With the close launch of Flare's pilot, we thought it was worth going back through the major ambulance news stories in Kenya over the last year. Many of these stories convinced us that we needed to move faster than ever to launch Flare.
August 27th, 2015: Excess of Ambulances in Kenya
RECAP:70 ambulances were purchased by Machakos county which has a population of 1 million. Because demand for the services are still low (i.e. revenue was also low), the county started using the vehicles for other purposes like transporting tents and equipment for events.
OUR READ: Supply of ambulances is not the pressing issue in Kenya even though wait times are incredibly long and most are unable to quickly access an ambulance in time of need. Based on the WHO recommendation that 1 ambulance is required for every 50,000, a county the size of Machakos should only need 20 ambulances. Building a system for patients to access these services must be done in parallel to purchasing more ambulances.
October 7th, 2015: Patient dies after 18 Hours in an Ambulance
RECAP: A car accident victim spent 18 hours in an ambulance after Kenyatta National Hospital, a public facility, said there was no available ICU bed. The patient was initially taken to another public facility and later referred to the national hospital due to the severity of the injury. The ambulance company was unable to take the patient to a private facility given his inability to pay.
OUR READ: There is definitely a shortage of ICU beds for a city the size of Nairobi especially since many Kenyans from outside of Nairobi seek care in the city. However, understanding hospital capacity and alerting them in advance of a patient arrival is key. There are at least 2 other public facilities in Nairobi with ICU beds and it's unclear if the ambulance company, patient's relatives and Kenyatta National Hospital were aware of the ability of these facilities to accept the patient.
December 13th, 2015: Admission Delays and Refusals
RECAP: A hit and run vehicle was taken to a public facility in Machakos where he was denied entry. The reasons were unclear. The patient was brought by an ambulance and there's video evidence of the medic pleading with hospital staff to admit the patient.
OUR READ:Covering the cost of the ambulance is only one barrier to accessing care. While all facilities and ambulance companies have taken an oath to stabilize emergency patients, there are instances when this doesn't happen. In this case, it's not entirely clear why the patient wasn't admitted, but one reason could have been his ability to pay. Understanding how to simplify and improve the payment processing for emergency victims is critical.
February 12th, 2016: Baby Dies Waiting for an Ambulance
RECAP: A 3 month old baby dies at a hospital waiting for an ambulance transfer to Kenyatta National Hospital. The only ambulance at the facility was out on a run and the family was unsure who else to call for help. After 5 hours, the father (read: not the hospital) was able to hire a private ambulance for 4,000 KES (around $40 USD)
OUR READ: While facilities often have a limited number of ambulances (if they own any at all), there are many private ambulance operators and government-run ambulances in Nairobi. Due to the challenges of trying to access these ambulances, because there's no centralized line or service to call, the patient or patient's family is often unable to access these services or they access them too late. From our research with the private ambulance companies in Nairobi, we found that most only complete 2 runs per day and operate at most at 30% of available capacity. This means that the majority of the time, ambulances are free.
May 6th, 2016: Patient dies due to ill-equipped ambulance
RECAP: A building in Huruma collapses in early May where more than 40 people lost their lives and 140 were saved from the ruble. One survivor died on the way to the hospital in an ambulance due to lack of an oxygen tank.
OUR READ: There is no over-arching regulatory body for ambulances in Kenya. As such, the quality is uncertain and highly variable. The vehicle, equipment on board and personnel need to be regulated to ensure consistent standards across government and private ambulance operators.
Did we miss any major stories? Let us know!