A technical team in Kollam tracked incoming medical emergencies which doctors gathered at a Cochin hospital attended to using phones, an excel sheet and a projector.

Ernakulam district in Kerala witnessed an unusual yet simple confluence of medicine and technology, which helped save several people in medical emergencies during the floods. This is how a team of techies and doctors solved medical cases using a simple Google excel sheet and a projector at the Ernakulam General Hospital.

Dr Praveen Pai is a geriatrician and a public health specialist based in Cochin. Having a population and technology based approach towards health, he initiated a project called Community Response to Emergency and Disaster, in May. As part of the programme, each Residents Welfare Association would have five first responders, who will be responsible for their area during a disaster or emergency situation. Just as he was close to implementing this, Kerala was inundated and Dr Praveen had to shelve his plan, but not for too long.

He later saw an opportunity to implement a similar model during the recent disaster in the state. “I was not sure if the officials concerned would let me try out this any module during the time of crisis,” says Dr Praveen, who got the approval to set up a single communication line to attend to calls of medical emergencies.

“We are going on a battlefield,” he told the members of his NGO Magics. He used all the infrastructure set for his Community Response to Emergency and Disaster Programme. “Vodafone offered telecom service and INI technology gave the necessary software expertise. The companies sent their respective members to set up a team of 12 software and technical members. We started functioning on August 17 at the conference room of Ernakulam General Hospital, with a single number for medical emergency - 9946992995,” says Dr Praveen, who is associated with the Indian Medical Association (IMA).

The functioning, however, went south. “On August 17, by afternoon, we faced power outage. By around 4 pm, the mobile network got jammed. Vodafone informed us that the network is weak and that if the water level increased, the mobile connection may go off. We decided to shift the team from Ernakulam to Kollam. After an overnight journey, the team was back behind the functioning phone lines at 6 am on August 18,” recounts Dr Praveen, who also had a backup space in Bangalore, if Kollam too was affected due to the crisis.

“They were all calls not for a demand, but cries for help,” he adds. While the technical team, under Dr Praveen’s supervision, was managing the distress calls, a team of over 20 volunteer-doctors and non-medicos were simultaneously staring intently at a projector screen at the conference hall of the government hospital in Cochin.  

Whenever the team in Kollam received a medical emergency call, it was keyed in on a Google Spreadsheet, after verification. This sheet was simultaneously shared with the team in Cochin, on the screen.  Each case got colour-coded depending on its status. When the case first appeared on the screen, it came colourless. If a doctor or volunteer was following up on a case, it appeared blue, and once attended to or solved, the case appeared as green. In instances of dire emergencies, the case column appeared red.  

“When a case appeared on the screen, a doctor or a non-medico took up the case immediately and made sure it was solved at any cost, be it evacuation of a patient, requirement of doctors or medicines at a relief camp or even to know the dosage of doxycycline tablet. Each case was his or her responsibility and many doctors from other hospitals volunteered to work with us,” explains Dr Anwar, who was part of the team in Cochin.

He adds, “All team members silently did their job, without asking questions on the availability of a vehicle or medicines. Some did not hesitate to go to relief camps or get into the water to provide medical assistance.” From a pregnancy-related emergency to cases where patients collapsed or experienced giddiness, around 300 people in and around Ernakulam district were attended to from August 18 to August 23.

“Each medical call, we assured to shift them as there was no point in delivering medicines to them when they can be rescued,” says Dr Praveen. The Rapid Rescue Team was also on stand-by. “A person, who was working at a relief camp all day long, returned home for dinner. When having his meals, he choked on his food and called us,” recounts Dr Anwar. “Luckily, his house was accessible and the Rapid Rescue Team rushed to the spot and brought him to the hospital.”  

There were, however, stray cases where the medical mission failed due to severe flood conditions. A medical team member, Dr Sajith was deployed to rescue a patient stranded in a place in Kuthiathode in Alappuzha district. “On August 17, around 12 noon, an intern and I took a truck to reach the place. However, the water levels were so high that the truck could not enter. Unfortunately, the navy personnel, who accompanied us, did not have a boat at their disposal. So, we had to leave,” he recalls. Later, a doctor and nurse were airdropped at the spot and due medical assistance was administered.

According to the statistics provided by Vodafone, the technical team received 4000-odd calls, out of which 3,100 calls were answered. “The remaining calls must have been call drops or disconnected calls,” says Dr Praveen. He adds that a majority of the calls were SOS calls. “In a crisis, people call to all numbers. The 1077 helpline was so busy that people started calling us. Out of 3,100 calls, 2,700 were calls from people who were stranded and needed to be rescued. All these calls were passed to the rescue operation teams or re-routed appropriately. Since we were in constant communication with the Navy, many of these cases were prioritised,” he recalls.

Around 300 doctors, who could not be on the field but were available to offer medical assistance via phone, were registered with the technical team. With the help of the call rerouting mechanism, all medical calls were triaged by these experts before they were registered as a case to be attended to, on the spreadsheet document.  

Government participation

Today, the conference room at the Ernakulam General Hospital is a hive of activities, as District Medical Officers pour through mounds of documents, doctors sort out heaps of medicines and volunteers attend to calls that still come to 9946992995. Impressed by the work carried out by the team of doctors and techies, the operations here have been taken over by the Kerala government according to Dr Praveen.

“The Ernakulam General Hospital has been converted into the control room for Ernakulam district, where 100 DMOs are functioning now. From private participation, it has come under government control. District Medical staff and health inspectors, who are on the field at Primary Health Centres and other areas, are giving ground reports and updates to the staff at the control room through excel sheets or WhatsApp,” explains Praveen.

This story was originally published on The News Minute and is reprinted here with permission. It can be viewed on https://www.thenewsminute.com/article/how-doctors-ernakulam-used-simple-technology-handle-medical-crises-during-floods-87768