Bringing ambulance service to millions who never had a chance

Posted October 11

I met a wonderful gentleman this summer. He would not want me to focus this column on him, so as you read imagine hundreds of people who share the goal of saving lives in Pakistan. Ahsan Jamil, CEO of Aman Networks, and his colleagues are committed to providing better health care access for millions living (and dying) in the slums and neighborhoods of Karachi, Pakistan.

The originator and main funder of Jamil’s project is the Aman Foundation. Aman made the original resources available to start a service that provides this city’s population with an opportunity it never had before. Aman has started a company that has over 80 fully equipped ambulances whose services are affordable to the poor. With well-trained staff, essential resources available on board, and quick response times, the ambulances have successfully worked to reduce the estimated 40 percent of preventable deaths in Pakistan through their 600,000+ interventions to date.

The Aman Foundation ambulance business not only employs over 750 emergency medical technicians and more than 100 doctors to operate its ambulances, but it also has educational programs in place to train students to fill similar roles. The company addresses the needs of the poor in Karachi and fights to reduce their challenges in remarkable ways.

Aman Ambulance, Pakistan’s first state-of-the-art ambulance network, provides 24/7 emergency medical services with an average response time of eight minutes. This is an admirable achievement in a city where in the past many sick and dying people called informal taxis called rickshaws to get them to the hospital.

But, like many social enterprises that are started by foundations, it was not clear what Aman Ambulance would do to create long-term viability. Providing low-cost service to the poor, who often do not have the ability to pay full-cost for such service, is a difficult business to sustain. However, they found an innovative solution to this problem of sustainability.

Aman Ambulance is part of a broader effort started by the Aman Foundation. The broader effort is called Aman Health. The other main component of the effort is known as Aman Telehealth. This service responds, over the phone, to the health care needs of mothers and children who receive triage assistance telephonically.

Initially, as is the norm across the world, the ambulances had doctors and nurses as operational staff on the vehicles. The introduction of paramedics seemed like a good idea, not only to streamline services, but also in terms of saving cost. To train the new additions to the staff, the Aman Paramedic Academy was launched in 2012. Conducting training sessions led to the realization that within the sphere of health, ambulance drivers and community health workers also needed to be trained according to international best practices. These individual training initiatives morphed into the Urban Health Institute (UHI), a training center for all of Aman Health, not just the ambulance employees. This training has not only increased publicity for Aman Health, but has gone a long way towards providing sustainability to the business. People from outside Aman are willing to pay for such training. All of this contributes to UHI becoming a center of excellence for medical safety and training, and in the process a recognized institute with the relevant accreditation.

In October 2014, the prestigious “Best Asian Emergency Medical Service Award” was conferred on Aman by the Pan-Asian Emergency Medical Council. Thanks to innovative thinking, this service is now on a sustainable footing. And the training program that both funds and staffs the ambulance service contributes more broadly to the improvement of health care in the area by making high-quality training available to other organizations and individuals.

John Hoffmire is director of the Impact Bond Fund at Saïd Business School at Oxford University and directs the Center on Business and Poverty at the Wisconsin School of Business at UW-Madison. He runs Progress Through Business, a nonprofit group promoting economic development. Julia Mahterian, Hoffmire’s colleague at Progress Through Business, did the research for this article.

John Hoffmire teaches at SaÏd Business School at the University of Oxford.


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