Is An Ambulance Donation The Best Way You Can Help?

"The siren of one ambulance can destroy Samaritan attitudes in an entire Chilean neighborhood"--Ivan Illich, Medical Nemesis

One of the more common development initiatives that EMS agencies undertake is the donation of ambulances. While at first this may seem like a worthwhile cause, realities on the ground offer significant evidence that these efforts are often far more detrimental to a health care system's progress than they are productive. To be sure, ambulances can have a significant, positive impact in a developing community's health care system. However, to ensure this, a thorough analysis of intentions, capacity and culture is absolutely necessary beforehand.

Donor Intentions

When considering the donation of an ambulance ask yourself, "Why are we donating this ambulance?" More often than not the response is, "Because we want to help." While that answer is typically true, in order to make sure the donation will in fact be helpful, it is best followed by the question, "Is this the best way we can help?" By honestly examining that question, an EMS agency can find solutions that will both fulfill its desire to help and to meet the needs of the community it wishes to support.

Experience has shown that ambulances are often donated because they have been replaced by a newer model. It's not because they no longer function, but rather they only have a few more years left in them, or they have a limited amount of miles on them before they are no longer serviceable. Of course, there are other situations including mergers, buyouts and station closures that can make ambulances available for donation. Nevertheless, conventional wisdom dictates that ambulances which can fetch a good return are sold, and those which cannot are prime candidates for donation.

Regardless of the event making the donation possible, it is important to first consider the functional utility an ambulance would have on North American roads, and then to compare what the same ambulance would have on roads which are far less accommodating, if they can be considered roads at all.

This is what should be reasonably expected by an agency that is about to commit to the significant time, effort and money it takes to donate an ambulance. The rest of this article will help to raise awareness of the challenges that developing communities experience as a result of donated ambulances, as oftentimes they are not aware themselves of the responsibilities and resources that running an ambulance demands.

Recipient Intentions

Just as the first question involves self-examination, a correlating question needs to be asked about the recipient, "Why do they want this ambulance?" This can admittedly be a difficult question to answer. Different cultures have different communication styles, and many times the individual who has solicited the donation is doing so more out of the assumed benefits of having an ambulance as opposed to an informed understanding of the actual responsibilities involved in operating one. There are endless stories of how wealthy businesspeople came to North America, saw the EMS system at work, and then believed that ambulances would solve many of their community's problems, without having fully understood the complex infrastructure needed to support an ambulance.

While this scenario could easily be explained as an uninformed romanticism, it is also possible that the individual who has solicited the ambulance for the local underfunded public hospital is fully intending to sell it to the wealthy private hospital across town. Therefore, it is extremely important that any ambulance donation takes place between known, trusted parties with ample means to ensure accountability. For example, providing ambulances to government officials who are about to end their term in office is clearly ill-advised. Likewise, it is also helpful to have the donation take place at a formal, public ceremony. Attracting local media is not only encouraged, but also relatively easy in most foreign communities, including capital cities. Similarly, creating a long-term partnership with the community to offer periodic trainings and a semi-regular supply of provisions also helps to create accountability and assists in ensuring the local's involvement in the operations.