Rethinking Emergency Services

On the 15th of January 2009, the world applauded the miraculous survival of all 155 passengers aboard a US airways (Airbus A320) flight 1549, which crashed into the Hudson River. A combination of masterful airmanship by Capt. Chesley Sullenberger, the rapid response of the New York City’s fire and police services, and the other commercial vessels in the vicinity of the accident; ensured that necessary assistance was provided in good time. This saved everyone aboard the plane. If a similar scenario was replicated in Nigeria, and a plane crashed into the River Niger after taking off from Asaba international airport, are you confident that all the passengers will be safely rescued? Or do you simply dread the very thought of it? The reality in Nigeria is that emergency services have been neglected and underfunded over the years resulting in uncoordinated and sub-standard platforms.

Emergency service providers are mandated to ensure and protect public safety and health in times of distress. They are made up of the fire, police, medical and rescue services which are categorized as public in nature. Traditionally, these services are provided by the government, either directly through the public sector or indirectly by funding or subsidizing the services. Emergency services are to be enjoyed by everyone within the government’s jurisdiction, regardless of their income. This understanding of the benefits of emergency services meets the academic and theoretical characteristics of public goods which states that “public goods are non-excludable and non-rivalrous in consumption”.

If there was a fire engulfing your neighbor’s house right now, what number would you dial? In the United States, it would be 911, in the United Kingdom it would be 999 but in Nigeria many would not know what to dial and when the call is eventually made, a positive response would be surprising. There are tales of people in emergency situations calling the fire service to find that there was no water or contacting the police and being informed that there were no vehicles available to respond to the emergency. In our quest to verify the validity of some of these tales, three people were asked to contact the emergency services and revert on their experiences.

Case 1: Tom, based in Abuja, asked around for the fire service number but no one at his office knew it, so he telephoned friends and eventually got a telephone number for the fire service; however it was a Lagos landline number 01 6584712. All attempts to dial the number for a further referral proved unsuccessful. Case 2: Harriet checked the internet to find the telephone number for an ambulance service. She saw a flurry of articles that touted 7411 as the only national emergency call

number and then dialed it. She asked the operator about the service and found that it is a directory service so she proceeded to request for the telephone number of an ambulance service. After a three-minute wait, the operator said she would have to ring Harriet back as she could not locate this particular number. After two days waiting for the operator to return her call, Harriet dialed 7411 again to follow up. This time the operator answered the call with ‘Bonjour, can I help you?’ As inappropriate as this mix of languages was, she restated her request and then was placed on hold for eight minutes before the number 0703 7444470 was provided. Case 3: Alfa dialed 112 accidentally because this number was saved on his Danish handset as the emergency number. He was connected to an operator in Nigeria instantly. He informed the operator that there was a medical emergency at his location in Gwarimpa and the operator took the details and also asked for landmarks. After five minutes, Alfa dialed the number back to check what had been done about his request and found that the details were adequately stored in the system though the new operator mentioned that he was just about to dispatch help. Alfa politely cancelled the request and thanked the operator for his assistance

These experiences raise a number of important questions, including: what is/are the number(s) for our emergency services? Is there a simple short-code for emergency services in Nigeria? Why are the numbers for the emergency services not publicized? Why are we not oriented on what to do in times of an emergency? What standards are set for frontline operators with respect to service levels and response time? Why do emergency services appear to be neglected so blatantly? … and so on.

Nigerians have become accustomed to providing most of the services they require. For the fortunate ones, they have generators to power their homes, boreholes to provide water, uniformed guards to provide security and they fly abroad for medical treatment since they cannot vouch for health services locally. Less fortunate others accept their fate, hoping and praying that they will secure better paying jobs in order to improve their standards of living. They all forget that it is the failure of governance over the years that essential, including emergency services are decrepit and citizens have been left to these responsibilities.

