State of emergency with shortage of ambulances

By Nyambega Gisesa

This is the sad state of affairs for more than 90 per cent of Nairobians: If you are hurt or sick and in urgent need of medical assistance, then you are likely to lose your life.

Nairobi, the largest city in East and Central Africa with 3 million people, has unreliable emergency services.

The city does not have well-coordinated disaster systems, enough ambulances or trained paramedics or emergency care units.

Recently, this writer came across, by chance, an emergency case during a night assignment and witnessed the desperate attempts made to save a life amidst a broken down emergency response system in the city.

Interviews with emergency units’ operators, police, medics and other journalists after the incident revealed that the emergency services in Nairobi are perhaps the cause of thousands of deaths every year. 

When a security guard was attacked and injured by gangsters at the Globe Roundabout on September 7, it took about 70 minutes for an ambulance to arrive.

It was one of the few cases described by emergency response teams as “rare” since many others wait for hours without getting any help.

During the long wait, the guard had lost a lot of blood since GSU officers on patrol, who got to the scene first, and passersby did not even know how to administer first aid. The guard succumbed to his injuries.

Police and medics told The Nairobian that rarely are lives saved in emergency situations as the sick or the injured sometimes wait for more than 12 hours before they get definitive care. According to the Kenya Council of Emergency Medical Technicians (KCEMT), there are only 68 ambulances in Nairobi. The entire nation of 41 million people has 354 ambulances. There is no single advanced life support ambulance in the country.

Kenyatta National Hospital has two ambulances. However, they are rarely used for emergency response services because the hospital does not have a dedicated ambulance service team.

The ambulances are mostly involved in inter-hospital transfers.

“Only a third of the privately-owned ambulances are equipped with basic life support tools whereas the government ones are just vehicles that have the words ambulance written on them,” said Bethuel Aliwa, the KCEMT secretary.

“Even with this, most of the government ambulances are either in garages for repairs or stalled.” 

Ambulance services are supposed to be free. However, most of the ambulances are operated by private organisations, which charge their clients for the services.

The organisation with the highest number of ambulances in the country is the Kenya Red Cross with about 28 followed by St Johns Ambulance that has eight.

Aliwa said the emergency services in the city need to be streamlined.

The State is preparing a law to regulate the use of ambulances. The National Ambulance Service Policy has been drafted and will soon be tabled in Parliament.

The Kenya Bureau of Standards (Kebs) has also come up with the National Ambulance Standards. These standards will ensure all vehicles used for emergency services are fully equipped.

The Nairobi county government has not announced any plans to revamp the emergency sector.

Only Machakos County, among the 47 across Kenya, has unveiled an ambulance project. In the project, Governor Alfred Mutua wants the county to buy 40 ambulances for all the wards in the county in the next three months. 

Kenya does not have a three-digit number for emergency services like America’s 911, which can easily be remembered by people in distress. The recently reopened 999 line for police is still unreliable and has now been overwhelmed by prank calls.

 Previously, there was a hotline between St Johns Ambulance and the police. It went dead several years ago and has never been revived.

But the problems with emergency services in Nairobi go beyond the infrastructure.

During the September 7 incident, it became clear that the county government services are unreliable because of lack of coordinated responses among all emergency personnel and sometimes incompetence.

The Nairobi County Council Ambulance services, less than 300 metres from the scene, did not pick up their calls.

Calls to the Kenya Red Cross Society, AAR Emergency Ambulance and the Kenya Red Cross, St Johns Ambulance, revealed that the private services are overwhelmed.

After the man was rescued, this writer visited two key public emergency centres in the city late at night to find out why there were no response distress calls.

At the Nairobi County Emergency Response office where the city’s fire engines and ambulances are stationed, there was no officer manning the offices.

 A guard informed The Nairobian that during the time the calls were being made to the station, an ambulance with registration number KAB 397Q was available but officers had ‘gone for a stroll’.

“He (the officer in charge) has now come back but he is asleep,” the security guard told us at 2am after the St John’s Ambulance team had rescued the guard. 

Twenty minutes later at Vigilance House – the National Police Service headquarters – where the 999 national response unit was revived recently there was silence.

 There was no single officer even guarding the telephone office.