Bihar’s Ambulance Services Raises Red Flags, A Matter Of Serious Concern Unleashes In Audits!

During the disastrous Delta wave in May 2021, then-Bihar Assembly Leader Tejashwi Prasad Yadav transformed his official mansion at 1, Polo Road into a Covid care clinic.

The institution, which provided ambulances, beds, oxygen cylinders, private physicians, & complimentary meals, was open for over a month. Yadav, now the state Health Minister, was highlighting what was then a national issue that is a stressed health system trying to handle a record number of cases.

Between 2017 and 2022, the infrastructure includes Dial 102, a call-an-ambulance service provided by a collaboration of Pashupatinath Distributors Private Limited (PDPL) and Samman Foundation.

From expired drugs to missing oxygen cylinders, insufficient staffing to improper cleanliness, as many as 12 audit reports covering the two catastrophic Covid years between 2019 and 2021 voiced concerns about the service provided by PDPL and Samman.

4th of October, 2019.

Expired consumables, including micro-drip sets, were discovered on board (7) ambulances examined in the districts of Bhagalpur and Munger (no number given). There was no oxygen cylinder in any ambulance in Jamalpur, Munger.

13th of February, 2020.

Expired drugs were detected in several of the ambulances tested in Vaishali and Muzaffarpur, air conditioning was non-functional in almost all ambulances, and no ambulance had the bare minimum of pharmaceuticals.

24th of February 2020. 

Expired medications and consumables were discovered in two of four ambulances examined in Nalanda and Nawada, no minimum amount of pharmaceuticals was stored in any ambulance inspected, AC was non-functional in two of four ambulances, and standard hygiene was not observed in any ambulance.

Expired medications were discovered in five of the nine ambulances inspected in Supaul, Samastipur, and Darbhanga, as well as non-functional air conditioning in four trucks and a lack of minimal pharmaceuticals in all ambulances.

6th of July 2020.

The audit discovered expired medications and empty oxygen cylinders in four of the 14 van inspected in the districts of Vaishali, Muzaffarpur, Samastipur, Supaul, and Darbhanga.

15th of December 2020. 

Expired drugs were discovered in three of the five van inspected in Arwal, Bhojpur, and Buxar, and oxygen cylinders were missing in two.

10th of February in 2021.

Expired drugs were discovered in five of the 11 ambulances inspected in Jehanabad, Sheohar, East Champaran, and West Champaran, an empty oxygen cylinder in one van, and non-functional blood pressure monitoring equipment in eight van; all ambulances were declared unsanitary.

Another example of how Dial 102 ambulances performed during Covid was a letter written on September 24, 2020 by the State Health Society of Bihar (SHSB), the state agency that monitors the Dial 102 service, to the consortium of PDPL and Samman Foundation on the poor services of five ambulances attached to the then dedicated Covid hospital, Nalanda Medical College and Hospital, Patna.

The SHSB official raised many concerns about ambulances, ranging from empty oxygen cylinders to non-functioning AC and no electricity in the cabin to a lack of a ventilator, a non-functioning suction equipment, and oxygen masks or nebulizers.

Brajesh Ranjan and Sunil Kumar, directors of PDPL, did not reply to SRU’s negative audit results.

When asked about the audit report’s conclusions, Samman Foundation head Irfan Alam stated that the foundation’s obligation was confined to technical knowledge exchange. According to him, all audit observations are linked to operations and management, which are solely the responsibility of PDPL.

While an SRU official declined to comment, a state health department source stated, SHSB would write to the contracting company as a standard procedure after SRU audit reports.

The Bihar government chose to grant the new Rs 1600-crore contract to PDPL exclusively for five years, with an option to extend the deal for another three years.

Despite the court’s warning to wait until a petition contesting the contract was resolved. The directors of PDPL include family members and relatives of JD(U) MP Chandeshwar Prasad Chandravanshi, who has denied any favouritism.

When contacted, SHBS executive director Sanjay Kumar Singh stated that the state was losing over Rs 2.5 crore per month due to the delay, therefore they went with the lowest bidder, PDPL. The SC ruling directing the Patna High Court to hear the case does not appear to be clear. The SC judgement did not stay the HC order, but it did request that further factors be considered. In these circumstances, they sought the advice of the A-G before awarding the temporary contract to PDPL. They will cooperate until the HC says differently.