I still get tears in my eyes when I think of her, as she tells me how this cruel and heartless world snatched her father from her, the only breadwinner of their family. I still get tears in my eyes as she tells me that it was 1 pm in the afternoon when her father got his second heart attack and was rushed to hospital in an ambulance. “He would have been alive today if they would have moved to the left”, she said. The siren was on with its red and blue light flickering, literally begging the drivers to give way but nobody cared and why would they?
It wasn’t their father on the verge of life and death, it wasn’t their beloved one in there.
“As we stood there stuck in traffic among that blaring horn, ambulance siren, and my
mother’s cries, the father took his last breath and our little world shattered into a thousand pieces but who cares? Why would anyone give a way to save a life? It wasn’t their father in there but you never know it could be their beloved one day?” she said with teary eyes. This was just one of the million stories we get to hear on daily basis where people loses the battle of their lives just because the ambulance got stuck in traffic, because someone’s meeting was more important to him than a human life or because we are getting more and more heartless, conscienceless and inhuman towards such critical situations.
Every year thousands of people die across the world, the reason being the delay in taking the patient to the hospital by the ambulance due to heavy trafficking and late arrival of ambulance to pick patients. About twenty percent of patients needing a quick emergency treatment dies on the way as the ambulance gets stuck in traffic. (The Nation 2017). With about a dozen of people dead in Bangalore, India (The Times Of India 2016) and the same in Lahore and Karachi Pakistan (Pakistan Today 2012). The statistics aren’t pleasing enough even in the most developed countries. A good sum of research been done regarding the delay of ambulances to hospitals and its linkage with road blockages either by heavy trafficking or a single car and it has been deducted that about 12.5% of patients out of 141,381 transports experienced a delay of about 30-60 minutes to large hospitals as compare to small ones. (Cone et al., 2012). According to a study carried out in 2015 increasing death rates in Rawalpindi has been directly linked with the health emergency issues and traffic jams. When asked as if health emergencies has led to an increase in death rates about 60% of the ambulance drivers along with 100% family members of the patients agreed (Nasir et al., 2015). Chances for a patient to survive a heart attack reduces by 10% with every passing minute, keeping this in mind we can very well predict how crucial it is for a patient to get to the hospital and how responsible we are as humans to give right of way to the ambulance. As per EMRI (Emergency Management and Research Institute), the time span for an ambulance to rush a patient to the hospital has increased dramatically to 40 minutes due to increased traffic and the lack of public awareness to give a way to an ambulance in case of emergency. According to the medical professionals in the emergency ward, delay of a half an hour might not seem much for a person traveling on a daily basis but for someone fighting between life and death, every second holds importance. “Just like that golden hour after every accident, minutes holds the importance of a platinum, an ambulance is sent to about 99 percent of callers but the delay in getting the patient back to the hospital is due to either high traffic or drivers not giving way to the ambulance. Even a five minutes delay or ahead can make a huge difference” says Imran Subhan (Head of the emergency department, Apollo Health City)
Now the question that we all need to ask ourselves here is that what we can do as responsible citizens to facilitate the ambulances in emergency situations? What I believe is that the facilitation of ambulances and saving the life of a patient in critical conditions isn’t just the responsibility of citizens or drivers alone. Each and every person be it a common man who is driving his car or getting in the way of an ambulance, a motorcyclist, a policeman, a government official, a traffic attendant, an ambulance driver, relatives of the patients, a media official, a license Issuer or even the ambulance service providers needs to play their part here. Most of the times for a driver who does not give a way to the ambulance isn’t always on purpose but most of the time either they get too confused or are not well aware of how to handle such a situation. So for a common driver on the road, he/she must always keep in check the following points while driving to avoid any mishap in the case of an emergency situation giving “right of way” to an ambulance.
Those lights and sirens on ambulance are just a signal for us to move to the left or right not to panic us in a way that we throw our car in a ditch or end up in an accident instead, however, this panic attack happens very often because most of the cars nowadays are engineered with noise cancellers hence most of the people are unaware of the ambulance sirens until they are too close to them. To avoid this situation it’s better for us to keep our windows a little open to neutralize the effect of noise cancellers or avoid hands free and loud music so we can hear the sirens as they approach us. Being fully aware of our surroundings while we drive is essential so that we can have an idea about our escape route in case of any bad situation.
