Doctors need a new prescription

Humphrey Nkonde looks at the needs of the Zambia Flying Doctor Service, which has been in existence for more than five decades.

The Zambia Flying Doctor Service (ZFDS) has been in existence for slightly over 50 years and currently needs helicopters to effectively cover new trends in medical services.

It is based at Ndola’s Simon Mwansa Kapwepwe International Airport, which started as a military base for the British colonial government in 1938.

It was 1965 when Dr James Lawless thought of the concept of aviation-based medical services, particularly to transfer medical personnel from advanced health facilities in urban areas to hard-to-reach rural areas.
ZFDS has also been evacuating patients from rural areas to advanced hospitals in bigger towns and cities.
President Kenneth Kaunda’s government turned ZFDS into a state-run institution by an Act of Parliament in 1967.
Using two Cessna Grand Caravans, one of ZFDS’ new mandates is to deliver medical and pharmaceutical supplies to health centres throughout the country.
ZFDS executive director, Dr Fabian Kabulubulu, said the institution had signed a memorandum of understanding (MoU) with Lusaka-based Medical Stores to deliver medical and pharmaceutical supplies.
In its initial stages, the government-controlled medical aviation institution mainly handled cases of maternity and general trauma.
However, more recently, ZFDS used a Cessna Grand Caravan to respond to a road accident involving 98 people, who were being carried in an overloaded truck in Mbala, near the border with Tanzania.
The accident, in December 2014, claimed 27 lives while 71 others were admitted to Mbala General Hospital.
“We responded to the accident by transporting medical supplies, four general and orthopaedic surgeons, four theatre nurses and two anaesthetists,” said Kabulubulu.
Another notable accident happened 11 years ago, when a truck carrying 100 pupils at Kawambwa Boys’ Secondary in Luapula Province overturned.
The accident claimed 42 lives, while 22 others sustained serious head or spinal injuries.
Because the accident happened in a rural setting, where standards of health care are low, the injured pupils were flown to Lusaka’s University Teaching Hospital (UTH).
Three of the pupils were further evacuated to South Africa for advanced health services.
Outside of its core medical aviation activities, ZFDS has been licenced to ply the sky as a charter operator as operations in the rainy season are halted because soil on airstrips gets wet.
The institution’s chief pilot, Major Charles Mutantabowa (retired), said it was not safe to land on wet ground using the Cessna Grand Caravans because of their weight.
To make full use the aircraft, the aviation medical institution uses its charter licence to offer services to tourists and others in need of air transport.
Mutantabowa has completed commercial flights to destinations such as Lake Tanganyika, on the border with Tanzania, and South Luangwa Game Park, one of the well-known wildlife sanctuaries in the world, near the border with Malawi.
He has flown other tourists to Livingstone, Zambia’s tourist capital and the seat of the Victoria Falls, one the seven natural wonders of the world.
In fact, Proflight Zambia, the country’s major local airline, used to hire aircraft from ZFDS in the years that followed its establishment in 1991.
Commercial aviation is part of ZFDS’ five-year strategic plan and 10-year business plan, crafted to raise funds for its core activities and to sustain its operations.
Since the 1990s, population growth, increased usage of motor vehicles and underutilisation of railway transport, have contributed to the ever-increasing number of road traffic accidents.
They went up by 85% between 2012 and 2014, according to the Zambian Road Traffic Trust.
In 2014 alone, the country recorded 32,392 accidents with 1,858 deaths.
“Accident death rates per 100,000 people increased by 31% from 156 in 2008 to 205 in 2013,” said the safety trust, whose chairman, Daniel Mwamba, added that most involved pedestrians, cyclists and motorcyclists.
Meanwhile, ZFDS medical services are discontinued when the Cessna Grand Caravans are not capable of landing on wet strips in rural areas.
According to Mutantabowa, using smaller aircraft, such as the PAC-750XSTOL, could solve the problems of short airstrips and wet ground at rural-based health centres.
He said that smaller make, with the capacity of 10 passengers, was suitable for ZFDS’ activities in the rainy season.
Another alternative is for the aero-medical institution to acquire helicopters that can respond to the ever-increasing road traffic accidents and to continue with operations during the rainy season.
Dr Kaunda’s loss of political power in 1991 to former ruling party, the Movement for Multi-party Democracy (MMD), dovetailed with the collapse of the aviation industry in Zambia.
Second President Frederick Chiluba’s MMD government liquidated the national airline, Zambia Airways, in 1994 and the Zambia Air Services Training Institute (ZASTI) reduced the number of trainee pilots.
Problems relating to ZASTI have created age gaps among pilots working for ZFDS, which has been solved by recruiting old pilots who previously worked for the Zambia Air Force and young ones trained in South Africa.
ZFDS has recently employed Brigadier General Goodwell Chilekwa, a former Zambia Air Force officer, and Evans Mauta, 20, the country’s youngest commercial pilot, who received training in South Africa.