As the government seem to care very little and people do not have much choice in case of emergencies, many people have taken the opportunity to make some quick bucks by turning their age old vehicles into ambulances.
Healthcare professionals say ideally, every hospital should have its own fleet of well-equipped ambulances. But reality is far away from that. Whenever someone needs an ambulance, inevitably, they would have to call up some private ambulance services.
Since most individuals or private companies that own ambulances are not affiliated with any hospital, they do not care about ensuring the least of live-saving facilities. All they want to do is make some money out of vehicles that should have been thrown into junk-yards.
Moreover, during hartals or at times of political unrest, ambulances, which remain officially out of the purview of political programmes, have recently been used for carrying passengers instead of saving people’s lives.
Worn out vehicles
An ambulance can be of two types: either a new microbus can be registered as an ambulance; or one can decide to turn a regular microbus into an ambulance against a certain fee.
Md Sanaul Haque, assistant director of Bangladesh Road Transport Authority (BRTA), said: “Ambulances are registered under the ‘chha-71’ serial. Most ambulances in the country were initially imported as microbuses and later turned into ambulances.”
He also said: “Sometimes owners of microbuses, after running them for 10-15 years, decide to turn the vehicles into ambulances that can be used commercially. In that way they can earn some money from vehicles that should have been thrown to junkyards.”
Because most ambulances operative in the country are ages-old worn out vehicles, they do not have proper air conditioning systems. Professionals say AC is a must considering that Bangladesh is a humid tropical country and ambulances often have to wait long periods on the roads because of the miserable traffic congestion.
Mohammad Momin Ali, owner of the private Alif Ambulance Service, thinks having a good bed and an oxygen cylinder is enough for an ambulance. “Air conditioning is not essential because it is not essential for saving lives. It only gives comfort to the patients. Non-AC ambulances are high on demand because they are cheaper than AC ambulances.”
Poor government facilities
Professionals blame the absence of a binding set of regulations or a regulatory body for that matter as the reason behind the sorry state of ambulance services in the country, eventually leading to harassment and suffering for patients and their families.
Specialised public hospitals have their own emergency services who receive patients on arrival and provide the required services. But these hospitals remain overcrowded most of the times and shortage of beds and other facilities make the services uncomfortable and unsatisfactory.
In the district-level hospitals, the facilities are a lot poorer and less adequate than those at the divisional levels. They provide emergency medical care of sorts for the district town and its surroundings; but problems arise when there is a big accident or a natural calamity.
Upazila-level hospitals also have some provisions for emergency medical services but their conditions are also nowhere near satisfactory. Even for the critical cases, they are only as good as providing some kind of first aid and on most occasions they refer patients to the emergency department of nearby medical college hospital or district hospital.
In the Dhaka Medical College Hospital (DMCH), the biggest public healthcare facility in the country, there are only four ambulances and those too are mostly used as transportation for doctors and seldom for carrying patients. On the other hand, at least 70 private ambulances operate centring the DMCH.
In the daytime, the ambulances owned by the DMCH are used by the officials and are left for the patients only for a few hours in the evening, sources say.
Recently, this correspondent has recently found a notice hanging in the ambulance parking area which says the service is limited within the city area and people have to pay Tk10/km and the minimum fare is Tk300.
When contacted, Dr Mushfiqur Rahman, deputy director of DMCH, said although he was not entitled to use the ambulance, he and some other hospital staffs sometimes used them in case of emergencies.
The capital’s Mitford Hospital, another major public healthcare facility, has only three ambulances of its own. At least 20 private ambulances operate centring this hospital.
According to Nilufar Yeasmin, on-duty officer at the control room of Fire Service and Civil Defence in the capital, they operate a total of 15 ambulances in the capital and 124 around the country.
“Patients can hire ambulances from us at Tk9 taka per km in the city. We generally use these ambulances in case of accidents or disasters and usually rent out 3-4 of them on general purposes,” she said.
Former BMA president Prof Dr Rashid-e-Mahbub said: “Just like fire service, it [ambulance] is also an emergency service and the absence of this has pushed patients and their caretakers to opt for private services. The BRTA should take a stricter stance about giving registration to vehicles as ambulances. In the least, the drivers should have the knowledge about first aid. Ambulances should be classified into various grades depending on the service they provide. There should be a single code dialling which patients and their families can access ambulances instantly.”
Mohammad Momin Ali, owner of Alif Ambulance Service, said: “As the government’s ambulance service is poor, patients do not have any other option but to hire our ambulances. Some people might exploit this situation which is highly unethical.”
Varied usages
Instead of deploying their vehicles on emergency duties, many private owners use their ambulances for non-medical urgencies for the well-disposed such as corporates and high officials.
During the year-long political unrest last year, many corporate houses reportedly hired scores of ambulances for transporting their employees.
Vandalising and torching vehicles have been a common practice for street pickets during any kind of political unrest in the country. But, ambulances are generally spared from these skirmishes.
A safe journey by an ambulance makes a company’s operation smooth and in return the ambulance owner gets some extra financial benefits, beyond its usual service and income.
There have also been instances in the past in which drug peddlers have been seen and caught carrying contraband items in ambulances.
