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Facing trauma

Facing trauma
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To add to the woes of the already embattled citizens, the existing fleet has been left completely mismanaged. Around 1300 lives are lost each year in road accidents and trauma, and at least 90 people are ferried per day, including accident victims, to hospitals across the city. But if you thought that if it were for the specialised CATS ambulances run by the  Delhi Government who were doing the rounds, you are wrong; instead of the ambulances, Police Control Room (PCR) vans were shockingly doing the job.

In a report filed by the Comptroller and Auditor General (CAG)  in 2013 it has been revealed that the reason why the PCR vans were being forced to double up as ambulances was due to the fact that they were being mainly used to procure medicines from the market, drop doctors home, collect cash from banks and carry dead bodies to the mortuary. It further higlighted the misuse of ambulances at city hospitals.

CATS services were visualised for the first time as a planned scheme  under the sixth plan in 1984. In 2001, 30 Nissan ambulances were procured from Japan under the World Health Organisation-aided programme. In 2010, 31 Force Motors ambulances were purchased during Commonwealth Games. These were advance life support and basic life support ambulances. The primary motive behind the procurement of the ambulances was to tackle the problem of shortage of emergency vehicles and ensure pre-hospital medical care to patients, including victims of accidents and sexual assaults. But, the city administration It is well evident that the city administration has absolutely no regard towards the upkeep of the of CATS services as they are being used for their personal requirements. 

CATS director N. Vasanthkumar says that the agency would like to reach out to a larger number of people instead of only catering mainly to accident and pregnancy cases. ‘This is something we would like to change to ensure that we cater to a wider section of the society,’ the director says.

Vasanthkumar further says, ‘Delhi is a large city and has a fleet of 152 ambulances with 21 advanced life-saving units. This needs to be augmented to ensure adequate coverage of the capital. The 100 new ambulances that will be brought in will have basic life support system, while 10 of them will be equipped with advanced systems.’

CATS is now planning a roadmap to work in close co-ordination with Delhi Police PCR units. ‘We are currently operating from 74 accident-prone places identified by the police,’ says the officer. But the fact of the matter is that this would just limit to offical files and may not see the light of the day  in the near future.

Trauma centre officials across the city say that majority of the patients are brought in autorickshaws and PCR vans and not ambulances. Some patients are also brought to the hospitals in private taxis and two-wheelers.

A senior doctor working with the Govind Ballabh Pant Hospital indicates how the present condition of ambulances is too critical. He says,  ‘Patients are literally bundled on to vehicles and do not get basic life support required in the first hour of accidents, cardiac arrests, brain attacks or other major health emergencies.’

It is a fact that many patients suffer from additional injuries and complications and even die while being  transported to the hospitals due to the lack of proper pre-medical care.  Dr Dheeraj Kumar, Medical Officer explains further, ‘Improper transportation is catastrophic, in particular, for those with spinal injuries.’

Scrutiny of the 2009-2012 records of ambulances at two Delhi government hospitals- Guru Teg Bahadur hospital in East Delhi and Lok Nayak hospital in central Delhi reveal what the CAG report indicated, that patient transport vehicles were used mainly to bring medicines from the market, drop doctors home, collect cash from the bank and carry dead bodies to the mortuary.

At GTB hospital, four ambulances ran only 3,571 km in 2011-12. Of this, 2,272 kms were timed because the patients were being shifted, 713 kms because the doctors were being ferried and 586 kms for ‘other purposes’.

In a shocking revelation, the medical superintendent says that ambulances are being made available for various drills organised by the disaster management authorities and not to bring in patients in critical conditions to the hospital.

Similarly, at the Lok Nayak Hospital, four ambulances ran 27,361 kms during 2009-12, of which 12,584 km were clocked to shift patients and the rest for ‘other purposes.’ The CAG report further states that funds for purchase of ambulances, their maintenance and ensuring salary for the eight drivers in both the hospitals were not properly utilized. The CAG report also carries the photographs of an ambulance used by LNJP hospital-a rickety Maruti van with no life support equipment or even a stretcher.

The report further gives ample detail about the sorry conditions of ambulances in the city by mentioning that most of the ambulances are not equipped with basic life support equipment such as oxygen cylinders, suction pumps, blood pressure instruments, stethoscopes and even first aid-boxes.
CATS has opened tender for procuring 100 more ambulances, including 10 advanced life-saving units. This may bring in some relief for the exasperated Delhiites reeling with a huge   shortage of ambulances. Delhi which  which records 13,000-15,000 cases a month, is in dire need of the advanced life support providing CATS services.

Also enjoying the parallel benefit will be the PCR vans, which often complain of having to double up as ‘patient transport vehicles.’ The condition of the PCR vans is not good either. Of the 1,000-odd PCR vans of the Delhi Police that ply every day, around 300 of them are diverted to VIP security and the rest 700 vans attend to the crisis calls. Out of the 700 vans who cater to crisis calls, 100  are in a condemned state. The 600 odd PCR vans, have to attend around 10,000 calls per day and around 73 lakh calls a year.

Experts suggest that the city requires at least 300 more ambulances- one for every 50,000 people and area of every five sqkm. However, state-run CATS have less than 200 vehicles only.
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