Restoration of Emergency Ambulance Service in Assam

Manoj Kumar Sarma

(The writer is Advocate & Administrative Consultant, He can be reached at 9864102213/9854047448)

Considering the increasing number of road accidents in Assam, Emergency Ambulance Service can play a significant role in saving lives of many. GVK Emergency Management and Research Institute (GVK EMRI) is an emergency response service operating in the Public-Private Partnership (PPP) mode which has been providing service at the national level to different States of our country. It is a completely free service, anywhere in the operational States which can be availed by dialling the toll-free number 108 for any emergency. This service was started in 2005, which however was available to people of Assam upon signing a memorandum of understanding (MOU) between the Government of Assam and the GVK-EMRI on July 2008.

The number of existing surface ambulances under this service is 380 of which a few are not functional now. The number of boat ambulances operational in the State is five as per records available. While the people living in char areas have been benefited by the services provided by the services of Boat Ambulances, people living in the urban and rural areas have been helped to a great extent by the service rendered by 108 services. The 108 services have undoubtedly proved its competency in providing pre-hospital care and have been contributing in saving life of a good number of people by bringing them to the hospital before situation become critical. This service has become very popular in Assam for a short period and helped in changing the attitude and perception of all people in health delivery mechanism.

However, one ill effect that was visible in the health scenario of our health care system was that with the introduction of 108 services, the ambulances that were lying at the disposal of Health department, which was available in the PHCs, district Hospitals or FRU’s were not maintained properly. This resulted in a situation where most of the department ambulances that were provided to hospitals remained inoperative, although technical defects in those ambulances were not that major. Under these circumstances, people had to rely on ambulances run by private operators which were not affordable to many.

While 108 services helped the people of Assam in cases of accidents, trauma and emergency cases which need immediate hospitalization, the recent spurt of events leading to an indefinite strike by employees of GVK-EMRI 108 Mrityunjoy has become a matter of concern. In the absence of this service, the number of deaths on account of accident and trauma is likely to go up. The worst sufferers would be those who are from the remote rural areas and those who cannot afford private ambulances. Expectant mothers who need to be moved to the nearest hospital for safe delivery would be the other group of sufferer and in the event of a number of pre-natal deaths going up, our State would earn a bad reputation in the country.

The All Assam 108 Mrityunjoy Employees Association has alleged that the Hyderabad-based company has flouted norms with regard to conditions of service of employees only to ensure maximum profit for the company. It is alleged by the association that there has been an acute shortage of staff because of which employees are compelled to put 12 hours of service, instead of mandatory eight, thereby violating the statutory Labour laws. Social security in the form of PF, ESIC facility is not provided to the employees and they do not have service rule as of now because of which they are victims of exploitation. It is alleged by the Association that GVK-EMI did not get the service rules certified by the Labour Department, which if true is a serious matter. It said after it brought the discrepancy to light, the department recently certified the service rules under the Industrial Employment (Standing Orders) Act, 1946.

But the new service rules are yet to come to effect even after eight months. The principle of equal pay for equal has also been violated according to the Association. While the exact terms of MoU between the Government of Assam and the GVK-EMRI is not transparent for the people of Assam, it is not out of place to mention that on previous occasions also employees of 108 Mrityunjoy had alleged that incidents of manhandling of Ambulance staff had taken place due to shortage of human resource and poor administrative machinery at the call centres of the Hyderabad-based company under which they are working. The employees have also alleged that their increment was stopped in the financial year 2015-16.

The present situation is highly alarming with the employees expressing apprehension that the company might leave Assam with the end of the agreement which falls due in a couple of months from now. It was the expectation of the people of Assam that Government would look into the just demands of employees by taking up the issue with GVK-EMRI.

However, contrary to expectation, the State Government instead of taking up the issues of violation of labour laws by the company, decided to tackle the agitating employees by use of force. This amounts to injustice which an ordinary citizen having respect for the Rule of Law would not support.

While, the Health Minister of our State preferred to remain silent over the present impasse for a long time, some private ambulance services took the opportunity of reaping the benefit out of the existing situation.

What the administrative heads of NHM of our state spoke was that it is an internal matter between the employees and the company which was indeed not expected by people of the State considering mainly the point that most of the employees in service with GVK-EMRI were from Assam.

Whatever it may be at the political level, one thing which is certain is that this agitation is going to have an adverse impact on the health delivery system. At a time when the Central Government is talking of schemes like Atal Amrit, Ayushman Bharat etc. which have drawn applause from the majority of people, especially the economically marginal section of the society, any down play by the Government to undermine the just demands of the agitating employees might tarnish the image of the Sonowal Ministry of Assam.

People expect that Government would intervene immediately to take a right step to diffuse the present situation and do the needful to put the emergency service back into track. In this connection, the recent announcement by the State Health Minister that he would discuss across the table the issues of the striking employees is indeed a good development. Considering the need of 108 services, the Government should not provide a scope to the agitating employees to think that they would be left “high and dry” in a couple of months from now. Till the time a solution is found to the present impasse, the Government should explore the possibility of making alternative free ambulance service to the people of the State to minimize their economic and mental hardship.