Trauma, Injuries and Disasters

Samina was a 19-year old medical student at the time her father lost his life on the way to the hospital in an ill-equipped, inadequately manned ambulance. The vehicle had no emergency equipment on board; not even an oxygen cylinder; neither was there a trained paramedic to accompany the distressed cardiac patient who fought for his life throughout the fateful journey. To the utter dismay of Samina, her 60-year old father breathed his last a few yards away from the first opportunity of medical assistance, just as the vehicle turned to enter the gates of AKUH.

A working group has been established to prepare a comprehensive emergency response plan.

This incident is one of many over the past years that led AKU’s Emergency Medicine section to organise the research symposium titled, 'Trauma, Injuries and Disasters: Research and Training Imperatives' in February. It was the first event of its kind, drawing attention to the neglected issue of emergency response for accidents, disasters and injuries. The recent earthquake disaster in Kashmir and the northern areas further highlighted the necessity of this seminar, organised under Johns Hopkins-Aga Khan University International Collaborative Trauma and Injury Research Training (ICTIRT) Programme at AKU.

Delegates from three countries shared experiences and research findings from their own regions. Special emphasis was laid on the situation in Low to Middle Income Countries (LMIC), where integrated emergency response systems usually do not exist.

The delegates noted that normally trauma and injuries receive attention only after a disaster has struck, and stressed on the need for raising awareness among donor organisations as well as governments to establish a comprehensive system to deal with emergencies.

Dr Junaid Razzak, Head of Emergency Medicine Section and Assistant Professor, AKU

 Health Policy and Systems Specialist, Dr Abdul Ghaffar from Global Forum for Health Research, Geneva, pointed out that in LMIC especially, attention was focused on injuries only when there was a catastrophe. He also said that none of the major donors were willing to commit significant resources to injury prevention. He mentioned poor regulatory measures and sketchy legal systems as factors affecting research in injury prevention and control.

The symposium highlighted a number of actions necessary to produce better results in future including introducing this subject in the curriculum at the undergraduate level. The needs identified at the symposium included the training of scientists and health professionals in the principles of injury control, efforts to raise awareness and foster national and international collaboration among researchers.

As a follow up to the symposium, a trauma and injuries working group has been established to hold regular meetings for the development of a comprehensive plan. An integrated emergency response system is being developed involving hospitals, care units and emergency vehicles as well as specialised training of health professionals in injury control.

Dr Ellen MacKenzie of Johns Hopkins University Bloomberg School of Public Health, USA, articulated the long term vision of ICTIRT that i n c l u d e s the establishment of a programme or institute for injury and trauma research and training at AKU that can serve Pakistan and other parts of South Asia.

This symposium was a major step forward in the field of emergency medicine in Pakistan. As efforts to put together an integrated system continue, hope is kindled for Samina and many others like her, who might be saved the traumatic experience of losing their loved ones through timely and effective preventive measures.