Abstract

Traffic congestion, poor road networks and unplanned urbanization are growing grave concerns. The spatial and temporal differences of EMS accessibility are vital for the assessment, provision and utilization of emergency facilities and the efficiency of emergency service dispatch in the urban communities. This mega metropolis city of Pakistan depicts unplanned urbanization resulting in formation of urban canyons, impeding the accessibility to emergency medical care services

A cross-sectional exploratory study conducted from October-December 2016 to analyze the impact of traffic congestion and unplanned construction of buildings on the temporal and spatial accessibility to EMS in Karachi- the economic and industrial hub of Pakistan. The target study area was Saddar Town- Karachi, the heart of all tertiary and disaster management healthcare services. The analysis was done using the elevated observation and photographic impressions during peak hours of weekdays, in-depth-interviews with EMS transportation personal and traffic constables and maximum-car-methods

The study revealed that the roads leading to major city hospitals including; burns and SMBB Trauma Centre, Sindh Institute of Urology and Transplantation, Civil, Sind Services and Lady Defren hospitals are inaccessible due to road works and traffic congestion. And, there have been no steps to clear the congestion and repair the roads in front of hospitals. The road from Pakistan Chowk to Dow Medical College (DMC) is uneven and offers a bumpy ride to the patients brought to the hospital. Heavy traffic congestion due to overcrowding of vehicles around DMC area is the root cause of the problem

Time is a sensitive and crucial factor in emergency medical service (EMS). The real-time traffic condition should be considered in urban healthcare infrastructure, planning, development and provision of EMS. An integrated approach is needed between healthcare and urban development ministries to optimize EMS scheduling and improved efficiency. Otherwise, limited accessibility and unavailability of EMS services for communities may result in compromised quality of care and health outcomes