By Mohammad Afzaal Rashid
A large number of patients in India die due to relentless delay in medical care caused by traffic jams and ill equipped ambulances. According to the Ministry of Road Transport and Highways’ data every day about 24,012 patients die due to delays caused by traffic related issues.
These tragic delays are exacerbated by numerous factors such as carts standing on road, unauthorized parking on roads, insufficient infrastructure, lack of a robust public transport system and widespread disregard for the civic duty of yielding to ambulances. These issues combine to create a dangerous environment where emergency services struggle to navigate and reach those in critical need.
In India, ambulance services are a crucial element of the healthcare system, tasked with providing emergency medical care and transporting patients to appropriate medical facilities. Ambulance market in the country was valued at $1.5 billion in 2022 and is projected to grow at a 5.12% CAGR from 2024 to 2028. Despite this growth, the focus of many ambulance services remains predominantly on patient transfer rather than critical emergency care. Currently, there are 17,495 operational ambulances in India. However, only 3,441 of these are Advanced Life Support (ALS) units, which are essential for handling critical emergencies. The disparity is particularly pronounced in high-focus areas like the Northeastern states, where only 26 ALS ambulances are available to serve a vast and underserved population. This shortage of advanced medical units, combined with ongoing challenges such as traffic congestion and inadequate infrastructure, significantly impacts the effectiveness of emergency medical services across the country.
Current Challenges:
Ambulance services in India face a multitude of challenges that hinder their effectiveness and efficiency. Problem of illegal cart standing and unauthorized vendors occupying roadways, which obstructs ambulances and significantly delays response times. Additionally, illegal parking by vehicles further compounds the issue, blocking access routes and creating hazardous conditions for emergency vehicles. A critical challenge is the lack of civic sense among the public, who often fail to yield right of way to ambulances in distress. This disregard exacerbates the delays experienced by emergency services and puts lives at risk. The broader problem is compounded by inadequate infrastructure for both general transport and emergency vehicles. Poorly maintained roads and insufficient designated lanes for ambulances further hinder their ability to navigate congested urban areas swiftly.
Moreover, there is a severe mismatch between the medical burden of road crashes and the capacity of the emergency system. Approximately 90% of road ambulances lack essential medical equipment, and 95% are operated by untrained personnel. Alarmingly, 98.5% of these ambulances are predominantly used for transporting deceased patients rather than providing critical emergency care. This stark discrepancy underscores the urgent need for improved infrastructure, better-equipped ambulances, and enhanced training for personnel to address the growing demand for effective emergency medical services.
Impact of Delays
The delays in ambulance services have severe consequences for patient outcomes and overall public health. According to a 2021 report by the Comptroller and Auditor General on Karnataka, approximately 90,000 crash victims did not receive timely medical care due to ambulances being stationed far away. The report also highlighted that in 6,000 cases, there was a delay of more than 30 minutes in dispatching ambulances after emergency calls were received, revealing a critical shortage in fleet strength. The implications of such delays are profound. Every day in India, 24,012 patients lose their lives due to delays in receiving medical help, primarily because ambulances are hindered by traffic congestion and are often inadequately equipped to handle critical conditions. This inefficiency not only exacerbates the suffering of patients but also leads to a deterioration in their condition while they wait for medical intervention.
Reliable data on ambulance numbers, locations, and distribution is essential for effectively addressing accidents and medical emergencies, especially in high-risk areas. The current deficiencies in response times and equipment underscore the urgent need for improved infrastructure, better fleet management, and enhanced emergency response strategies to mitigate the devastating impact of delays in ambulance services.
Main Issues:
Traffic Congestion
Traffic congestion in India presents a significant challenge to ambulance services, severely impacting their ability to respond swiftly to emergencies. The situation is particularly dire during peak hours, such as school drop-offs and office commutes, when roads become increasingly congested. Major cities like Mumbai, Bengaluru, and Delhi frequently experience some of the worst traffic conditions globally. According to the latest TomTom World Traffic Index, roads in these cities rank among the top 10 most-choked in the world.
This congestion not only delays ambulance response times but also endangers patients who require immediate medical attention. The prolonged travel time due to traffic jams can mean the difference between life and death, especially in critical situations where every second counts. As ambulances navigate through the dense and often gridlocked traffic, their effectiveness in delivering timely emergency care is significantly compromised, exacerbating the public health crisis.
Illegal Cart Standing
Illegal cart standing on roadways is a pervasive issue that severely impedes ambulance services in India. Vendors and small businesses often set up stalls and carts on busy roads, obstructing traffic and creating obstacles for emergency vehicles. This problem is particularly acute in densely populated urban areas, where the lack of designated areas for street vendors forces them to occupy crucial road space.
A 2022 report by the National Association of Street Vendors of India (NASVI) highlights that street vendors in major cities like Delhi, Mumbai, and Kolkata frequently encroach on public roads, exacerbating traffic congestion and limiting the maneuverability of emergency vehicles. According to municipal data, over 20,000 illegal carts are reported in Delhi alone, contributing significantly to road blockages and delays for ambulances
Other Obstructions
In addition to illegal cart standing, several other factors further obstruct ambulance services in India. Illegal parking, where vehicles are often left unattended in critical areas, creates significant barriers for emergency vehicles. According to a 2023 survey by the Traffic Management Bureau, illegal parking contributes to nearly 30% of the traffic congestion in major Indian cities.
Poor road conditions also play a crucial role in delaying ambulance services. Many roads are poorly maintained, with potholes and uneven surfaces that slow down ambulances and pose risks to patients. The Ministry of Road Transport and Highways (MoRTH) reports that approximately 40% of urban roads in India are in disrepair, which directly impacts the speed and safety of emergency medical transport
What is Solutions?
Regulate and Remove Illegal Activities:
Implement stricter regulations to remove illegal vendors and parked vehicles from roadways. By enforcing these rules, roads will be less obstructed, leading to smoother traffic flow and quicker access for ambulances. Designate specific areas for street vendors to prevent them from blocking major traffic routes. Creating organized market zones will help keep roadways clear and reduce congestion.
Enhance Public Transport:
Invest in advanced and efficient public transport systems to encourage people to use public transportation instead of personal vehicles. Improved public transit can decrease the number of vehicles on the road, thereby alleviating traffic congestion and facilitating quicker ambulance access.
Improve Ambulance Services:
Increase the availability and deployment of ALS ambulances, especially in high-demand areas. Equip these ambulances with essential medical equipment and ensure they are staffed with trained health professionals who can provide critical care during transport. Invest in training programs for ambulance personnel to enhance their ability to assess and respond to patient conditions effectively.
Create Dedicated Emergency Vehicle Lanes:
Establish dedicated lanes or corridors for emergency vehicles, including ambulances and fire brigades. These lanes will allow emergency services to bypass traffic congestion and reach their destinations more quickly.
Deploy Traffic Police:
Traffic Management: Increase the presence of traffic police on roads to enforce traffic laws and manage congestion more effectively. Well-managed traffic control can improve overall road conditions and facilitate smoother passage for emergency vehicles.
Mohammad Afzaal Rashid is a student of B.A Politics and Governance at Jamia Hamdard, New Delhi