One must recognize the pockets of programmes that the government embarks upon to alleviate the plight of people at times of emergency; however, these are observed to be more reactive that strategic. For instance, the National Emergency Management Agency distributes relief materials to victims of disasters round the country and recently trained 45 National Youth Corps Members on medical intensive care. The Federal Road Safety Corps deployed ambulances to some locations around the Federal Capital Territory, manned by drivers who have insufficient medical training. It also embarks on initiatives to ensure that people carry around fire extinguishers amongst other items. However, when we compare these initiatives to those in other countries such as the

purpose built paramedic school established in Ghana in 2012 to provide extensive specialized training to hundreds of paramedic staff every year or the St Johns Ambulance service in the United Kingdom, which trains approximately 500,000 people annually or the enhanced 911 system in the United States of America that pairs caller numbers to a name and physical address with immediate dispatch and a response timeline of eight minutes; it becomes evident that much more is required to resuscitate emergency services in Nigeria and make them fit for purpose.

In 2010, the United Kingdom allocated an estimated 23% of its annual budget to financing the different organizations that comprise the emergency services while Nigeria, in the same period spent less than 5% on these services. Developing countries like India, Bangladesh and Ghana, invest significant resources in their emergency service infrastructure. In 2012, the fire service in Ghana was allocated $171,640,880 while its Nigerian counterpart was allocated $18,446,505. In December 2005, a Sosoliso aircraft crashed close to the airport in Port-Harcourt and whilst the fire service was present, it was unable to effectively assist the victims due to a shortage of personnel and specialized equipment to adequately tackle the blaze. As a result, parents literally watched their children burn to death. One would have expected such a tragic event to be a catalyst for attitudinal change from the government towards improving the capacity of the fire service to respond in such circumstances, but this has not been the case.

Further research on emergency services revealed that there indeed is a short code that integrates emergency services in Nigeria and it actually works. The number is 112. The government has established this short-code to provide a platform for Nigerians to call for help, irrespective of their location and circumstance and to get help. Given the issues earlier identified and the rights of the citizenry, we recommend a three-step process to revive emergency services in Nigeria.

The first step is internal. The government needs to prioritize this sector and increase focus and funding in the direction of emergency service provision. Certain services such as medical, may be better provided by private sector organizations; however, a partnership model may be required whereby the government covers certain costs and other providers make contributions to ensure that emergency services are provided to all who live in Nigeria irrespective of financial standing or location. An emergency services tax can also be levied by NAICOM based on insurance premium collected by insurance companies, as a contribution to fund emergency services. The contribution from insurers can be likened to the mandatory contribution by banks in Nigeria to fund AMCON. Whilst not all depositors are debtors, certain levies are made in the interest of improving the status of the entire system.

The second step is operational. Emergency services are required to be better integrated so that one phone call to the short-code 112 guarantees a response whatever the emergency. This process may require a full review of status quo and a clear mapping of response requirements according to geography. The police, NEMA, fire and ambulance services should work collaboratively, noting that this integration will curb waste, improve responsiveness and outline a process for future interventions and programmes of the government. In addition, the services will need to be decentralized such that local providers are placed within the emergency framework and the emergency call centre can connect instantly with the applicable providers in the specific territory to localize and speed up delivery. In the 1980s, western countries like the United Kingdom adopted the model of decentralization and this improved the response time and promoted good governance. In addition to integration and decentralization, Service Level Agreements must be established for all contributors in the process and standards must be set for all operators with regards to courtesy, responsiveness and dispatch while local service providers must have timelines for responding to delegated calls. Lastly, the short-code must be configured to allow people to select and converse in their language of comfort and/or literacy.

The third step is external. A mass orientation campaign is required to be embarked upon to inform people of the existence of these services, the number to dial in case of an emergency, the information that is required to be provided to ensure that the emergency services can reach the requisite location and what first aid is applicable to various situations. This is a call on the National Orientation Agency to prioritize this awareness campaign across the entire country. It is a call on the Ministry of Education to incorporate first aid training in basic education and also a call on the Ministry of Health to train health officers on first aid and basic rescue techniques.

A focus on emergency services is not a function of development or the lack thereof, it is a measure of the value that is placed on the lives of ordinary citizens. It is time for this value on lives to be increased and one way to contribute to this process is by resuscitating emergency services in Nigeria.