5.6 Emergency care Although care for emergencies and accidents have been available in government health institutions since the inception of health care, the current model of specific services for emergency and trauma care in Sri Lanka was established with the introduction of the first ever Emergency Treatment Unit (ETU) at the Base Hospital, Nuwara Eliya in 1988. This was followed by the rapid establishment of similar units in many other hospitals (Ministry of Health, Nutrition and Indigenous Medicine, 2015b). The establishment of the Accident Service of the National Hospital in Sri Lanka in 1991 was a major milestone in emergency and trauma care. The A&E policy of the country was developed in 2016, the main aim being the organization of coordinated, stratified and cost-effective A&E care services within the country. In Sri Lanka, provision of both pre-hospital and emergency care are under the purview of the MoH. The ageing population and an increase in the numbers of people requiring emergency care for NCDs, especially traffic accidents, have resulted in an increased need for emergency care services. Currently, an A&E treatment unit is available in all government facilities, including and above the level of BHs. These offer A&E services of varying sophistication. Some DHs also have small emergency care units. PMCUs, which currently provide only outpatient care, will have functional emergency care units as identified in the Essential Services Package under the new reforms.
5.6.1 Services for patient transport and pre-hospital care Pre-hospital care was available as a fragmented service, provided in response to demand through the fire brigade ambulance service within the Colombo municipal area, ambulance service in Jaffna, St John’s Ambulance Brigade and small-scale privately owned ambulance services. Furthermore, the public sector has 689 ambulances in running condition used for transporting patients between institutions, which can be mobilized in case of emergencies. A pre-hospital toll-free ambulance transport service (Suwasariya) was initiated in 2016 as a donation to the Sri Lankan people from the Indian Government. This service was first instituted as a pilot system and since then has been scaled up to cover the entire country. It is implemented under the Ministry of Economic Development and Public Distribution and is managed by the MoH. A toll-free hotline 1990 has been made available for this service. It transports patients from their homes or accident victims from any location to government hospitals. It is only in very rare situations, such as the need for
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