KARACHI, June 8: With most hospital ambulances not what they used to be and government not interested in bettering its service, people have learnt to depend on and trust their lives with the various NGOs and volunteer ambulance services operating in the city.

Operating over a thousand ambulances across the country, Edhi Foundation, which happens to have the largest fleet in the world, has some 200 ambulances in Karachi alone. “The 200 I mentioned are the Suzuki high-roof ambulances. There are also 20 Toyota Hiace, two Mercedes vans and four Toyota Land Cruisers. Besides, there are the Edhi air ambulances — a plane and a helicopter,” says Raheem Ghani, the official in charge of their 24-hour emergency ambulance section, at Tower.

In one of its rooms, young men surrounded by computers, landlines and cellphones are busy taking calls and sending text to whoever has registered for the Edhi mobile alerts. A few computers are being used to monitor the status and movement of their ambulances with the help of trackers. “We have around 80 to 90 vehicles with trackers. The green dots that you see moving around on the maps on the screens are the ambulances that are on the road and the red dots are the stationary vehicles,” Mr Ghani explains. There are several white boards in the office with various statistics, too. One mentions the number of calls they got each month on their 115 number.

Under the total in April the figure is 28,045. “But these are only the calls that we get from hospitals or homes to transport the sick, etc. This number does not include the emergency calls like accidents and gunshot injuries that we volunteer for free of cost,” he adds.

Mr Ghani says that they charge Rs200 per trip. “And after the CNG crisis, we have started running most of our vehicles on petrol,” he provides.

Asked if their work had eased to some extent after the arrival of other ambulance services such as Aman Foundation, Chhipa, KKF, etc., the gentleman says that Karachi still needs more such services to deal with the emergencies here.

Picture gallery In the main office at Tower, there hang framed pictures of ambulance drivers who were killed in the line of duty. “They are our martyrs. Some got shot, some died in accidents and some drowned while trying to rescue others,” says Saleem Anwer, an Edhi ambulance driver, associated with the trust since 1999.

The driver says that he understands very well the risks involved in driving an ambulance. “It is rough driving, but its all part of the job,” he says, adding that he had other options open to him after joining Edhi Foundation “but I felt that my services would best we utilised as an ambulance driver.”

Asked if he had ever used the ambulance siren unnecessarily in heavy traffic, the driver shakes his head. “The one who is most disturbed by the siren directly over his head is the driver himself. Besides, Edhi sahib says that one should never misuse any facility,” he adds.

About their training, the driver says that batches of around 25 are given paramedic training soon after induction. “We know how to move a patient with a back injury, we can give cardiopulmonary resuscitation [CPR], etc.,” he says.

Meanwhile, Anwar Kazmi, a spokesperson of the Edhi Foundation, informs that the Edhi ambulance service goes back to 1949 when Maulana Abdul Sattar Edhi converted a Hillman truck into an ambulance and learnt how to drive it himself.

The yellow ones The yellow Toyota Hiace Aman Foundation ambulances only operate in Karachi and follow a 911 standard. “Our ambulances may be big in size but they are life-saving ambulances,” says Murtaza Abbas, assistant manager, PR and events, at Aman Foundation.

“The smaller vans belonging to other NGOs that you see around the city are usually for transportation of patients only but the Aman Foundation ambulances are mini hospitals where the treatment of patients begins the moment he or she is in the van,” he says.

“That is also why we have signed a memorandum of understanding with the Edhi Foundation, which we are very proud of as Edhi doesn’t usually sign MoUs with anyone. As per the understanding, Edhi Foundation forwards all their life-threatening cases to Aman Foundation, which always has one doctor and one paramedic besides the driver in the ambulance,” he explains. “And we charge those who can pay of course the same as Edhi does,” he adds.

“The moment we receive a call on our emergency number 021-11-111-2626, the call centre staff have a short and quick question and answer session with the caller in order to understand the priority of the situation and send out the category of code according to it. That’s when we also decide whether to send out the Basic Life Support or the Advance Life Support ambulance,” Mr Abbas explains. “We also have nine ambulance stations across Karachi apart from having our ambulances standing by at the major hospitals in order to minimise delays. The average time for our ambulances to reach a designated spot is around eight minutes,” he provides.

Siraj Ahmed at the Chhipa point outside the Jinnah Postgraduate Medical Centre explains that they always keep their six ambulances parked and ready go at each of their spots outside hospitals. “When one leaves on a call, another is called in to take its place,” he says.

The St John’s ambulance service also has Toyota Hiace vans but very small in number. “We have four or five vehicles in good running condition,” says Mohammad Yousuf, one of their ambulance drivers.

“Earlier, there were just the St John’s and Red Cross ambulances doing most of the work in the city but the Edhi and Chhippa services have taken over in a big way,” he says. “It is fine, too, as we haven’t got very good response from some people because of our organisation’s Christian name. In fact our vehicles were stoned during the Nishtar Park tragedy a few years ago,” he regrets.

About their charges, the driver says that they vary. “For instance, we can charge Rs800 from, say, the Seventh-Day Adventist Hospital to the Aga Khan University Hospital and from Sea View to the AKU it can be up to Rs1,000,” he says.

“But all our ambulances are fully air-conditioned and our staff trained in first aid,” he justifies the costs.

At the Pakistan Red Crescent Society, the charges are Rs400 for a single trip that is less than eight kilometres. “And we add Rs40 per each extra kilometer that we travel,” says their driver, Mohammad Inayat.

“Our ambulances, all Toyota Hiace vans, have different equipment. Like at Hilal-i-Ahmer in Clifton, we have two dedicated cardiac ambulances and three to four plain ones,” he explains.

About the training standards of their ambulance staff, he says that from training in driving in heavy traffic to first aid, they have different week-long courses and refresher courses after every one to three months.