Dena Rashed keeps up with plans to upgrade Cairo's quixotic ambulance service With the siren at its loudest and the driver pleading ever more desperately in the amplifier, there is only one thing to do: say a little prayer for the patient involved. It is not that people are unwilling to let the ambulance through: in the congestion there is really very little room for manoeuvre. Sometimes in Cairo traffic there is just nowhere to go. "We usually get there within eight minutes," says Hatem Abdel-Hakim, who has been a paramedic at the Cairo Ambulance Unit (CAU) for 23 years, "but when the bridges are crammed it is totally out of our hands". As it turns out, automobile congestion is not the only kind paramedics like Abdel-Hakim must face: all too often, at the scene of an accident, the crowd that has gathered is such it becomes difficult for them to do their job: "People are either blocking the way, or offering unnecessary -- for which read harmful -- assistance." According to CAU head Adel Azzouz, indeed, "I send seven or eight ambulances to the scene of a big accident, and they arrive one after the other. The problem is: people generally assume no more ambulances will be coming and cram all the casualties into one or two vehicles. If the paramedics attempt to stop them, they turn on them. In either case the consequences are terrible," he winces, "terrible." The only way to deal with this problem, as Abdel-Hakim explained, is for the first ambulance or two to wait for the rest and move the casualties into them. As Azzouz says, sadly, this is not the only way in which the public can be obstructive: "Over 90 per cent of the calls we receive are false alarms. People think we're just saying that but ask this young woman operator here," he ushers me into the CAU call centre, "who receives an average of 79 calls an hour. People think her tone is harsh but just think about the number of people testing out a new mobile phone on the free hotline: 123." The operator looks up. "Today the callers are on the whole polite," she remarks sarcastically. "They're just calling for a laugh." No sooner has she finished saying that than she receives a rude call, however. She often puts the phone on speaker mode so I can hear what's going on. If the call is not about an ambulance now, the rule is to put down the phone as soon as possible so you can give people a chance. Just think about children dialing the number over and over again for the fun of it or, what is worse, young men trying to flirt with a disembodied female voice, and try telling her she's harsh." Mohamed Sultan, head of the Emergency Unit at the Ministry of Health, cites the results of a recent study conducted at the centre: no more than 2.7 per cent of the calls are genuine. Charging the callers might help, Azzouz says, but it prevents those who need an ambulance from getting one. Perhaps mobile phone companies should punish those who harass the centre somehow. Raising awareness is the only real solution, Azzouz concludes, but it remains slower than other methods. In fact, upgrading the call centre is part of a bigger plan to improve the unit, whose annual budget has increased from LE30 to LE840 million, freeing it of dependence on uncertain grants. According to Sultan, Health Minister Hatem El-Gabali's request for funds with which to upgrade was enthusiastically granted by the powers that be. The plan aims to make one ambulance available per 5,000 city residents, and so it provides for 3,200 new vehicles, 500 of which are to arrive within a month. (Of the unit's 1,875, only 850 are less than 10 years old; 200 are being upgraded by the Ministry of Military Production). It also provides for safe driving campaigns and human-resource training, but perhaps the most important part of the programme is the campaign to raise public awareness to prevent fake calls. Also the CAU will soon introduce sophisticated software to assist the hotline operators to sift through the calls. For Makram Mounir, head of information and training at the CAU, however, the unit is also in dire need of qualified drivers: "The most important aspect of an ambulance is its driver. Currently we have a shortage because few long-term contracts were made available in the past, so we depend largely on what is in effect day labour, who could leave at any time." Some 157 highway units are being renovated and another 45 are to be introduced, with the ultimate aim of providing at least one unit within any given 20km distance. "We are also studying a new satellite tracking system," Sultan added. Perhaps the little prayer will be answered, after all.
