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The largest hospital in Luanda, reopened in June 2015 by the Angolan executive and currently managed by the GPL, has been without functional ambulances for about two months to assist patients who need them. In the struggle between life and death, many are forced to wait more than 24 hours for light at the end of the tunnel and a chance to save their lives, when there is still time.

At a time when governments around the world are forced to reflect on the attention and investments they devote to their health systems, due to the collapse caused by the COVID-19 pandemic, hospital units in Angola, regardless of their size and or capacity, they also face needs that are so elementary that they compromise their normal functioning, often costing defenseless citizens the lives of them.

The Luanda General Hospital (HGL), for example, considered a potential “reference unit” in 2016 by the then governor of Luanda, General Higino Carneiro, has been without functional ambulances for more than two months to assist patients in need. immediate medical transfer to other hospitals in the capital, a source confirmed to Maka Angola.

Our source says that currently the HGL has only one ambulance in operation and that it has been with this one that has helped the “most serious and urgent” cases. To make matters worse, the vehicle, despite “running more or less well”, does not have the ideal specific requirements to be used as an ambulance.

“This car lacks a siren, a horn, the fireflies don’t work well and there’s not even oxygen in the back”, assured our source.

It is a white Toyota Land Cruiser, with a sticker bearing the Republic of Angola insignia and large letters written “Ministério da Saúde”, with a cracked front window, perhaps because it was hit by a stone or similar.

As for the poor technical condition of this ambulance, the HGL board confirmed to Maka Angola that it is aware of the situation, but does not consider it a problem. “It doesn’t have a siren, but at least it has an ambulance!”, the director of the HGL, Dr. Bernabé Lemos, told our report.

On the day of our second visit to the HGL, July 22, 2021, we witnessed the arrival of this same ambulance at the hospital, bringing two different patients, who did not even know each other, and in completely different health conditions: one lying on a stretcher and the other sitting in one of the back seats of the car. What, according to one of the nurses at the hospital, who prefers not to be identified for fear of reprisals, has been a recurrent practice, “due to scarcity of resources”.

“This has happened even during a pandemic!” emphasizes the nurse.

Parked in the interior park of the HGL, we identified two more ambulances, one of the Renaut-Master brand, in relatively good condition, despite having suffered an accident, it damaged one of its rear bumpers; and another brand Stavic Sv 270, visibly damaged, with flat tires and apparently out of service for some time.

None of them, as we have found, are working. “They’ve been out of order for some time,” adds our source.

“We found only one functional ambulance”

In order to better understand the imbroglio of HGL ambulances, there is a variable that cannot be ruled out. It is an alleged workshop where many hospital ambulances go and from which they never return.

Our source has memory of at least two ambulances that were taken to the alleged workshop and that so far have not returned to the hospital. “They say they are going to take the ambulances to the workshop. Some go and don’t come back anymore”, he declared.

A former HGL doctor, who also prefers not to be identified, says he has a memory that, during his time working in that unit, about a year ago, the hospital had about five ambulances.

“If I remember correctly, there was an ambulance for each specialty: one for surgery, one for gynecology/obstetrics, one for pediatrics, one for internal medicine and one for nephrology,” the doctor told Maka Angola.

Therefore, there is a question that does not want to remain silent: where are the other ambulances at the Hospital Geral de Luanda?

In order to better understand the imbroglio of HGL ambulances, there is a variable that cannot be ruled out. It is an alleged workshop where many hospital ambulances go and from which they never return.

The current management of the HGL, in office since May 2021, says it is not aware of the existence of the ambulances in question and claims to have received only three ambulances from the previous management, one in operation and two completely out of order.

“We found only one functional ambulance, but also in poor technical condition”, assures the new director of the HGL, Dr. Bernabé Lemos.

At this moment, according to the director, there is one more ambulance to be repaired so that the hospital can have at least two functional ambulances.

