of
the highest
accident rates in
the country. The
state highway
patrol was set up
to minimise
casualties on road.
But ill-equipped
trauma centres and
ambulances render
the efforts futile.
Pradeep Sharma
Faridabad
N a general reflection of the rising
accidents on Haryana’s ‘killer roads’,
the highway patrol of the Haryana
Police attended to nearly 9,000 accident cases in 2013. Gurgaon accounted for the highest number of 955 accidents
followed by Faridabad at 713 cases.
The districts along the GT Road and
other major national highways accounted
for the lion’s share of accident victims
rushed to the nearby trauma care centres
in the state by the highway patrol.
Ambala accounted for the maximum
528 cases, followed by Karnal, Panipat,
Faridabad and Rewari. Data collected by
The Tribune shows that the districts
along the state highways such as Yamunanagar, Kaithal, Fatehabad, Panchkula,
Sirsa, Jind and Mewat accounted for
lesser number of road accidents.
Haryana has one of the highest accident rates in the country, with nearly 13
persons being killed and about 25
injured every day on the state’s roads.
The high density of national and state
highways passing through the state, rash
driving and alleged faulty design of
roads are some of the causes for the accidents. Recently, five police personnel
were suspended and another five were
warned against dereliction of duty while
handling accident victims in Gurgaon
district last year.
Less equipment,
lesser staff
Bijendra Ahlawat
T
Yamunanagar
Districts
Cases
Districts
Gurgaon
955
Yamunanagar 284
‘102’ ambulance
service doing well
Faridabad
713
Kaithal
275
Shiv Kumar Sharma
Ambala
528
Fatehabad
218
Karnal
547
Panchkula
232
Panipat
505
Sirsa
223
Faridabad
575
Jind
286
Rewari
502
Mewat
264
Cases
T
HE ‘102 Ambulance Service’ is a
life saver. The service rushes
about four to five accident victims
to hospitals every day. There are 18
ambulances in the fleet, with each
covering an area of 10-12 km.
Fleet manager Sachin Sharma says
the ambulance reaches the accident
spot within 15 to 20 minutes. Dr Vijay
Dahiya, Medical Superintendent, Civil Hospital, says directions have been
issued to officials handling ambulances to ensure no negligence is committed in providing the service to the
needy. The ambulances have been
provided at every Civil Hospital, CHC
and PHC level. Two ambulances are
equipped with advance life support
and 16 with basic life support equipment. There is an emergency medical
technician for every ambulance.
Sachin says last year, 24,677
patients, including accident victims,
were provided with the ambulance
facility. People of rural areas are more
aware about the service. Patients are
not charged any fee, but Rs 7 per km
is charged from patients other than
pregnant women, accident victims,
infants, and heart disease and burn
patients if the ambulance is
required outside the district.
Ambala
Emergency services
non-existent
Emergency wing lacks facilities. TRIBUNE PHOTO
Manish Sirhindi
H
AVING failed to serve the purpose
for which it was conceptualised a
few years ago, the Trauma Care Centre
at Ambala City Civil Hospital has been
reduced to a mere ‘referring centre’,
where patients requiring emergency
care are simply referred to the PGI,
Chandigarh.
Located near the National Highway
No. 1 on the Ambala-Hisar National
Ambala
Highway 65, the hospital is of great
Yamunanagar significance as it can provide immediate aid to accident victims.
Kurukshetra
However, hit by a shortage of specialist
doctors, the emergency services are
Karnal
almost non-existent. A trauma care centre
Jind
is supposed to be well equipped and adequately staffed so that comprehensive
emergency medical services can be proJhajjar
vided to patients. According to doctors,
Faridabad victims of trauma require specialised
and experienced multidisciplinary
treatment, for which a diagnostic radiology laboratory, computed tomography
and CT scan, and subspecialty surgical
care in disciplines like cardiothoracic surgery, neurosurgery, orthopaedic surgery
and urology, is a must for a centre.
However, the 20-bedded Ambala centre
lacks most facilities. With no provision for
a CT scan and computing tomography,
most cases of head injury are often not
diagnosed. There is no neurosurgeon or
plastic surgeon and rehabilitative services, considered a must for a trauma centre,
are also missing. The post of radiographer
has been lying vacant and x-rays are conducted by junior technical staff. Sources
say the lab also lacks facilities and most
tests were referred to private labs.
