The feel of the city pulse with a day's ride in the 108 ambulance

On a hot summer morning, the inside of the ambulance was like an oven. The siren blared non-stop, and traffic on a street near the railway station moved sluggishly out of the way. But the man behind the wheel was focused completely on getting to the hospital as fast as possible. He wove dexterously around auto rickshaws, buses, bikes and cars.

In the back, a woman sobbed as emergency medical technician S. Kannan administered oxygen to the man lying on the gurney. In less than half an hour since the original call to 108, the ambulance had picked up the sick man and delivered him to hospital.

Intense

A day in an ambulance is a combination of intense adrenalin surges and hours of monotony. Kannan and M. Manickarajan, the ambulance driver, run the ambulance parked at the western gate of the railway station. “This spot gets a lot of calls,” said G. Thanigaivel Murugan, district manager, Emergency Management Research Institute (EMRI), mainly because several main roads converge here.

Kannan, 28, has been with the service for two and half years. In this time, he said, “we have seen it all.” That includes delivering a baby in the back of the ambulance and diving into the Vaigai reservior to save a baby girl, an act for which he was awarded the gallantry medal in 2010.

GVK EMRI, a non-profit organization, provides the free 108 ambulance service in partnership with the government of Tamil Nadu. The system consists of a call response centre in Chennai and a network of ambulances with trained personnel across the state who respond to medical, police and fire emergencies. Two people generally man an ambulance – the driver and the technician, both trained at the Chennai centre. 108 has been operating in the state for three and a half years now, and Madurai has 14 ambulances placed in strategic spots across the city. Last month, the district handled 1,699 calls. Of these, the railway station ambulance handled 155.

Kannan and Manickarajan's day begins at 8 am sharp. The ambulance always has its fuel filled and medical paraphernalia sorted and placed conveniently. Inside it is roomy. At the back, apart from the stretcher, there is a bench for relatives of the patient to sit on. This bench doubles as a cabinet to store a kit for deliveries, suction equipment, a cervical collar, splints, a non-inflatable anti-shock garment (for burns victims) and various other equipment.

A BP monitor and oxygen tank are fitted to one side; there is also an ECG monitor. On the other side is a disposal system for syringes, bandages and other waste. A portable oxygen tank, a wheelchair, emergency medicines and all sorts of other medical equipment fill up the back, all arranged so that they can be reached easily in a fast-moving vehicle.

Barely two hours after duty begins, there is a call for help. After a nerve-racking journey to the man's home and then the hospital, the ambulance trundles back to its spot at a much more sedate pace. Kannan and Manickarajan get out and rest a little. They chat while Kannan fills in his logbook, a register he has to update after every emergency.

Manickarajan, 36, began driving ambulances a few years ago. “Our training included first aid, ensuring scene safety and, of course, driving,” he said.

It is not easy to battle traffic, inch through narrow spaces and at the same time keep the ambulance as steady as possible so as not to jolt the patient.

“When we initially started here, people were completely unaware,” said Manickarajan. “They just did not realise that when an ambulance is using its siren it means there is an emergency situation. Over the years, though, with ample awareness programmes, it is much better. People now get out of the way – buses, cars, even autos. There are still a few here and there that do not give way, and in that case, we use the PA system to tell them to move.”

EMRI tries to ensure there is at least one local person in the ambulance team so that navigation in the city is that much easier, said Mr.Murugan.

Relentless

At 2 pm, a place is decided on for lunch. “We tell them not to go too far from the ambulance, just in case,” explains Mr. Murugan. Sure enough, while they're eating at a canteen nearby, the familiar ringtone erupts. A man is lying on the flyover in front of the station. Details are unclear, and Kannan asks the dispatcher to put him on a conference call with the original caller, even as lunch is disposed of. Running back to the ambulance, Kannan gets more details about exactly where the man is. Manickarajan is already driving.

A few minutes later, they find Karappiah, 54, passed out drunk. His clothes are muddy, his eyes bloodshot. There is a small wound on his left cheek and he seems unsure of what has happened. Kannan helps him into the ambulance, cleans his face and dresses the wound. He is a carpenter, Karappiah says. Someone beat him up. After taking his blood pressure and checking his vital signs (all normal), Kannan tells him to go home. Apart from the wound, he is fine.

(City3sixty is a monthly column that captures the different moods of the city)