The death of former Education Cabinet Secretary George Magoha has, once again, brought to the fore the ambulance crisis in Kenya.

Though a booming business for those who own them, a number of Kenyans have found themselves in urgent need of medical assistance and lost their lives due to an acute shortage of ambulances.

A section of medics believe that, had a well-equipped ambulance been available, Prof Magoha’s life might have been saved.

It is reported that the professor’s son was forced to drive him to hospital in a personal vehicle after unexplained delays by an ambulance they had requisitioned.

Health sector analysts believe that inadequate emergency services are the main cause of thousands of deaths every year.

If these lifesaving services were unavailable for a renowned national figure, what about the majority of Kenyans? Hundreds of road victims and the sick are forced to wait for hours for help.

Waiting in vain

In 2020, Fredrick Ouma Omondi lost his wife and child after waiting for an ambulance for six hours. Omondi had taken his wife to Ukwala sub-county hospital where she spent a night before she was referred to Siaya County Referral Hospital.

“The medics assured me that an ambulance would be there in 30 minutes, but six hours later, none was available. My wife later died while the doctors were operating on her to remove the baby,” he said.

Fred Majiwa, the head of programme and emergency medical services at St John’s Ambulance, says one of the things afflicting concerned Kenyans is shortage of ambulances and the hefty fees that majority of hospitals demand beforehand.

“There has been no stock taking on the number of ambulances available in Kenya. But Nairobi has approximately 100 ambulances, the majority of which are owned by private hospitals and private investors. The close to 4.3 million Kenyans living in Nairobi have to rely on these 100 ambulances,” he laments.

Ideally, one ambulance should serve about 7,000 people but that is not the case for the majority of the counties in Kenya where a single ambulance services a population of close to 100,000 people.

In fact, Nairobi is doing much better compared to other counties where ambulances lie “dead “in the hospital facilities.

With such few ambulances, Majiwa says, the chances of getting one in times of emergency are slim. That is why the majority of Kenyans use other means to ferry patients to hospitals.

“An ambulance has special equipment akin to an ICU. Ferrying patients in personal cars and even bodaboda is highly discouraged, yet it is the only option most Kenya’s have,” he says.

Majiwa adds: “The majority of emergency phone numbers are also unreliable; they go unanswered or take ages to be answered. In emergency cases, the first few minutes are critical. When a call centre delays in responding, the whole process becomes flawed,” he says.

A spot check on several emergency numbers, starting with 911, proves Majiwa right. It took five minutes before a customer care at the National Emergency Centre picked our call. On inquiring how long it would take to get an ambulance in Machakos, the responder said: “It depends on availability of an ambulance”.

Most of the numbers listed for public hospitals went unanswered while some were non-functional.

Those lucky to get ambulances are usually required to pay up-front by hospitals and service providers. Ambulance services cost between Sh5,000 and Sh10,000. While this might seem small, not so for many Kenyans who live below one dollar a day.

Majiwa notes this issue could be easily settled if these services were included in health insurance covers. He says emergency services are included in NHIF cover but mainly for those in a particular “super-cover” category.

Those with private insurance covers have to go through the bureaucracy of clearance before they can call in an ambulance.  When lucky to get an ambulance, the patient has to battle to hospital through congested roads and unruly drivers.

Traffic jams

“Despite ambulances having priority on the roads, it is a tough task making their way through. They get stuck in traffic and have to wait to be cleared. Many Kenyan drivers are also reluctant to give them way.

The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) Secretary General, Dr Davji Atellah, describes the state of emergency services as pathetic. “Despite the presence of ambulances at health facilities and strategic locations in Kenya, when such care is needed, they are unavailable,” he said.

Atellah adds that another crisis is lack of a trained paramedics dedicated emergency services. “Many hospitals lack emergency services, while the few that have them are not up to date,” he says.

“Public facilities should have at least two fully-equipped ambulances. These should be placed at strategic points, “he says.

Sadly, many Kenyans lack knowledge on the available emergency service, says  Doctor Ahmed Kalebi. “Even people in urban areas don’t know how to access emergency services,” he notes.

Majiwa says St John’s Ambulance, which he works for, offers free emergency services, adding that both national and county governments should buy more vehicles.