Ambulance drivers, who did extra shifts and risked their lives while working closely with COVID positive patients, still struggle to sustain a living.
Bengaluru: Prakash Halli gets up at 6:30 a.m. every morning. He gets ready and reaches 100 Bedded MCH Hospital, Bidar, six kilometres away from his home, at 8:00 a.m. sharp. Even though his 12-hour shift ends at 8:00 p.m., he usually ends up working overtime and reaches home at around 10:00 p.m. But he feels that it is worth it since it is a government job.
Prakash has been an ambulance driver for the government-run 108 ambulance service for nearly 12 years. He was one of the 3,000 Arogya Kavacha staff members who had not been paid salaries for nearly three months. “After our dues got cleared at the end of February, we rejoiced. But now, we fear that we would have to live through the same conditions again,” Prakash said, expressing concern about not receiving a salary, again, for the past month.
Not receiving salaries on time is not the only problem that many ambulance drivers like Prakash face. When the pandemic started, these drivers became frontline workers and risked their lives while working closely with COVID positive patients. “The government promised to pay an extra Rs. 500 for every day that we took a COVID patient to a hospital,” Prakash said, “but only some drivers have received the amount owed to them.” He explained that nearly 40 percent of the amount owed to all ambulance drivers for their COVID duty remains due.
The sole bread-winner of his family of four, Prakash earns Rs. 12,000 per month. “There is only so much one can do with such little amount of money,” he said.
GVK Emergency Management and Research Institute (EMRI) runs 711 ambulances (dial 108) for the Karnataka state government under the Arogya Kavacha scheme. Out of these, 71 are operating in Bengaluru. These 108 ambulances are stationed across various hospitals in the city. The operational costs of these ambulances are supported by the government under the National Health Mission (NHM).
A few senior 108 ambulance drivers have received a 15 percent increment in their salaries as promised earlier, but a few unlucky ones like Prakash continue to work without a hike.
In 2016, when the Arogya Kavacha staff across the state protested demanding better pay and facilities, GVK-EMRI terminated a few employees. Prakash, leading the protest along with a few others, was one of them. “The company also filed an absconding case against us, and we remained unemployed for almost two years,” Prakash said.
Prakash, along with other drivers who were terminated, filed a court case against GVK-EMRI. “For two years, all we did was go to the court. The court finally ruled in our favour, and we were hired again,” he said. During the case, Prakash worked at an MRF tyre factory on a daily wage to sustain his family.
He had already worked for eight years before he was terminated. When he rejoined, the company had deleted his previous record of employment. “The increment is for senior drivers who have worked for more than 10 years. I have worked for 12 years and am still not eligible for the increment because of the termination,” he said.
The problems of ambulance drivers in government service may not end soon. Srishail Hallura, president of Arogya Kavacha Employees Association, explained that the arrears of many employees are yet to be cleared. “The confusion between the government and GVK-EMRI is the root of all problems,” he said. The association organises meetings in different parts of the state every month to address the grievances of the ambulance drivers.
GVK’s contract with the State government ended in 2018, but they were asked to continue the service till a new tender was floated. The tender is not yet issued, and GVK continues to handle all operations.
Naushad Ali Khan, Manager (call centre and supply chain), GVK EMRI, said that the payment of salaries is delayed because the government doesn’t release funds on time. “This ambulance service is fully funded by the government. We only bring in technology, leadership and management,” he said. “The pandemic has led to a delay in the release of funds from the government. Although a bit late, but we have paid the salaries for all the months,” he added.
Dr. Prabhudev Gowda, Deputy Director (EMRI), Health and Family Welfare Department, Karnataka, said that there are no lapses in the release of funds from the government’s side. “We have been releasing funds on time and GVK should own up the responsibility to give salaries on time,” he said. Reports suggest that the State releases Rs. 40.6 crore every quarter to GVK, out of which Rs. 5.6 crore is required for salaries alone.
Dr. Gowda added that the government has taken a call to increase the number of ambulance fleet with advanced technology. “The technical committee has given their opinion, and within the next two and a half months, we will float a tender and select a new service provider,” he added.
