A recent review of ambulance services at several major healthcare facilities in Sierra Leone has uncovered significant operational and maintenance issues that are hampering effective service delivery.
At Connaught Hospital, it was noted that despite its large size and the high volume of patients, the facility only has two ambulances for referrals. Furthermore, there is no clear policy guiding the operations and maintenance of these vehicles. The hospital charges fees for ambulance services—NLe500 within the Western Area and NLe600 for destinations outside the area—yet records such as movement logs, receipts, and bank statements related to the revenue generated were not made available to auditors.
The National Medical Supply Service (NEMS), which operates a fleet of over 100 ambulances, also faces numerous challenges. Many of the vehicles, purchased during the Ebola outbreak nearly ten years ago, may have exceeded their useful lifespans. Over 17 ambulances were reported to have been involved in accidents and were undergoing repairs at the time of the audit. Additionally, 93 ambulances were found to have empty oxygen cylinders, and 21 lacked global positioning system (GPS) tracking, which is crucial for navigation and efficiency.
At Jui Government Hospital, the situation was equally concerning. The facility relies on just one ambulance for referral cases, and should it break down, no alternative vehicle is available to meet urgent transport needs. Compounding this issue, the utility vehicle used for administrative purposes was reported to be faulty, and the only available ambulance was also being used by the Hospital Secretary for personal commuting.
The 2023 audit report has recommended urgent action to address these challenges. The Medical Superintendent, Chief Medical Officer, and Permanent Secretary have been urged to collaborate on developing a comprehensive strategy to improve the management of ambulance services and ensure that these critical resources are properly maintained and efficiently operated. This would enhance the overall delivery of medical services across the affected institutions.
