Nepal’s fledgling ambulance service is in need of urgent support, say health experts, particularly in the area of trained paramedics.
There are only 21 trained paramedics in a country of nearly 30 million people, according to Nepal Ambulance Service (NAS) .
The Nepal Red Cross Society (NRCS), the country’s largest NGO, has 168 ambulances but none have trained paramedics, and only 35 percent of ambulance drivers have had first aid training.
“The ambulance service in Nepal is very poor,” Rajesh Gongal, dean of Patan Hospital and president of NAS, told IRIN.
Most vehicles that operate as ambulances in Nepal are privately owned cars completely unsuitable for medical treatment and lacking effective communications equipment, says NAS.
A study by Patan Hospital indicated that fewer than 10 percent of people arriving at medical facilities for emergency treatment in Kathmandu Valley arrive by registered ambulance; more than half arrive by taxi.
Many arriving by police or army vehicle, taxi or bus suffer secondary injuries as a result of their journey, said Bulund Thapa, director of Bir Hospital.
Kathmandu, with almost two million inhabitants, has just 21 officially registered ambulances, government figures show, most of which are owned by NGOs and community-based organizations. Many hill and mountain districts do not have any registered ambulances.
Only 2-3 hospitals in the disaster-prone country have trained paramedics on their staff, says NRCS. Patients are dying on the way to hospital because of the lack of trained paramedics, said paramedic and NAS employee Umesh Prasad Sah.
“Nepal’s ambulance service cannot even handle a small-scale natural disaster, much less a major earthquake like the one predicted for the Kathmandu Valley,” said Amod Dixit, general secretary of the National Society for Earthquake Technology (NSET), one of the country’s leading experts on disaster preparedness.
“In the absence of proper primary care and transportation, patients often travel long distances, causing undue delays in obtaining proper medical treatment,” explained Ram Shah, head of department at the Orthopaedic and Trauma Surgery in the Nepal Medical College Teaching Hospital. He said current levels of training and services were “inadequate”.
“Pre-hospital care is [a] very important aspect of all trauma care and there is evidence that if you can get professional help within a certain period of time then the number of injuries and deaths can actually be reduced,” said NAS’s Gongal.