Emergency Assistance to Traffic Victims

Injuries are a serious problem in Cambodia. Consequently, there is a great need to develop an adequate emergency medical service to deal with injuries. According to the Cambodian Demographic and Health Survey 2005, 2% of the population is affected by accidental injuries and deaths. The breakdown is included in the table below:

The high volume of road traffic accidents is more acute as existing emergency medical services are not adequate. According to RTAVIS statistics for 2007:

• Only 26% of casualties are transferred to clinics or hospitals by ambulance;
• 34% arrive at hospital more than 2 hours after accident (“golden hour” is less than one hour);
• 43% of severely injured casualties in the provinces take more than two hours to reach the hospital
• 4% of casualties died immediately at the scene of the accident, 2% died at hospital and 26% were severely

Percentage of casualties by type of transport to the hospital–2007

Emergency Medical Services (EMS): Considering the high volume of road traffic accidents, the development and strengthening of emergency medical services is crucial to preventing deaths and disabilities on the roads in Cambodia. EMS is defined as is a system which provides personnel, equipment, transportation, and communication to ensure effective and coordinated delivery of medical care in emergency situations (ie. accidents, illness) from the site up to hospital. Consequently, EMS is an existing component of the National Road Safety Action Plan. However, the present situation in Cambodia presents a challenge to setting up an EMS system. Various constraints, according to the World Health Organization and Ministry of Health, include:

• Expensive for most people, especially in rural areas (i.e.: transport cost);
• No formal management call system and dispatch centre;
• Long period from site to hospital (leading to increase of injury severity);
• Insufficient trained staff (FA, basic life support), hospital capacity & capabilities;
• No integrated information system to capture situation and trends.

Yet, the development of an effective emergency medical service is now on the agenda in Cambodia. The WHO and Ministry of Health are drafting an EMS System National Strategy. The proposed strategic priorities and activities of the EMS system will include:

1. First Aid and On Site Management: Development of local capacity of FA among first responders (police, firemen) and community volunteers;
2. Aspects of Transportation: Development of fleet of ambulances, equipment, trained staff; Identification of other appropriate means of transports such as tuk-tuk, taxi; and appropriate emergency routes;
3. Capacity of Hospitals: Development of hospital staff qualification in EMS and improvement of emergency equipment;
4. Mechanisms to Manage the System: Improvement of dispatch centers, protocol and standards, trained personnel and equipments; creating coordinating body; developing policy, legislation, regulations;
5. Integrated Information System: Development of health information system (road traffic accident, injury, and non-trauma), public education on EMS

The Ministry of Health is currently drafting the strategy. The document will be posted on this website upon publication. Handicap International Belgium is currently training traffic police in first aid, and organizations such as Tokushima International Japan and Side by Side provide ambulance service for accident victims and emergency response training to medical staff in Phnom Penh and along National Road 4 respectively. They have also set up emergency hotlines in their respective areas of operation.

• Ministry of Interior (MoI)
• Ministry of Health (MoH)
• National Road Safety Committee (NRSC)
• Handicap International Belgium
• World Health Organization (WHO)
• Cambodia Red Cross (CRC)
• Tokushima International Cooperation (TICO)
• Side by Side International