WEST NEWTON -- A West Newton woman in India when the tsunami hit Dec. 26 has been asked to develop an emergency management system in that country.

Mary Popovich returned Jan. 9 from India, where she taught advanced life-support courses to physicians and medical students in and around Trivandrum, a city on the southern tip of India about 40 miles inland of the Indian Ocean coast. An EMS instructor at California University of Pennsylvania, she has been involved with emergency services for over 30 years.

"They've requested I come back and take the challenge of trying to develop some sort of emergency management system," said Popovich, a Pennsylvania certified EMT-paramedic who holds a master's degree in athletic training. "Believe me, it's going to be a daunting task, since there are no established traffic rules or guidelines in place for trained emergency medical service personnel."

Popovich, a long-time volunteer member with the Rostraver/West Newton Emergency Services, said India lacks a centralized dispatch system, a single emergency response number, efficient ambulance transportation, minimum government standards and recertification regulations, government financial support and up-to-date medical equipment and facilities.

"Because this disaster struck and it affected India, it should be a wake-up call to the general population and governing bodies to assist in educational efforts and financial support for this humanitarian project to take place. Unfortunately, often a disaster must take place and lives lost before any action takes place," said Popovich.

Popovich and colleague Adam Bloomanthal of Boston Medical College were in India under a program coordinated by Dr. George P. Abraham of Troy, an American physician of Indian descent. Their mission was to teach emergency medical courses and create awareness to physicians and medical students through the Indian Institute of Emergency Medical Service.

The two had plans to meet with Prime Minister Manmohan Singh and Chief Minister, Y.S. Rajasekhara Reddy, and senior officials about their mission prior to the tidal wave disaster, but due to the enormous devastation throughout the coastal area of India, the meeting was canceled.

However, word was received from the chief minister's office through Dr. Abraham that permission was granted to conduct a pilot study concerning the formation of Emergency Medical Services in Trivandrum, Kerela State. Unfortunately, Popovich said this project will begin without government financial support until a positive impact can be proven.

Popovich said she is certain a preliminary study will produce the evidence needed for community as well as government support. "A project of this magnitude will take cooperation and dedication by hospital officials, and an EMS council will have to be formulated to ensure establishment of policies and procedures and prevent group participation bias," said Popovich.

Popovich left the United States for India Dec.18. While there, she taught advanced cardiac life support, basic trauma life support and neonatal resuscitation program at Ghandi Medical College in Hyderabad and at various hotels in Thiruvananthapuram (Trivandrum) and throughout Kerala State.

She said teaching was focused in Kerala State most likely because that state has a 90 percent literacy rate.

"This was absolutely by far the most rewarding project I've ever done," said Popovich. "To see those people, like sponges, absorbing the knowledge, and the gratitude that was displayed to me and my cohort.

"Since there are no pre-hospital trained personnel, the responsibility falls directly on emergency room physicians, who are not trained in the advanced procedures offered during these sessions. Many of the skills obtained previously during their medical education to become a practicing physician are outdated and not up to the standards Americans take for granted."

Popovich said there is not the luxury of 12 lead monitor defibrillators, automated external defibrillators, combitubes, laryngeal mask airways, or meconium aspirators, or ambulances with highly trained pre-hospital personnel with state of the art equipment, just to name a few.

"It was surprising to discover the lack of basic life support skills in cardiopulmonary resuscitation or any requirement to obtain and recertify in any American Heart Association Discipline.," she said. "What really struck me is the luxuries I'm afforded when teaching in the United States. I'm used to having the best equipment, up-to-date manikins, defibrillators, all this wonderful equipment.

"But because this group depends on memberships or donations, the equipment is old and some outdated. I've never been faced with that situation, and therefore we had to improvise to enhance the learning experience. The government provides health care for those not covered by health insurance, but this privilege comes with an average emergency room wait of 8 to 10 hours and no facilities are available to house a patient's family."

Popovich said each hospital has its own emergency number, and ambulances are used basically to transport patients from one hospital to another or to pick up deceased patients.

To prove the inefficiency of lacking a universal number, Popovich said Dr. M.I. Sahadulla, an advocates for placement of an EMS system, called '101', which is listed as a medical assistant emergency number in Thiruvananthapuram.

"He was asked to contact another six-digit number, '501255', and was instructed to report personally to their office at Chakkai, pay the fees first and then take the ambulance," said Popovich.

She said ambulances in India are miniature versions of those in the United States, some furnished with outdated equipment, while most just have bench seats, no oxygen, no reflective insignias or warning lights.

Popovich said her hosts were excited about a sight-seeing tour and were anxious for her arrival into Thiruvananthapuram. However, due to heavy fog on Christmas Day, her departure from Hyderabad was delayed about eight hours. This delay caused late arrival to Trivandrum, along with fatigue, which elicited a plan for a resting day, dinner and relaxation at a hotel before resuming classes on Monday.

The tsunami struck the coastline the following day, about 30 miles from where she was housed.

"We were teaching all over India, so the tsunami didn't affect our work directly, but it was timely because our mission was awareness," said Popovich. "What is hard to forget is the massive loss of lives and livelihood. Many of the affected people lived along the shore and depended on the fishing trade. They lived simple lives with few amenities.

"Not only have they lost their equipment, loved ones and homes, but now must deal with the loss of income, since the demand for fish has dropped due to the massive bodies found floating in the sea. Many believe the fish had consumed the flesh of departed loved ones, and refuse to include fish in their diet."

Popovich said she is hoping to coordinate an EMS project in India with a dissertation for a doctoral degree in education and administration. She plans to apply for acceptance to Indiana University of Pennsylvania.

Dr. Abraham and his India colleagues are anxiously awaiting her return.

"There are so many challenges to this. First you have to educate, and secondly you have to figure out how to fund it," said Popovich. "You have to make people see that their quality of life will be better if they have this in place."

Popovich said she has received numerous e-mails from students she helped train in India. "I can't wait to return to see how they are progressing with the training we provided," she said.

"It took almost 40 years to get an EMS system in place in the United States.," she said. "I'm lucky to have been involved as a participant for the past 31 years. I've seen many changes throughout my career and I have numerous contacts in various levels of the EMS system in our emergency medical service region.

Popovich welcomes the knowledge and expertise of anyone willing to assist her in this enormous task.

"I urge anyone who would like to donate training equipment or make a monetary contribution to this non-profit organization of the Indian Institute of Emergency Medical Services, to contact Dr. George at: bg@iiems.org or visit the web site at: http://www.iiems.org," Popovich said.

Popovich is also a member of West Newton Borough Council and owns and operates Merrie The Clown in West Newton.