As soon as we hear the siren we should always pull to the right or left coming to a complete stop in a smooth manner while giving way to the ambulance to pass by. In case if we can’t move to the right or left it’s always appropriate to get over safely while coming to a stop in a controlled manner. Always find a way for the ambulance in a safer manner. I mean if we can pull over for a cop’s vehicle giving us a ticket for over speeding, why not for an ambulance which will cost us nothing but someone’s life to be saved?
Never ever try to race an ambulance or trying to overrun it. Doing so not only makes you look stupid and illiterate but at the same time slows down the ambulance while maximizing the chances of you getting into a road accident.
Never ever hit those breaks suddenly while the ambulance is right behind you.
Being a bad driver is a curse and no amount of law or enforcement can make up for that. Hence in case of a heavy traffic, if you see an ambulance arriving just like in the USA, the best approach is to pull over to the right and stop. However, if because of some obstacle
behind you cannot pull to the right it’s better to come to a dead stop suddenly instead of pulling over to the left because in doing so we are not only blocking the way for ambulance but also there is a high chance for the accident as the ambulance try to take over us to our left. Pulling to the right is the right option for you giving a way to the ambulance to get around you taking left. Good drivers know that because of their common sense.
Moving to the left or right while giving way to an ambulance depends merely on the lane you are driving in and also it depends from country to country. In the United States, it’s
preferable to move to the right while in Australia its left. Talking about Pakistan it’s preferable to move to left just like in India.
Being a good citizen it’s our utmost duty not only to give right of way to a blazing ambulance but also we should try our best in guiding other drivers to make a way as well. The best thing we can do is to roll down our window and listen carefully to the ambulance driver to assist help and make a way.
One point that we need to keep in mind here is the volume and sharpness of the ambulance
siren. If it’s too faint then we need not come to a stop all of a sudden because the ambulance most probably is either too far away or on a totally different road.
Ambulances are licensed to drive through the wrong side or breaking the signals but at the same time, we should be fully aware that it’s legal for any driver or motorcyclist to break a signal in case there is an ambulance behind it (National Highway safety ordinance 2000). This law is what most of the drivers are not fully aware of and also something that’s not practiced on a daily basis especially if we talk about Pakistan. However certain safety measures should be kept in check making sure that the road is empty and safe in case we opt to break a signal for the sake of “right of way”.
Being a good driver we should never ever try to take advantage of an ambulance by getting behind it trying to escape the traffic. Even if we see one doing so they should be reported directly to the traffic police.
One of the main reasons for a traffic jam which hinders the passage of an ambulance is parking on the sides of the roads. This is something which should be banned completely because it narrow downs the lane causing traffic jam which results in loss of a life. Any such vehicle parked on sides of the road hindering the passage should be complaint directly to the traffic police. Unfortunately, in Pakistan, this is something we see daily but no productive measures been taken against it yet. In short, while driving on the roads what we need to keep in mind is to be well aware of our surroundings and as soon as we see an ambulance we need to move to left/right (depending from country to country), stop traffic until the ambulance passes, never try to press those breaks suddenly when an ambulance is behind us, try not to park on roads and also breaking a signal to let an ambulance pass. Only if we are able to follow these simple rules, we can save a life which could be the life of our own beloved on.
