Ambulance service in disarray

Because of a veritable lack of concrete policy, ambulances in the country operate in a free-for-all style, with the sole aim of fleecing patients in their times of distress. Though the services are supposed to be given free of any charges, in reality we see a diametrically opposite picture. At times, private ambulance owners charge atrocious amounts for carrying patients to a small distance. Reportedly, about 11,000 vehicles labeled as ambulances run across the country but most of these lack emergency equipment inside. As a result, terminally ill patients often cannot survive the ordeal.

Ambulances are an integral part of emergency medical services dedicated to saving human lives. They are not for rental, as it is not permitted by law. But the owners/drivers operate these vehicles commercially openly under the very nose of the law enforcers. A detailed report on the topic published in this daily yesterday finds that the lack of a policy on ambulances operated by hospitals and rental services, government is being deprived of revenue.

 The report elaborates that ambulances are supposed to be used for transporting sick or wounded individuals to and from hospitals and clinics. The emergency vehicles are registered as ‘Not for Rent’ by the Bangladesh Road Transport Authority (BRTA), but in reality they are operated on a rental basis to meet public demand. Interestingly, ambulances have long been getting registered as private vehicles against institutions or firms. And even though ambulance owners have been requesting the government to form a policy to bring their business under a legal framework to reduce costs and avoid other hassles like police harassment on roads, it has not happened till date.

What transpires from the Business Post report is the fact that the government is losing revenue in the form of import duty as ambulances get tax rebates during import. But, despite the law, these are being used commercially by the unscrupulous owners. On the other hand, common people, especially patients, suffer as there is no government control on its rent.

The number of ambulances in the country is rising as operators find it a lucrative business, especially during the pandemic when serious patients need to be transported to a hospital.  According to BRTA, between 2010 and May 2021, a total of 7,076 ambulances obtained licenses to go into operation and of them over 4000 operate in Dhaka.  

The BRTA sources further said the organization registered 563 vehicles as ambulances in 2018 and the number rose to 788 next year. Dhaka Metropolitan Ambulance Owners’ Association said around 680 private ambulance service providers are operating over 3,000 ambulances in the capital city alone. And business insiders estimate that over 10,000 ambulances run privately across the country, meeting 95 per cent of the  demand while the other 5 per cent is met by 900 government ambulances.

Ambulances are known to have been in use first in 1487 by the Spanish forces during the Siege of Malaga. During the American Civil War vehicles termed Ambulance Wagons were used to transport the wounded off the battle fields. Field Hospitals became popular since then in many wars. And now ships and aircraft have been converted to hospitals which are equipped to do emergency operations to save lives. This may be mentioned here that when the warring sides began to use aircraft to release bombs on enemy positions, the pilots avoided the ambulances that had the insignia of Res Cross painted on the roofs of the ambulances.     

It is good to learn that since commercial use of ambulances is illegal, BRTA takes legal actions against errant owners of such vehicles. But what is needed at the moment is a concrete policy regarding import, import tax, registration, ownership and operation of ambulances to ensure public welfare. Some kind of mechanism has to be developed to control the rent charged by private ambulance operators. At the same time, monitoring has to be done by BRTA against allegations that some hospitals use ambulances to transport their employees instead of patients, while some microbuses were modified to work as ambulances to carry patients.