Private ambulance drivers tell a different story
Ahmed, an ambulance driver for Siddapajji Ambulance service, a private agency, spent most of his time sitting in an auto-rickshaw outside Bowring and Lady Curzon Hospital, chatting with his colleagues, before the second wave of COVID-19 hit Bengaluru. His ambulance, then fully covered in dust, acted as a canvas for people standing idle outside the hospital.
Ahmed has been in the business for four years. Since the pandemic, his income has been minimal. Ahmed said that he was lucky enough to get paid for his work during the lockdown. He received Rs. 38,000 from the government as compensation. But his main source of income were private hospitals, which paid him to ferry patients. With corporate agencies entering the emergency service sector, steady income became a dream for Ahmed.
Ahmed is not alone. Three kilometres away from Bowring Hospital, in a small park in Cubbonpete, four ambulances stood parked, their drivers waited for phone calls from their manager in a small one-bedroom-hall-kitchen flat, 200 metres away. Ramakrishna, an ambulance driver for Kaveri Ambulance Service, tried to pass time by scrolling through Facebook posts, sleeping, or watching videos. The sudden increase in the number of COVID cases has brought him out of that slump.
He was one of the ambulance drivers who were part of the protest in Freedom Park in February. They protested against corporate ambulance companies from neighbouring states which were taking over their jobs in Bengaluru. These drivers were hired by private hospitals earlier. The hospitals paid them for each patient they brought. Now, private hospitals like Fortis, Apollo, Ramiah, etc., have tied up with agencies like Stanplus Red Ambulance and are no longer contacting the local private agencies for ambulance services.
“Bengaluru already has over 300 ambulances currently being operated by local private players, why do these people from different states want to take over our job?” Chandu, manager of Kaveri Ambulance Service, and a member of Akhila Karnataka Ambulance Drivers Association said.
“These corporate agencies charge exorbitant amounts from patients,” Chandu said. “Red ambulance services charge nearly Rs. 5,000 for the same distance for which we charge Rs. 2,000. On top of that, agencies like these ask for a 30 percent commission from the drivers for each ferried patient,” he added.
The problems these local ambulance drivers face are synonymous with the problems of local auto-rickshaw and taxi drivers, who face competition from Ola and Uber.
Prabhdeep Singh, Chief Executive Officer of Stanplus Red Ambulance, explained that ambulance operators in the country have not purchased new ambulances for the last six or seven years. “Why would anyone take an Uber over local autos? Because of its safety, transparency and reliability. It’s the same with us,” he said. “Hospitals choose us because local operators have been fleecing them. They bring the patient to the hospital and stand there for hours till they are paid,” he added.
He explained that corporate agencies have a non-referral model. “Uber does not get paid when they bring a person to PVR, do they?” he said. He suggested that local agencies are protesting because they will have to increase their reliability and stop cheating the patients to stay in business.
“We give transparent prices to patients, our drivers don’t eat tobacco or drink while driving, they don’t wear shorts or chappals, we take care of their families, they have insurance, and we don’t cut corners when it comes to COVID,” he said. “Top hospitals across the country are moving to us because we are 10 times better experienced to take care of the patients than any local private agency that exists,” he added.
The way forward
Neethi P., Consultant, Academics and Research (labour informality and urban employment), Indian Institute of Human Settlements, explained that the best way for both the government and private set-up to move forward is to learn from each other. “Both these set-ups have different worker models and service mechanisms, and only one of these systems cannot be deemed the best,” she said.
Neethi explained that government ambulance drivers are a part of the formal sector. “They are assured that they will get their salary, even if it is delayed. They also have a grievance redressal system,” she said.
“Private ambulance drivers are employed in the informal sector,” she added. “Their work hours are more flexible but they face a lot of competition from each other. Their remuneration may be assured, but it is subject to the business they get.”
She suggested that both systems adapt and evolve to increase their efficiency and support the interest of their workers.
Most ambulance drivers come from economically weaker sections of society. Even after being employed in emergency services, their financial condition remains poor.
Prakash’s two-year-old son will start going to school next year. He still waits for his job to pay him decently so that he can pay the fees for his son’s schooling while taking care of the day to day expenses. Ahmed has finally wiped the dust off his ambulance and started spending time doing what he is passionate about – helping people in need. He is still worried about what might happen once this pandemic ends.