A need of emergency served businesswise
Sourav Hossain of Jamtala in Narayanganj felt at a loss failing to avail an ambulance to take his mother to hospital after she suffered a massive heart attack.
Amid an acute shortage of ambulance to meet so many emergencies of their own, the hospitals could not provide him with the service when he needed it most in the dead of night.
“I was crying, when one of my cousins told me to call 999. As I dialled the number, they gave me a phone number of a private ambulance company, Al-Amin Ambulance Service,” recalls Sourav.
“The ambulance came to our residence soon and we reached National Institute of Cardiovascular Diseases (NICVD) at around 4:30am. Finally, my mother could be put under treatment there," he heaves a sigh of relief.
The genesis of private ambulance service
Like Sourav, innumerable others all over the country are now taking the service of private ambulance, which, besides being a service in itself, has a business aspect to it.
And to tap into the commercial potential of the service, Alif Ambulance Service began its operation in 1989 with just a single vehicle.
“I started with the aim of meeting the huge demand for ambulance in the capital and my initiative was highly appreciated at that time,” recounts Momin Ali, owner of the company.
Before starting his own business, he tells Dhaka Tribune, he was a partner in a company ‘Day & Night’, also an ambulance company, which failed to take off commercially.
Now, his company has 15 vehicles, including one ICU ambulance for critically ill patients.
Leading players in the sector
In the ensuing years, following his footsteps, other companies appeared in the scene, with about 50,000 people now involved with this business.
According to Dhaka Metropolitan Ambulance Owners Co-operative Association, there are around 512 private ambulance service providers operating their business in the capital.
Alamgir Hossain, president of the association, says because of the increasing demand private ambulance services have been expanding for the past 15 years. There are both charitable and commercial services.
In the capital, ambulances of Anjuman Mufidul Islam, a charity organisation, Ad-din Hospital, a non-profit organization, and those of Al-Marakazul Islam, a subsidiary of a local non-government organisation, are widely used as they can be availed easily at comparatively lower rents.
Ad-din Hospital is operating the highest number of ambulance in the city as well as districts surrounding the capital at a minimal rent.
Saiful Islam, transport in-charge of Ad-din ambulance, says that they are currently operating 100 non-AC ambulances in the city and within 100km -115 km outside the city.
Anjuman Mufidul Islam has 40 vehicles, including ambulances, freezer vans and corpse haulers.
Al-Marakazul Islam runs 30 ambulances and since it is a charitable organization, the rent is not fixed. After getting the service people pay as they wish. For the poor, it is free.
There are others which operate fully commercially.
In terms of business, Adiba Ambulance service has the highest number of ambulance operating in the city as well as across the country. Their 18 ambulances include two ICU ambulances, three freezer vans, 12 AC ambulances and one non-AC ambulance.
Alif Ambulance has 15 ambulances including one ICU ambulance and Asha Ambulance service has 14 ambulances.
Fares of ambulance service
To hire a privately-owned, non-AC ambulance within Dhaka city, one has to pay between Tk1,000 and Tk3,000 on an average. The price depends on the distance, time of the day, and the condition of the vehicle.
The average rent of a private air-conditioned ambulance is almost double that of a non-AC ambulance — from Tk1,500 to Tk4,000. Outside the city, the fare ranges between Tk4,000 and Tk20,000.
The base fare of an ICU ambulance (without doctor) within the city varies between Tk5,000 and Tk8,000 and outside the city it can range from Tk10,000 to Tk1 lakh depending on the distance.
The fare for the corpse carrier freezer van within Dhaka depends on time and distance and the average fare outside the city is between Tk5,000 and Tk30,000.
The fair of an air ambulance will vary between Tk1 lakh and Tk3 lakh depending on the distance.
Ad-din Hospital provides ambulances to its hospital from anywhere in Dhaka city for only Tk350, while the fee is Tk520 to carry patients to other hospitals.
Anjuman Mufidul Islam provides free ambulance service for the poor in the Dhaka metropolitan area. Besides, they have air-conditioned ambulances, which charge Tk600 for a single trip.
Types of ambulance
Currently there are four types of ambulance available in the country: standard (non-air-conditioned), air-conditioned, intensive care unit (ICU) or cardiac ambulance, and freezer (for transporting the deceased).
The ICU ambulance is the most expensive, and has a team comprising doctors and nurses with a complete ICU setup inside the vehicle. Under different private companies, around 10,000 - 12,000 ambulances are in services in the capital as well as across the country.
Besides these categories, high-end air ambulance service is also available. Only a few prominent companies have this type of ambulance. Square Group, Basundhara Group and Apollo Hospital are operating air ambulance services in this sector.
How it is different from rent-a-car business
“This business is getting popular because it a secure income source. Anyone can start the business with a single vehicle with facilities of ambulance and start its operation with permission from the authorities concerned," says Alamgir Hossain, president of ambulance owners' association.
But, he says, for starting a rent-a-car business one has to have a specific office place, which many people cannot afford.
“In terms of security, ambulance service business is more secure as there is no chance of vehicles being hijacked," he claims.
The average cost of per ambulance is Tk15 lakh to Tk18 lakh. The total investment in this sector is about Tk160 crore and yearly turnover is around Tk700 crore, industry people say.
Challenges facing the sector
Though this business is contributing to the economy along with providing humanitarian services, it is facing some hurdles hindering its further development.
Private ambulance business is yet to be recognized as a business since there is no definite rules and regulations for it, Alamgir mentions.
“Every year the government earns Tk20 crore from this sector in customs duties, taxes, and licences and fitness fees. But there is no monitoring on the part of the government and we cannot get bank loan for this business. The way of getting trade license is also very complicated as we cannot get direct trade licences for starting this business," he laments.
“There is no government policy for fixing ambulance rent, and for that reason, some people charge extra from the helpless customers, which tarnishes the sector's image," he added.