With depleting Lagos ambulance points, vehicles, accident victims now at higher risk

Lagos State government’s desire to provide adequate facilities and care for its ever-increasing population and visitors, led to the establishment of the Ambulance Stations in 2011. Located in strategic points across the Lagos metropolis, these points served as temporary sites for accident victims to receive basic First Aid treatment before being moved to the appropriate hospital. They were to ensure that accident victims received quick medical care that would prevent their cases from deteriorating.

Thus, the fully-serviced points were positioned at Iyana-Itire, Adeniji-Adele, Abule-Egba, Anthony, Costain, Igando, Mile 2, Oshodi, Jibowu, Iyana-Dopemu, Mile 12, Ajara-Badagry and Third Mainland Bridge, among others.

On its website, Lagos State Ambulance Service (LASAMBUS), set up to provide pre-hospital care service, disclosed that 15 ambulance points were established throughout the state, with plans to add five more.

But this grand dream may have been lost, as some of the ambulance points are currently lying in ruins, while many that are still standing have no stand-by ambulance. The state government simply seems to have lost the zeal to carry on with this noble idea.

Indeed, many of the ambulance stations have either been pulled down and converted into other structures, or totally neglected that they bear little or no resemblance to what they used to be.

For instance, only the Third Mainland Bridge and Anthony ambulance stations presently boast of ambulances.

Those that have been pulled down or converted into other structures and overtaken by development include the Abule-Egba Station that got bulldozed during reconstruction of the Lagos-Abeokuta Road.
The ambulance station at Jibowu was also removed to pave way for the construction of a recreation centre that is not accessible to residents.

Also, the ambulance stations at Costain and Oshodi are in ruins. While the roof of the Oshodi ambulance station is missing, the one in Costain has been blown off, but is lying on the floor.

According to the World Health Organisation (WHO), about 1.3 million people die from road traffic accidents yearly. This is aside the fact that between 20 and 50 million more people suffer non-fatal injuries, with many incurring one disability or the other, as a result of injury.

Globally, road traffic fatality rates are the highest in the African continent at 26.6 deaths per 100,000, with Nigeria having yearly mortality rate of 20.6 deaths per 100,000 people, in comparison to the USA at 10.8 deaths per 100,000 people and the UK at 2.9 deaths per 100,000 people.

In Nigeria, between January and September, not less than 3,689 persons reportedly died from road accidents. A breakdown showed that between January and March 2020, there were 1,758 deaths; April to June 2020, 855 deaths; and July to September 2020, 1,076 deaths.

Recently, Secretary General, Nigerian Red Cross Society, Abubakar Kende, said 59 per cent of those who died yearly could have been saved, if they had received basic First Aid at accident scenes.

He said: “According to estimates by the British Red Cross, as many as 59 per cent of these people could have been saved, if they had received Basic First Aid on the spot. Even in countries with the best emergency services, it can take up to 10 minutes for an ambulance to arrive at the scene and help the patient or victim. This is a crucial 10-minute window of opportunity to save the victim’s life, and even with the most advanced medical care later in hospital; patients could still lose their lives.

An empty ambulance station at Iyana Itire

“The crux of the matter is ensuring that injured or sick people get quick and effective pre-hospital care, otherwise known as First Aid treatment before trained medical help arrives. Life saving First Aid is simple and could be as easy as putting an unresponsive person, who is breathing on their side and tilting their head back to open their airways.”

Kende explained that it could simply be applying pressure to a bleeding wound to help slow down the loss of blood. “Sadly, this is only done in less than half of most situations, as bystanders typically have no clue of First Aid and panic. Indeed, many victims of accidents have ended up suffering severe spinal cord injuries or may have been killed, due to the manner in which they were roughly pulled out of the wreckage of an accident by good Samaritans,” Kende said.

According to medical experts, pre-hospital care management is integral to improving patient outcomes, particularly victims of Road Traffic Accidents (RTAs) because previous studies have shown that mortality rates could be up to 5.5 times higher in RTA victims without pre-hospital care.

