Hasan Mansoor discusses how people have learnt to depend on and trust their lives with the volunteer ambulance services in Karachi

Out of the around 500 privately-run ambulances in Karachi, the majority are run by the two charities, Edhi Foundation and the Chhipa Welfare Association. Predominant among these is Edhi Foundation, which has its network across the country with equal measure and strength and is reckoned as one of the largest ambulance networks in the world.

Edhi runs some 275 ambulances in Karachi out of the total of around 1,900 vehicles dedicated to health-related emergencies across the country, while Chhipa, with service mainly concentrated in Karachi, has some 100 ambulances for the busy metropolis.

The ambulances of both these charities are used for urgent transportation of patients in duress to hospitals and are dedicated to emergency response, which is a widespread phenomenon. However, Edhi’s ambulances also transport unclaimed and unidentified bodies from the city streets, shift people and children who have no family or relatives to the charity’s concerned facilities and even reach out to help animals in distress.

According to Edhi officials, they charge Rs200 to transport a patient from one’s house to hospital or vice versa within a city. However, they charge Rs12 to 20 per kilometre to shift the patients from one town to another.

Chhipa officials shied away from giving their charges from patients who can afford. However, it was independently known that they charge from Rs200 to Rs500 according to the distance their ambulances travel and the service remains confined to Karachi.

Anwer Kazmi, spokesman for the Edhi Foundation, says the charity has not increased their charges though it has shunned using CNG and opts for petrol because of continued closure of CNG stations. “The constant CNG outages had been affecting our service as our ambulances had been hooked to gas, thus we converted them to run on petrol and diesel for public benefit,” he says. A similar step is being taken by the Chhipa Services. “We could not afford to stay in long queues at CNG stations; our job is to serve and that too as early as possible,” says a Chhipa official.

Karachi’s prolonged traffic jams have become exasperatingly regular, which have dearly affected the city’s emergency services. Traffic constables are routinely seen working hard to clear roads for VVIP convoys, but they impassively see crying ambulances and fire tenders entangled in a maze of vehicles.

The ambulance services find it gravely annoying to be trapped in traffic mess at a time when ambulances are frustratingly trying to reach an area of emergency.

“Our ambulances work unhindered in crossfire and among mobsters but increasing traffic jams have emerged as our worst foes. It is difficult to move ahead when you are trapped with thousands of vehicles from all sides,” says Mohammad Ashraf, who has been running an Edhi ambulance for years.

“Sometimes we can’t do anything but to see a patient die helplessly because we can’t pass through traffic jam,” says Yousuf, a Chhipa ambulance driver.

Though both the charities have dedicated volunteers yet they have little capacity to train them. “Our drivers need to know how to rush to a spot or house and which route to choose to reach to a nearest health facility. We have trained paramedics as well, but I must admit they are not enough in number and we need more,” says Mr Kazmi.

The ambulances run by both the charities are popularly called ‘transportation vehicles’ for they are devoid of the facilities an ambulance is required to have. Chhipa officials claim that they have first-aid box, an oxygen cylinder and a paramedic in every ambulance, Edhi officials say they could send 20 ambulances at a time with the same facilities if need be.

Kazmi says the Edhi service has an agreement with the Aman Foundation. “We hand over serious patients to the Aman Foundation because their ambulances are fully equipped with life-saving facilities. Our volunteers have been trained to make sure that a patient keeps breathing; they try to control bleeding as well.”

Both the charities rely on public donations to run their affairs. While Chhipa does not share their earnings and expenditures, Abdul Sattar Edhi, who is the trailblazer of Pakistani philanthropy, does not hesitate in doing so. “We require some Rs400 to Rs500 million a year to keep the ball rolling. Every year we need some 300 new vehicles; salaries of the paid volunteers and fuel, etc. cannot be purchased from the money we charge from people who can afford,” says Mr Edhi.

He says he gets everything from the common people. “I have faith in my people. They are far more generous than the rich. Whenever I want more I go anywhere and start begging. My people have never sent me back empty handed.”