What do you do if a friend drinks too much and gets sick?  Luckily, on campus we have Villanova Emergency Medical Services just a phone call away to help with any medical emergency on campus.  But what happens in areas of the world where there is no 911 and no established emergency response system?

An emergency response system, including police, fire department and EMS, is a hallmark of modern society.  We take it for granted that when there is a problem, help is only a call away. But in other areas of the world, there is neither the infrastructure nor the training to create a system like that in the United States or in other industrialized nations.

Landline telephones, advances in mobile medical technology and the widespread distribution of training opportunities have created a rich environment for the development of both professional and volunteer EMS systems.  In the United States, ambulance companies use a “boomerang” model of service.  This means that ambulances and other responders are sent out to the scene of the emergency, pick up and transport victims to the hospital and return to their “base,” similar to the action of a boomerang, which returns to where it was thrown from.

In other countries though, the system to gain access to emergency resources is more like the use of a beacon.  Think about “The Return of the King” in the Lord of the Rings series, when Pippin climbs the tower and lights the beacon.  When observers at the next site see that it has been lit, they light theirs and so on until the lit beacons can be seen by Aragon in Edoras.  Similarly, when an emergency occurs in some parts of the world, the timeliness of emergency response is dependent on how quickly word can get to the responders.  This wastes valuable time, which is often the difference between life and death.

In the interest of trying to improve this system, TrekMedics, an international non-profit organization based in New York City, has created “Project Beacon,” which was recently piloted in Haiti. The project seeks to create an SMS-text message based system of emergency dispatch.  By tapping into the widespread use of cell-phones—about 80 percent of the world population has access to mobile phones—the intent of Beacon is to find the nearest responders to an emergency, coordinate their actions in a timely manner and connect them to the resources at the local hospital which provides on-line medical direction and make arrangements for when the patient arrives.

According to press material on the organization’s website, the overall goal of the project is to “reduce the incidence of preventable death and disability through improved access to basic emergency care in both the clinical and pre-hospital settings.”

This goal is achieved through improving the clinical emergency care provided at the hospital, and organizing community-based response capabilities.  By coordinating with authorities in the area to increase the availability of appropriate transportation methods, as well as creating necessary oversight and accountability of these systems, TrekMedics hopes to create sustainable systems that help to improve emergency medical responses at all levels.

“People are already transporting the sick and injured, and have been since long before ambulances came onto the scene,” added Kevin Munjal, Trek Medics’ medical director. “We’re hoping to offer something that can help improve coordination and prevent premature deaths without relying on North American or European models.”

Munjal, whose clinical and research focus is pre-hospital care, is from Mt. Sinai Medical Center’s Emergency Department, and is part of the staff of the Icahn School of Medicine.  He described the current system of emergency response in low and middle-income countries as “an informal system of responders” and that through the use of Beacon, people would be able to “better send for help.”

This help would mostly come in the form of volunteers, and that reinforces another goal of Beacon—to provide training for new emergency responders.  Through this training and coordination with government agencies, Munjal said the project aims to “add a layer of structure and security to a system of lay-responders already in place.”

The reason for harnessing the powers of SMS technology is two-fold—it is a widespread resource in nearly all parts of the world and its relative low cost makes it a viable option for countries that lack the infrastructure to create a true 911 like system.

In the United States the existing system of EMS is sufficient, but Munjal said a system like Beacon could be used in situations like crowd-sourcing emergency responses at large mass-gatherings.  Through the pervasiveness of smart-phones, such a feat could be accomplished with an app that could alert potential responders to the location and nature of a situation, and allow the closest responders to react quickly.

While the pre-hospital care system in the United States is certainly safe and efficient, it is nowhere near perfect.  Munjal, in addition to his work with TrekMedics, is also a very active researcher.  One of his current projects looks into the attitudes patients have about EMS, and ways in which the system could be changed to focus more on patient needs.

Data collected from surveys with patients in the emergency department at Mt. Sinai showed that patients are interested in systems of emergency care that allow for direct contact between patients and the directing physician from the field, as well as a system that gives the patient the option as to where they would like to be transported. This research is a first step in showing that reforms to the systems, financing and legislation involved in EMS care should be changed to improve patient experiences and outcomes.

TrekMedics started a source-funding campaign on the website IndieGoGo.com, with the slogan “Help fund 911 where there is none.”  Additionally, the campaign illustrates that a contribution of $5 will fund the SMS for one day of training, and $25 will fund the training for five new responders.  And while our system may not be the best around, it is still better than what some places have.   The benefits of quick and efficient care are not only relevant to lives of college students, but should be thought of as a basic component of standard healthcare for all people around the world.


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