NAS: critical health sector for frequent government support
The solidity of the National Ambulance Services (NAS) towards the provision of highest quality and cost-effective emergency healthcare to Ghanaians cannot be overlooked.
The Service, though faced with challenges, including inadequate source of funding and lack of basic infrastructure like office accommodation hoisted itself above its problems to deliver prompt and quality pre-hospital Emergency Medical Service (EMS)in Ghana.
The Ghana News Agency took a retrospective look at the functions of the Service to ascertain its relevance to the health sector and the way forward to ensuring continuous and efficient discharge of its duties without difficulties.
Establishment
Ghana’s EMS, in other words called NAS was established two decades ago but it now operates under the National Ambulance Service Act, 2020 (ACT 1041) which strengthened the young Service to overcome its challenges to make it one of the most reputable public health entities in the country with well-trained and committed staff.
Ghanaians could not forget the tragic football event between the two most glamorous clubs in the country, Accra Hearts of Oak and Kumasi AsanteKotoko Football Clubs which hit the country severely on May 9, 2001, where 126 spectators painfully lost their lives.
This led to the setting up of the Okudzeto Commission of Enquiry chaired by the prominent Ghanaian politician and Lawyer Samuel Awuku Okudzeto by ex-President John Agyekum Kufuor and among the recommendations made by the Commission was for the Country to establish a comprehensive ambulance system to attend mass public events to provide basic life support to save lives when the need arises.
Functions
NAS is mandated to provide efficient and timely pre-hospital emergency medical care to the sick and the injured and transport them safely to health facilities.
Statistics
NAS has saved many lives in the country and has created jobs for over 3,000 Paramedics and Emergency Medical Technicians (EMTs) in the Country.
According to its annual reports of 2018, 2019 and 2020, the Service attended to a total number of 51,981 cases.
The 2018 report indicates 7,687 cases that consisted of 3,957 females and 3,730 males.
At the same time, medical cases were 3,740, maternal, 1,726, trauma 1,761 and investigative (scan) 385.
But 6,039 cases that comprised 3,271 females and 2,768 males were handled in 2019.
The breakdown was 4,495 medical, 1,167 maternal, 1,328 trauma and investigative (scan) 49.
In 2020, there was a huge upsurge of cases as the Service recorded 38,255 which consisted of 19,849 females and 18,406 males, but medical cases were 18,789, maternal 9, 313, trauma 9,247 and investigative 906.
Brief history of the EMS
Pre-hospital EMS or Ambulance Service is out-of-hospital medical services rendered to people involved in Road Traffic Crashes (RTC), domestic or industrial emergencies and required immediate treatment and transport to the hospital for definite care.
According to a research affirmed by ‘Ogel and Duquesne, 1995’, the Service is believed to have started in 1487 when Spanish armed forces first used Ambulance emergency to transport casualties during the siege of Malaga by the Catholic Monarchs against the Emirate of Granada and as indicated by another researcher, ‘Shah, 2006’, the evolution of the EMS system therefore started to develop slowly.
But, in the late 1800s during the French civil war, Napoleon Bonaparte’s chief physician, Jean Dominique Larrey was cited to have organised system to treat and transport injured French soldiers which saw the beginning of modern EMS.
It was therefore documented as stipulated by Shah in his 2006 research that between 1960 and1973, several medical, historical, and social forces emerged and therefore led to the development of a more structured EMS system in the United States, United Kingdom, Germany, France, and other parts of the world.
Africa’s pre-hospital EMS
Pre-hospital EMS in Africa is known to have started in the early 1970s in South Africa and since that time other African countries like Ghana, Nigeria and Tanzania have followed with EMS systems and gradually advanced it on the continent.
Ghana is noted to be among the few African countries to set up an EMS system and the only West African country with a Paramedics and Emergency Care Training School at Nkenkaasu in the Offinso North District of Ashanti Region.
The establishment of the school started in 2004 with a pilot of only seven Ambulance Stations in Greater Accra, Eastern and Ashanti regions.
Challenges
The NAS is beset with challenges such as inadequate funding to function more effectively and lack of office accommodation for staff at its offices across the country.
Another striking challenge is the alleged meagre salary of its employees as some of them in the Bono Region who spoke to the Ghana News Agency on condition of anonymity claimed lack of risk allowance which they described as “not motivating for the job.”
Way forward
The NAS over the years has been supported by successive governments, but the peak of it was on January 28, 2020 when President Nana Addo Dankwa AkufoAddo handed over 307 state-of-the-art ambulances to it (Service) for effective pre-hospital emergency services in the country.
This massive boost to the Service led to the extension of EMS systems in all constituencies across the country, but notwithstanding this support, the pre-hospital EMSs in Ghana still have challenges that require the support of all stakeholders.
The field of EMS as the name implies is an emergency field and therefore requires dedicated and enthusiastic personnel to carry out its functions to expectation.
This however, calls for the provision of high remuneration as part of a good condition of service like other category of health workers under the Ministry of Health.
The upsurge of cases attended to by the NAS in 2020 could be attributed to the 307 ultramodern ambulances handed to the Service by the Akufo-Addo government.
Hence with adequate investment into the Service, saving human lives in an emergency could be fully assured.