Indian ambulance service kick starts:

Free of charge, round the clock

by Carol Aloysius

Prime Minister Ranil Wickremesinghe launches the ambulance service in the presence of senior government ministers and Indian High Commissioner Y. K. Sinha.

The yellow and blue balloons, hung from the ceiling, paper decorations pasted on doors of the ceramic tiled office are still there. They are a reminder to all who enter the office of the GVK EMRI Lanka at Cotta Road , Rajagiriya, of the recent launch ( July 29) of the new Indo- Sri Lanka ambulance service which those responsible for introducing it said, ' a landmark in the history of medicine in Sri Lanka.'

The new service came with the blessings of the Prime Ministers, of the government of India and Sri Lanka. According to the press release from the Indian High Commission, the idea had germinated when the Indian Prime Minister Narendra Modi visited Sri Lanka in March 2015 and received a request from Mr Wickremesinghe to set up an emergency ambulance service in Sri Lanka. The Indian P,M assured him of his fullest support.

The agreement was formalized at a Letter of Exchange ceremony when Mr Wickremesinghe visited India, in September 2015.

Under the agreement the press release states, the project would cover the Western and Southern Provinces of Sri Lanka .

Launched ceremonially on July 28, 2016 at Galle Face Green, lined by eighty eight brand new ambulances awaiting their first call, the service is now under way in the Southern Province.

According to the press release, the project was being implemented through a grant assistance of the Government of India, of around US$ 7.55 million.

Project elements included an emergency response centre, deployment of the 88 ambulances in the Southern and Western Provinces, and recruitment and training of nearly 600 Sri Lankan personnel to implement it. Only 4-6 staff members are to be deployed from India to provide management and technical expertise guidance.

"While the Indian Company has been chosen as the implementing agency, all assets including ambulances, will belong to the Ministry of Health, Nutrition and Indigenous Medicine, Sri Lanka. The emergency ambulance services would be provided free of cost to the beneficiary," the Indian Company sources said.

Dire need

"All they need to do is call our hotline 1990 any time of the day or night. The ambulance will answer the call within thirty minutes, free of charge to patients travelling to state hospitals."

Pic: Chinthaka Kumarasinghe

The new service admittedly fills a dire need in the country, where critically ill patients requiring emergency care find it difficult to find an ambulance to take them to the nearest hospital. Yet, not everybody in the medical field seems happy about it, in spite of the fact that Health Minister Dr Senarathne has allegedly said, "Various groups oppose establishing this service. But, we have provided answers to them, thereby silencing them".

Costs involved

Medical professionals interviewed by the Sunday Observer raised several questions on what they felt were ' grey' areas: Was it a joint venture? If so, was it on a profit sharing basis? In that case, who gets the biggest slice of the profits? Who is the final implementing body? Who bears the costs involved in running these vehicles? Are the drivers trained? What are their basic qualifications? Where were the para medics sent from Sri Lanka to India trained? How were they selected? Did the Training institute or organisation have proper medical qualifications to do so? From where are the funds obtained to run them?

The Government Medical Officers' Association continued to maintain its stance that the whole process was wrong. President, GMOA Dr A. Padeniya charged, that the new services had been introduced only on a Cabinet paper issued from the Prime Minister's office and thereby overlooking the Health Minister's office.

It was never discussed with the stakeholders before launching it, It is a structural change that has an adverse impact on the entire health system islandwide", he told the Sunday Observer. He further said, the service had been introduced from a country where the standards of medicine were inferior to that in Sri Lanka. Sri Lanka Medical Council and Sri Lanka Medical Association were not available for comment at the time of going to press.

Response from GVK EMRI Lanka

Manager Human Resources, GVK EMRI LANKA, Mr Sunda Mudaliyar in an exclusive interview with the Sunday Observer, emphatically refuted the charges.

Fielding the questions raised by the local medical community he laid to rest some of their fears. "No, it is not a joint venture . It is a Memorandum of Understanding (MoU) between the government of Sri Lanka and India. We are just the implementing agency appointed by the Ministry of Health in Sri Lanka.", he said.

Responding to the question on whether it was a shareholding business and if so ,what percentage of shares the company had , he said, " We are a non profit service organization . Our ambulance service is free of charge for everyone. The project is being implemented through a grant assistance of the Government of India, of around US$ 7.55 million".

Asked to comment on the quality of the training given to the Lankans sent to India for training, prior to launching the service, he said, " Two hundred and forty trainees were sent to our Training Institute - The Emergency Management & Learning Center at Hydrebad, which has been approved by the Stanford University in the USA..

Training

All the trainees selected to man the new ambulance service had been selected by the health authorities in Sri Lanka and had two passes in the science stream. They were trained by senior lecturers from Stanford University, in all aspects of emergency care and first aid. The training lasted 52 days and included classroom and practical training", he said.

Asked if the drivers were also trained, he said , " They don't need to be trained. But, all of them have a GCE O.L pass and should pass the medical tests conducted by your health authorities".

Tight lipped

A question troubling most was, whether the ambulances are roadworthy.

Allaying these fears, Mr Mudaliyar said, emphatically, "They are all brand new vehicles which have been brought directly from the TATA company in India. All of them have basic life support and are fully equipped for emergency care".

He denied there were teething problems and remained tight lipped when we asked if there had been any breakdowns or accidents. " They are running very smoothly.The number of patients we are transporting is increasing. On Saturday alone five patients requested our service for hospital admission."Asked if there had been any complaints, he said, "so far no one has complained. If they have any complaints they can visit our office at No.415, Cotta Road, Rajagiriya and we will be only too happy to sort out their problems.

The 550 employees are hundred percent Sri Lankans and can speak all three national languages".

For the time being, under the first phase of the project, he said, they had been asked to operate the service only in the Southern Province (Galle and Hambantota). "If we are requested by the Sri Lankan government to extend our services to other parts of the island, we will continue the service", he said.

"Provision of ambulances is part of the Accident and Emergency Policy of the Sri Lankan Goverment," Deputy Director General, Dental Services, Dr. Jayasundara Bandara said.

"When the Indian PM visited Sri Lanka, our PM made a request from him to start a new ambulance service and he had agreed.

"All the money from the grant of US dollars 7 million through the Indian High Commission was channelled to an ambulance company in India owned by E. V. K. Reddy, who undertook to runs it at their expense.

"There are 250 emergency technicians, 150 drivers and 50 emergency response officers who man the call centre.

"The ambulances have a big demand and although parking is still a problem, they offer a speedy service. Yesterday, it took only 15 minutes for a patient to be admitted to the Balapitiya hospital by an ambulance parked at Polwatte. "The service is now operating at Hambantota, Galle and Matara," he said.