It takes a system to save lives
The initial need was to improve trauma care to save lives and reduce disability from accidents. However, it was recognised that to achieve this requires a coordinated system of care, which starts from the community’s response to emergencies, the number to call for an emergency, timely ambulance dispatch and paramedics providing care enroute to the emergency department.
This system of care, which we take for granted in high-income countries is missing or incomplete in many lower-resource settings. Even where elements exist, they often lackpolitical support, adequate funding and quality standards, resultingin delayed and suboptimal emergency care- and ultimately higher mortality and long-term disability. (Nadarajan, Gayathri Devi, et al. "Establishing Core elements for a Prehospital Emergency Care Systems Evaluation Tool (PECSET) for systems in early stages of development: A Delphi consensus." Prehospital Emergency Care 29.7 (2025): 982-992)
From necessity to vision
Dr Suryanto’s path to this work was anything but straightforward. Growing up in Malang, he entered nursing school after junior high to secure a job quickly and support his family. Yet over time, his curiosity for emergency care deepened. He went on to pursue both his Master’s and PhD in Nursing at Monash University, focusing on how nurses work within ambulance systems in Indonesia; a country where paramedics are not yet formally recognised.
“Most ambulances in Indonesia are staffed by nurses,” he explained. “But for a long time, our nursing curriculum didn’t include prehospital care. That meant many of us were learning on the job. I wanted to change that.”
In 2019, Suryanto joined Dr Ali and a small team to develop Indonesia’s first Emergency Medical Services (EMS) training curriculum, equipping nurses and doctors with the skills needed to respond effectively in the field. They have since trained healthcare workers across the country, from Malang to Lombok and Borneo and are helping local authorities build the foundations of an EMS network.
Learning from Singapore
This year’s fellowship offered a chance to see how Singapore’s prehospital systems operate as one connected chain; linking ambulances, emergency departments, academia, and national policy.
“What inspired me most was how well connected everything is,” said Dr Suryanto. “The hospitals, the universities, and the Ministry of Health work together — research, practice, and policy move as one. That’s the kind of system we hope to build in Indonesia.”
Armed with new insights, he plans to pilot a quality improvement study in Malang using an evaluation tool known as the “Back Step” mapping out the strengths and gaps in existing prehospital care units to guide national standard-setting.
But beyond technical skills, he says the fellowship reaffirmed something deeper.
“In Indonesia, we sometimes feel small compared to other systems,” he said. “But Dr Ali always reminds me, start where you are, and do what you can. Seeing Singapore’s system motivates me to continue the journey, one step at a time.”
The power of mentorship
The connection between Dr Ali and Dr Suryanto goes beyond professional collaboration; it’s a shared mission built on trust and friendship.
“Dr Ali keeps pulling me up,” Suryanto said with a smile. “He says, ‘Come on, join me, we’ll do this together.’ That spirit keeps me going. Not many people in Indonesia focus on prehospital care, but his encouragement helps me stay the course.”
Together with colleagues, they are now mentoring younger teams across Indonesia. Helping hospitals and local universities establish EMS training programmes, run simulation courses, and even train resort staff in first aid on Indonesia’s tourist islands.
“Mentorship doesn’t stop with us,” he added. “We try to pass it on to guide the next generation to care for their communities in emergencies.”
Carrying the legacy forward
The month-long fellowship ended in October 2025, Dr Suryanto hopes to continue what began almost three decades ago; strengthening systems so that timely care reaches everyone, everywhere.
“The trauma project in 1996 was the start,” he reflected. “It showed us what’s possible when people come together with the same purpose. I’m proud to continue that story.”
What began as a small SGH project in Malang has now become a movement. One sustained not by grand programmes, but by passionate individuals like Dr Ali and Dr Suryanto, quietly building bridges of care across borders.