Emergency care ’immobilised’

The few government-owned Advanced Life Support ambulances that are currently operational in the Capital function only between 8 am and 4 pm

Emergency care 'immobilised'

The few government-owned Advanced Life Support ambulances that are currently operational in the Capital function only between 8 am and 4 pm

What good are ambulances that remain immobile? That's a question Delhi government needs to find answers to. Another Commonwealth Games (CWG) controversy has emerged to vex the authorities. Apart from the beautiful stadiums, roads, flyovers etc that were constructed ahead of the event, the city government also procured 21 Advanced Life Support (ALS) ambulances to cater to the needs of athletes, visitors and Delhiites in general.

Dead Stop: New ambulances parked outside Babu Jagjivan Ram Hospital
in Jahangirpuri.u00a0 Interior of one of the ambulances .
PIC/Rajeev Tyagi

Now more than six months after the culmination of the Games, these vehicles have hardly been usedu00a0-- at least 10 of them are gathering dust at various hospitals, a few others allegedly malfunction and the rest run only a few hours every day. That's because in an RTI reply, the Delhi government has conceded that so far only one paramedic has been trained to operate these vehicles. MiD DAY has a copy of the documents.

Emergency!
That means, if at any point of time you need help and call for an ambulance, it's likely that your request will be denied and you will have to find other means to reach the hospital. The cost of one ALS ambulance is Rs 35 lakh. The ministry also spent Rs 7 crore on the fabrication of CATS ambulances. Previously, only Basic Life Support (BLS) ambulances were available with the health department, which just have Automated External Defibrillators (AED), oxygen masks, stethoscope and other basic equipments.

But ALS ambulances are equipped with all the necessary equipments such as Cardiac Monitoring, Cardiac Defibrillation, ventilators, and other life-support equipment. According to the Centralised Accident and Trauma Services (CATS) officials, many of the ALS ambulances are standing unused outside hospitals as there aren't enough trained personnel to operate them or attend to their maintenance.

Less is more?
"We were told that proper training would be given to 21 of our members so that they can operate the ambulances and help patients. These ambulances are complex and no common driver can understand how to manage them," said a CATS official on the condition of anonymity.

"The only trained member is also posted in the administration centre. We do not understand what he will do there. If he was trained then he must give training to others," added the official. Interestingly, the working hours of the functioning ambulances are also odd. According to an order by Directorate of Health Services (DHS), ALS ambulances are operational only from 8 in the morning till 4 in the evening.

"Many of the accidents and emergencies occur at night; very few ambulances are required during the day time. We see accident patients coming in generally at late hours. These ALS ambulances are so well-equipped that they can at least save someone's life. But if they function only part of the time then what good are they?" said a senior doctor from AIIMS on the condition of anonymity.

According to guidelines by DHS, every such ambulance will have one driver and a doctor, to be provided by the hospital and one personnel from CATS. But due to the unavailability of doctors and properly trained CATS staff, the vehicles largely remain anchored.

Stand by
"Though the ambulances are standing outside the hospital, I have not seen them working any day. We don't have doctors to go with them," said a doctor from Babu Jagjivan Ram Hospital on the condition of anonymity.
Even the Basic Life Support (BLS) ambulances are facing an acute shortage of staff. Of the total 35 ambulances, five to six are redundant because of engine problems and other technical snags.

'We're helpless'
"This is a complete waste of public money. These ambulances which are designed to serve the public are not being used properly. We feel terrible when we have to turn down emergency calls. But what can we do?" said a CATS official.

When MiD DAY contacted Delhi health ministry officials, they refused to confirm the allegations. They also were not prepared to comment on the RTI. "We have placed the ambulances with the hospitals so that they can also look after them. And regarding the training, we have started training CATS members, but I have to check that RTI for the further information," said Diwan Chand, Secretary, Health Department, Delhi government. However, city Health Minister Dr AK Walia and Health Secretary Rajendra Kumar did not respond to any calls or messages from MiD DAY.

CATS scan
Centralised Accident and Trauma Services (CATS) was conceptualised as a plan scheme in 1984 during the 6th Five Year Plan. The scheme was to be implemented under the aegis of All India Institute of Medical Science (AllMS). In April, 1988, the ambulance service was transferred to the Delhi Fire Service (DFS) with a fleet of 14 ambulances. Since the service required multi sectoral coordination, it was later decided that the scheme may be implemented by a society registered for the purpose. Consequently, CATS society was formed by Delhi Administration as a registered society In June, 1989.

The West Zone Pilot Project (WZPP) was inaugurated on 15.3.1991 by then Lt. Governor Markandey Singh after the second annual meeting, of the Governing Body of CATS. The primary objectives of CATS are to reach the site of the accident as quickly as possible, to give first-aid to the patient, quick and safe transportation of the patient to the hospital, to involve liaise with other organisation as Delhi Police, Delhi Fire Service and any other governmental agencies for the benefit and the care of the accident victims.

Central Control Room of CATS is situated at Deen Dayal Upadhyay Hospital at Hari Nagar. Calls are received through the four digit no. "1099" allotted to CATS. There are 10 lines available on telephone No.1099. Calls are also received through Delhi Police and Delhi Fire Service through wireless sets.

'Stop the rot'
"The condition of the ambulances with us is so bad that they can't even travel for 1 km," said a senior official from CATS on condition of anonymity. "Most of these ambulances have faulty brakes and problems in their engines as well," said an ambulance driver. The CATS services were also suffering from severe staff crunch as the last recruitment drive took place in 1999.