Why doesn’t JJ Hospital have a trauma centre?

The world over, the ‘golden hour’ after any major accident is considered crucial to save lives and limbs of injured victims. But in Mumbai, Wednesday’s blasts have once again underlined the lack of a trauma management centre at the city’s largest health facility, the state-run Sir JJ Hospital.

The state government’s priorities seem to be skewed, say doctors, pointing to the recent grant of Rs375 crore to JJ Hospital for building a 19-storey super-specialty hospital in its campus, while permission is yet to come for a Rs40 crore trauma care centre.

Doctors at the hospital, which has over the years seen a steady increase in the number of terror victims brought in for treatment, admit that they find it difficult to provide comprehensive emergency medical services to patients with traumatic injuries.

Senior surgeon and medical director of Hinduja Hospital, Dr Gustad Davar, also point out the need for such a facility at JJ given the fact that it gets referrals of such patients from across the state.

“A trauma centre is not merely an emergency room. International guidelines stipulate that the centre should come equipped with a qualified trauma surgeon, a radiologist, a physician, and an anaesthesiologist, apart from being manned 24x7 by trained paramedics,” he explains. “CT scan, MRI and X-ray facilities should also be available 24 hours.”

In appreciation of the ‘golden hour’, it is mandatory for major trauma centres to have trauma surgeons trained in such specialties like neurosurgery and orthopaedics, while smaller trauma centres generally provide initial care and stabilisation of traumatic injuries before arranging for the patient to be transferred to a higher level trauma care centre.

“This is the norm followed by almost every health facility even in smaller South East Asian countries with smaller GDPs than India’s. But here, forget the major centre, we do not even have a smaller one,” rues a senior doctor at JJ.

He further points out, “Recently, the state government sanctioned Rs375 crore to JJ hospital for building a 19-storey super-specialty hospital. How many tragedies like Wednesday’s terror attack does the government need before it understands that it is possible to create a life-saving trauma management centre with far lesser money?” Other senior JJ doctors say they even have a spot in mind for such a centre. “Ideally, it’ll be best to have it near the entrance to the casualty department at the blood bank centre.”

KEM hospital dean, Dr Sanjay Oak, too feels that a city like Mumbai, which has had to bear the brunt of repeated attacks, needs such a specialised trauma management center. “In an emergency, it is impossible for patients to run around for treatment. Since the victims in Wednesday’s blasts were fewer, we could manage to treat them, otherwise it can be overwhelming.”

For the record, there is a 15-bed trauma care centre at the civic Lokmanya Tilak Memorial General Hospital, Sion, but it is 25 years old, and is not equipped to handle large numbers and complicated cases. It is this need that will be addressed with the creation of a centre at the state-run JJ.

When contacted, JJ Hospital dean Dr TP Lahane said, “We have already approached both the State and the Centre to set up a trauma centre at our hospital. Our Rs 40-crore project proposal is pending with the Centre since February 2011.”

Western India Automobile Association executive chairman Nitin Dosa recounts how the government set up a committee to address this problem after the 1993 bomb blasts.

“Everyone knows that we need such a centre in the city but nothing has come of the committee findings,” he says. “We do not even have good ambulances, you expect a trauma management centre? We wrote to the government five years ago about this, but there has been no response to date.”