Talking about what drivers can do, let’s divert our attention towards what traffic police can do in this regard. According to a research done back in 2003, it was concluded that most of the ambulances remain stuck in traffic due to the policemen not taking any action against the circumstances and clearing the road. There was also no strict implementation of traffic rules by the management hence leaving a bad impact on the health of common men (Golob and Regan, 2003). Besides keeping the traffic in check which no doubt is one of the most basic duties being a traffic attendant, making sure that the ambulance reaches its destination on time, making sure that each and every citizen on roads obeys the rules and gives “right of way” to an ambulance should be one of the priorities of the police officials as well, be it a traffic police or a common police. There should be a proper system where a coordination needs to be maintained between hospitals and police stations. Not only should this coordination be based on picking the patient and making sure he reaches the hospital on time but also a proper coordination needs to maintain between the traffic officials and hospitals in clearing the traffic for the ambulance who gets stuck in heavy traffic in case of emergency situations. To my surprise, such a system has already been implemented in INDIA where an alert is being sent over by the EMRI-GVK (Emergency Management and Research Institute) to the police officer on spot for traffic clearance in case of an emergency. The issues are coordinated between the traffic policemen on the field. (Dayanand “Commissioner of traffic”, Times of India 2014). The traffic police of BANGALORE India have installed software which turns traffic signal from red to green giving way to ambulances and fire tenders. The software was developed by Opticom USA and is controlled manually by the officials turning red light green as soon as they see an ambulance on their big screens in the premises of about 760 meters. The project is still in its early stages and is expected to be expanded in the whole country. Such projects are very much beneficial in facilitating ambulances. (Time of India 2013).
An important role has also been played by the ambulance drivers and the ambulance managements services themselves to make sure the patients reach on time and gets the desired medical attention. Proper education and training of the ambulance drivers are of crucial importance, along with a well-equipped ambulance to give patients pre-hospital medical attention on the way. Ambulance drivers need to be given proper training
regarding keeping an eagle’s eye on the road along with certain rules and regulations to follow while handling drivers and making a way for themselves in the case of emergencies avoiding any kind of accident. Some of the rules that Ambulance drivers need to keep in check includes
Exceeding the speed limit only when the condition of patients demands it.
Passing a red light or a stop signal while slowing down to avoid any accidents.
No misuse of the siren.
Ambulance drivers should also be trained emotionally as we are well aware of the abuse they face on daily basis. Ambulance staff faces the highest amount of abuse. 36% verbal and 22% physical coming from about 60% of the patient’s relatives. Hence the staff needs to be well trained if any such situation arises because a panic and mental stress often result in accidents. Besides having some equipment like a ventilator, stretcher and a trolley an ambulance need to have a spinal cord board and patient monitoring system along with the highly qualified medical staff. Also, the siren of the ambulance needs to be such that it’s loud enough and differentiable from the rest. Two of the most common siren tones used in the US are wail and yelp. Many emergency vehicle drivers are taught to change the tones of their ambulances as they reach an intersection hence getting the attention of drivers which I believe is a good idea. In short, every ambulance needs to be like a mobile ICU moving around on roads with well-trained drivers and highly qualifies medical staff. In US one paramedic with 2 EMT basics while in Europe one physician and a paramedic are must facilitate patients.
One of the biggest problems that are often faced is the delay of the ambulance in reaching patient on time. As per latest statistics, about 3000 patients would be saved easily if the ambulance was able to reach on time to pick them up, out of 32 only 3 ambulances services in England reaches within 8 minutes to some of the “life threatening” calls made. In London about more than half of the ambulances arrives 15 minutes late with the figures even worse for Manchester and Pakistan. (MailOnline 2016). Some paramedics have to wait for as long as 30 minutes. (BBC 2013). Lack of clear and visible leadership on board along with traffic and lack of awareness are some of the reasons that often causes the delay, but the question is what could be possibly done to give patients the required medical attention before an ambulance gets to them?. To tackle this problem a first of its kind bike ambulance service has been introduced in India recently and is already been practice in US, Brazil, Australia and London which reaches the patients within 10 minutes of the call providing the necessary medical attention until the ambulance arrives. This service is not only beneficial in minimizing that gap between ambulance arrival and the patient receiving the required medical attention but also it can save many lives in a highly congested area with heavy
trafficking, hence saving patient’s life during that “Golden Hour”. Karnataka India became the first state to launch this service in India and was named “Platinum 10 minutes”. Each bike is highly equipped with 40 emergency care medical items along with 53 basic drugs and each bike costs around 2 lakhs. The bike drivers are trained paramedics reaching to the patient in 10 minutes. The system works as soon as control rooms get information about any accident and after analyzing the traffic situation on the specific route through GPS bike ambulances are dispatched. Based on the condition of the patient he could be carried to near hospital even on a bike or wait for the four wheeler ambulance to arrive while providing crucial medical attention to patient meanwhile. (Patel and Ekkiswala, 2010). Though such emergency service is already been launched in Pakistan what needs to be done is its practice across Pakistan to reach patients on time. (Dawn 2016).Another approach that we can follow is by providing basic medical training to volunteers who are all ready to help a patient living one or two blocks away from them before an ambulance can get to him, hence decreasing that gap between ambulance arrival and patient. An even better approach in near future would be the introduction of air ambulance system for a quick approach with zero hurdles.
