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World J Surg (2008) 32:16131617 DOI 10.1007/s00268-008-9634-5
Trauma Care in India: Current Scenario
M. K. Joshipura
Published online: 14 June 2008 Socit Internationale de Chirurgie 2008
Abstract Trauma-care systems in India are at a nascent stage of development. Industrialized cities, rural towns, and villages coexist with a variety of health care facilities and an almost complete lack of organized trauma care. There is gross disparity between trauma services available in various parts of the country. Rural India has inefcient services for trauma care, due to the varied topography, nancial constraints, and lack of appropriate health infrastructure. There is no national lead agency to coordinate various components of a trauma system. No mechanism for accreditation of trauma centers and professionals exists. Education in trauma life-support skills has only recently become available. A nationwide survey encompassing various facilities has documented signicant deciencies in current trauma systems. Some initiatives on improving prehospital systems have been seen recently. Although injury is a major public-health problem, the government, medical fraternity, and the society are yet to recognize it as a signicant public health challenge.
Introduction
Accelerated urbanization and industrialization have led to an alarming increase in the rate of accidental injuries, crime, and subsequent violence in India. An unprecedented increase in the number of vehicles has outpaced the development of adequate roads and highways. India has
1% of the motor vehicles in the world but bears the burden of 6% of the global vehicular accidents. It is well recognized that the health care system in India is not fully equipped to meet the challenge.
In May 2002, The Academy of Traumatology (India) undertook a maiden study of trauma systems, regardless of their stage of development or geographical region. This survey revealed striking deciencies in the system.
Injury as a problem
Road-trafc accidents are increasing at an alarming annual rate of 3%. In 1997, 10.1% of all deaths in India were to the result of accidents and injuries [1]. A vehicular accident is reported every 3 minutes and a death every 10 minutes on Indian roads [2]. During 1998, nearly 80,000 lives were lost and 330,000 people were injured. Of these, 78% were men aged 2044 years, which signicantly impacted productivity [3]. A trauma-related death occurs in India every1.9 minutes [2]....