Concept/ Introduction

  • Systematic identification, training, rostering and mobilization of volunteer community first responders, Community Emergency Medical Technicians (CEMT)
  • Standardized and coordinated ambulance network
  • Development and implementation of standardized referral protocols and pathways.
Health Emergency as a cycle
fig: Health Emergency as a cycle

First National Conference on Pre-Hospital Care for Emergencies in Nepal

19-20th July, 2018

Background

Nepal is prone to natural disasters including earthquakes, floods, landslides and severe weather events. Nepal is placed 20th on the global hazard map, 30th with regard to water induced hazards (floods and landslides). A study by the United Nations Development Programme (UNDP) Bureau for Crisis Prevention and Recovery (BCPR) ranks Nepal as the 11th most at risk country in the world in terms of relative vulnerability to earthquakes. Due to the lack of infrastructure, combined with urbanization, limited implementation of building codes and the challenges with retrofitting earthquake prone structures, it is reasonable to anticipate that the incidence of injury, death and damage following an earthquake in the Kathmandu Valley could be devastating. It is estimated that 300,000 injuries and 100,000 fatalities could result from a strong earthquake in the Kathmandu Valley (MoHA/ 2011). In the meantime, death and injury due to trauma is also increasing. The reasons are again, narrow roads, non-adherence to traffic rules, too many vehicles, etc. Most of the victims ride motorbikes and they are young. The concept of using ambulance with EMT and treatment before transport is still lacking and so victims are sent to hospitals in taxis. They usually reach late and in worse condition due to small space of taxi and the traffic jams.

To improve the pre hospital care, a sensitization program was felt and thus, the First Pre hospital conference was envisioned.  First, all the stake holders were identified and invited to present what they were doing and then together to find the way forward. In collaboration with the WHO Country Office for Nepal and the MoHP, NAS held the First National Conference on Pre Hospital Care on July 19 and 20 so that the stakeholders can gather, network, discuss and disseminate the message on the need for the optimal and standardized prehospital care. Key experts from abroad who are involved in the prehospital care were also invited and their interaction with the national participants enriched the learning and discussion.

 Objectives:

By the end of First National Conference on Pre Hospital Care, all stake holders will be able to list out their:

  • Achievements
  • Challenges
  • Recommendations

Methodology:

The pre identified stakeholders (national and international) in the area of Pre Hospital Care were invited in advance with preparation for the technical sessions in the conference (Annex 1. Schedule).

1. In the inauguration, prominent person from:

  • Ministry of Health and Population,
  • National and international pre hospital care givers
  • Parliamentarians
  • Member of Planning commission
  • Members of academia
  • Service providers
  • EMTs were invited.

2. Two Keynote speakers (international and national) were invited

3. Policy and regulations in Nepal for pre hospital care

4. Nepalese pre hospital care giver experiences

5. International pre hospital care giver experiences

6. Challenges in implementation of these polices

7. Way forward in small group discussion

8. Practical demonstration of ambulance service

9. Closing with recommendations

Expected outcome

1. Awareness of what is already available

2. Awareness of government polices

3. Challenges

4. Way forward – recommendations