One of the main roles that government and its official can play in facilitating the ambulance services is to not put a hurdle in its path the first place. One of the buzz words that we get to hear again and again in this regard is “The VIP Culture”. The same VIP culture that took the life of a 10-month-old girl in Lyari Karachi when an ambulance got stuck in traffic jam on the protocol route for the PPP leader Bilawal Bhutto Zardari. “She would have been alive if we would have reached the hospital 10 minutes earlier, no little girl should die the same way as my daughter did,” said the father of the deceased. (Dawn 2015). But it’s not just Pakistan where we get to read about this happening Meanwhile in India the ambulance carrying a critical patient was stopped for about 20 minutes at Kakinada for the convoy of Andhra CM. (The News Minute 2017). Solution to the whole situation? No exceptions given to VIPs regarding the basic traffic rules is the real solution so that no other human life is lost and later on remained unquestioned, unanswered. Strict rules need to be implemented by the government where every citizen including the big VIPs has to obey the basic laws while at the same time giving right of way to ambulances. In Queensland, every driver who wouldn’t give right of way to an ambulance or not moving out of the path is fined $284. The same needs to be applied in Pakistan as well. Every formally defined law needs not to include “should” but a “will” for every driver to strictly follow rules hence facilitating ambulances. But yet again it all comes down to the common man being responsible enough to follow the rules because it’s almost impossible for the police officer to take hold of every second person who doesn’t follow the rule. Strict laws need to be implemented regarding the driving license issue to citizens. Along with driving skills, every driver needs to be given proper education and driving training on how to handle and give way to ambulances. Such training can be carried out with an ambulance around. Proper infrastructure by the government can facilitate ambulance services as well by making a separate one-way route on every road specific for ambulances.
A campaign was launched in Dubai last week with the motive to spread awareness about keeping the roads clear for ambulances. The basic agenda of the campaign was “An
ambulance on the way means someone’s life is in danger”. The advertisement was done in several languages along with the pamphlets distributed in about 15 shopping centers. (Gulf
News 2017). Making laws is just about solving one portion of the problem but the huge part still remains which is about spreading those laws and enforcements among the general public which can be done v well by the media bodies. Only when one is aware of his/her duties in facilitating ambulances on road can they very well play their part in saving a life. In most of the western countries as soon as people hear the ambulance siren they move to the left reason being they fully aware of the laws while in still-developing countries like India and Pakistan you would rarely see any such thing happening because there is a lack of awareness among the common public. This awareness can be spread by different means which includes billboards on the sides of the road and in between the intersections, different talk shows on televisions and radios along with pamphlets distribution. Different advertisements through articles and short films that can emotionally attract the general public are the cherry on the cake. To check the effect of these media campaign a study was conducted by APPNA institute of public health and funded by International Committee of Red Cross (ICRC). It has been concluded that most of the drivers who doesn’t give a path to an ambulance are behavioral negligence of the basic rules and regulations but it was also concluded that the percentage of vehicles giving right of way to ambulance increased dramatically from 60 to 77 percent after the media campaign. (Shaikh et al., 2017)
The advent of soft applications regarding traffic awareness combined with health monitoring systems must be used in order to avoid traffic congestions and ensuring the timely and safe passage of the ambulances to the hospitals nearby. A smartphone application
