THAT more than 70 per cent of Pakistan’s population is deprived of basic health facilities is a matter of great concern. Successive governments have given little priority to improving our healthcare systems, and this lack of interest means that people are either deprived of basic health, or forced to seek expensive treatment from private-sector services.
Since the 18th Amendment, it is the responsibility of the respective provincial governments to provide health services to their people. The PPP-run Sindh government, now in its third consecutive term, should focus on improving its healthcare facilities — one of which is transporting patients. This is a serious issue due to the lack of life-saving ambulances in the province.
The concept of life-saving ambulances is relatively nascent in Pakistan. In the 1950s, Abdul Sattar Edhi laid the foundation for the country’s first-ever ambulance service when he realised there was a need for facilities for transporting patients whose families did not own a car from their homes to hospitals.
This effort solved the larger-level issue of transporting patients (and dead bodies), but these vehicles were not equipped with oxygen cylinders, pulse oximeters, cardiac monitors, defibrillators and other life-saving emergency equipment and medicines. As a result, the probability of a critical patient expiring in an ambulance before reaching a medical facility is very high. In this scenario, the need to have life-saving ambulances on the roads is imperative.
There is a desperate need for an integrated life-saving ambulance service in Sindh.
A large fleet of life-saving ambulances would increase the likelihood of critical patients reaching hospital alive to a great extent. In Punjab, such a service was launched in 2004 with Rescue 1122, which has in subsequent years begun operating in parts of Khyber Pakhtunkhwa as well. Sindh, likewise, needs such a service.
It is unfortunate that Karachi’s private and government hospitals either don’t have ambulances or have them in negligibly low numbers. Currently, Aman Foundation is operating 60 life-saving ambulances in Karachi. But, keeping in mind its population, expected to become the world’s third most populous city by 2030, this metropolis needs at least 200 life-saving ambulances. Meanwhile, in Thatta and Sujawal, the Sindh government is operating 25 life-saving ambulances, known as the Sindh Peoples Ambulance Service (SPAS), in partnership with Aman Foundation.
So far, thousands of lives have been saved by providing first aid to patients, either on the spot or en route to the hospital. It goes to the credit of SPAS that their trained staff has so far carried out more than 80 deliveries inside the moving ambulances. Had these life-saving ambulances not been available, it is possible that some of these deliveries would have resulted not in the joy of welcoming a newborn into this world, but of mourning the death of a mother-to-be or her child.
It is therefore imperative that the Sindh government also launch its own integrated ambulance service along the lines of Rescue 1122. This model should be replicated throughout Sindh, beginning with a pilot project in Karachi, where more than 30pc of Sindh’s population resides and where more than 90pc of emergency patients are taken to hospitals, either by family members, or in vehicles ostensibly called ambulances that only act as carriers. With hospitals few and far between in Karachi, and with many patients needing immediate emergency care, having a life-saving ambulance fleet staffed with trained paramedics can significantly improve patient outcomes.
The common man cannot differentiate between a carrier ambulance and a life-saving ambulance. I, like many others, was also unaware of this difference until I found myself in a situation a few years ago in which I was required to use an ambulance to shift a patient. I did my research and found out that only Aman Foundation’s ambulances have life-saving equipment.
It is now the responsibility of the Sindh government to create awareness about the benefits of life-saving ambulances and start its own fleet service. A sum of approximately Rs3 billion is required to run a fleet of 200 life-saving ambulances for a year. This is roughly only 3pc of the annual health budget for Sindh.
In September, during the budget session of Sindh government, Chief Minister Syed Murad Ali Shah announced his government’s intention to run, in partnership with Aman Foundation, a fleet of 200 life-saving ambulances in the city of Karachi by the end of 2019. He also committed to have 100 life-saving ambulances running in the city before the end of 2018. The launch of life-saving ambulances in Karachi will serve as a stepping stone to extend this service to the whole province in order to reduce the public’s misery.
The writer is a freelance contributor.
Published in Dawn, December 18th, 2018