Representative image of an ambulance.
Credit: iStock Photo
A quarter of Karnataka’s 108 ambulance fleet being off the road is not a routine administrative hiccup; it is a public health red flag. Of the 715 ambulances under the Arogya Kavacha programme, only about 530 are currently available. In a service where response time often determines survival, this shortfall is not an abstract statistic but an ordeal for patients and families waiting in desperation. The 108 system is designed around a 20-minute response benchmark, achieved by positioning ambulances at strategic locations. When nearly 25% of the fleet is under maintenance, the logistics network collapses. Vehicles have to be dispatched from farther away, response times stretch, and the “golden hour” for trauma, cardiac events, or obstetric emergencies is squandered. The impact is particularly severe in rural taluks, where the absence of even one ambulance can leave an entire population exposed.
Principal Secretary (Health) Harsh Gupta’s defence that the shortage causes problems largely in the morning offers little reassurance. Emergencies do not follow office hours or optimisation charts. A senior emergency care doctor’s blunt counterpoint is worth heeding: there is no such thing as a convenient hour for a medical emergency. Any interruption in the fleet, at any time, risks lives. For millions, the 108 ambulance is more than an emergency vehicle; it is the poor man’s taxi to the hospital. Expectant mothers form the largest user group, followed by accident victims, cardiac patients, and rural families with no access to private transport. That the service has evolved into a universal lifeline is a testament to its success, but it also means that any disruption disproportionately hurts those with the fewest alternatives.
The current strain is unfolding amid the state’s transition from a Public-Private Partnership (PPP) model to full government management by February 2026. The government claims this will ensure greater transparency, better technological monitoring, financial savings, and labour stability. Trials of new software and integrated emergency platforms are encouraging. Yet the pitfalls are equally clear. Transitions are messy, and bureaucratic delays in maintenance, hiring, or repairs can paralyse a service that cannot afford downtime. There is no disputing that 108 has served Karnataka well for nearly two decades. It is precisely for that reason that the transition must be handled with exceptional care. Clearing the maintenance backlog, prioritising repairs, and ensuring uninterrupted operations are not optional administrative tasks; they are matters of life and death. Reform should strengthen a lifeline, not weaken it. In emergency care, even one missing ambulance can mean one life too many.