Bhutan

Passing the buck at what cost?

Sep 20, 2017
Ambulance service is at the forefront of healthcare services.
 
That we see an average of two referrals every day from district health centres to the referral centres show that our ambulances are always on the move, providing critical service to the people. If we go by the recent figures, the frequency is even higher. With 3,268 patients referred by vehicle ambulance from January until August this year, ambulances transported at least 13 patients every day.
 
While it is good to see our health services reaching more people, the high number of referrals could also be indicating the health of our people. It also suggests the need to have more health workers who could cater to remote communities.
 
Given its vital role in helping patients receive medical care irrespective of the weather and road conditions, health workers from the dzongkhags raised concerns of inadequate maintenance budget for ambulance services.
 
They may not be wrong. As we connect more communities to road, accessibility to ambulance services would have increased over the years. With health services reaching more people in the unreached parts of the country and given the country’s terrain, the need for additional budget to sustain ambulance services must not be brushed off as a management issue.
 
Each ambulance is worth about Nu 4.3 million and, since they are imported from Japan, dzongkhags are challenged in getting spare parts. These concerns are valid and merits attention. Health officials in the headquarters say that its fleet of 118 ambulances is less than 10 years old and provided that the need for additional budget is justified, no authority would decline the request. They may not be wrong.
 
Perspectives aside, there is a need for the health ministry to assess these concerns from the dzongkhags. The issue may be with the ambulances now. Next time, it could be with the farm machinery, which is also brought all the way from Japan. But the agriculture ministry appears to be better prepared in terms of proving repair and maintenance services than the health ministry.  Now that the issue has been raised, it is hoped that the health ministry will keep its word and set up more automobile workshops in the dzongkhags to cater to the needs of the health centres.
 
Consider the cost of patient evacuation by helicopter. In the last eight months, the helicopter evacuated 84 patients, which cost Nu 
30,238,542. While it is understood that the patient’s condition determines the need for them to be airlifted or transported by road, the difference between the costs of transporting a patient by ambulance and helicopter cannot be ignored.
 
Studies have already found that Bhutan is one of the countries with highest patient care transportation expenses due to difficult  terrain. But there is only so much we can do about the terrain.
 
What we can do, however, is review the budget allocated to maintenance and repair of ambulances. Concerns from the dzongkhags where a majority of the country’s population lives must be heard.
 
Kuensel Online, September 20, 2017

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