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Times of India
06 January 2011
By Senthalir S
Bangalore, India

This is one emergency service that spreads happiness. It has brought into this world 8,000 bundles of joy in two years since its launch. The credit goes to te 108 ambulance service. This toll–free number is for any emergency: medical, police or fire.

Ask 20–year–old Nirmala D L of M Sathyavara village in Hoskote. She will ever remember December 4, 2010, because she delivered a baby in an ambulance.

It’s been a month now. Beaming, Nirmala recalls the day: "I experienced labour pain at midnight. My family members immediately called 108. They reached at 12.30am; but on the way to hospital, I delivered in the ambulance." She adds: "I wish I knew about the ambulance service earlier. It is a free service, and I would have had a safe delivery during my first pregnancy as well." Her mother Susheelamma says Nirmala had to face complications while delivering her first child in a government hospital. The long mile: more delivery cases on the move in villages

Deliveries in ambulances are predominant in rural areas because the distance from the villages to the hospitals is generally 30–40 km, said Gurucharan KS, who handles 108 ambulance service.

Christopher David, an emergency medical technician working for 108 Emergency Service, who helped Nirmala deliver her child, said that he had conducted 14–15 normal deliveries in ambulances in the past one year.

"In most of the cases in rural areas, people call us when the p re g n a n t women are experiencing their secondary labour pain. It would be too late by the time we reach the hospitals. Hence, we do not have a choice but to stop the ambulance and help the woman to deliver. It was the same in Nirmala’s case as well. The hospital was 20km away from her house in Doddaralagere to Hoskote government hospital. After she delivered the baby, we moved the mother and child to the hospital," he said.

He added that in Nirmala’s case he conducted the delivery without help from the emergency response centre physicians in 108 Emergency service centre as he had no time to call them.

Gurucharan KS, senior partner – marketing, GVK Emergency Management and Research Institute who handles 108 ambulance service, said that at least 42% of cases they handle are delivery complications in rural areas and 18% are accidents. However, in urban areas, 16% of cases are related to delivery and 23% are accident–related cases.

"More than 8,000 deliveries have been conducted in ambulances from the launch of the service," he said. Gurucharan added that such cases are rare in urban areas because of the awareness. Women in urban areas are aware when their date of delivery is and get admitted a week in advance. But it is not the case in rural areas. However, we get a lot of emergency delivery–related calls from Bangalore rural areas.

"We have a delivery kit and the required equipment available in the ambulance. There is an emergency medical technician (EMT) and driver. For various reasons, EMTs are forced to carry out deliveries within the ambulances under guidance from the Emergency Response Centre Physicians (doctors who are present in the response centre) by way of a call conference," he said.

Emergency Care
108 – This toll–free number is for any emergency – be it medical, police or fire. In case of a medical emergency, the ambulance reaches the victim and provides pre–hospital care within the ambulance en route to the nearest hospital or to a hospital of the victim’s choice.

The MoU between GVK EMRI and the department of health and family welfare, government of Karnataka, was signed on August 14, 2008. The service was first launched in Bangalore on Nov. 1, 2008 under the Arogya Kavacha scheme. 108 service covers all 30 districts of Karnataka with 517 ambulances.

In Karnataka, at least 8.64 lakh emergency cases were reported from Nov. 1, 2008 to Dec. 31, 2010. Of which, 3.60 lakh were pregnancy–related cases which constitute 42% of emergency cases. At least 1,28,997 are accidentrelated cases, which form 15%. In Bangalore, the total emergency cases handled are 83,806. Of which, 14,383 relate to pregnancy–related cases which form 17% and accidentrelated are 19,929 which form 24% of the cases.

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