Games ambulances in need of emergency care

The emergency medical services  (EMS) needed for such a massive showpiece event as the Commonwealth Games, which will have top athletes from all over the world, is still in a rag-tag state.

The ambulances won't arrive till three weeks later, no training of manpower has begun and the jury is still out on whether the control room\software (the backbone of any such services) can be used for the EMS.

Contrast this with the London Olympics, an event scheduled for 2012. The London Ambulance began discussions on how to handle medical emergencies in 2007. The ambulance's website talks about regular training camps for paramedics and, according to newspaper articles, a blueprint for the EMS for the Olympics has long been prepared.

On Friday, the Delhi government's health department was in a huddle. Details were being worked on the conversion of the 31 Tempo Travellers acquired less than two days back into ambulances. Diwan Chand, secretary in the Delhi government's health department, told TOI: "We will provide 64 ambulances as promised. We are getting it done".

But this zip-zap-zoom acquisition seems to be coming at a premium - a charge Chand denied. The math, though, is there for all to calculate. Chand told TOI that "we are getting a basic ambulance at Rs 13 lakh and an advanced one for Rs 26 lakh". These figures are better than the previous quotations of a basic ambulance at Rs 30 lakh, he added.

But consider the figures mentioned in a document - 'Study of Emergency Response Service-EMRI Model' - prepared by the National Health Systems Resource Centre of the ministry of health and family welfare in 2009. The report states, "initially, the India-built ambulances would cost about Rs 21 lakh for the Advanced Life Support (ALS) and Rs 15 lakh for the basic life support (BLS)... but as the number of ambulances have gone up, the costs have come down to Rs 15 lakh for an ALS and Rs 11 for BLS". Thus, Delhi's quick-fix seems to certainly come at a premium.

The Delhi ambulance story is laced with crises. It was in 2008 that the Sheila Dikshit government announced its plans to set up Centralised Accident & Trauma Services (CATS) with a fleet of 150 ambulances that would be ready in time for the CWG. But the batch fleet of ambulances was rejected due to technical reasons.

Thereafter, little happened in 2009 and 2010. "We do have 35 basic ambulances as of now but not all are in a working condition. And to be fair to us, we did keep releasing tenders but didn't get appropriate response," said a Delhi government official.

Chand blames the "cartelization" among ambulance suppliers for the mess. "We have managed to get a decent quotation only in the last 10 days," he said.

Now the emergency plan for the CWG EMS is thus: the 31 tempos that the Delhi government has procured in the last two days will be refurbished into ambulances over the next three weeks. The remaining 33 ambulances needed for CWG will be "borrowed" from Delhi's elite hospitals such as the Fortis, Max and Apollo chains. Affan Atiq of Apollo Hospitals in Delhi said, "Yes, we have been asked to provide ambulances and we will provide as many as the government wants".

But what about the training that is needed for a quick response in times of medical emergencies? Only the Games will tell.