Before lockdown on 24 March, ambulance call-outs were averaging 185 runs per day. From end March until mid-April call-outs were running at 1,537 per day. This is an astonishing 8 fold increase in demand.

 

Due to this sudden upsurge in calls, NAS increased on-duty dispatchers from 2 per shift to 4.

 

One explanation for this increase might be the unavailability of any other means of transport (public or private) due to the enforcement of lockdown regulations. It is also possible that word-of-mouth hearsay about NAS competence with suspected Covid-19 patients may have been a factor.

 

This significant jump in demand for NAS may mark an important strategic turn for Friends of Nepal Ambulance Service. Since its inception FoNAS has sought to promote awareness of EMS across Nepal, increase ambulance call-outs and build a community wide knowledge base in first aid. Ironically the pandemic may have helped FoNAS advance those goals.

 

FoNAS has long been concerned with the underutilisation of NAS ambulances. It was initially completely mystifying that seriously ill patients would forego an ambulance with trained emergency medical technicians and instead opt for a taxi.

 

Subsequently FoNAS studies have shown that there is very little understanding about EMS and that this is a strong barrier to patients accessing definitive healthcare in a timely fashion. 

 

Because there is so little understanding of EMS – or even the value of first aid – many patients present very late to hospital despite a time critical illness. They do not call for help in many cases because they simply do not realise how unwell they really are.

 

An important part of the chain of survival starts within the community. Patients need to recognise they are unwell or badly injured, and that basic first aid and calling an ambulance is an important part of improving their outcome. 

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FoNAS research will continue to pursue an understanding of the cultural impediments to using NAS ambulances and we will share that research with you in these pages.

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FoNAS also plan to use precious donor funds to support an awareness raising campaign about emergency medicine in Kathmandu. Once the campaign is launched this page will keep donors fully informed.

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