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The emergency services in a developing country are virtually non-
existent to a large part of the rural population. The larger cities do
have hospitals where there is an emergency service. However these services
are poorly organised and insufficiently staffed and equipped.
The situation is particularly tragic as the effect of trauma to the
individual, the family and the society is considerable. To some, life
after trauma is useless. The cost to the country of looking after people
unable to fend for themselves, is unbearable.
The prevention of trauma, the management of the patient in the
field/site, first aid measures, proper handling/moving of the injured
patient and appropriate transport, could be very effective. This alone
could well make a big difference.
Trauma/Emergency management must be taught in school. The teachers
must be educated, the students by them and their parents by the children.
There should be trained volunteers in the village including, General
Practitioners, native medical practitioners, public health nurses etc. It
must be part of primary care.
This will be far more effective than just developing hospital care as
No competing interests
01 March 2004
Nandalal J Gunaratne
Colombo South Teaching Hospital, Kalubowila, Sri Lanka