THE global medical fraternity unanimously agrees that providing pre-hospital care to patients can save many lives. In India’s state of Tamil Nadu, the 108 emergency transportation service, launched in 2008, has played an effective role in reducing infant mortality, and also saved the lives of 120,271 road accident victims through timely interventions. The response rate of Sri Lanka’s Suwa Seriya ambulance service is 12 minutes, which is the fastest in the world. The Rescue 1122 emergency service was launched in 2004 in our own province of Punjab.
Karachi, Pakistan’s largest city, has many ambulance services, but most, unfortunately, do not have the requisite facilities and equipment needed to administer pre-hospital treatment to patients. The first lifesaving ambulance on Karachi’s roads was seen courtesy of the Aman Foundation. In 2018, this foundation handed over its 60 lifesaving ambulances to the Sindh government, on the understanding that the provincial government would increase the number of lifesaving ambulances to 200 for Karachi. The Sindh chief minister reiterated on the floor of the assembly that his government would increase the size of the fleet in accordance with the requirements of the city. Unfortunately, this pledge has not been fulfilled.
The Sindh Medical and Rescue Service (SERS), which started out with a fleet of 85 lifesaving ambulances (60 in Karachi, 25 in Thatta and Sajawal) in 2018, now has a total of 411 such vehicles. The size of the fleet has increased manifold, which is a good sign, but it seems that Karachi has been left out.
Although the province was to provide an additional 140 lifesaving ambulances, in the last six years or so, only 31 new lifesaving ambulances have been added to the fleet of ambulances operating in Karachi under SERS. Karachi is the capital of Sindh, and more than 40 per cent of the province’s population resides here. On the basis of population, it makes sense for 40pc of the province’s, health, education, and development budget to be spent on Karachi. If that is not possible, then at least 25pc. If SERS had diverted only 25pc of its fleet expansion to Karachi, the city could now have had 140 lifesaving ambulances, a strategy that would not only have benefited Karachi’s residents but also brought the chief minister closer to fulfilling his commitment.
The Sindh government has not fulfilled its commitments.
The lack of lifesaving ambulances is felt when people speak of their ordeal. I decided to raise this critical issue again when, a few weeks ago, the wife of a deceased friend narrated how she kept trying to get a properly equipped ambulance for her husband for three hours; after this critical period of time, she had to shift her husband to hospital via a carrier ambulance from a social welfare institute. The patient had already expired upon reaching the hospital.
Two years ago, I, too, had to wait for a SERS ambulance for more than three hours to shift my mother to hospital. After this atrociously long wait, we shifted her, in critical condition, to a private hospital using the ambulance of the same hospital because of a relative’s links with the medical unit’s administration. If people living in the city’s more upscale localities struggle to get even basic services, what must be the problems faced by residents in underprivileged localities?
While discussing the provision of lifesaving ambulances, an argument that is often put forward is that Karachi has an abundance of narrow lanes and huge lifesaving ambulances would not be viable. This, in my view, is not a valid argument and deprives citizens of a basic right. If the entrance of big vehicles inside narrow streets is not possible, then it is the responsibility of the provincial government to find a method to solve this problem. The quickest solution is for a small vehicle to bring the patient out of the street and shift him/her to the lifesaving ambulance at the first accessible point.
SERS is operating 10 motorcycles in Karachi under its Rapid Response Bike project. Although this is a good initiative, it cannot be a replacement for lifesaving ambulances. In 2018, when the chief minister announced that Karachi would have an additional 140 ambulances, the cost of making such an ambulance was approximately Rs75 million. Today, this figure has jumped to Rs125m. Also in 2018, Karachi needed 200 ambulances based on the city’s population. Today, not only has the cost increased but the required number of ambulances has also gone up due to the city’s growing population.
Karachi has provided shelter to people of all ethnicities, but when it comes to being served, there is no one to help it.
The writer is a freelance contributor.
Published in Dawn, October 18th, 2024
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