Raja Ali, a former first-class cricketer, collapses on a pavement in Bhopal. He has a cardiac arrest and onlookers simply watch.
That left-handed batsman Ali, was an important member of the Railways team that lifted the Ranji Trophy twice and Irani Trophy once did not matter as he lay writhing in pain a couple of months ago before departing from this world within minutes at a young age of 36. Eventually police take him to hospital where he is declared brought dead.
While the real cause of his cardiac arrest cannot be ascertained, the ignorance of the onlookers about its symptoms and the first aid that could have saved his life definitely had a role in his death.
Ali was one among about 7.5 lakh people who die of sudden cardiac arrest every year in India. While news of Ali's death was a rude shock to the cricketing fraternity, the manner of his death raised a pertinent question. Is anyone doing anything to make India embrace the concept of 'First Responders', which is common in western countries?
First Responders are people who provide the initial treatment at the scene of the incident or accident before definitive treatment is provided. They include fire, police and emergency medical personnel. But because an emergency, by definition, happens unannounced, it is rightly believed that common men, regardless of their fields of specialization, ought to be trained in basic life-saving techniques.
A victim of a cardiac arrest begins to suffer irreversible brain damage four minutes after the cardiac arrest takes place if no CPR (cardio-pulmonary resuscitation), a combination of rescue breathing and chest compressions, is administered.
The recently held 64th conference of the Cardiological Society of India revealed that heart disease is the biggest killer in India and by 2015 it will supersede all other fatal ailments. Fifty per cent of heart disease cases in the world are from India and heart attacks are more common among youth here than anywhere else in the world.
According to the World Health Organization, cardio-vascular diseases are the No. 1 cause of death annually. In 2008, 17.3 million people died of heart disease, accounting for 30% of all global heart disease deaths that year. So, the importance of remedies for diseases of the heart cannot be overemphasized.
In the past five years several organizations and specialist trainers have come up in the Delhi-NCR region who offer training in basic life-saving techniques to tackle any unexpected health emergencies or natural calamities, thereby transforming ordinary individuals into extraordinary saviours.
"Training in handling emergencies still take a back seat in most training schedules planned for the year by companies. Corporates tend to take these courses and workshops as 'nice to have' rather than as essential," says Dr (Col) G S Ahlowalia, owner of Gurgaon-based Spearhead Training Solutions, who has been conducting programmes on health and safety needs for the past six years in Gurgaon.
"The cost of first aid training is minimal, but the result of not having it could be fatal for someone who needs treatment and detrimental to one's business or the individual who administers first aid in the wrong manner," Ahlowalia says.
While several countries across the world are training the common man - in schools, colleges and workplaces - about chest compressions or CPR to save cardiac victims from dying, the World Heart Federation (WHF) says less than one per cent of Indians would know how to carry out a CPR.
"For every minute that a cardiac arrest victim does not receive CPR, his chances of survival drop by 10%. An effective CPR from a bystander can double a victim's chances of surviving a cardiac arrest," says Ahlowalia.
The time duration of the training programmes on CPR ranges from two hours to four hours. The workshop could extend up to five days when it includes first aid in other medical emergencies such as road accidents.
What if a First Responder gets it wrong when he is tending a patient?
"While it is difficult to give a categorical answer to this question, the training usually does not fail a person at the time of need," says Vikas Tripathi of VIVO Healthcare, a Gurgaon-based company that has trained 10,000 First Responders in more than 20 cities across the country from its inception in April 2011 till now.
Says Ahlowalia, "It is untrained bystanders who cause more damage unwittingly because of their ignorance. They tend to overlook the importance of blood loss in injuries that could lead to irreversible shock and irrational mobilization of fracture cases, aggravating even minor injuries into serious or fatal ones by the time medical aid reaches them."
The reason why bystander care is particularly important in India is that the country does not have a well-established emergency medical service (EMS) system to bring urgent care to accident victims, leading to thousands of avoidable deaths every year.
On the logistics of covering the second most populous country in the world, Ahlowalia has a suggestion: "Why not set up a national network of permanent first-aid training centres at airports, bus stands and railway stations under the aegis of the Red Cross? Travellers spend many hours waiting in these places, so they can learn to be life-givers in zero time."
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