For a new model to handle disasters
Kiran KarnikPublic purpose and private entrepreneurial drive and efficiency need to meld to help those who have to contend with calamities.
By Kiran Karnik, |
Recent months have seen another round of disasters, many man-made and some natural. The frequency of such calamities has inured us and deadened our collective sensitivity, but that does not reduce the enormity of the personal tragedy of each victim, family and community. The economic loss is only secondary to the human suffering, but is also substantial.
The government ��� whether state or central, and irrespective of the political party ��� has standardised its response. By and large, this consists of reacting late, blaming others, visits or aerial surveys by VIPs, announcing a relief package, including compensation for those affected, and then forgetting all about it. There seems to be little attempt at drawing lessons from each disaster, storing the knowledge for future use, long-term planning, or studying possible pre-emptive or preventive action. While preparedness for disasters may have improved, it is very short of what is possible in the context of today���s technologies.
Floods in many parts of the country ��� most notably in Bihar and Assam ��� are a well-known, yearly phenomenon. Yet, year after year, the authorities seem to be caught by surprise. It is obvious that tarpaulins, vaccines, medicines, kerosene, clothes and food will be needed, as will buses and boats for evacuation. Large numbers of doctors and para-medical staff need to be on call. Satellite phones, in large numbers, must be available. The list of such essential items is known to all who have dealt with emergencies. Yet, amidst each disaster, one hears of the non-availability of these when most desperately needed. Worse, the organisational structure and mechanism for dealing with disasters, without which all else is of little use, are lethargic and ill-defined.
National Disaster Management Agency, set up some time ago, being a central government agency, has limitations related to infringing the jurisdiction of states. It could, however, have aggregated and disseminated experiences and knowledge, and helped in preparing plans. It could also stock many of the items that are required in large-scale emergencies, or at least work with agencies concerned to ensure sufficient stocks which can be immediately accessed in such a situation.
While the picture with regard to such mega-disasters is dismal, equally sad is the response (or rather the lack of it) to emergencies relating to individual accidents. Victims sometimes lie unattended on a busy road, because all passers-by ��� even good samaritans ��� are wary of getting caught in our labyrinthine police and legal systems. The resulting delay in treatment converts injuries into deaths. If only the person could have had prompt medial attention in that first, ���golden hour���, a life may have been saved.
At least in this area ��� unlike in disasters ��� there is now a silver lining to the otherwise dark clouds. A unique, free service to provide assistance in the case of any emergency ��� police, fire or medical ��� is now operational. Emergency Management and Research Institute (EMRI) has, for the last three years, been running a very successful effort. Over 1,000 ambulances, with a driver and a para-medic trained in emergency medical care, well-equipped for all medical and other emergencies, are now operational. Each one not only includes appropriate medical stocks and equipment, but also specially-designed trolley-stretchers, a device to lift persons with spinal injuries, and a metal cutter for extricating people stuck in vehicles after a road accident.
The government ��� whether state or central, and irrespective of the political party ��� has standardised its response. By and large, this consists of reacting late, blaming others, visits or aerial surveys by VIPs, announcing a relief package, including compensation for those affected, and then forgetting all about it. There seems to be little attempt at drawing lessons from each disaster, storing the knowledge for future use, long-term planning, or studying possible pre-emptive or preventive action. While preparedness for disasters may have improved, it is very short of what is possible in the context of today���s technologies.
Floods in many parts of the country ��� most notably in Bihar and Assam ��� are a well-known, yearly phenomenon. Yet, year after year, the authorities seem to be caught by surprise. It is obvious that tarpaulins, vaccines, medicines, kerosene, clothes and food will be needed, as will buses and boats for evacuation. Large numbers of doctors and para-medical staff need to be on call. Satellite phones, in large numbers, must be available. The list of such essential items is known to all who have dealt with emergencies. Yet, amidst each disaster, one hears of the non-availability of these when most desperately needed. Worse, the organisational structure and mechanism for dealing with disasters, without which all else is of little use, are lethargic and ill-defined.
National Disaster Management Agency, set up some time ago, being a central government agency, has limitations related to infringing the jurisdiction of states. It could, however, have aggregated and disseminated experiences and knowledge, and helped in preparing plans. It could also stock many of the items that are required in large-scale emergencies, or at least work with agencies concerned to ensure sufficient stocks which can be immediately accessed in such a situation.