named “traffic aware health monitoring application”, “THESA” has already been developed and tested for the patients and ambulances of twenty hospitals. According to Jasleen Kaur and Neera Batra, December 2014, the health monitoring devices with the enriched database will store the patient’s health record and will virtually bring the experts to the emergency site within the ambulances. In addition to that, THESA will locate and navigate the ambulance to the nearest available health care facility for that specific illness. Moreover, the software is also linked to the traffic monitoring unit which dauntlessly guides the ambulance driver concerning possible traffic congestions and blockades. Finally, the navigation system built in this software ensures locating the open routes towards the nearest destination efficiently and eliminate the possible mishaps. (Kaur and Batra, 2014). Bawna Rai and Vivek Chawla, IJSR 2015, furthered their work to construct a model which will provide a jam-free path to the ambulance in thickly populated areas and bigger cities. They majorly focused on traffic management and proposed a model containing RF module combined with GSM module to open up the automated red signals as an ambulance approaches towards it. This plan needs a fully automated traffic signals to pave the path towards unhindered rescue operation carried out by an ambulance (Rai and Chawla, 2015). Similarly, the road signals used in approximately all the countries use the static lights which turn on and off regardless the number of vehicles on the road. This can be swapped with smart signaling system which will turn red for the minimal duration of time in case if the roads are empty (Singh et al., 2012). And will ultimately help the ambulances and health care machinery. Thus, it is vividly clear that the use of technology- whether electronic or software- will be helpful in controlling the traffic congestion, health monitoring of patients and can save our loved ones.
All in all the fact that still remains is that facilitating the ambulance services and saving a human life isn’t just the duty of one group of people or those driving their vehicles and motorcycles on the road but instead it’s the duty of every single policeman out there to make sure the citizens are playing their part and following the law properly, to make sure that ambulances gets the proper path to pass even in the worse of the traffics, it’s the duty of every single government official out there to cut on the VIP culture and to make sure that the infrastructure of their city and its roads are well constructed to avoid any kind of congestion, to put forward such strict laws with some ugly consequences for those who don’t follow them, it’s the duty of every ambulance driver and those on board to make sure they are well aware of getting along heavy traffics in critical conditions and also to make sure all the calls are answered and treatment is delivered on time, it’s the duty of every researcher and technologist to come up with much better systems, ideas and gadgets to facilitate the ambulance services, it’s the role of every media official to spread awareness among the common public regarding the facilitation of ambulances and giving right of way because for us commuters traffic is no more than us stuck in a frustrated situation but for some it might be a killer.
So to talk about what “we” can do to facilitate ambulances in case of traffic or emergency the thing we need to get our attention towards is what “I” can do about it? Because it all
depends on “me” as an individual to ponder over it as a good human being and to understand that nothing holds more importance than a human life. To understand that
affording a car and driving around no doubt a privilege but it shouldn’t be put ahead of a
human’s life. Police no doubt can play an important role but to follow the traffic rules and also to report those who don’t is the duty of every responsible citizen. Again it all comes down to us stop being heartless, illiterate and ignorant towards a human life and stop behaving like those “3 monkeys” of Gandhi who are blind towards an ambulance approaching them deaf towards the blazing siren and dummy towards spreading the awareness to other citizens. It’s time for us people to realize that, because rules are there but nobody follows. Implementing laws can’t make a person follow them but it all depends on how sensible we are as human beings because only a sensible person will give way to the ambulance weather or not there is a law while a coldhearted won’t even if there are strict laws implemented. The only way for us to change the mindset of people is to start it with ourselves first by not only following the rules but also making others inspired by this act and spreading the awareness about it among our friends, families, and acquaintances. Next time you see an ambulance approaching towards you just for a minute imagine a situation when you are having this deep horrible pain in your chest, breathlessness, and blackness lingering in front of your eyes. The ambulance rushes you to hospital but gets caught among those motorcyclists and car drivers refusing to give way. Every second passing might seems like hours with that unbearable pain, watching those tears rolling down the cheeks of your loved ones. At that moment you would have wished for one thing and that is to reach the hospital and get out of this misery as soon as possible. You would have cursed every single driver who didn’t give the way. Imagine your breaths leaving you, your life leaving your body but you are too helpless, likewise how helpless that patient would have been whom you didn’t give way the next day? Think about it! “Save a life and give way to the ambulance, it might be you one day, it might be your loved one”.