EMERGENCY MEDICAL AND AMBULANCE SERVICES IN INDIA

To Call an Ambulance in India

AT-A-GLANCE

THERE ARE A LOT OF NUMBERS USED TO CALL AN AMBULANCE IN INDIA

  • India is a paradox in emergency medical systems development, with both a preponderance of advanced technologies and large populations with no access to even basic services
  • For the upper- and middle-classes and tourists, ambulances are readily available; for the massive slums that have no roads, ambulance and prehospital providers are inaccessible
  • Despite the proliferation of private-public partnerships to improve access to emergency medical services, a wide majority of patients are still transported to hospital by private vehicle
  • To be sure you will find an ambulance in India when you need one, make sure you know the local emergency (or taxi) numbers

SCOREBOARD

% of Seriously Injured Transported by Ambulance in India, 2013

11-49%

[Source: 2013 Global Status Report on Road Safety, WHO]

Road Traffic Injury Deaths, 2015
(per 100,000 population)

  • India
  • Russia
  • United States

[Source: 2015 Global Status Report on Road Safety, WHO]

Reported Homicides, 2012
(per 100,000 population)

  • India (2012)
  • Russia (2012)
  • United States (2011)

[Source: 2014 Global Status Report on Violence Prevention, WHO-UNDP]

HOW CAN I CALL AN AMBULANCE IN INDIA?

HOW DO I CALL FOR HELP?

“In India, there is no centralized EMS system” (Sharma 2014). It depends on where you are and how much you have to pay, so please see our India EMS Coverage Map (at top of page) for a better idea of who providers in your area may be.

  • It may be possible to dial 108, which is a free service in some parts of India.
  • It may be possible to dial 1298, which is a paid-service available in some parts of India.
  • In Delhi, dial 102 or 1099 to reach the Centralized Accident and Trauma Services (CATS) with 151 ambulances bases around Delhi. CATS provides ambulance transport free to all. Read the full list here.

India’s EMS system is very complicated with significant fragmentation that is both a result of, and a cause for, entrepreneurialism in country with great disparities. Emergency response and ambulance systems are “run by a multitude of agencies that include the government, police, fire brigades, hospitals, and private agencies” (Roy 2010)

“Prehospital care is virtually nonexistent in most rural and semiurban areas in India…. Gross discrepancy is seen in prehospital services between urban and rural settings, as well as between paying and non-paying patients” (Joshipura 2008)

WHAT OTHER EMERGENCY NUMBERS CAN I CALL?

There are hosts of numbers you can call, depending on where you are and how much money you have to pay. Please see our India EMS Coverage map (above) for more info on providers across the country.

Because there’s no organized prehospital EMS system, there are several types of possible ambulance providers in India:

  • Private ambulance companies – Available in large cities, they provide services on a subscription basis or through public-private partnerships with municipal governments.
  • Private hospital-based ambulances – These provide ambulance service to paying customers, typically on a subscription-basis with a defined geographic catchment area
  • Government ambulances — These are typically single vehicles managed and staffed by a public hospital, likely used for inter-facility transfers in the majority of cases
  • Fire departments — Not common, but when available they are often reserved for emergency incidents requiring rescue, like road traffic collisions, fires and mass-casualty incidents — not so much for medical causes
  • Informal network – Predominately uncoordinated and inconsistent care and transportation can be provided to trauma patients by police, bystanders, taxis or NGOs

GROUND AMBULANCE IN INDIA

According to a report from 2010, “One-third of ambulances serve only as transport vehicles with no paramedic staff. Only 28% of the ambulances have two or more paramedics” (Joshipura 2008). Included here are some of the more well-known ambulance providers in India:

 

AIR AMBULANCE IN INDIA

WHAT ABOUT IN DISASTERS?
ARE THE RESPONDERS TRAINED?

Possibly, but very likely not. There is an increasing number of training providers for both prehospital and clinical emergency care, but they are often restricted to large cities, wealthier communities and private healthcare providers. Some organizations like Save Life Foundation, St. John Ambulance India and Lifesupporters Institute of Health Sciences have been trying to increase the scope and reach of prehospital training, and the Quality Council of India has reportedly accredited some curricula (Sharma 2014), but there is no national standard curriculum for prehospital emergency care providers.

Emergency Medical Technician courses are offered in partnership with overseas institutions … but are few in number and insufficient to service… The absence of minimal educational and training standards for paramedics promotes unskilled labor to handle the most delicate of tasks … Currently, only 4% of the ambulance personnel have any certified formal training.” (Joshipura 2008)

HOW WILL I GET TRANSPORTED?

TRANSPORT BY GROUND AMBULANCE IN INDIA

There are a number of vehicles types used to transport the sick and injured in India, ranging from basic vans to advanced ambulances. Fortunately, the Ministry of Road Transport and Highways released the National Ambulance Code in 2013 to create minimum standards for the constructional and functional requirements of ground ambulances.

