KARACHI, Jan 25: The Malir blast and the subsequent rescue services provided by volunteers and charity groups in the absence of a government-owned and medically-equipped fleet of field ambulances on Tuesday evening highlighted the need to review and improve the emergency response strategy in order to keep the death toll minimum in the events of blasts, accidents and natural disasters. While the death toll in the Tuesday blast remained low, immediate medical treatment to the blast victims was delayed because of the travelling time the ambulances took to reach the nearest major government hospital, Jinnah Postgraduate Medical Centre, which is around 20 kilometres from the blast site.

Medical experts while speaking to Dawn stressed the need for a proper and efficient emergency response arrangement in the city. “Blasts, major accidents or natural disasters demand more than what is performed by unskilled rescuers handling patients in urgent need of first aid,” they said. More importantly, they said, there was a need to have a skilled rescue workers team and equip secondary healthcare units functioning in different parts of the city with the required resources to deal with an emergency situation. “This will help reduce not only the burden on the city's three major hospitals, but also the delay in medical response,” they said.

The official in charge of JPMC emergency and casualty centre, Dr Seemin Jamali, who is also the hospital's additional executive director, said that doctors, paramedics and allied departments were ready to meet any eventuality in the wake of increased state of alarm on the occasion of Chehlum of Imam Hussain.

She added that while the casualties remained considerably on the lower side this time, the stress caused to doctors and injured people and their relatives on Tuesday was high in the wake of the last year blast on the hospital premises. “Though still scared of the bomb explosion that ripped through the hospital premises last year when doctors and paramedics were busy handling the victims of a bomb attack on a bus carrying participants of the Chehlum procession, the staffers tried their best to serve the injured patients this year,” she said.

In reply to a question, she said that NGO-run rescuers, city administration officials, police and others concerned preferred to rush the injured and deceased to the JPMC because of efficient patient handling with the help of senior doctors, specialists, critical care and surgery set-up under one roof.

However, it is believed that medical staffers at the JPMC, Civil Hospital Karachi and Abbasi Shaheed Hospital in the public sector are already handling a lot of patients seeking free of cost health services and in this situation, thoughtless shifting of all blast or accident victims, including those who do not need critical care, only overburdens doctors that may affect medical treatment.

It was witnessed that drivers and volunteers of NGOs sometimes preferred to pick up the bodies first instead of rushing the critically-wounded persons to hospitals, a social worker said. Besides, with no knowledge of first-aid treatment, they obviously did no good to the injured, he added.

A former medical superintendent said that such practice could be done away with if a well-trained team having medical and relevant knowledge was available for emergency response. “These rescuers could examine the condition of the injured victims on the spot and shift them to major and secondary care hospitals according to their needs,” he added.

Trauma centre

Referring to a government's decision to discontinue its half-done project of a trauma centre situated in Safoora Goth area of Gulshan-i-Iqbal Town, a senior citizen said that had that project not been handed to a private party through the privatisation commission, residents of Gulistan-i-Jauher, Gulshan-i-Iqbal, Malir, Shah Faisal and neighbouring areas could have benefited.

Dr Kaleem Butt, who is associated with an NGO managing medical equipment-fitted big ambulances, was of the view that the establishment of a real trauma centre was a big task. “You need to find out a purposefully located amenity plot first, which has become almost impossible, and then spare a sizable government budget for construction, infrastructure, machines and deployment of medical and paramedical staffs,” he added.

However, he said that the existing health facilities in Malir, Korangi, Landhi, New Karachi, Orangi, Gadap and other towns could be upgraded to manage trauma and accident cases. “By focusing our peripheral hospitals we can provide immediate and right treatment to the victims of disasters in the shortest possible time,” he said, adding that this would save not only the time of patients in need of critical healthcare but also reduce the burden on the JPMC or the CHK.

He also stressed the need for guiding ambulances, volunteers and social workers about correct priorities in emergence cases.