By Dr Tiameren Jamir
On February 19, Meghalaya woke up to the shocking news of the sudden passing of Ricky Andrew J. Syngkon, who collapsed during a football game. Reports say he fell on the field, was quickly taken to a nearby health facility, and later declared dead at a city hospital, likely due to a cardiac arrest. Much of the discussion since then has focused on the availability of doctors and preparedness of the health facility he was taken to—and rightly so. Health facilities must be prepared and ready for any eventuality. But beyond that, Dr Syngkon’s passing also forces us to ask a harder question: what actually happens in those first few minutes when someone collapses like this in our communities? In this article I try to argue that the case was lost in the first few minutes of the incident.
Around the world, out-of-hospital cardiac arrest (OHCA) is a leading cause of sudden death. But survival is not decided only in hospitals. It often depends on what happens before medical help arrives. Every minute without action reduces the chances of survival. Sometimes, that action can be as simple as calling for help quickly. At other times, it means starting CPR or using a machine to shock the heart (Automated External Defibrillator – AED) if one is available.
Over the years, studies have consistently shown that people who receive CPR immediately from someone nearby are far more likely to survive and recover well than those who do not (Chen, 2025). Put simply, it often comes down to whether someone present knows what to do—and is willing to step in.
Doctors often talk about something called the “chain of survival.” According to the American Heart Association, this includes recognizing a collapse early, starting CPR immediately, using an AED as soon as possible, getting emergency services involved, and ensuring good hospital care. If any one of these steps is delayed, the chance of survival greatly diminishes.
What is important to understand is that the first few steps depend almost entirely on bystanders: early recognition, early call for help, early CPR, early use of an AED. In some cases, just starting CPR early can double or even triple the chances of survival.
There is also clear evidence that communities can do better when people are trained and aware. Public awareness drives, CPR training programs have been shown to increase the likelihood that someone nearby will step in to help (Yu et al., 2020). Places that invest in such training see more people responding to emergencies and more lives saved.
Using an AED can also make a huge difference. Many cardiac arrests are caused by abnormal heart rhythms, and a timely electric shock can restart the heart. Studies show that when AEDs are available and used quickly, survival improves significantly (Elhussain et al., 2023). The use of an AED is now taught as a part of the First Responder (FR) and Basic Life Support (BLS) programs. The newer devices have become more user friendly and trained lay persons are encouraged to use them in an emergency.
All of this points to a simple reality: what is done in the first few minutes can decide whether a person lives or dies.
In many parts of India—and in Meghalaya—those crucial minutes are often lost without any action. Ambulances take time to reach, especially in crowded areas or remote locations. In that gap, the only people who can help are those already there—friends, colleagues, or even strangers nearby.
The problem is that most people are not trained in CPR. Even when someone collapses in front of them, many hesitate. Fear, confusion, or simply not knowing what to do hold people back. And even when CPR is attempted, it is sometimes done incorrectly, with long pauses that reduce its effectiveness. It is likely that some of these challenges played out in those critical moments when Dr. Ricky A. J Syngkon collapsed on the football field—uncertainty, panic, and a lack of immediate action, not because bystanders did not want to help but because they did not know how. This was made worse by the absence of an AED at the sport facility and delays in the ambulance reaching in time.
This is why Dr. Syngkon’s passing should not just be seen as an isolated tragedy. It should make us think about whether we, as a community, are ready to respond in such moments.
Several countries have shown that change is possible. Many have introduced CPR training in schools and workplaces, leading to more people stepping in during emergencies. Even schoolchildren are taught these basic skills. The Indian Institute of Public Health Shillong has also been training volunteers, doctors and nurses in health facilities and various other institutions for the last 2 years. The BLS training is also a part of the Masters in Public Health (MPH) and Bachelor of Science in Public Health (BScPH) curriculum to ensure that every student enrolled is equipped with these essential lifesaving skills.
For Meghalaya, the message is clear. We need to build a culture where people are prepared to help. This could mean introducing BLS training in schools, colleges, and workplaces. It could also mean public campaigns to help people recognize cardiac arrest and understand what to do. Placing AEDs in busy public areas—like markets, sports grounds, and government offices—could also be extremely helpful.
These efforts do not require huge investments. What matters most is awareness and readiness. One person who knows what to do can make all the difference.
The loss of Dr. Ricky A. J Syngkon is deeply felt, not just by his family, but by the wider community. But it also reminds us of something important. Cardiac arrest can happen to anyone, anywhere. And when it does, survival often depends not on doctors or hospitals alone, but on the people standing nearby.
If this moment pushes us to learn, prepare, and act, it may yet leave behind a legacy that saves countless lives in the future. Because when emergency strikes, the most important responders are often the people standing just a few feet away—and the first few minutes may be the only ones that truly matter.
(The writer, Dr Tiameren Jamir is a faculty at the Indian Institute of Public Health Shillong. Email [email protected] )