Though there is no dearth of ambulances at the hospital, most lack facilities
to handle emergencies. Other than the
basic oxygen cylinders, equipment like
cardiac monitor, collapsible wheelchair,
medical kits, inflatable splints, blood presAmbala woes
sure cuff, spinal collars, burn kits, glu(Distress calls in 2013)
cometers and instant cold packs are missing. Most also do not have paramedics.
Received in Ambala by
Though the staff maintain that prompt
ambulance services
ambulance services are provided, there
have been reports of ambulances reaching the site after 45 minutes. Last year,
Patients rushed to PGI,
Chandigarh
the district administration had prepared
a Rs 75 crore plan to revamp the hospital
and centre, but nothing has happened.
8,687
CHANDIGARH | SUNDAY | 2 MARCH 2014
Fractured service for road casualties
I
Total road accidents in 2013
29,048
123
Jhajjar
Neither police ambulance nor specialists
Ravinder Saini
N
OTWITHSTANDING the rising number of road mishaps due to inclement
weather and foggy condition, the police is
ill-equipped to provide quick relief to victims. Surprisingly, no trauma care van is
available in the district.
Though the police has two ambulance
vans in Bahadurgarh, these are being
used merely to rush victims to hospital.
The vans do not have any medical facility or first-aid kits. Police personnel The Trauma Centre is facing a shortage of
supportive staff. A TRIBUNE PHOTO
deployed with the vans are
not trained in providing firstlacks equipment and specialist
Jhajjar’s
tally
aid to victims.
doctors. It is also facing acute
Road safety experts say prop- Killed
Injured shortage of support staff. The
er handling is the most vital
centre, set up in 2011, is being
YEAR
2013
part of first-aid. “The victim
run without any emergency
219
231
should be laid straight before
facility for the last three years.
being shifted to an ambulance. YEAR 2012
MRI and CT scan facilities are a
This is rarely done in normal
distant dream as the centre
172
215
practice,” says an expert.
does not even have an ultraAs per information, no police
sound machine. Patients have
ambulance is available in Jhajjar city. The to go to private labs for these tests. The
police has to depend on private ambu- General Hospital has deputed its staff at
lances. Yogesh Kumar, traffic in charge the centre on rotation.
(Bahadurgarh), says one of the two ambu“We have informed the headquarters
lances had been stationed at the police over and over again about the shortage of
post in Aashodha village located along the staff and lack of facilities, but to no avail.
National Highway No. 10 while the other The headquarters itself is struggling to
was at the city police station in Bahadur- get the services of specialist doctors as
garh. “The ambulance vans are pressed they don’t seem interested in joining the
into service as soon as we get information government sector,” says Dr Kashmir
about any accident,” he says, adding that Singh Dalal, SMO of the centre. Hospital
no doctor was available with the ambu- sources say they treat patients with the
lance to provide first-aid to victims.
help of available doctors but any serious
The trauma care centre at Bahadurgarh case has to be referred to other hospitals.
HE preparedness of the police
and health department to tackle
trauma cases continues to fall short
in the absence of adequate staff and
equipment in Faridabad and Palwal
districts. These districts share
around 60 km of the National Highway No. 2, one of the most congested highways of North India. The district reported about 600 deaths in
road accidents till November 30 last.
Though police and health department claim to be tackling the situation well, there is much scope of
improvement. The traffic police,
which is headed by a DCP, requires
over 605 personnel and adequate
number of vehicles and related
infrastructure to handle road safety,
sources in the department admit.
“We have written to the higher
authorities and expect to get at least
half of the staff,” says Devender
Yadav, DCP Traffic.
He says the police is maintaining a
fleet of seven ambulances, one FSL
van and two recovery vans to handle
relief work during accidents.
The health department on the other hand has 16 ambulances to rush
patients and accident victims to
hospital. While the police has provided the helpline number ‘1071’,
the health department attends to
the helpline number ‘102’.
However sources say the traffic
police in Faridabad and Palwal districts require at least two dozen
ambulances and support vans in
view of the high density of traffic on
the national highway and other vital
roads used by thousands of commuters daily.
Kurukshetra
Incomplete flyovers
not helping
The flyover at Pipli Chowk is still under
construction. A TRIBUNE PHOTO
Nitish Sharma
D
Karnal
Life-saving equipment missing
Parveen Arora
T
HE district lacks hi-tech facilities in
ambulances to tackle the crucial
hours after an accident. The highway
police ambulances do not have basic
equipment like ventilators and oxygen
cylinders and inadequate paramedical
staff only adds to the misery of victims.
