For the want of an ambulance, lives are lost

Baby Mivuyo Damsesi clutches a toy ambulance in her grubby 2-year-old hands. Her mother, Noluthando Damsesi (28) says that it was given to her at the crèche she attends in Silatsha Village, 50 km from East London. This is likely the only ambulance the little girl has seen in her short life. On the night she was born, her mother went into labour late in the afternoon and an ambulance was called. Mivuyo’s grandmother, Nontangabomo Totwana remembers the day clearly.

“Normally my daughter joins me around dusk for supper but that day she did not appear,” says the 50-year-old grandmother. “When I checked on her, I found her writhing in pain and I realised that the situation was an emergency.” Nontangabomo rushed to a neighbour and called an ambulance but after hours of waiting, none arrived. Terrified, she walked her daughter to a neighbour and between the two of them they delivered Mivuyo safely. The ambulance never did arrive.

In her 2015/16 budget speech delivered in June 2015, Eastern Cape MEC for Health, Pumla Dyantyi, said “emergency medical services (EMS) play an essential role in responding to medical and obstetric emergency in the delivery of health services to communities and this compels the department to pull (sic) all efforts to build functional emergency services.”
Dyantyi said her department had, as of July 2014, increased the province’s ambulance fleet from 306 to 416 and was “coming closer to the ideal target of 656 for the province”.
She announced plans to “have designated ambulances for inter-facility transfers”, and clarified that the changes would include establishing inter-facility ambulance services to respond to emergency assistance to pregnant mothers, and provide dedicated MDR ambulances in order to prevent patients from coming into contact with XDR/MDR-TB (extensively- and multidrug-resistant-TB) patients during transportation. But the people of Silatsha have yet to witness the difference. Emergency services vehicles are a rare sight in this village. If they come at all, they often have no medical personnel and no equipment.

“This is no emergency”:
This was the case when Xolisile Sam lost his sister, Tumeka. Though he has told the story many times, it is clear the memory still haunts Mr Sam. His sister Tumeka was diagnosed with HIV in 2008 and began taking ARVs shortly thereafter. Her condition deteriorated at the beginning of 2014, requiring frequent visits to the Mooiplaas clinic, 10 km away.
Because no ambulance would come to Silatsha to collect her and take her to the clinic, her family was forced to use what little money they had to hire one of two cars available in the village to take her to the clinic, at the cost of R150 per trip. On 26 September 2014, the family had depleted their funds and even if there were money available, neither of the two private vehicles in the village was available to transport Tumeka. So Mr Sam was forced to rely on the emergency medical services call centre. He placed the call at 2 pm and was told that the ambulance would be dispatched.

Hours passed and Mr Sam called again only to be told that he was exaggerating the severity of his sister’s condition and that ambulances were for emergencies only. Still, he hoped that someone would come to his sister’s aid. At 11 pm he called again and was told that no ambulances were available, and there was no guarantee that one would arrive before the next morning. The family continued to hold vigil at their daughter’s bedside as she struggled to hold on. She survived till morning.

Mr. Sam, seeing no recourse, called the Daily Sun and an article appeared in newspaper the following day. Having read the story, an official from the Department of Health contacted Mr Sam and promised to send an ambulance. It arrived a day later with oxygen, no drips and no medical personnel. Tumeka was transported, along with others collected at Cefane, to Frere Hospital. “She was admitted but given no help,” says Mr Sam. “There was no doctor at the hospital on that day. Tumeka died few days later.”

Mr. Sam told his story at a Human Rights Commission hearing into allegedly poor emergency medical services in the Eastern Cape, held in March 2015. Following the hearing, the commission is due to make public its report, which contains recommendations for improvements to the system, in October 2015. Mr Sam is eager to hear the recommendations of the report but all he wants to see is better training for emergency services personnel so that others do not experience the level of disregard he feels his family received at their greatest time of need. •