By Goodluck Musinguzi
Naguru Ambulance Station is set to open for the public to access ambulance services in Kampala Metropolitan Area ending years of complaints from the public against lack of access.
Dr. Diana Atwine, Permanent Secretary Ministry of Health said each ambulance should be fitted with the Global Positioning System (GPS) so that it is easy to locate the ambulance from the call and dispatch center based Naguru National Hospital.
The Ministry of Health will ask people to download the google application so that they are able to access the ambulances in times of need. Later the private ambulances will be integrated so that people who want their services can use the same center.
Too many people die due to delayed medical assistance every day in Uganda. This is despite government efforts to ramp up emergency pre-hospital care, which includes a more efficient and effective ambulance system. Most people have a story about someone in their family or community who did not receive the medical attention they needed because the ambulance never arrived.
In 2016 alone, 336 out of every 100,000 pregnant women died because they were unable to reach a health facility or emergency service in time to safely deliver their babies.
Reasons often have to do with people not being able to afford the service, or the poor state, and low number, of vehicles, or misuse by ambulance drivers—including the unlawful transportation of non-medical goods or people.
All these things make ambulances unavailable to the people who need them in the case of an emergency.
A medical worker from a hospital in Bugiri District in Eastern Uganda, drove the point home, recounting the daily reality. “I lost a patient because he was referred to Mulago Hospital in Kampala and had no money to afford fuel for ambulance transport. In the end, he decided to go back home. This isn’t unusual. There are many others who do the same.”
What’s more, is that dispatch emergency management communication systems are not yet fully established across the country. People who live in hard-to-reach areas often cannot call an ambulance and receive help. They must instead find their own way to a hospital or a health facility.
Real-time tracking and performance monitoring
In response, the Government of Belgium donated ambulances to medical facilities in the Rwenzori and West Nile regions of Uganda, to ensure that people, and especially pregnant women, receive access to transportation and assistance.
To understand how these ambulances are being used and what other steps could be taken to improve emergency service delivery, Pulse Lab Kampala developed a digital application called Cheetah Tracker.
The tool, implemented with the Ministry of Health and Enabel, Belgium’s Development Agency, uses Global Positioning Systems (GPS) data to provide analytics on transport-related aspects of health service delivery through a user-friendly dashboard and SMS/email alerts.
How it works and primary results
Metrics about how ambulances operate are gathered and analyzed, giving medical staff and health officials real-time tracking information. For example, the application allows officials to know how much fuel was used, the top speed reached, and where (and for how long) an ambulance was parked.
Ms. Maria N. Nkalubo, Principal Operations Officer of Emergency Medical Services at the Ministry of Health, has seen the benefits first-hand and believes this use of big data is one way to provide better emergency services to citizens.
“There are many challenges in providing emergency service care across Uganda,” she said. “Some of the larger gaps include prohibitive operational costs of an ambulance fleet in some districts, while in others ambulances are so old or have logged so many kilometers they have become a hazard and should be taken out of service.”
By using the digital application, local and regional health departments will be able to keep better track of their ambulances. Users receive performance reports in real-time, which improves efficiency and can help emergency staff better manage the limited resources they have.
Most striking is that the GPS software has already made health staff across Uganda more conscious of how emergency vehicles are used. Because it allows someone in Kampala to monitor the location of an ambulance in Rwenzori, it provides better coordination. In addition, “If an ambulance is being misused,” Nkalubo said, “we are able to intervene and take corrective action, which saves lives and improves overall health service delivery.”
Saving lives, one ambulance ride at a time
To date, 27 GPS systems have been installed in ambulances in West Nile and Rwenzori and, once additional funds are secured, Pulse Lab Kampala will scale up the application so local and regional health authorities can outfit all emergency vehicles in both regions with Cheetah Tracker. Once those fleets are running at optimal capacity, other sub-regional facilities are in line to have the application installed in their vehicles.
Various other emergency services—firefighters, first response teams and law enforcement, have also expressed an interest in piloting Cheetah Tracker.
KAMPALA GETS EMERGENCY MEDICAL SERVICES CALL AND DISPATCH CENTRE
By Goodluck Musinguzi
The Ministry of Health has set up an ambulance station to complement ambulance services in Kampala Metropolitan Area. This is in fulfillment of the pledge by Dr. Diana Atwine, the Permanent Secretary of the Ministry of Health.
“Government is considering setting up an emergency center in Kampala from where the ambulance services will be coordinated to serve Kampala Metropolitan Area while promptly responding to all manner of emergencies wherever they occur”, Dr.Diana said in 2019.
Emmanual Ainebyoona, Senior Public Relations Officer said Naguru Ambulance Station is expected to start with over 20 ambulances from government.
Once the Ambulance Station is ready it will be opened to the public for use. We are going to deploy paramedics who are health care professionals who main role is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical system. Not all ambulance personnel are paramedics.
Naguru ambulance station is a structure or area set aside for storage of ambulance vehicles and their medical equipment as well as working and living space for their staff.
Naguru Ambulance station will have facilities for maintaining ambulance vehicles, such as a charger for the vehicles’ batteries, tyre clinic and servicing of engines.
Dr. Diana Atwine said her team assessed the readiness of the Naguru Ambulance Station expected to host the emergency medical services call and dispatch center. This and other regional centers will coordinate Ambulance services in different regions of the country.
In a bid to improve Emergency Medical Services across Kampala Metropolitan Area, the Ministry of Health handed over 7 ambulances funded by African Development Bank to Kampala Capital City Authority (KCCA).
During the handover ceremony, the Under-Secretary, Ministry of Health, Mr. Ssegawa Ronald Gyagenda highlighted the multisectoral approach among Government bodies aimed to improve service delivery across the city and country at large. He noted that among many existing services to expand service delivery, procurement and effective use of ambulances were important to improve the quality of care for emergency cases by ensuring quick response during emergencies.
“The key resources for operation are human resources such as ambulance crews, fuel, and maintenance of the ambulances is crucial to effectively run the ambulances,” Mr. Ssegawa said. He added that in collaboration with partners, the Ministry is in the process of developing an Emergency Medical Services Policy, Standards, and Strategy which will spell out the coordination of ambulances in different regions in the country.
The Acting Deputy Executive Director, KCCA then, Ms. Juliet Namuddu commended the Ministry’s efforts and entrusting the authority with the responsibility of running the ambulances across the city. “Without ambulances, it is difficult to respond to emergencies in a timely manner,” she said.
Ms. Namuddu informed the public that KCCA has put in place a call center (Toll-Free: 912) to enable dispatch and coordination of ambulances across Kampala City.
Speaking at a press briefing at the Ministry of Health headquarters, she said the policy will define what an ambulance is and the kind of equipment it should have.
Dr. John Baptist Waniaye, the commissioner for emergency care services hopes that the policy if approved will lower the cost of ambulance services in the country.
According to Dr. Waniaye, the cost of ambulance services in Kampala is very high and exorbitant. Ambulance transport in Kampala costs around sh150,000 while in areas like West Nile, the cost can go up to sh3m.
He noted that through the policy they will establish a district system whereby every health Centre IV has a type B ambulance. Type B ambulance has basic life support equipment.
Currently, there are 421 ambulances in the country, out of which 181 (Type B) are in government, 124 in private not-for-profit organizations, and 116 in private facilities.
Tom Kyobe, President Association of Ambulance Professionals of Uganda, said that a standard ambulance costs about $22,000 (sh81.4m) while the more specialized ones cost up to sh500m each. In Uganda, he added, commonly used are the Type B ambulances.