I recently came across an article in an old newspaper with the title “Emergency hospital care in Kenya is designed to kill accident victims” in a nutshell I understood the journalist wanted to highlight the plight of ambulance service in Kenya what we professionals call pre-hospital care. Pre-hospital or emergency care is the initial care given to a suddenly sick or injured person before the patient is taken to hospital for advance treatment, in plain English you can call it first aid if you wish.
The ambulance were designed to not only transport patients from a scene of an accident to hospital, but also offer medical care to the victims, so as to increase the chances of survival. Ambulance paramedic’s or Emergency Medical Technicians (EMTs) are medical personnel trained to offer such care to patients from the scene of an accident and en-route to hospital. It is sad that many ambulance operators do not offer the right staffing hence many deaths or more harm occur to victims of accidents.
Ambulance are categorised according to their capabilities, we have two standards of ambulances that is Basic Life Support Ambulances (BLS) and Advanced Life Support Ambulance (ALS). When I talk about capabilities I mean the level of care one can get while riding on the ambulance. The level of care will depend on two things, one the staff qualification and two, the type of equipments and medication stocked in the ambulance. An ALS ambulance for example will offer superior medical care compared to a BLS ambulance. In the development world, these two categories are well defined. A BLS ambulance will ride with an EMT on board, while an ALS ambulance will have a paramedic on board, who is technically more qualified than an EMT.
A quick snip in the industry will make you realise that a lot of ambulance providers do not have the appropriate personnel, either due to ignorance or negligence. They employ people who do not possess the right qualification and this has attributed to more harm to patients and deaths that have been had to quantify, due to lack of data. An EMT for example is capable to undertake basic medical manoeuvres like maintaining an open airway, controlling bleeding which otherwise could be fatal and performing Cardio Pulmonary Resuscitation (CPR) to a casualty who is not breathing. These are critical interventions that can determine chances of one surviving.
A number of factors contribute to the lack of seriousness and attention the industry is given. We have the Ambulance act that is still laying somewhere gathering dust, because the lawmakers have not passed the law. This means anyone can buy a van, take it to jua kali and fix a stretcher, put some few drawers and a sink, install an oxygen cylinder, tint the windows put a flash light and a siren beacon, brand it as many brief companies do and alas! There comes an ambulance. There is no regulator that controls the use of ambulance in Kenya.
A few organizations have however played a major role in regulating the industry by having EMTs under one body. The Kenya Council of Emergency Medical Technicians (KCEMT) has gone a big stride of training and certifying EMTs in Kenya. The downside is the council is struggling to be recognised by the government and bodies like Kenya Medical Practitioner’s and Dentist Board (KMPDB). However KCEMT has trained more than 1000EMTs in Kenya and still training more and it is vigorously championing the interest of its members by advocating ambulance organizations and Accident and Emergency department in hospitals to employ EMTs who have been trained, certified and licensed with the council to be allowed to work in Emergency Medical Services.