Ambulances are supposed to be lifesavers, the first port of call in emergencies. They offer vital life support, unavailable in other vehicles, which can vastly improve the prospects of patient treatment and survival, minimizing deaths from accidents by as much as 60 percent. In the absence of such care, thousands of people are losing their lives in poorly-equipped ambulances every year, as most ambulances operating in Nepal have been found to be little better than ordinary taxis when it comes to pre-hospital care. Not only are most ambulances deficient both in terms of equipment and manpower, they also charge exorbitant sums from those in need. Not just that, the government has had to ban registration of new ambulances after it emerged that many of the category ‘D’ ambulances were involved in illegal activities.
The reason the ambulance service in Nepal is in dire straits is that most operators see it as just another business opportunity, completely divorced from the service-motive underlying the concept of pre-hospital care. This is the reason that although incidents of heart diseases and with it the number of heart attacks has increased many fold in the last decade or so, no category ‘A’ ambulances are in operation. These come equipped with facilities like ECG, cardio monitor and defibrillator as well as an attending doctor and a staff nurse, whose presence could be a matter of life and death for heart patients seeking emergency care. What is more, there are only a handful of category ‘B’ ambulances equipped with basic life-support and trained paramedics. Category ‘C’ and ‘D’ ambulances, which are the most abundant, are very poorly equipped to handle emergency situations.[break]
The egregious commercialization of healthcare services, coupled with an utter lack of accountability, has had a deleterious impact on emergency care too. A big chunk of the remittance money that is entering the country by truckloads is going into construction, including new hospitals, which seem to be sprouting in every nook and cranny of major urban hubs, particularly Kathmandu. There is little or no monitoring to ensure basic standards of care, which allows hospitals to operate just like any other business venture, whose sole goal is to maximize profits for their owners and shareholders. But healthcare is not just another business, and no one should be allowed to trifle with people’s lives.
It is long past the time that the District Public Health Offices (DPHOs), the regulatory bodies for ambulances in the country, tightened the screws on unscrupulous ambulance operators. They must follow regulations, failing which their licenses should be scrapped. The excuse that the government must be lenient on ambulance operators because of the ‘sensitive nature of their work’ is costing the lives of hundreds every week. In fact, it is because the services they are supposed to be providing are so vital that they should be brought under tight regulation. The least the people expect of their government is creation of an environment where they feel secure that they will not be left in the lurch in an emergency.
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