India wakes up to the need for ambulances

India wakes up to the need for ambulances

Dealing with a medical emergency can be a nightmarish experience. In India, the lack of emergency medical services makes it far worse. Now, several efforts are on, by government, non-profit and for-profit organizations, to try and fill an often-scary void.

Ziqitza Healthcare Ltd (ZHL), which runs the Dial 1298 for Ambulance project in Mumbai, has launched services in Kerala and plans to offer services in other Maharashtra cities shortly. “We hope to start operations in at least 10 cities in the next five years," says Manish Sacheti, one of the founders of Ziqitza.

The company was set up by five friends who had at some point been affected by the lack of such services. “Each of us had gone through the trauma of trying to access emergency care. In some instances, we had even lost near ones who might have been saved if they had received timely help," says Sweta Mangal, company marketing director. They started out with one ambulance and now have fleet of about 40, including those from partner organizations. The cardiac ambulances have life-saving equipment and medication and are fitted with global positioning and radio systems.

The project has been fairly successful in Mumbai, with over 30,000 completed calls since it started in 2005. Though Ziqitza is a for-profit company, it has a sliding scale tariff plan. Patients transported to free beds in government hospitals don’t pay, while those who wish to go to private hospitals pay about Rs1,500 for a cardiac ambulance—still less than half the cost of some private ambulances.

The firm recently received funding from US-based non-profit Acumen Fund, which funds business models that fight poverty and sustain development, to scale up services in Mumbai. “We plan to have about 70 cardiac ambulances in the city and with this, we hope to cut down our response time to about seven or eight minutes from the current 15 minutes," says Sacheti. Ziqitza, which pioneered the concept of an integrated emergency medical service in Mumbai, has tie-ups with London Ambulance Services and the American Heart Association.

For a country that has never had a structured system for dealing with medical emergencies and is estimated to have a nationwide fleet of just 10,000 ambulances, these developments hold promise.

Ziqitza is now talking to state governments to assist in providing services. The Delhi government, for instance, plans to launch services in the next few months with 150 ambulances. Ziqitza Healthcare has bid for the Delhi project, a public-private partnership.

Lifeline Foundation plans to scale up the Highway Rescue Project. The Hyderabad-based Emergency Management and Research Institute (Emri) plans to launch services across the country over the next few months.

This non-profit emergency medical services provider, backed by the promoters of Satyam Computer Services Ltd, has been operational in Andhra Pradesh for the last two years. Venkat Changavalli, Emri chief executive officer, says 380 ambulances cover every district in the state now, providing free emergency services.

Emri will begin its expansion in Gujarat, in partnership with the state government. In the first phase, to be unveiled shortly, the state will have 100 fully-equipped ambulances. “Over the next two years, we will grow the fleet to 400 ambulances," says Changavalli. Emri has trained 200 people.

A similar system is planned for Madhya Pradesh, J ammu & Kashmir and Maharashtra. The Union government has also shown interest. “We have had discussions with the Prime Minister and the health minister, and they are quite keen on taking this project forward," says Changavalli.

Going national, he admits, is daunting—especially for a country that spends less than 1% of its gross domestic product on health.