Air ambulance urgently needed to save accident victims
The National Ambulance Service (NAS) has warned that more accident victims may continue to die before reaching the hospital if urgent steps are not taken to improve emergency medical services (ambulance services) in the country.
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The Director of the NAS (the division of the Ministry of Health in charge of emergency medical services), Prof. Ahmed N. Zakariah, in an interview with The Mirror, pointed to air ambulance or air medical services as the most pressing need of the service.
Air Medical Services is a comprehensive term covering the use of air transportation - aeroplane or helicopter - to move patients to and from healthcare facilities and accident scenes.
Specially trained personnel provide comprehensive pre-hospital, emergency and critical care for all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft.
The advantages of medical transport by helicopter may include providing a higher level of care at the scene of trauma and improving access to trauma centres.
Helicopter-based emergency medical service also provides critical care capabilities during inter-facility transport from community hospitals to trauma centres.
Prof. Zakariah said air ambulance was urgently needed in Ghana, especially in view of the country’s poor road infrastructure and inadequate ground ambulance fleet, which makes it difficult for the NAS to generally respond to emergency situations within the standard time of eight minutes.
He cited the death of many people in the recent Melcom disaster, the El wak cargo plane crash and the victims of a fire in Wa, saying they might have died because they could not be conveyed quickly enough to receive specialist care at the Korle Bu Teaching Hospital, which is Ghana’s premier health facility.
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Need for standard air ambulance
The director also noted that the drilling of oil at West Cape Three Point and Deepwater Tano in the Western Region had taken workers into distant locations, including those offshore.
The remoteness of the offshore platforms and vessels, coupled with the potential risk of being cut off by bad weather and other situations, he observed, could present particular challenges for emergency medical response; hence, the need for a standard air ambulance.
He said the nation needed at least two well-equipped (emergency medical service) helicopters, one each for the northern and southern parts of the country.
Prof. Zakariah said though the Ghana Air Force and some private entities owned helicopters, there was no typical helicopter ambulance in the country.
Presently, the Service has 161 ambulances operating at 121 stations across the country. There are 1,316 personnel serving the over 25 million Ghanaians.
“Ideally, one ambulance should be available to 25,000 people at all times but now in Ghana, one ambulance serves about one million people. In fact, we require about 5,000 ground ambulances plus two air ambulances to operate a good system,” Prof. Zakariah stated.
He said by international standards, all ambulances that were five years old must be taken off the road because emergency services could not be delivered with vehicles in poor condition.
“So the vehicles that were acquired in 2009 have been taken off the road. Some of them have broken down completely, while the fairly good ones may be used as hearses or vehicles for inter-hospital patient transfers,” Prof. Zakariah said.
Besides the absence of air ambulance and poor road infrastructure, the National Ambulance Service also faces enormous financial challenges.
For instance, the percentage of the Ministry of Health budget it received while it was operating 24 stations in 2008 is the same amount that is allocated for its operations currently, though it now runs 121 stations.
The services provided by NAS are also offered to the public absolutely free of charge and though the National Health Insurance Authority (NHIA) offers some financial support for its recurrent expenditure, that arrangement is not structured and thus comes as benevolence from the authority.
This is because, according to the director, ambulance services are not scheduled for reimbursement by the NHIA.
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Again, the NAS lacks adequate office accommodation. In some parts of the country, it shares office spaces with the Ghana National Fire Service and other state institutions.
The Mirror also learnt that the operations of the service are not backed by any specific law because the Ambulance Service Bill has not been passed and the delay has denied the NAS the level of autonomy it requires to operate effectively and more efficiently.
Response to concerns
In response to the concerns raised by the NAS over the danger that oil workers faced, Ms Bernice Natue, Communications Executive at Tullow Ghana Limited (a major player in Ghana’s oil industry), in a written statement said “each major installation has a professional paramedic or doctor stationed permanently on it to provide medical care as and when the need arises.”
“Each offshore installation is expected to maintain a fit- for-purpose medical facility suitable for the installation. There are industry standards and guidelines that stipulate the requirements that must be met,” the statement said.
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In drill rigs or on the floating, production, storage and offloading ( FPSO) units, where more than 100 persons may be on board at any time, the statement noted that a standard two to four bed facility is provided with all necessary equipment to stabilise and support an injured or critically ill patient until further assistance can be accessed.
In the absence of an air ambulance, Tullow’s standard helicopters used to transport workers to and from the rigs are configured to take a stretcher in the event of a medical emergency.
Over the past years, the statement said, Tullow had had medical situations that required emergency evacuation from offshore to Accra or Takoradi as well as, in rare cases, directly from Takoradi to Accra.
“We have used the Cardiothoracic Centre in Korle Bu on a number of occasions but most of our cases end up at the Intensive Care Unit of the 37 Military Hospital.”
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“In some cases there has been the need to evacuate the affected individuals outside the country for further treatment. In such events we have another provider to handle the international transfer.”
State of country’s trunk roads
Commenting on the state of the country’s trunk roads, which largely affects ground ambulance services involving long distance travels from accident/disaster points to health facilities, a senior engineer at the Ghana Highway Authority, Ing. Ernest Osei Bonsu, conceded that more than 48 per cent of the country’s roads were in fair or poor conditions.
That may not augur well for the delivery of smooth and timely ground ambulance services, leading to many preventable deaths; hence, the need for air ambulance.
The region with the worst trunk road condition is the Eastern Region, which has only 22 per cent of its major roads in good state.
Ing. Osei Bonsu, who is also the Road Maintenance Programmes Manager at the GHA, attributed the poor state of the roads to lack of funds but gave an assurance that the authority would continue to do its best to maintain the existing roads in the country.