In Lagos State, the government agency saddled with the responsibility of providing pre-hospital care for accident victims is the Lagos State Ambulance Service (LASAMBUS). The body became especially germane because of the increasing urbanisation and industrialisation, which has led to an appreciable increase in the number of road traffic, industrial and marine accidents, as well as medical emergencies.

In a research on the activities of LASAMBUS, titled: ‘Lagos State ambulance service: a performance evaluation’, by some scholars published in March 2020, it was revealed that LASAMBUS did not address 53 per cent of the RTA calls it received, of which false call accounted for 26 per cent and crash already addressed accounted for 22 per cent.

It was also stated that the average response time of each LASAMBUS call was 17.0 mins (seven to 60 mins), which was described as being alarming, playing a part in the increasing mortality rates. The researchers said constantly increasing the number of ambulance stations would simultaneously decrease response time and increase proximity to RTA sites.

Director, Training and Disaster Management, Red Cross Society, Lagos, Mr. Oladimeji Ige, said it is important that government sustains the philosophy behind creation of the ambulance points all over Lagos, so that accident victims and people who are vulnerable can get assistance and First Aid support promptly, thereby saving lives.

He noted that the issue of non-availability of ambulances at strategic points could be solved through sustainability of the policy. While lauding the state government for initiating the project, he said success could only be achieved, when government, communities and humanitarian organisations partner to support the vision.

He said: “There should be ambulances in strategic areas of the state, so that when disaster strikes, the response time can be reduced to the barest time. It does not have to be only ambulances; motorbikes could also be stationed to get to the scene of the accident quickly. It is important for us to partner with community members, so that they would know what to do, when there is an emergency, rather than people crying and taking pictures, because they do not know what to do. If there is partnership between the community, government and other relevant stakeholders, we would have a better way of managing the project.”

Ige explained that an accident victim should be able to get help, less than five minutes after the event. “Even researches have proved that when someone collapses and people around can give simple first aids and Cardiopulmonary Resuscitation (CPR), and the ambulance arrives on time, the chances of the accident victim surviving is about 85 per cent.

“So, it is important that government, public and humanitarian organisations partner, so that we can give better and quality assistance to accident victims.”

He advocated that average Nigerians should be taught and know what to do, when there is emergency, which are unavoidable in any community. However, if an average community member knows what to do before an ambulance arrives, it would be better for all concerned.

A medical doctor, Akintayo Adebayo, said medical emergency and /accidents do not give notification before they happens, which is why it crucial that ambulances be stationed at various points in the city, as part of emergency response and preparedness.

He said: “In emergency response, time is of great essence. Many times, people involved in accidents would have survived, if first responders (medics) and ambulance had arrived promptly for triage and management. Also, medical emergencies, such as heart attack/ cardiac arrest and cardiovascular accidents can occur at home or anywhere.

“Obstetric emergencies can also occur at several other places, aside hospital environment. We have had cases of pregnant women who went into labour in market places, on the street, and sometimes on buses. Availability of functional ambulance in these scenarios will definitely improve access to emergency care, thereby reducing morbidity and mortality.”

Adebayo noted that Lagos State government has performed remarkably well with LASAMBUS initiative. However, the government cannot do it alone, therefore it is important to develop a strategic framework for collaborative partnership with NGOs, CSOs, religious organisations, corporate bodies and other stakeholders to improve access to emergency care and ambulance services.

“Aside this, there is an urgent need to develop and adopt planned preventive maintenance culture for ambulance supported with an endowment fund, which can also be deployed for replacement of worn-out/old ambulances,” he stated.

The Commissioner for Information and Strategy, Mr. Gbenga Omotoso, said the state is planning a reformation of the ambulance service, as LASAMBUS is going to be reformed and equipped with new ambulances, aside refurbishing damaged ones to make the service more accessible to people.

“It is being discussed at the highest level of government, with plans to equip the agency with new equipment and stations. The service is going to be expanded and made more efficient than it used to be,” Omotoso stated.