India: saving lives thanks to basic first aid

Police pharmacist Srinivas*  was about to call it a day when two constables with gunshot wounds were brought to his medical room, the only one for 40 kilometres. An armed group had attacked their vehicle about seven kilometres away from the camp, and two of the four people travelling in the vehicle had already died from their injuries. The remaining two were badly injured, with bullets still lodged in their legs.

Sunil* was one of these two wounded constables. With no senior medical officer around, Srinivas had to take the lead in treating the two casualties, with the aid of a nursing assistant. Without wasting time, he elevated Sunil's leg, simultaneously checking him for nausea. However, there were no splints to immobilize the wounded leg. Undeterred by the lack of resources, Srinivas grabbed a cardboard box that had contained cotton wool, plus a towel to secure the joint above and below the knee. During the journey to the local hospital, the nursing assistant wrapped the towel around Sunil's leg to prevent further bleeding.

Today, Sunil is back at work, and he has come to meet Srinivas. "Until three months ago, this sort of improvisation wouldn't have crossed my mind," Srinivas smiles as he watches Sunil walking around, realising the difference his early intervention made. "Basics like immediately bandaging the wounded area with cloth can make all the difference between life and death," he adds, recalling an incident in 2001, when his camp in Imphal (the capital of Manipur, in north-eastern India), came under attack. A senior officer with an entry-exit gunshot wound in his right arm succumbed to severe bleeding after four days of treatment, having been brought in for treatment with his arm unbandaged.

In December 2011, Srinivas attended a first-aid training/training of trainers workshop conducted by the ICRC, the Indian Red Cross Society and the Chhattisgarh state health department in Bastar. The participants included personnel from the health department, security forces and medical colleges, plus volunteers from the Indian Red Cross. The aim of the workshop was not just to reduce deaths in the field but also to ensure that health facilities were not swamped with minor injuries during emergencies.

In eight days of highly interactive sessions, ICRC pre-hospital emergency care specialist Dr Eric Bernes trained over 40 participants, including Srinivas. His focus was on improving early response to bleeding, fractures, burns and specific injuries in remote areas where there is no immediate access to specialist surgical care. The workship also covered the transportation and management of mass casualties. Even though Srinivas had already been on a first-aid course, he feels the workshop gave him the necessary skills to "adapt, improvise and apply locally-available resources even in remote, rural areas in the absence of specialized medical or surgical facilities."

Mr P. Anbalagan is Bastar's District Collector and a former director of state health services. As he emphasized at the end of the course, "It is for the ICRC and the Indian Red Cross Society to now take this training to the villages and equip Mitanins (grass-roots health workers) with first-aid skills."

Srinivas aims to create at least 10,000 first-aiders like him. To achieve this goal, the ICRC has ensured that there are qualified first-aid trainers in the remotest areas of Chhattisgarh, ready to impart first-aid skills to as many people as possible. Their aim is that inaccessibility and a lack of surgical resources no longer get in the way of saving lives.

 * Names changed