Journey of the Indian Society for Trauma and Acute Care: An enlightening story

Trauma is a leading cause of death worldwide and mainly affects young people. However, trauma-related mortality rates are higher in low and middle-income countries (LMICs) as compared to high-income countries (HICs).¹ Higher mortality rates are due to the underdeveloped or nonexistent trauma and emergency care system in LMICs.¹ According to the World Bank, developing countries lose approximately $100 billion every year due to road crashes, which is twice the amount of all development aid provided by donors to developing countries. In India, 3.14% of its gross domestic product (GDP) is spent on the care of trauma victims.²

According to the National Crime Records Bureau (NCRB), 171,100 people died on Indian roads in various road traffic incidents in the year 2023. The majority of victims (45.5%) were two-wheeler riders, followed by victims of cars, trucks and three-wheelers, who accounted for 14.1%, 8.8% and 4.5% road traffic deaths, respectively.³ What is most devastating is that the majority of the victims were in the third and fourth decades of life. It is not only a loss of life of an individual but a loss to the family and society at large. With every death, 60 to 70 persons are injured in these crashes and might lose years of their productive lives. The overall burden on society is thus humongous. Hence, there is a need to develop a robust trauma care system in LMIC countries through awareness about trauma care, trauma training and education, advocacy and policy making. In India, there is a growing realization amongst the key stakeholders about the need to improve trauma care, and efforts are going on in this direction through government agencies, non-governmental organizations (NGOs), academic societies and associations, and institutions. ‘Right to Emergency care’ and ‘Good Samaritan law’ are important outcomes of such efforts.⁴

“A journey of a thousand miles begins with a single step” is a common saying that originated from a Chinese proverb.⁵ The origin of the Indian Society for Trauma and Acute Care (ISTAC®) was that single step which was taken by a group of like-minded professionals together with an aim to enhance awareness about trauma care, trauma training and education in the country. ISTAC® was born in 2007 as a scientific society. It is the only independent national trauma society in India and is involved in various educational activities related to trauma care and injury prevention since its inception.⁶ The first academic conference, ‘Trauma 2008’, was organized under the aegis of ISTAC® in the year 2008. Its fifteenth annual meeting, ‘Trauma 2025’, will be held in the month of November this year at Navi Mumbai (http://www.trauma2025.com). ISTAC® is a member of the World Coalition for Trauma Care (WCTC), and it hosted the third conference of WCTC – ‘World Trauma Congress (WTC)’ in 2016 in India.⁷ It was a great success with participation of more than 1800 professionals from more than 35 countries. Our society is so committed to spreading knowledge about trauma care and to imparting training that it organised its annual conferences in a virtual mode even during the COVID-19 pandemic. I distinctly remember that when I was a surgery resident 30 years ago, there used to be hardly any lectures on ‘Trauma care’ in both regional and national surgery conferences. Now it is very satisfying to see the change that the professionals are realising the need of such educational activities in the field of trauma care. These educational activities of ISTAC® also helped in strengthening the membership of the society. Currently, it has more than 1100 members.⁶ ISTAC® is an inclusive society and has all cadres of healthcare professionals in the field of trauma and acute care as its members, be it doctors, nurses or allied healthcare providers. ISTAC® encourages young professionals and trainees to participate in such educational activities not only in India but outside India as well to learn advancements in trauma care by awarding them travel fellowships and awards.

ISTAC® is expanding its base by forming its chapters in various states. Uttar Pradesh (UP), the largest state of India, deserves all the credit for starting the first chapter of ISTAC® in 2019. Other state chapters, such as the West Bengal and Madhya Pradesh chapters, are underway.

An important milestone in this journey was the promulgation of Advanced Trauma Life Support (ATLS^©), Advanced Trauma Care for Nurses (ATCN^©) and Prehospital Trauma Life Support (PHTLS^©) courses of the American College of Surgeons (ACS), Society of Trauma Nurses (STN) and National Academy of Emergency Medical Technicians (NAEMT), respectively, in India.⁸ Our society is constantly pushing the boundaries for the benefit of healthcare professionals. It achieved another important milestone by developing consensus guidelines on the ‘Management of Blunt Solid Organ Injuries’.⁹ It is actively involved in organizing continuing medical education (CME) activities, webinars, advocacy and policy making through its sub-committees. ISTAC® is privileged to have worked closely with the Army Medical Corps of the Indian Army in organizing CMEs. ISTAC® has also worked closely with the regulatory bodies responsible for medical education in India, such as the National Medical Commission and the National Board of Examinations in Medical Sciences, to develop curricula of various postgraduate courses in the field of trauma and emergency surgery.¹⁰

Trauma is a niche area, and there are few dedicated journals to cater to the needs of professionals working in the field of trauma care. There was a long-standing demand to start an official journal of the society. The request was unanimously approved in the annual general body meeting of ISTAC® in the year 2024 during its annual conference ‘Trauma 2024’. As a result, the executive committee of ISTAC® decided to start a scientific journal of its society by the name ‘Journal of Injury and Acute Care’ (JOIAC). Scientific Scholar is the official partner and publisher of JOIAC, which is an open-access, online, peer-reviewed journal (http://www.joiac-istac.org). Its scope for publication is very wide and it includes trauma care, emergency general surgery, surgical critical care, emergency care, injury prevention, disaster management, trauma surgery, orthopedic trauma, and neurotrauma. There is no article processing charges (APC) for publishing in JOIAC. It will be a long and tedious journey before the JOIAC gets its due recognition from indexing agencies. It will require time and the efforts of each one of us to achieve the desired results. On behalf of the editorial board, I wholeheartedly invite you all to join us in this noble cause as authors and reviewers to make it a huge success. Trauma care is a TEAM effort and Together Everyone Achieves More.