Ambulances are an everyday sight in Addis, zipping from one side of the city to the other, carrying patients to hospitals around the city. However, even as they carry out their life saving work, they are faced with many obstacles, including Addis’ notorious traffic problem, which delays them from reaching their destinations in a timely manner. EBR’s Menna Asrat explores the problem and what is being done to lessen it.
Geremew Asfaw, 32, is taxi driver in Addis Ababa. He has never forgotten the life threatening incident his aunt went through a couple years ago. “My aunt was suddenly collapsed and we couldn’t wake her up. Someone called an ambulance,” he tells EBR.
But it was not easy to take Geremew’s aunt to hospital as quickly as possible. “Even with just a little crowding on the roads we are unable to get there fast. When we reached the hospital the doctors told us she should have got there sooner, as it was an issue with her heart. Although I am thankful she survived, I will never forget that terrifying moment,” Geremew recalls.
Traffic jams have almost become a trademark of Addis Ababa. In fact, rush hour is not the only time that cars are vying for passage on each of the city’s major streets. In between the cars and trucks jostling for street space, are ambulances, rushing to and fro to bring patients to hospitals, often for life saving treatment.
However, traffic jams have also been one of many roadblocks for these ambulances, creating many issues for the patients who use them. For those who see ambulances working around the city, it seems like they are just a form of transportation from one place to another, instead of providing care on the way to the hospital. However, for healthcare providers and professionals, this should not be the case.
Megbare Senay Hospital, a private hospital in Yeka District, near the Balderas condominium Site is one of the private hospitals that have extensive experience with ambulances. Teklay Reda, the chief executive officer of the hospital, was an anaesthetist before becoming an administrator. “We see ambulance services as being of extremely high priority,” he says. “Illnesses and injuries that are not treated in a timely manner can lead to even worse outcomes and even death.”
Of course, issues of road access, road safety, and overall awareness are making it harder for the ambulances to do their work, according to Teklay. “I think the problem is that there is an imbalance between the roads in Addis, and the number of cars that are trying to use them. You can see it every day. Even if a driver wanted to let an ambulance pass, often there is nowhere for them to pull over. They are forced to wait to make a little space to let an ambulance pass.”
Geremew agrees. “Sometimes, people act like they are unaware that an ambulance is behind them and needs to get by. Other times, they just don’t care. They want to get to where they are going, and that’s all they think about.”
This is not the only issue that ambulances are facing in Ethiopia. There is also the matter of what equipment they bring to accident scenes. “In my experience there is one person in the ambulance besides the driver, and all I could see was one old oxygen tank,” explained Geremew.
Teklay agrees. “Ambulances should not be just a form of transportation from the area where the patient is to the hospital. They should have facilities and staff to stabilize and treat patients on the way, whether is it intubation kits, oxygen, or suction equipment.”
However, many older ambulances do not have all the equipment they need to be effective in this way, according to Teklay. “Of course, we can’t say that just because an ambulance is lacking this equipment they do not safe lives. It is better to have an older ambulance to take someone to a hospital, even if they don’t have a complete set of equipment, than letting patients just die where they are. But many of them are under equipped because of a lack of funding, or trained personnel.”
It was this, among other issues that drove Kibret Abebe to found Tebita Ambulance, the first private ambulance company in Ethiopia. The company has a fleet of ambulances outfitted with the equipment they need to be able to help patients on the way to the hospital.
Also an anaesthetist by trade, Kibret was inspired to start the company during his extensive travels. “There was an incident when I saw a man collapse right in front of me. The paramedics were called right away, and they arrived so quickly. It made me think about the situation in my own country. I have great experience in critical care as well, and I was seeing patients brought in by ambulances, and they were not getting the care they needed promptly.”
Coupled with the high rate of traffic accidents in Addis, he decided to sell his house and build a fleet of ambulances that could deliver quality care at the scene of accidents and injuries.
“Ambulances are not ambulances because they are painted up and have lights and stickers on them,” Kibret says. “They are ambulances because of what is inside, because of the equipment and the personnel that can integrate care for the patients.”
Of course, for many people, the question lies in what the way forward it. Kibret sees an increased use and integration of technology as the only way that the emergency healthcare situation of the country can be improved. “Most of the problems in this country can be solved through effectively using IT,” Kibret argues. “In fact, we are currently working to implement a method by which computers and GPS can be used to effectively deploy ambulances. We are also rolling out a program where motorcycles with trained paramedics are dispatched to accident scenes that might be difficult to reach by car, in order to treat patients there.”
Teklay, however, says the government also needs to take a bigger role. “There needs to be a concerted effort to make sure that resources are given to the ambulances and healthcare facilities that need them,” he says. “But the government also needs to work on the transportation issue in this city. Other than that, I think there needs to be education for ambulance drivers, to reinforce that they shouldn’t have their sirens on when there are no patients in the back. Otherwise, people become desensitised to the sirens.”
But the bottom line, according to Kibret, is ensuring that patients have full access to whatever services they need, no matter what socioeconomic level they are on. “Some people think that ambulances, and especially private ones, are only for those who have economic means. I think we need to raise awareness and work together with the government to ensure that everyone has the level of emergency care they need, no matter what.”
8th Year • Jan.16 – Feb.15 2019 • No. 70