While the picture with regard to such mega-disasters is dismal, equally sad is the response (or rather the lack of it) to emergencies relating to individual accidents. Victims sometimes lie unattended on a busy road, because all passers-by ��� even good samaritans ��� are wary of getting caught in our labyrinthine police and legal systems. The resulting delay in treatment converts injuries into deaths. If only the person could have had prompt medial attention in that first, ���golden hour���, a life may have been saved.
At least in this area ��� unlike in disasters ��� there is now a silver lining to the otherwise dark clouds. A unique, free service to provide assistance in the case of any emergency ��� police, fire or medical ��� is now operational. Emergency Management and Research Institute (EMRI) has, for the last three years, been running a very successful effort. Over 1,000 ambulances, with a driver and a para-medic trained in emergency medical care, well-equipped for all medical and other emergencies, are now operational. Each one not only includes appropriate medical stocks and equipment, but also specially-designed trolley-stretchers, a device to lift persons with spinal injuries, and a metal cutter for extricating people stuck in vehicles after a road accident.
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The ambulances are supported by a world-class call centre, sophisticated software and state-of-the-art equipment. Already, some 5,000 calls are being handled each day, and 93% of them are answered within two or less rings. An ambulance is then dispatched, which reaches the site of emergency within an average time of less than 20 minutes in rural areas and 15 minutes in urban areas. Even before the ambulance itself reaches, EMRI staff ��� including a doctor, when necessary ��� provides virtual, telephonic ���hand-holding��� to provide advice to the victim or to care-givers. Thus, care begins right from the time a call is received. This is not a transportation service, as are some other ambulance providers, but an integrated emergency management system. This professionally managed operation ��� initiated by the vision of Ramalinga Raju and a large grant from him and his family ��� has now become an outstanding example of an ideal public-private partnership. A number of states have emulated the example of Andhra Pradesh, and the ���108 service��� (as it is most commonly identified) is to be operational in at least 10 states by March next.
The exciting part of this effort, from a structural point of view, is the extraordinary success of a true public-private partnership model. While the state provides almost all the funding, EMRI brings in the drive, professionalism and output-linked efficiency of a good corporate organisation and the sensitivity and public purpose of a NGO. An international comparison on key metrics indicates that EMRI is performing more efficiently than others, and at a cost per case that is a fiftieth of what it is in the United States.
Given the sad and chronic failure of the conventional organisations to effectively cope with disaster mitigation and relief, it is time that we looked for alternatives. The PPP model evolved for emergency management is worth a close look, without the government in any way seeking to abdicate its responsibility.
As part of this, can we not create a quick-reaction team for disasters? A team that can, in a matter of hours, reach an affected site anywhere in the country, carrying with them the key required items ��� food, medicine, clothes, water (and water-purification plants), fuel, etc. Our security forces have their commandos and a Rapid Action Force to handle exigencies. Do not disasters merit a similar rapid action group, and would this not be best done in a PPP model? This will ensure competent management, efficient and effective operations and measurable results. Public purpose and private entrepreneurial drive and efficiency need to meld, as they have in EMRI, to help those who have to contend with calamities. Here, then, is a very worthwhile challenge for both the corporate world and the government.
(The author is associated with various NGOs and is on the board of EMRI)
The exciting part of this effort, from a structural point of view, is the extraordinary success of a true public-private partnership model. While the state provides almost all the funding, EMRI brings in the drive, professionalism and output-linked efficiency of a good corporate organisation and the sensitivity and public purpose of a NGO. An international comparison on key metrics indicates that EMRI is performing more efficiently than others, and at a cost per case that is a fiftieth of what it is in the United States.
Given the sad and chronic failure of the conventional organisations to effectively cope with disaster mitigation and relief, it is time that we looked for alternatives. The PPP model evolved for emergency management is worth a close look, without the government in any way seeking to abdicate its responsibility.
As part of this, can we not create a quick-reaction team for disasters? A team that can, in a matter of hours, reach an affected site anywhere in the country, carrying with them the key required items ��� food, medicine, clothes, water (and water-purification plants), fuel, etc. Our security forces have their commandos and a Rapid Action Force to handle exigencies. Do not disasters merit a similar rapid action group, and would this not be best done in a PPP model? This will ensure competent management, efficient and effective operations and measurable results. Public purpose and private entrepreneurial drive and efficiency need to meld, as they have in EMRI, to help those who have to contend with calamities. Here, then, is a very worthwhile challenge for both the corporate world and the government.
(The author is associated with various NGOs and is on the board of EMRI)
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