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Prehospital System Development in Jaffna, Sri Lanka

Published online by Cambridge University Press:  10 July 2013

John R. Zimmerman ,
Kecia M. Bertermann ,
Paul J. Bollinger  and
Donnie R. Woodyard Jr.
John R. Zimmerman
Affiliation:
United States Sri Lanka Fulbright Commission, Colombo, Sri Lanka.
Kecia M. Bertermann
Affiliation:
Medical Teams International, Tigard, Oregon USA.
Paul J. Bollinger*
Affiliation:
Medical Teams International, Tigard, Oregon USA.
Donnie R. Woodyard Jr.
Affiliation:
Medical Teams International, Colombo, Sri Lanka.
*
Correspondence: Paul J. Bollinger, MPH Emergency Medical Care Senior Advisor Medical Teams International 14150 SW Milton Court Tigard, OR 97224 USA E-mail [email protected]
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Abstract

Introduction

The building of prehospital emergency medical care systems in developing and lower middle-income countries (as defined by the World Bank) is a critical step in those countries’ efforts to reduce unnecessary morbidity and mortality. This case report presents the development of a prehospital care system in Jaffna District, Sri Lanka and provides the results of the system's first year of operations, the likely reasons for the results, and the prospects for sustained operations of the system. The goal of this report is to add to the literature surrounding Emergency Medical Services (EMS) in developing countries by providing insight into the implementation of a prehospital emergency care system in developing and lower middle-income settings.

Methods

The level of utilization and the financial performance of the system during its first year of operation were analyzed using data from the Jaffna Regional Director of Health Services (RDHS) Call Center database and information from the implementing organization, Medical Teams International.

Results

The system responded to >2000 emergency calls in its first 11 months of operation. The most utilized ambulance of the system experienced only a US $13.50 loss during the first 12 months of operation. Factors such as up-front support, a systematic approach, and appropriateness contributed to the successful implementation of the Jaffna prehospital EMS system.

Conclusion

The implementation of a prehospital EMS system and its functioning were successful in terms of utility and, in many regards, financial stability. The system's success in development may serve as a potential model for implementing prehospital emergency medical care in other developing and lower middle-income country settings, keeping in mind factors outside of the system that were integral to its developmental success.

ZimmermanJR, BertermannKM, BollingerPJ, WoodyardDR. Prehospital System Development in Jaffna, Sri Lanka. Prehosp Disaster Med. 2013;28(5):1-8.

Keywords

ambulanceEmergency Medical ServicesSri Lanka
Type
Case Report
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 5 , October 2013 , pp. 509 - 516
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

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References

1.The top 10 causes of death: 2008. World Health Organization Web site. http://www.who.int/mediacentre/factsheets/fs310/en/index.html. Accessed February 20, 2013.Google Scholar
2.O'Brien, G, O'Keefe, P, Rose, J, Wisner, B. Disaster risk, climate change and disaster management. Disasters. 2006;30(1):64-80.CrossRefGoogle ScholarPubMed
3. Bulletin of the World Health Organization. Preventing death and disability through the timely provision of prehospital trauma care. World Health Organization Web site. http://www.who.int/bulletin/volumes/84/7/editorial20706html/en/. Published July 2006. Accessed March 10, 2010.Google Scholar
4. World Health Organization. Prehospital trauma care systems. World Health Organizaation Web site. http://www.who.int/violence_injury_prevention/publications/services/39162_oms_new.pdf. Published 2005. Accessed February 20, 2013.Google Scholar
5.Husum, H, Gilbert, M, Wisborg, T, Van Heng, Y, Murad, M. Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. Journal of Trauma. 2003;54(6):1188-1196.CrossRefGoogle ScholarPubMed
6. The World Bank. Data–Key Data and Development Statistics: Sri Lanka. The World Bank Web site. http://data.worldbank.org/country/sri-lanka. Accessed September 15, 2009.Google Scholar
7. Department of Census and Statistics- Sri Lanka. Basic Population Information on Jaffna District 2007. http://www.statistics.gov.lk/PopHouSat/Preliminary%20Reports%20Special%20Enumeration%202007/Basic%20Population%20Information%20on%20Jaffna%20District%202007.pdf. Published 2007. Accessed January 18, 2013.Google Scholar
8. Vanni IDP Camps and Hospital Situations. Sri Lanka Humanitarian Portal. http://www.humanitarianinfo.org/sriLanka_hpsl/Files/Thematic%20Maps/Displacement%20Maps/IDP-Access%20Maps/LKM0446_COL_SL_Displacement_Vanni_IDP_sites_PUB_V39_26June2009.pdf. Accessed March 10, 2010.Google Scholar
9. Sri Lankan Ministry of Healthcare and Nutrition. Sri Lanka Ministry of Healthcare and Nutrition Annual Health Bulletin. http://203.94.76.60/AHB2006/AHS-2006%28PDF%20FILES%29%20for%20WEB/9%20detailed%20tables-mortality%20&%20morbidity.pdf. Published 2007. Accessed March 10, 2010.Google Scholar
10.Nagai, M, Abraham, S, Okamoto, M, Kita, E, Aoyama, A. Reconstruction of health service systems in the post-conflict Northern Province in Sri Lanka. Health Policy. 2007;83(1):84-93.CrossRefGoogle ScholarPubMed
11.Reilley, B, Simpson, I, Ford, N, DuBois, M. Conflict in Sri Lanka. Sri Lanka's health service is a casualty of 20 years of war. BMJ. 2002;324(7333):361.CrossRefGoogle ScholarPubMed
12.Ketheeswaran, A. 110 An Emergency Ambulance Service Of the Department Of Provincial Health. Valumpuri (Newspaper Article). April 19, 2009.Google Scholar
13. Sri Lanka | Medical Teams International. Medical Teams International Web site. http://www.medicalteams.org/what_we_do/emergency_medical_services/sri_lanka_ems.aspx. Accessed March 15, 2011.Google Scholar
14. Sri Lanka Department of Census and Statistics, Ministry of Finance and Planning. Household Income and Expenditure Survey–2009/10. http://www.statistics.gov.lk/Newsletters/HIES200910FinalBuletin.pdf. Published 2011. Accessed November 15, 2011.Google Scholar
15.Occupational Outlook Handbook. Emergency Medical Technician and Paramedics. Bureau of Labor Statistics, US Department of Labor. http://www.bls.gov/oco/ocos101.htm. Accessed March 20, 2011.Google Scholar
16. Population Estimates. US Census Bureau, US Department of Commerce. http://www.census.gov/popest/data/national/totals/2012/index.html. Accessed January 18, 2013.Google Scholar
17.Chamara, N, Raheem, S. Sri Lanka Prehospital Emergency Medical Care Review 2005-2011. Report presented at the meeting of the Trauma Secretariat; October 2011; Colombo, Sri Lanka.Google Scholar
18.MacFarlane, C, Benn, CA. Evaluation of emergency medical services systems: a classification to assist in determination of indicators. Emerg Med J. 2003;20(2):188-191.CrossRefGoogle ScholarPubMed
19.Joshipura, M, Hyder, AA, Rehmani, R. Emergency care in South Asia: challenges and opportunities. J Coll Physicians Surg Pak. 2004;14(12):731-735.Google ScholarPubMed
20.Kobusingye, OC, Hyder, AA, Bishai, D, Hicks, ER, Mock, C, Joshipura, M. Emergency medical systems in low- and middle-income countries: recommendations for action. Bull World Health Organ. 2005;83(8):626-631.Google ScholarPubMed