Ambulance driver training in Tansen

Hi! We are starting our blog posts again – after not having added any new ones during our 18 months in the U.S. Thanks for reading this story from Les!

Being an ambulance driver in Nepal is a hard job for several reasons.

The roads are very bad. Anywhere they are going, there is a possibility of the road being closed with a landslide or construction, and often there is no alternate route.  Many roads are unpaved and rough. There is always the risk of losing control.

The salary is not great.  The driver is a low-level staff member of the health post. The money will get some food on the table for the immediate family, but is not enough to pay for higher education for their children or to build a larger house. Most of these drivers live in the village close to the health post they are assigned to, in a traditional Nepali home made from either cinder blocks or bricks. They may not even have a refrigerator and certainly no microwave or washing machine.

The ambulances are “on call” all the time. The only driver at the health post does not have any time scheduled off, and needs to respond whenever there is a call, day or night.

But worst of all, the drivers are usually the only staff in the ambulance with the patient and their family member(s). These men (I have not yet heard of a woman doing this job.) are often the only person at the accident scene except maybe for a police officer. They have to load up the injured and drive them to a facility with no medically trained person to help them. Even transporting a seriously ill person or woman in labor from a home or health post to the hospital is done alone.

So, it is not surprising that they can get frustrated.

Our hospital also has an ambulance, as required by the guidelines from the government. Our 3 drivers take turns being on ambulance duty. The rest of the time they are driving the other hospital vehicles or helping in the workshop. Han (name changed) is one of them. He is a friendly, talkative fellow with a bit of initiative. He is the chairperson of the district ambulance drivers’ association. He was talking to our hospital director one of the times he was driving her (not in an ambulance!) and suggested giving some training to the members of “his” association. She thought the idea had merit.  She spoke to me, as the training coordinator, and I discussed it with our clinic in-charge. Since we had never done this before, we made up a one-day course, which Han thought was a good idea, and he started inviting his friends.

The training happened last week, with 14 drivers participating, and 3 of us doing the training.  We had classes and skill stations on initial trauma care and stabilization, dealing with deliveries and resuscitating newborn babies, managing oxygen cylinders and intravenous infusions, and getting victims safely out of crushed cars. Everyone practiced the skills enthusiastically. At the end, I asked for feedback, since this was the first time we had done such a course. It was hard to get anything negative out of them.  When pushed, they said, “I wish you had done this 20 years ago.” “I had no idea all the things I could be doing to help patients myself.” “Why isn’t this required of all ambulance drivers when they are first hired?”

After taking the requisite group photo and handing out certificates, everyone went home happy. I don’t think this kind of course will be sanctioned by the authorities in Nepal anytime soon, since so much emphasis is put on qualifications here, and none of these drivers have any medical qualifications. But I believe that ambulance transports in this part of Nepal will now be a little better because of this course.