Due to the shortage of ambulances,
help is sometimes sought from the
health department. Sources say the
condition of the department’s ambulances is shocking. Even the three ‘life-
saver’ ambulances do not have a ventilator and regular drivers. Out of the 19
ambulances of the department, three
are off the road and others are engaged
with hospitals, and are also used for
delivery cases. However, they claim that
they have the facility of an emergency
Karnal road accidents
2012
Mishaps
2013
477 Mishaps
570
Killed
219 Killed
272
Injured
449 Injured
481
medical technician in ambulances.
A majority of cases of head injury are
referred to the PGI at Rohtak and
Chandigarh in the absence of a neurosurgeon at the trauma centre.
As per the accident data with the
Kalpana Chawla Government Medical
College Hospital, 733 road accident calls
were received in 2011-12, 1,001 calls in
2012-13 and 24 calls at the accident control room. “Requirement for eight
ambulances has been sent and posts of
driver have been advertised,” says Dr
Vandana Bhatia, Civil Surgeon.
“We do not have paramedical staff, but
we do our best to save the injured by
taking them to hospital on time,” says
Satyadev Singh, SHO, highway patrol.
Jind
No trauma centre, nearest referral hospital 60 km away
Parvesh Sharma
I
T ’ S the oldest district of Haryana, but
when it comes to health facilities, it is
far behind even some new cities of the
state. The district does not have a single
trauma care centre.
The health authorities claim to have
made arrangements for the speedy
treatment to the injured, but a ground
check reveals they only have ambulances at places like Safido, Kandela,
Kalua, Aleva, Narwana, Uchana and
Julana. The ambulances provide only
first-aid and bring patients to the Jind
Civil Hospital.
Hospital sources say they have
received over 70 accident cases in the
last six months, but a majority of cases
were referred to the PGI, Rohtak, and
Khanpur hospital, both of which are
over 60 km away, and not all victims survive the long journey.
“We do not have the facilities to treat
head and chest injuries,” says Amit, a
The much-needed trauma centre under construction in Jind. A TRIBUNE PHOTOGRAPH
pharmacist with the hospital ambulance. He admitted that they only have
first-aid facilities.
The hospital does not have an operational ultrasound machine and costly
equipment is gathering dust as there is no
staff to run them. Locals allege that
health officials are in connivance with private ultrasound centres and taking commission by referring patients to them.
‘Things will improve’
We are facing some challenges
❝
and so we have to refer patients to
other hospitals. I have directed my
staff to take the required steps to
operate the ultrasound machine in
the hospital. Other facilities would
also improve in the coming days.❞
Dr Jatinder Grewal , CMO JIND
ESPITE being on the world's
map for its religious importance,
this holy city has no trauma centre
facility. Most emergency cases are
referred to the PGI. With no oxygen
cylinder, adjustable stretcher and
24-hour availability of paramedics,
the police ambulance vans deployed
at Pipli Chowk, Pehowa, Ladwa and
Shahabad are only used as an ‘accidental victim transport vehicle’.
The van has a team of a doctor, a
driver and helper. The van driver at
Pipli Chowk says he has been
assigned the areas of Samanai, Dhantodi, Mathana-Ladwa road and sector
2, 3 and 5. “Incomplete flyovers are Kurukshetra
the biggest obsta- casualties in
cle because we 2013
have to take a long
route to reach the KILLED 189
accident
spot.
During fog it INJURED 264
becomes
even
more difficult as the van does not
have fog lights,” he says.
The doctor is available with the
van only between 9am and 5pm.
An NHAI official says nine air-conditioned ambulances have been
deployed between Babarpur and
Jalandhar and are on the move 24
hours even in adverse weather conditions. Every ambulance has been
assigned an area of 30 km so that it can
reach on the spot within 15 minutes.
Every ambulance has a team of
two nursing staff, one driver and
one traffic controller. The ambulances are equipped with an oxygen
cylinder, a stretcher and first-aid.
Shiv Kumar, Chief Medical Officer,
Kurukshetra, says 17 ambulances
have been deployed in the district.
Critically injured victims are referred
to the PGI after being given first-aid.
The ambulance carries an oxygen
cylinder, emergency drugs and a medical technician to provide first-aid.