Call from anywhere in Andhra, and you will be connected to qualified professionals providing free medical advice over the phone. The service, provided by Health Management & Research Institute (HMRI) immediately sorts and prioritises calls. Those needing an ambulance pick up are guided to 108 and EMRI. Acute non-life threatening cases are given advice on how to stabilise their condition and directed to appropriate nearby clinics or hospitals.

The majority of 104 calls are not for emergency help, and often seek advice on difficult psychological problems. Calls are routed to a doctor, nurse practitioner, or psychologist as required. Ayurvedic and homeopathic doctors are also available for advice. The 104 workers currently operate from a call center in Hyderabad. The target for the year is to increase the number of doctors in the call center to about 200 and hire about 2000 paramedics, from about 50 doctors and 250 paramedics currently on staff. About one quarter of the calls require professional medical advice and about half the calls originate from small farming villages with no permanent medical infrastructure. Shortly EMRI will field-test a mobile hospital.

The Indian government ensures that each village is visited weekly by a health worker trained to give basic medical assistance, primarily to pregnant women. These women are called accredited social health activist (ASHA) workers. Doctors at HMRI have begun to provide non-prescription drugs to the ASHAs for dispensing upon advice from a 104 call.

The 108 and 104 call centers were conceived by Ramalinga Raju, founder chairman and CEO of Hyderabad-based Satyam Computer Services Ltd.; Ranga Rao; and Balaji Utla. Mr. Raju had previously created the Byrraju Foundation to support rural health development in more than 100 villages in Andhra. Dr. Rao worked for many years within the state health ministry. Dr. Utla, responsible for creating one of the largest corporate volunteering efforts in India is also CEO of HMRI.

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