Ambulance services are least frequently accessed by patients in need of emergency medical services in Dhaka, a recent study has shown.
A report by The World Economic Forum (WEF), in collaboration with the University of Toronto, suggests that only 8% of patients accessed ambulances during a three-week study period by researcher Justin Boutilier.
The most popular mode of transport is the rickshaw, which was used by 34% of the patients in Boutilier’s study. The CNG was used by 25% of the patients.
Boutilier, a PhD candidate in industrial engineering at the University of Toronto, further recorded that ambulances are also the most expensive service: ranging from Tk500 to Tk5,000. Ambulances also have a long response time – which defeats the purpose of its existence.
However, for some people ambulances are better service operators than private transportation.
“We prefer an ambulance because they are equipped with the medical equipment which may be essential for someone having a stroke or other health emergencies,” says Tahsin Choudhury, whose family has a cancer survivor and a stroke patient.
“An ambulance has a handy oxygen facility and sometimes if the patient is in critical condition, they might require more than just oxygen (saline, blood, injection, etc),” says Rifat. Islam, who has a patient in the family and often has to access emergency medical services.
Furthermore, given the grave issue of traffic congestion, where citizens often spend hours on the road in Dhaka, ambulances are given space to drive past.
“A normal transportation may be unfortunate to face a lot of traffic jam, an ambulance gets lucky most of the time and evades traffic jams,” says Rifat.
Boutilier’s study further suggests that many patients, majority of whom do not take ambulances, are often stuck on the road for five hours before getting to the hospital.
A change in the making
One of the biggest challenges that remain is the lack of a hotline number for help in medical emergency. In Dhaka, when a medical emergency strikes, there is no 911 to resort to. In case of hotlines at hospitals, many doctors on emergency duty often don’t provide the service the patients require.
“The emergency medical services do not have experienced doctors who can actually give instructions to patients who might have several conditions,” says Rifat. “Usually help lines have fresh doctors who just received their specialisation. So that’s a little risky for either side – for the doctor to instruct medication or come up with a quick fix and for the patients to accept it.”
However, things are beginning to look up as increasingly more people are addressing this issue.
Currently, CriticalLink, the world’s first mobile app-driven emergency medicine system, is undergoing trial in Dhaka. Jennifer Farrell, founder and CEO, says this app has been designed to use “mobile technology to connect those with medical training to the people on the streets that need their help.”
According a report in The Guardian, Farrell has trained some 3,000 people from all walks of life, with 500 registered unpaid volunteers, both male and female, aged on average 21 or 22 years old, for emergencies in various fields ranging from industrial accidents to road accidents to murders and threatening incidents on the streets of Dhaka.
Another project working on this field is Ad-din care for maternal health, an initiative of Akij Group, funded by USAID. Ad-din provides emergency maternal services to pregnant women across Dhaka, at a subsidised rate. Currently, the service has a fleet of 46 vehicles, with 52 drivers and five ambulance desk dispatchers as staff.
Boutilier is also working on a project to make emergency services more accessible to patients in developing countries, with special focus on Bangladesh.
“Our research has two components: first, locate the ambulances throughout the city, and second, routing them to the patients,” says Boutilier. “If the city of Dhaka is going to implement an ambulance service, where should these be stationed around the city, how many are needed, and what are the most effective routes?”
Traffic congestion being one of the biggest hampers to emergency medical services, Boutilier says it’s difficult to implement a North American model here. Thus, him and his supervisor Timothy Chan plan to evaluate other forms of ambulance systems such as CNG or rickshaw ambulances, that can help address issues of reaching patients in all areas – even those without proper access to big ambulances.
