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New ambulance service in South:
Public demand high
by Carol Aloysius
As the new Indian emergency ambulance service enters its second month
of operation, members of the public continue to have mixed feelings
about the new service. Many have welcomed it as a 'step forward in
filling an unmet urgent need for transporting critically ill patients to
a hospital.'
The Health Ministry, however, seems happy about the progress of the
new service which they say, has received a positive response from the
public. So does the GBK Emergency Medical Research Institute EMRI) which
runs the service and also bears the costs incurred, claiming that the
number of calls they get at their call centre hotline 1919 has been
increasing daily since its inception on August 5.
Opportunity
Deputy Director General, Dental Services, Dr Jayasundara Bandara
whose unit is directly involved with the new service, backs this claim.
Speaking to the Sunday Observer, he said: "Just yesterday there had been
160 callers from various parts of the Southern Province where the
service is currently operating. All thirty five ambulances now operating
in the Province had responded to the calls without delay. We are glad
that due to this ambulance service, people living in remote areas in
Galle , Hambantota and Matara who have found it difficult to get an
ambulance to transport a critically ill patient quickly to a nearby
hospital, are now being given that opportunity".
Not everyone agrees however. Aside from the positive aspects of
having an additional emergency service to transport patients to
hospital, certain members of the medical fraternity have voiced fears
over the quality of the new service.
A usually outspoken health official speaking on grounds of anonymity
expressed concerns over the kind of training given to those manning the
new ambulances.
"An ambulance is a specialized vehicle used to transport sick or
injured people to medical treatment facilities", he noted. "It is not a
vehicle that simply drops off a patient at the hospital and goes off,
like some cab service. It must therefore, be fully equipped with first
aid care and most importantly, manned by trained paramedics and drivers
who should be able to assist the emergency medical technicians if the
need arises.
Resources Manager GBK EMRI Sunda Mudaliya, however, is quick to
defend the service for which he is in overall charge, in Sri Lanka.
Since he was unreachable when writing this article, we quote a previous
interview he had, with this writer on the same question. According to
him, all 240 paramedics selected by the Health Ministry for training in
India had undergone, "excellent training approved by the Stanford
University of USA. The trainers were from the same university. The
trainees, who incidentally had at least two passes in the Science
stream, were trained in house classroom training and at hospitals. They
followed practical and theoretical training at our Emergency Management
and Learning Centre in Hyderabad, the only one of its kind there".
Dr Jayasundara Bandara said, although 88 ambulances had been brought
down from India, only 35 were being used. "The balance will be used when
we introduce it to the Western Province and other parts of the country,"
he said. However, there seems to be some confusion over extending the
service to the Western Province. Mudaliya when questioned said, "Our
Company is committed to the first phase of the project. It is left to
our Government to decide whether we should continue the project after
that".
GMOA
The Government Medical Offices' Association (GMOA) while admitting
that they are not against the concept of a new ambulance service,
pointed out that what irks them is the manner in which it was
introduced.
Asked if the new service filled an urgent need in the country, Dr
Bandara's response was, " Certainly. With more people now getting sick
and a fast aging population with chronic illnesses, the more ambulances
we have, the better".
New concept
Dr Jayasundara Bandara noted, the concept of a dedicated emergency
ambulance service in Sri Lanka was new. "It is not fair to make
comparisons because this is the first time in history that we have a
full time Dedicated Emergency Medical Care Service in Sri Lanka. Except
for three failed attempts to introduce a dedicated ambulance service -
two in Colombo and one at the Kurunegala Teaching Hospital, which did
not survive as they were not sustained, this is the first time we have
implemented such a service," he explained. "We are still in the initial
stages of putting this concept into operation. We need more time to
review it", he added.
Are ambulances in private hospitals a suitable option?
While most private hospitals, especially, in Colombo have their own
fully equipped ambulances , patients say they too have proved
unsatisfactory in a dire situation.
" We live close to the -- hospital which we know has a great
ambulance service. But when our mother had a stroke and needed to be
rushed to the General Hospital Stroke Unit , it was impossible to get
the ambulance. We had to wait for nearly one and a half hours and the
patient was gasping for breath by the time we reached the hospital", her
daughter said.
Our sister paper the Daily News quoting Health Minister Dr Rajitha
Senaratne Friday, stated that a private ambulance which had earlier
quoted Rs 9,000 to transport a sick patient to a private hospital, had
later charged Rs 25,000. while adding the ambulance was unconnected to
the hospital, he had said he would soon be introducing guidelines to
regulate private ambulances among other private health services to
eliminate these irregularities. " It is a good move. We welcome it", a
patient said,
So what do members of the public have to say?
"All I can say is, there is no difference in the time taken to reach
a hospital, whatever mode of transport we use. Whether we go by van,
bus, car, trishaw or ambulance, we have to travel on the same highway or
road," says Dinesh 34, a resident of Watthegama in the Galle district.
"The only alternative is to go by helicopter - if one is available", was
his tongue in the cheek comment.
Public response
Nursing sister Bernice in Matara, said, she was happy such a service
had been introduced. "I have seen many people being brought to the
hospital in three wheelers, vans, cars or even motorbikes or cycles. By
the time they come to us their injuries have worsened, making their
recovery slow with some having lasting disabilities. The key to pre
hospital care is safe transport, and the answer, an ambulance with
trained personnel", she said.
Over to our readers
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