In dire need of an Emergency Medical Service

When as a child my mother returned from a trip to Cairo, I asked her if Egypt was more developed than Nigeria. She asked me what I understood by ‘development’. I was surprised she was asking me what seemed like a no-brainer and went on to answer the question the best way I knew how. I asked her how the roads were, and if they had modern buildings etc. This was my understanding at the time of what ‘development’ meant. Now, I think I have a bit more insight into what this term means. In light of this, can I ask you, our esteemed readers at what stage of development do you think our country is – if there is no functional emergency medical service in the country. To make the question simpler – if driving on Ahmadu Bello Way in Abuja and you see a major motor accident – what number do you call? If you cannot answer this for Abuja – tell me if you think there’ll be a number in Jalingo, Abakiliki, or Birnin Kebbi – all state capitals in our once great country.

Last week, some newspapers (Leadership, Vanguard, Daily Trust etc) reported with a lot of fanfare that our Federal Ministry of Health is partnering with the Israeli government and is sending a delegation of doctors from the University Teaching Hospitals of Abuja, Jos, and Maiduguri to Tel Aviv for a 2-week training course. This has been apparently facilitated by a group called YBF Nigeria, the training arm of PlusFactor International Ltd (no website was found).

But really? After all the bombs, the continuous stream of accidents on our roads….all they can really do is send a group of colleagues on a 2 week training programme to Israel? Yes – the Federal Road Safety Corps have ambulances dotted around the FCT – but these are manned by drivers! If you expect any of these to render first aid…think again! Secondly, and more importantly – an emergency medical service – contains 3 words that are critical;

1. It must be available and accessible in emergencies.
2. It must be led by medical professionals.
3. It must be a service – integrated from the point of patient collection, to the nearest hospital with all the
    emergency care facilities i.e a fully functional surgical theatre.

So far in 2012, 52 years after independence there is no functional “Emergency Medical Service” in Nigeria. Terms like ‘The Golden Hour’ and the ‘Platinum Ten Minutes’ that define Emergency Medical Services all over the world are practically irrelevant in Nigeria. It is a well-accepted fact that a patient who receives basic care from trained professionals, and is transported to the nearest healthcare facility within 15-20 minutes of an emergency has the greatest chance of survival. EMS is an essential part of the overall healthcare system as it saves lives by providing care immediately.

So, how have other countries at a similar stage of development dealt with this – where governments fail. I looked at India – and forund this fascinating service called Dial 1298 Ambulance. This model works on the principle of cross subsidisation, where the ambulances are are made self sustainable by charging the end user a charge which differs based on the choice of the destination. A patient going by choice to a private hospital pays the full charge, while a subsidized charge is paid by a patient going by choice to a government / municipal hospital. Free service to accident victims, unaccompanied unconscious individuals and victims of mass casualty incidents. Listen to the fascinating TED talk by the Founder here.

So…..if our government has failed what of the private sector in Nigeria – renowned for its entrepreneurship? So you can imagine my excitement when I found this advertisement in “Businessday” recently.

I looked through their website and looked up the services they offered. These are listed as:

We offer the following services to Corporate Organizations and individuals:
> Dispatch Services
> Air ambulance services
> Events Stand by

…it was immediately obvious that this was not really the type of emergency medical service I had envisaged it was. No wonder it was being advertised in Businessday. So, the struggle continues. Nigeria remains in search of an emergency medical service – any takers out there?

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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