The District Ambulance Operation and Management Committee (DAPMC) says that though the cooperatives procure vehicles with customs waiver for use as ambulances, these are in fact used for business purposes. [break]
The committee also says that most ambulances operating in the capital are ill-equipped.
“As per the rules, an ambulance can charge only Rs 20 per kilometer from patients,” Indira Pandey, focal person of the committee, said adding, “But ambulances are charging patients as much as they can.”
She said that most ambulances are in breach of government rules as they are not listed at the committee.
A year ago, the committee made listing compulsary but only 18 ambulances have been listed so far.
Among the listed ambulances, only one ambulance belonging to Norvic Hospital comes under "A” category. The remaining 17 are “C” category. The committee provides a quality sticker to the listed ambulances.
“Almost all the ambulances operating in the capital are ill-equipped and do not meet the minimum requirements set by the government,” said Sanga Ratna Shakya, a representative of the committee. Shakya is also secretary of the Nepal Red Cross Society.
“They are operating without basic life support systems.” he said adding, “Those ambulances do not even have on hand formally trained personnel for pre-hospital care.”
According to Shakya, drivers of ambulances must have training in pre-hospital care but most of them do not.
Nepal Red Cross Society conducted a survey of ambulances operating in the capital a few months back. “We found shoes being kept in first aid boxes in some ambulances,” he said.
The survey team found that some vehicles were used to carry patients as well as dead bodies. Most ambulance vehicles were found charging exorbitant fares.
The Red Cross Society found 175 ambulances being operated in the capital by various hospitals, social service organizations and cooperatives, but this list is not exhaustive.
The committee says that it is working to amend the rules so that ambulance operators not appearing for listing at the committee will face punishment.
“We have included the chief of Metropolitan Traffic Police in the committee to bring errant ambulance operators under the regulations,” Pandey added.
According to requirements set by the Ministry of Health, ambulances seeking to qualify as A category should have ECG, Cardio Monitor, Defibrillator, Ventilator, Nebulizer and Head Immobilization facilities, a Catheterization Set, and a length and weight-based chest for pediatrics. Along with these, an A type ambulance should have a doctor and staff nurse in the ambulance. It should also have all the facilities of a B category ambulance.
Similarly, an ambulance of type B should have a suction machine, fracture splints, cervical collar, airway, patient restraint strap and one trained paramedic.
The C category ambulance is required to have a first aid medicine, oxygen cylinder, flow meter, mask, tools required for intravenous injection, stethoscope, BP set, torch light and a stretcher-cum-bed.
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