TRANSPORT BY AIR AMBULANCE IN INDIA

There are a lot of companies providing air ambulance service in India. Some are fixed-wing airplanes, others use propellers, a few have helicopters. The main companies are

TRANSPORT BY TRAIN AMBULANCE IN INDIA

Many of the same companies offering air ambulance are able to arrange for train transport as well.

WHERE WILL I BE TRANSPORTED TO?

It depends on where the incident occurs and how much money you have. If you are wealthy enough to afford a subscription-based ambulance service, and are having an emergency at your home, it’s possible to have a fully-equipped ALS ambulance come to your home, provide you advanced medical care, and transport you to a private hospital with state-of the-art equipment. If you are poor, in a community with no roads and/or outside your insurance company’s ambulance catchment area, you will more likely be dependent on a good Samaritan to get you to a public hospital.

If you are a Western tourist or obviously not poor, it’s likely the bystanders or police will either call a private ambulance company or take you to a private hospital.

HOW WILL I PAY?

It is most likely you will have to pay out-of-pocket for an ambulance in India. According to Sharma (2014), the going rate ranges from USD$270-$370 for private ambulances.

Some services are provided free of charge, including in communities served by the 108 ambulance service, and in Delhi which is served by CATS.

ADDITIONAL INFO

COMMON EMERGENCIES AND VACCINATIONS

Common Emergencies in India

  • Road traffic crashes
  • Train collisions
  • Security threats
  • Earthquakes
  • Tropical cyclones
  • Flash flooding
  • Zika Virus is a risk in India, according to the CDC

Vaccinations for India

According to the US Centers for Disease Control and Prevention (CDC), different groups of travelers will require different vaccinations for travel in Oman:

  • All Travelers
    • Measles-mumps-rubella (MMR) vaccine
    • Diphtheria-tetanus-pertussis vaccine
    • Varicella (chickenpox) vaccine
    • Polio vaccine
    • Your yearly flu shot
  • Most Travelers
    • Hepatitis A
    • Typhoid
  • Some Travelers
    • Cholera
    • Hepatitis B
    • Japanese encephalitis
    • Malaria
    • Rabies
    • Yellow Fever

Read more about travel in Oman at the CDC website: https://wwwnc.cdc.gov/travel/destinations/traveler/none/india/ (Last accessed: Aug. 7, 2017)

HISTORY
GOVERNMENT OVERSIGHT

While a couple Indian states have established legislative and regulatory oversight of emergency services, most haven’t – and the national government hasn’t either. “The first step in building a robust EMS system in India would be to develop enabling government policy.” (Sharma 2014)

From “Trauma care in India: current scenarios.” (Joshipura 2008):

  • “There is no central government agency to integrate policy-making, planning, financing, drafting legislation, or establishment of minimum standards for the performance of a trauma-care system”
  • “Legislative provisions for the minimum qualification of ambulance personnel, the type and quality of ambulance equipment, and essential hospital capabilities are not in place”
  • “Formal licensing to an ambulance service in India is not mandatory”
  • “State governments of Andrha Pradesh and Gujarat have started prehospital systems through EMRI [Emergency Medical Research Institute], but the long-term success of this program is yet to be evaluated”
REFERENCES
  • Adhikari DD et al: “Impact of pre-hospital care on the outcome of children arriving with agonal breathing to a pediatric emergency service in South India.”   2016;5(3):625-630.
  • Brown HA et al: “Development and Implementation of a Novel Prehospital Care System in the State of Kerala, India.  2016;31(6):663-666.
  • Joshipura MK: “Trauma care in India: current scenarios.” World Journal of Surgery 2008;32:1613-17.
  • Joshipura MK, Shah HS, Patel PR, Divatia PA, Desai PM: “Trauma care systems in India.” Injury: International Journal of Care for the Injured 2003;34:686-92.
  • Khan A et al: “A Study of Prehospital Delay Patterns in Acute Myocardial Infarction in an Urban Tertiary Care Institute in Mumbai.” J Assoc Physicians India. 2017;65(5):24-27.
  • Roy N, Murlidhar V, Chowdhury R, Patil SB, Supe PA, Vaishnav PD, Vatkar A: “Where there are no emergency medical services – Prehospital care for the injured in Mumbai, India.” Prehospital and Disaster Medicine  2010;25(2):145-51.
  • Sharma M et al: “Emergency medical services in India: the present and future. 2014;29(3):307-10.
  • Sriram V et al: “Comparative analysis of three prehospital emergency medical services organizations in India and Pakistan. 2016;137:169-75.
  • Vyas D et al: “Prehospital care training in a rapidly developing economy: a multi-institutional study. 2016;203(1):22-7.
  • Wesson HK et al: “Trauma care in India: A review of the literature.”   2017;S0039-6060(17)30093-4.
  • Wijisekera O et al: “Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments.”  2016;31(6):675-679.
LINKS

OFFICIAL TWITTER FEEDS

PUBLIC AUTHORITY FOR CIVIL DEFENSE AND AMBULANCE (PACDA)

NATIONAL EMERGENCY MANAGEMENT CENTER

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