As for the alleged mysterious workshop, the current HGL management says they are totally unaware of what it is: “From our management, the only ambulances that went to the workshop are this one, which is walking, without a siren, and the other one that is about to go out.” If there are ambulances going to the garage and not returning to the hospital, adds the director, “only if it was in the past administration. In my lifetime there is no ambulance that was sent to the workshop at our command and has not yet returned.”

Maka Angola contacted the former director of HGL, current director of Hospital Josina Machel. In this portal, Dr. Carlos Zeca refuted the existence of more ambulances than those he left to the hospital’s new management.

“From 2016 to 2021 [the time of his term] the HGL only had three ambulances, which are the ones I left in the hospital,” said the doctor categorically. As for the “mysterious workshop”, Carlos Zeca says this is not a new conversation, as he also heard it when he arrived at HGL in 2016 to manage the unit.

“The ambulances at this hospital, when we arrived, they all said they were at the mechanic. When we got there, none of them were in conditions”, reveals the hospital manager. The former director of HGL also stated that the lack of ambulances has always been a concern for the hospital and that, therefore, they have always relied on INEMA’s collaboration for medical transfers. He adds that in 2019 the hospital received an ambulance from MINSA, through the Central for Procurement and Supply of Medicines and Medical Resources of Angola (CECOMA), the Renaut-Master, stopped in the hospital’s interior park due to an unknown malfunction.

Human lives at risk from mismanagement

While the whereabouts of certain HGL ambulances remain uncertain and others remain to be repaired, it is the patients who need them who suffer most from the effects of this problem of poor hospital management.

Jack António, 10, was admitted to the HGL emergency room on the morning of Sunday, 11 July, with severe pain in his jaw and difficulty breathing. The attending physician detected a fracture in his jaw and informed his family that he needed immediate surgical intervention.

As the HGL did not have any professional specialized in the type of surgical intervention required, Jack had to be transferred to the Josina Machel «Maria Pia» Hospital. The only problem is that at that time the HGL had no ambulance available.

António Komba, Jack’s uncle, says that his nephew’s condition got worse during the day he was admitted to the hospital, but that the staff said they couldn’t do anything else.

“They said to wait for the ambulance to be able to take the boy to Maria Pia’s pediatrics, but until 8 pm nothing had been done! And they weren’t touching him, they weren’t doing anything to him,” his uncle declared.

According to one of our sources at the hospital, who was on duty on the day of the incident, “the hospital was trying to contact INEMA to request an ambulance for the boy, but they didn’t answer”.

Daniel Nzagi, another uncle of the patient, explains that he had to impose himself so that the hospital would do anything to guarantee the transfer of his nephew. “I had to threaten the hospital management that I would denounce the ‘Fala Angola’ program if they didn’t solve the ambulance problem.”

As the HGL did not have any professional specialized in the type of surgical intervention required, Jack had to be transferred to the Josina Machel «Maria Pia» Hospital. The only problem is that at that time the HGL had no ambulance available.

After nearly 48 hours, Jack was finally transferred from the HGL to “Maria Pia” by an INEMA ambulance around 5 pm on Monday, July 12th.

As for this occurrence, the director of the HGL says he has no knowledge: “I was not going to allow that to happen. I don’t know; it didn’t come to me.”

However, it promises an internal investigation to investigate the circumstances of the facts that occurred.

Jack Antonio is just one of hundreds of patients who see their lives at risk due to the lack of ambulances at the HGL. Others weren’t even as lucky. In February 2019, for example, Jornal de Angola reported that a 13-year-old boy died at Luanda General Hospital after waiting eight hours for an ambulance from the institution that was supposed to transport him to the Josina Machel. The director of the HGL, at the time of the facts, denied the occurrence and assured that “we have the three ambulances working”, according to JA. An ambulance is more than a car; it’s a way that can save lives. It is necessary that the managers of hospitals in Angola look at the ambulances, their technical conditions and their drivers with a clear eye, so that they stop innocent Angolans from dying for serious errors in hospital management.