WHO Representative to Sri Lanka, Dr Jacob Kumaresan, highlighted the importance of emergency care as follows: “A well-functioning ambulance service is an essential part of an emergency care system, and should be accessible to all. Ambulance services save lives, by stabilizing a person at the scene and transferring them as quickly as possible to more advanced care.”
Accordingly, 1990 Suva Sariya pre hospital care ambulance service, that began operations in the Western and Southern Provinces in July last year, has responded to a total of 44,925 emergencies, as at October 16, 2017, as per statistics. The 24 hour service is offered free of charge and can be contacted in case of a medical emergency via the toll free number, 1990. This emergency medical service provides lifesaving treatment until the patient reaches hospital.
Deputy Minister of National Policies and Economic Affairs, Dr Harsha de Silva, who was instrumental in launching the ambulance service, said, the Suva Sariya emergency service currently transports patients to the nearest Government hospital with facilities to deal with the emergency at hand. “If the patient requests transportation to a private hospital, it is granted free of charge,” he said.
Dr de Silva added that the 1990 Suva Sariya pre hospital care ambulance service has been one of the most successful initiatives of the Government.
Initially, operated under a Grant by the Indian Government, the operations are now under a private pubic partnership between the Ministry of Health (MOH) and GVK EMRI Lanka (Pvt) Limited, said GVK EMRI Lanka (Pvt) Limited, Program Manager, Gayan Chathuranga. He added that GVK EMRI Lanka (Pvt) Limited is a nonprofit company.
Speaking of the public reach out to the service, Gayan said, public reception of the service has improved over time. “We receive an average of 750 calls per day, including inquiry calls,” he said. As per statistics provided by the Company, the number of calls received has increased from 6,881 in August 2016, to 13,136 in September 2017, which indicates a 91 per cent increase.
The total number of ambulances assigned has increased by 3,815, from 335 ambulances dispatched in August 2016, to 4,150 in September 2017. The average response time is 12.42 minutes. The highest number of ambulances (13,424) was assigned for the Colombo district, and the lowest number, (1,759) assigned for the Hambantota district.
In September 2017, out of 4,150 ambulances dispatched, there were 3,705 hospital admissions, 39 emergencies availed with first aid and 363 un –availed emergencies, where patients left for hospital via other means by the time the ambulance arrived on the location.
“We responded to all weather related disasters, and the Meethotamulla garbage dump collapse. Also, so far, 13 babies have been delivered within our ambulances,” Gayan said.
At present, 1990 Suva Sariya ambulance service has a fleet of 88 ambulances, 210 Emergency Medical Technicians (EMT) and 210 pilots to manoeuvre the ambulance; and 50 operators at the command and control center. “There are 550 employees, with one Indian citizen at the command and control center, assisting in transferring the technology,” said Gayan. He added that the ambulances are currently parked at public places, including police stations, temples and Divisional Secretariat Offices.
According to Gayan, on average, there are 150 emergency calls per day. “This is roughly two emergencies per ambulance; we have the capacity to include six emergencies per ambulance, “he said.
Adding to the subject, GVK EMRI Lanka (Pvt) Limited, Head of Human Resources and Administration, Udaya Imbulpitiya said, the full capacity of emergencies per ambulance has not been reached yet. “Sri Lankans have an emergency service that can save life. The services, including the calls are free of charge. We request the public to make use of it,” he said.
Imbulpitiya says, medical equipment within the ambulance and EMT training are on par with international standards.
GVK EMRI Lanka (Pvt) Limited, Executive Admin Operations, Amanda Senarath Abeygunawardena, explained that the command and control center conducts case following, both real time and after 48 hours. “We contact the caller and inquire whether the service was satisfactory. Also, we have an in house police officer, who attends to crime related emergencies,” she said.
Dr de Silva said, as a result of the discussions he initiated with the Indian Government, a further grant of US$ 15 million has been offered, to expand the 1990 ambulance service to the other seven provinces. “This is to finance additional 215 ambulances, to add to the existing fleet and also for one year operational expenditure of the service to these seven provinces.
The paper work is being finalized now and I hope to operationalize the emergency service by the first quarter of 2018,” he said.
Dr de Silva added that the Indian Government will grant a further US$ 3 to 4 million to build a state-of-the-art, command, control and training facility, for the 1990 Suva Sariya service.
This facility is planned to be built in Kotte. “Also, Cabinet just ratified the establishment of the1990 Suva Sariya Foundation. In a few months, with parliamentary approval, all operations of the 1990 ambulance service will be conducted under this Foundation,” he said.
He added, it would be a Government owned entity. “I want the 1990 Suva Sariya emergency service to remain, serving the people, irrespective of the Government in power. This should become equivalent to the Mahapola or the BMICH,” he said.
Explaining that discussions are underway on generating revenue to fund the operations in the years to come, Minister de Silva said, the fundamental principal of the service lies in not charging the patient.
Speaking about his experience with the 1990 ambulance service, Hasitha Suvimal, a resident of Boralasgamuwa, said, it was when his father had a heart attack that the ambulance was called.
“They arrived immediately, on receiving the call and provided attentive care until he was taken to hospital. Also, they had a good knowledge of medical conditions and informed both, my father and myself on what to do in case of an emergency.” He added that the most notable thing about the service was that it is offered for free, thus making it accessible to everyone.
Leela Fernando, a resident of Moronthuduwa said, the 1990 emergency service arrived in about eight minutes after the call. “Their quick arrival was notable. However, they informed that the patient had already passed away, upon examination.
They attempted defibrillation, which failed to restore the patient’s life. They then asked me whether to transport the patient to a hospital, which I said was not necessary since it was too late,” she said.
The 1990 Suva Sariya pre hospital care ambulance service was initially launched with technical assistance and US$ 7.6 million grant from the Indian Government, under the direction of Prime Minister Ranil Wickremesinghe. At present, the operations are funded by the Ministry of Health.
Pix: Saman Sri Wedage