An alliance of public and private healthcare institutions, supported by the Sindh government, has launched the Pakistan Life Savers Programme, PLSP, an initiative to train 10 million Pakistanis in key skills such as CPR, cardiopulmonary resuscitation, and bleeding control, at an event at Aga Khan University. PLSP aims to reduce the burden of death and disability from two major causes of death: cardiac arrest – when the heart suddenly stops beating – and blood loss from injuries, through a nationwide training plan that will teach citizens how to perform simple measures that can improve an individual’s chances of survival. Preventing deaths from cardiac arrest and injuries (such as road accidents, gunshot wounds and serious household mishaps) requires a strong ‘chain of survival’. This chain is a sequence of critical actions that starts at the incident site and ends at the hospital. Trained bystanders represent the first ‘link’ in the chain and can play a vital role in improving survival rates after these two life-threatening circumstances. Since the majority of cardiac arrest and injuries cases occur out of hospital, Pakistan needs a critical mass of citizen rescuers who can act as a ‘bridge’ in the healthcare system and provide essential support before a patient is taken to a hospital for care. “As physicians we feel a sense of powerlessness when we see cardiac arrest or injury patients come to the emergency room,” said Dr Noor Baig, a senior instructor in emergency medicine at AKU. “In the majority of cases, these patients arrive at the hospital when it’s too late as they have either lost too much blood or their heart has stopped beating for too long.” If a trained bystander can provide early vital care by recognising a cardiac arrest or massive bleeding, activating the emergency system and applying CPR or measures to stop the bleed, doctors would be in a better position to treat patients, Dr Baig concluded. PLSP is a multi-stakeholder collaboration whose members include Aga Khan University, Aman Healthcare Services, Dow University of Health Sciences, Edhi Foundation, First Response Initiative of Pakistan, International Committee of the Red Cross, Jinnah Postgraduate Medical Center, Mukhtar A. Sheikh Hospital, National Institute of Cardiovascular Diseases, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, the Sindh government and Ziauddin University. Emergency medicine specialists at the PLSP launch event at the 5th AKU Annual Surgical Conference noted that countries such as Japan, Singapore, Ireland and the United States of America have benefited greatly from similar initiatives to train citizens in CPR and bleed control. PLSP will be launched in Karachi where hundreds of volunteers from the alliance will impart CPR and bleed control skills to trainers. This group will then teach the same content to school and college students with each session guiding participants to: Assess the individual’s condition and ensure scene safety To communicate with emergency response services To initiate chest compressions in the case of cardiac arrest, or to apply tourniquets and other bleed control measures for injuries. To disseminate preventive public health messages The programme will start in Karachi in 2020. It will then be expanded across Sindh and other provinces in line with its goal of training 10 million people across the country over 10 years. “Every member of society should be trained in life-saving skills,” said Dr Junaid Razzak, director of AKU’s Centre of Excellence for Trauma and Emergencies. “Besides imparting lifesaving skills, the Pakistan Life Savers Programme seeks to instill a sense of leadership and civic responsibility. Each preventable death represents an enormous loss to our country and PLSP seeks to empower Pakistanis to protect their loved ones and fellow citizens from harm.” Speakers at the event noted that they aim to partner with schools to scale-up the number of training sessions provided. Sindh Minister for Human Settlement Ghulam Murtaza Baloch expressed support for PLSP and mentioned that he was involved in discussions to contribute to the success of the programme. “Thousands of lives are lost each year due to sudden cardiac and traumatic injuries in Pakistan,” said Mr Baloch. “There is a huge need for life-saving skills and the education department is committed to supporting and ensuring the success of this programme.” A tripartite MoU was signed by Aga Khan University Medical College Dean Dr Adil Haider, Sindh Secretary for College Education and Literacy Mr Rafique Buriro and Sindh Secretary for Health Mr Zahid Ali Abbasi. PLSP has been initiated by AKU’s Centre of Excellence for Trauma and Emergency and is supported by the University’s MBBS class of 1994 and by the Mukhtar A. Sheikh private-sector hospital in Multan. The programme is part of AKU’s efforts to achieve targets under Sustainable Development Goal 3: to ensure healthy lives and promote wellbeing for all ages. Targets under the goal call for measures to reduce the burden of deaths caused by non-communicable diseases, such as cardiovascular conditions, and to halve deaths and disabilities resulting from road traffic accidents, which is a major cause of injury in Pakistan.