Project Summary
In November 2007 St John Zambia received a donation of an ambulance to help them operate more effectively in delivering health services to the local communities where they operate. The ambulance will be based in St John’s headquarters in the impoverished community of Matero in Zambia’s capital city of Lusaka.
The primary function of the ambulance will be to attend road traffic accidents; although it will also be used to transport other emergency cases, mostly maternal, to the city’s University Teaching Hospital. Having operated for so many years without an ambulance, St John Zambia are understandably very appreciative of the donation and keen to ensure that it operates in a cost effective and safe manner.
The Problem
For so many years Lusaka District health centres and hospitals have been operating with very few ambulances - as of August 2007, only one functioning ambulance was available to serve 1.7milion people in the district. Drinking and driving, non compliance of seatbelt regulations, poor road infrastructure and excessive speed has made Zambia’s roads incredibly treacherous. The ambulance donated to St John is a timely gift to the local communities and will help save many lives.
The Process
Through discussions between Transaid and St John it became clear that St John was committed to investing in building their human resource capacity in order to utilise the new ambulance as efficiently as possible so in turn, it can service the community with optimum effectiveness. Early focus areas were the training of ambulance drivers, development of a transport policy, and implementation of basic transport management tools to record data such as fuel consumption and maintenance costs.
Driver Training: To satisfy St John’s requirement for driver training, Transaid facilitated the execution of a training course utilising one of Transaid’s partners; Tony Walsh a senior instructor who has much experience delivering driver training courses throughout Africa. The course covered the following topics:
• Basic Vehicle Handling
• Defensive Driving Techniques
• Advanced Driving Techniques
• Driving at Night or in Poor Conditions
• Attending Road Traffic Crashes
• Completion of Log Sheets and other Administrative Duties
• Daily Vehicle Inspections
Ten drivers attended the 2 week course, one of whom has been designated as the full time driver for the ambulance whilst 5 were part time volunteer drivers for St John. The remaining 4 were two drivers from the Lusaka District Health Management Team, one driver from Zambia Police’s Emergency Response Team and one ambulance driver from University Teaching Hospital.
Transport Management: During a series of training sessions, Transaid was able to work with St John to develop a suitable and comprehensive policy to guide use of the ambulance. The policy covers issues of vehicle security, completion of log-sheets, health and safety, and maintenance.
Transaid also developed a basic Transport Management System (link to transaid TMS) for St John and delivered training to key administrative staff on the system’s use. The system will allow for the collection and analysis of the following 7 Key Performance Indicators (KPIs):
• Kilometres travelled per vehicle
• Fuel utilisation per vehicle
• Running costs per kilometre
• Availability
• Utilisation
• Needs satisfaction
• Safety record
The Results
With the Transport Management System in place, collection and analysis of Key Performance Indicators (KPIs) can commence. Over time, with the appropriate interventions successful use of the system will deliver the following benefits:
• Greater vehicle utilization – less vehicles doing more
• Reduced maintenance costs
• Reduced maintenance time
• Reduced expenditure on fuel
• Faster response to vehicle demand
• Longer vehicle life
The benefits of the training for the drivers will be:
• Reduced Fuel Consumption
• Reduced Maintenance Costs
• Reduced Number of Road Crashes
• Reduced Downtime for Vehicles
Results Update
Six months after implementing the monitoring system St John have discovered that the most common cases of patient transfers using the ambulance are maternity cases which involve transporting pregnant women to hospital. They have also used the vehicle to attend a number of road traffic accidents. St John can now determine the average running cost of the vehicle which enables them to charge the correct fee to users. The data collected has shown that there is a significant amount of unused capacity to help the local community and St John will now focus on increasing utilisation of the vehicle. The vehicle has suffered no damage since they began using it and recently underwent its first service.
Impact
Effective management of the ambulance will serve to enhance and prolong the impact which this vital asset can have upon health service delivery – increasing capacity and giving more people access to health services.
“With this professional training I am confident that myself and my fellow trainees will be able to drive more safely and as such service patients more effectively.”
Hastings Kamanga, Zambia Police Emergency Response Team
“I am delighted that the drivers will now be able to operate the ambulance more safely, with a more safety conscious attitude resulting in less risk of damaging the new vehicle. The Transport Management training and system will allow us to manage our new vehicle and show our partners that we have complete control over this valuable item.”
Caroline Mweemba, Chief Executive Officer and National Coordinator, St John – Zambia.
For more information about this project please contact our Southern Africa Programmes Manager, Gary Forster at garyjforster@hotmail.com, or contact us at +44 (0) 20 7387 8136
