It would not be too hard to find people who have bitter experiences with ambulances, people who can tell true stories about how the lives of critical patients could have been saved if ambulances had the least of facilities.
Official count shows that more than three and a half thousand ambulances are operative around the country, of which around only two thousand have proper registrations. But the unofficial figure is not less than 10,000, which is way above what the authorities say.
Still, finding an ambulance at the time of dire need is an ordeal in itself because most hospitals, especially the public ones, do not have enough ambulances of their own. As a result, in most cases, the private operators are the only option for people.
There is no comprehensive standard or study that can show what an ambulance should ideally have or how many in Bangladesh have those facilities.
But the Dhaka Tribune has found that the available ambulances are absolutely ill-equipped for carrying patients.
Lack of basic facilities
According to healthcare professionals, a standard ambulance should have a bed, an oxygen tank, stethoscope, blood pressure measuring machine and a first-aid box equipped with antiseptic medicine, sterile gauze and saline.
There should ideally be a doctor in the ambulance; but if that is not possible then there should at least be a paramedic who can use these equipments in case of emergency.
But in reality, apart from some highly-equipped and expensive ambulances belonging to some four to five posh hospitals in Dhaka, most of the available ambulances just have a bed and an oxygen tank.
In most cases, the drivers and their helpers, most of whom have very little or no education, are the people one has to rely on. The only thing they are capable of doing is using the oxygen tank.
There is no question of using stethoscopes, BP machines and first aid equipment because most of these ambulances do not have them at all.
Prof Dr Rashid-e-Mahbub, former president of Bangladesh Medical Association (BMA), told the Dhaka Tribune: “We have often encountered critical patients whose life could have been saved if they got proper treatment in the ambulance, especially those coming to Dhaka from the district areas. What makes things worse is that there is no regulatory mechanism to govern the operation of ambulances in the country.”
Types and fares
The Dhaka Tribune has found that several different types of ambulances are available in the country.
Starting from the big caravan ambulances equipped with all kinds of state-of-the-art technologies to the cheap Indian Maruti Omni human hauliers, virtually every kind of vehicles are used for transporting patients.
Only a few modern Dhaka-based hospitals own these caravans which have all the facilities that a full-blown intensive care unit (ICU) has. However, these well-equipped ambulances operate only within the limits of the capital city. Some of them also have air ambulance services in helicopters, which of course is hard for a middle class family to afford.
Dhaka-based hospital Ad-Din operates a general ambulance service at a relatively cheaper price. These are mainly Indian-made Maruti Omni human hauliers which operate within Dhaka at a flat rent of Tk260. These vehicles are generally equipped with a small bed and an oxygen cylinder.
Charity organisation Anjuman Mufidul Islam also operates a similar ambulance service in Dhaka at more or less the same cost. But these ambulances are mainly used for carrying dead bodies.
This organisation generally charges from Tk600 to Tk1,800 for its ambulances. For the air-conditioned ambulances, the costs may go up to Tk2,400.
Forkan Ali, transport officer of Anjuman Mufidul Islam, said they have some 23 ambulances of which nine are air-conditioned.
“Except for the airports, the ambulance services are available free of cost for all religious groups both for carrying patients and dead bodies in and around Dhaka city. Donations for such services are received at fixed rates for other places of the country as well. Our drivers and carriers have the capacity to operate oxygen cylinders,” he said.
Mohammad Momin Ali, owner of private Alif ambulance service, said: “Fare differs depending on the quality of service. Distance is also a matter. Air-conditioned and non-AC ambulances have different fares. The relatively new vehicles charge more than the older ones.”
He also said: “If are our ambulances are well-equipped, air-conditioned and new, then fare will be high. If people are not ready to rent them at high fare, what will we do with these new vehicles?”
For availing a privately owned non-AC ambulance within the limits of Dhaka city, one has to pay between Tk700 and Tk2,000 on an average depending on the distance, time of the day and condition of the vehicle.
In case of a private air-conditioned ambulance, the average costs are just double that is from Tk1,500 to Tk3,000.
The posh hospitals, who have modern ambulances, do not generally charge patients separately for the transportation. The cost of the ambulances are included in the overall bill for treatment.
Often the regular private ambulances carry patients from the capital to the other districts. That usually costs around Tk8,000 to Tk10,000 per trip.
