109 Access to emergency health care in tiger reserves in the central Indian landscape. lessons for global emergency care

Aims/Objectives/Background Forest staff working in remote locations are at high risk of life-threatening emergencies; including major trauma and snakebites. Timely access to appropriate emergency care is pivotal to life-saving treatment. This is the first study to systematically map public health facilities (PHFs) around tiger reserves (TRs) in central Indian state of Maharashtra. Methods/Design Using publically available data; GPS coordinates, medical staff, and services were identified for PHFs in increasing order of specialism; including Primary Healthcare Centre (PHC), Community Health Centre (CHC), Sub-district Hospital (SDH) and District Hospital (DH). GIS Network Analysis was used to identify the nearest PHFs in relation to the access points of eight TRs; and the shortest distance by road and corresponding travel time by vehicle were calculated. Results/Conclusions Of all PHFs, 87.5% offered basic emergency care, while only 54% offered radiology services. Of all trauma beds 99.9% were placed at DH level; along with 89% of all MBBS trained doctors. Only 28.6% of TR exit points had access to emergency ambulance service based within 30 minutes. Conclusion This study highlight the challenges of providing emergency healthcare in low- and middle-income countries and the urgent need for greater resources and infrastructure to support the delivery of emergency care for frontline forest staff in rural areas. Further work in progress to look at the provision of emergency care in remote settings.