For more than a year, during the worst of the pandemic, I have been involved in a ground-breaking project looking at post-crash response in four countries: Tajikistan, Kyrgyzstan, Lebanon and Egypt. With support from the Global Road Safety Facility of the World Bank and UK Aid, the European Bank for Reconstruction and Development (EBRD) initiated this study to understand better how post-crash response is organised in these four countries. In doing so, they hoped to get a better idea of how donors and others might support life-saving improvements. The project was implemented by EASST, FIRE AID, the George Institute for Global Health UK and SharedAim. We originally intended to visit each country to carry out on-site assessments, but the pandemic put a stop to that plan. Thanks to our EASST partners and networks, we worked remotely instead, interviewing key stakeholders in every emergency service and agency contributing to post-crash response or holding data about its impact. This included important information about how the picture varies regionally in each country, as well as the strengths and weaknesses of the different emergency services. By this means we were able to carry out a full review of the situation and challenges faced in each country. In Tajikistan – where the Japanese International Cooperation Agency (JICA) had surveyed every ambulance and emergency vehicle just a year before – we were able to put together a particularly comprehensive report. This highlighted the challenges of post-crash response in a country that is 93% mountainous and home to one of the world’s most dangerous roads; the Pamir Highway. In some examples shared with us it took the emergency services up to 4 hours to reach the scene of a crash, and once they arrived they then struggled to reach the casualty given the difficult terrain and lack of specialist equipment and training. What was clear from our research was that despite every country having different structures and although ‘one size DOES NOT fit all’ – there are certain challenges which all the countries we reviewed share:

1. A lack of collaboration and communication between the emergency services: We heard first hand stories of how lack of joint protocols and procedures resulted in confusion and poor scene management. This caused further delays in the extrication of a casualty and sometimes even resulted in the fatality of emergency service workers themselves.
2. Uneven allocation of resources: It is clear that resources are often focused on urban areas given the high population density at the expense of rural areas are forgotten. Mountainous or desert regions are where some of the most dangerous roads can be found, and where emergency services could take hours (and even days) to reach the scene.
3. Lastly, data collection, management and strategic planning are a challenge for all four countries. Inadequate data made it difficult to understand where the crashes are happening, the severity and outcomes of these.

After conducting our assessments, the next stage of the assignment involved bringing together key stakeholders and ministries at an online round table event (with the exception of Tajikistan where our guests convened in a COVID-secure venue). Despite the challenges of technology we were successful in getting key stakeholders to attend and actively participate in these meetings. In some cases it was the first time these stakeholders had met together to discuss post-crash response – a step in the right direction in itself! I really enjoyed these online meetings, and found them really interesting. The engagement of the participating agencies with the content of our presentations was rewarding. It was good to witness the beginnings of communication and collaboration between the emergency services in these countries. At each event our project experts were presented with questions from the audience and requests for follow-up. The discussions also kicked up important local issues. During the Lebanon event for example, a lengthy discussion took place about prioritising the safety of emergency workers at the scene and the need for joint coordination. In Kyrgyzstan stakeholders stayed online after the event to continue their discussions about improving coordination and equipment. An important aspect of the project was the development of a Post-Crash Response Emergency Toolkit as a legacy for each country. The Toolkit has been designed as a helpful resource for joint planning, to assist all stakeholders in the management of post-crash response to save lives and improve outcomes for survivors. It covers basic best practice around the need for strategic planning and investment, good coordination, communication, equipment and training. As part of this toolkit our team put together 6 animations covering the key stages of the post-crash response life-cycle. These can be viewed via the video below.

The toolkit and animations will be valuable resources for both promoting the importance of post-crash response and encouraging best-practice. FIRE AID will work to ensure the project continues to raise the profile of post-crash response across the road safety community and in the minds of the donors. We hope the launch of the toolkit and animations will be a starting point for further dialogue and discussion aimed at identifying goals and improving post-crash response – not only the countries we studied, but more widely. Investing in post-crash response can yield large economic returns by saving lives and reducing injuries. It develops skilled services that are more equipped to respond to natural disasters and other emergencies. It underpins a country’s resilience, an important goal for all.