A pilot project in Bangladesh has shown that trained community volunteers can mean the difference between life and death in a road collision. A delay in emergency care by minutes can determine a victim’s fate, and the initiative in Bangladesh ensured that all crash victims received first aid in just five to eight minutes.
Based on the number and severity of recent road crashes, a 10 km stretch of a busy national highway was selected for the pilot phase in 2023, with a further 30 km added in 2025. With WHO support, the Bangladesh Directorate General of Health Services piloted the community first responder project which includes a 24-hour emergency hotline, a call centre, and 120 trained volunteer first responders.
The volunteers were made up of residents living close to the highway, including shopkeepers, drivers, homemakers and teachers who demonstrated a clear determination to save lives. All volunteers were trained in first aid and mass casualty triage and are provided with essential medical supplies.
Volunteers provided 625 victims with first aid and care and attended every reported incident. Where necessary, they triaged victims and used local transport to move them to the nearest health facility. By engaging local stakeholders, including the fire service and highway police, nearly 80% of patients arrived at a hospital within 30 minutes of a crash, which can significantly raise the chance of survival.
“This is a potential gamechanger where emergency services are limited. Cutting waiting times means more lives saved, and this model proves that support from trained volunteers can be delivered rapidly and reliably at scale and with coordinated efforts,” said Dr Ahmed Jamsheed Mohamed, WHO Representative in Bangladesh.
A dedicated focal person staffs the emergency hotline 24 hours a day. Contracted by an expert agency, the operator enters information on a crash into the system, which automatically dispatches volunteer responders based on their proximity to the crash by sending text messages to their phones.
The programme collected detailed crash data that reflects Bangladesh’s wider road safety challenges. Bus passengers accounted for the largest proportion of victims, at 23%, followed by motorcyclists at 22%, and pedestrians at 18%. More than half of victims were males aged between 21 and 40 years.
The Government of Bangladesh has signaled its commitment to scaling up the initiative in a sustainable way, with plans to expand the model to other stretches of the national highway network. The programme’s architecture is adaptable and replicable in settings with similar challenges, and the government continues to use the expert agency’s support to operate the call centre at the pilot site.
WHO has long advocated for community-based first responder models as a practical solution to pre-hospital care gaps in settings where ambulance-based services are not viable. The Bangladesh pilot shows these models can be operationalized effectively, with community ownership at their core.
