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An IT industry backed non-profit is rolling out an ambulance service across India, giving the vast continent a single emergency number for the first time.

The Emergency Management and Research Institute (EMRI), which has been bankrolled by the family of Satyam chairman Ramalinga Raju since 2005, has been building up the service in the state of Andhra Pradesh, and plans to roll it out across the country in partnership with the Indian government.

Despite giving the impression it has an inexhaustible supply of doctors, India faces a wealth of health challenges, not least the lack of a single emergency number, and little or no coordination between the patchy existing services, said EMRI CEO Venkat Changavalli.

EMRI has settled on a single number, 108, and will also route calls to fire and police services. The figure has mystical connotations in Hindu culture, and also escapes some of the negative connotations of the US's 911 emergency number.

EMRI has rolled out from its base in Andhra Pradesh to cover four states with 300 million people, with more states due to join this month. By 2010, it should be covering the entire country with 10,000 ambulances and 100,000 employees, 95 per cent of whom will be manning the ambulances while 5,000 are in the call centres.

Changavalli said that while each call to a US emergency call centre costs about $43, EMRI's cost per call was 50 cents. He acknowledged this was partly down to obvious factors like lower cost of labour in the country, but also credited the organisation's use of [Satyam-developed] technology, and the fact that as a public-private partnership, it had a tighter focus on waste and expenditure than public organisations.

As the scheme is rolled out across India, the government will fund 95 per cent of the $500m running costs of the scheme, while the Raju family will continue to bankroll executive salaries, likely to account for about five per cent. It will also fund R&D, which is expected to clock up another $25m.

Over 3,000 hospitals have agreed to join the scheme. The journey and paramedic care will be free to the patient, while hospitals in the scheme have committed to not charge the patient for "stabilisation". Once the patient is stable he can opt to continue his stay in a free government hospital or a private clinic.

A key part of the proposition is the ambulance itself, which Changavalli said had been designed with a uniquely Indian perspective. The ambulances are based on a Mercedes Benz design built by a local licensee. As well as space for the patient and paramedic in the back, it features a bench seat for family members because, as Changavalli puts it, when a casualty is popped in the ambulance, "in India, three to four relatives get in as well".

They will be able to enjoy water and aircon as they watch over their writhing relative. Changavalli said there was a positive benefit to having the rellies in with the patient and presumably keeping them cool and well watered: "If the relatives are happy, the patient is happier."

The ambulances also include much bigger oxygen tanks, as they will often be heading into rural areas where they can't rely on quick refills, as well as cutting gear and other rescue equipment, a major innovation in India apparently. The Indian-built ambulance will cost about $40,000 compared to the $120,000 a western ambulance can cost.

Lastly, they will not have drivers, but "pilots". Changavalli said this was because pilot was a higher status title in India. More specifically, "pilots" do not drink and drive, whereas this is not seen as a problem for regular drivers in the country. Also, pilots are not likely to solicit tips from their passengers, something a mere driver would see as part of his job.

Changavalli said the scheme had seen interest from other countries from around the world, including Egypt and other African nations. Of the six billion people in the world, he said, only two billion currently have access to a single emergency number.

He discounted the possibility of other countries outsourcing their emergency call handling to India, saying that while it might be technically possible, it would be politically difficult, particularly for countries where the government oversees healthcare. ®

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