Single partially functional CCA caters to Srinagar city

Patients die on way to hospitals for lack of critical care ambulances

SRINAGAR: Catering to huge rush of patients in Valley on daily basis, the eight hospitals including Shri Maharaja Hari Singh, chest disease hospital and the major maternity hospital of Valley- Lalla Ded, associated with Government Medical College Srinagar have only one critical care ambulance to transport critically ill patients within hospitals.
Considered to be backbone of healthcare in Valley, the hospitals—SMHS, Lalla Ded, , Chest Disease hospital, Bones and Joints surgery hospital, psychiatry disease hospital, Super Specialty hospital, Kashmir Nursing Home Gupkar and Chitranjan Mobile hospital–witness a heavy rush of patients everyday within Srinagar and from all other districts of the Valley.
As per insiders, the critical care ambulances are never sought by the authorities and patients are transported in normal ambulances that at times have proven fatal for the patients.
“Due to loss of excessive blood and missing emergency medical aid deteriorates the condition of already critical patients which most of the times leads to death before reaching the hospital. During the last two years, the ‘brought dead’ cases have increased gradually,” they said.
Kashmir where violence has remained an inevitable phenomenon due to violence emerging from political dispute, the availability of CCA in good number would have played a crucial role in saving lives of the patients who succumb to injuries while being escorted towards the hospitals.
President Doctors Association of Kashmir (DAK) Nisar-ul-Hassan told Kashmir Reader that CCAs are ambulances which can transport a patient with a feel-at-hospital condition without impacting the condition of the patient.
“But unfortunately, the critically ill patients are being transported in ambulances that are as good as trucks. A critical patient if shifted by hospital authorities to other hospitals here, a driver driving the ambulance is expected to take care of the patient,” says Hassan.
He says that a ‘golden hour’ is lost while ferrying critical patients to hospitals and when they reach hospitals, doctors declare them brought dead.
As per the guidelines set up the Ministry of Health and Family Welfare, the ambulances need to have a Basic Life Support (BLS) and must carry equipment and medications as per requirement of treatment protocols and meet any international standard for ambulance supplies specifications.
However, in clear violations, the ambulances available at these hospitals and even other hospitals in Srinagar and elsewhere, the ambulances are not following any of such guidelines. An official of Lalla Ded hospital put it like this: “A passenger vehicle can be treated as an ambulance here if it is coloured white and fitted with a couch inside and siren atop over it.”
The guidelines further say that the ambulances must have a trained paramedic accompanying the patient and also making it mandatory to have all the necessary equipment for the basic, advanced and cardiac life support system.
Besides, it says, an ambulance should be air conditioned and have crash-resistant cots, airway, ventilation, oxygen and suction equipment that consist of portable oxygen with a minimum 350 liter capacity, an in-ambulance oxygen system with a minimum 1200 liter capacity and other emergency equipment.
Hassan further says that ambulances that are not even good for the transported simple patients are being used to ferry critically ill-patients where the attendants of patients are watching their relative dying in front of their eyes while the patient is craving for emergency aid.
“On many occasions it has happened and is still going-on without anyone being held responsible. Had there been CCAs fitted with necessary equipment available, we could have saved numerous lives,” he said.
A proposal that 25 CCAs would be placed along the Srinagar-Jammu Highway and other accident prone areas after every 30 km distance was put forth by authorities few years ago, but the proposal is biting dust somewhere in the government offices.
Accepting that there is lack of CCAs in its hospitals, principal GMC, Dr Samia Rashid told Kashmir Reader that they are in touch with higher officials for acquiring more vehicles for their hospitals.
“We had two CCAs available but both of them developed some fault. Currently we are managing it, but we are in touch with higher officials (for acquiring more CCAs for their hospitals),” she said.
One CCA ambulance that principal said was damaged due to floods in September 2014, is yet to be restored. “We have another CCA ambulance but that is functioning partially,” she added.
Director Health Services Kashmir, Dr Saleem-ur-Rehman says that a total of five CCAs are currently functioning at “strategic locations” in the Valley.
“But they are not enough. We are acquiring more CCAs and soon going to make available at all our district hospitals. Currently, we have CCAs at Kreeri, Bijbehara, Srinagar, Anantnag and Baramulla,” Rehman said.