15 March,2025 07:13 AM IST | Mumbai | Aishwarya Iyer
According to the data made available by the MEMS, only 91 ambulances serve a population exceeding 1.25 crore in Mumbai. File Pic/Satej Shinde
Maharashtra has only 937 ambulances under its flagship public-private partnership (PPP) 108 Maharashtra Emergency Medical Services (MEMS), a project launched by the state government in 2014. Of these, 704 are basic life support (BLS) ambulances, while only 233 are advanced life support (ALS) ones, which are crucial for handling critical emergencies.
At the time of its launch, the ambulance fleet was allocated based on a ratio of one per lakh population, using the 2011 census, which recorded Maharashtra's population at 9.37 crore. However, more than a decade later, a report by the Technical Group on Population Projections, released on February 14, 2025, projects the state's population to exceed 12.87 crore on July 1, 2025 - highlighting a widening gap in emergency medical resources. At the ground level, the hospital staff claim that many of these ambulances are constantly in garages.
In Ulhasnagar, the shortage of ambulances led to two major incidents this year. PICS/NAVNEET BARHATE
As per the data made available by the MEMS in Mumbai, just 91 ambulances cater to a population exceeding 1.25 crore, raising concerns about response efficiency in the densely populated city. In the 91 ambulances operating in Mumbai, 26 are ALS while the remaining are BLS. The situation is even worse in Thane district, where the number drops to just 39 ambulances, despite its mix of urban and rural regions. Breaking down the 39 ambulances, only 12 provide ALS, the remaining being BLS.
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âWe are addressing gap'
Dr Dnyaneshwar Shelke, chief operations officer, BVG India MEMS, told mid-day, "Since its launch in January 2014 until February 2025, the 108 ambulance system has provided life-saving services to 1,07,27,661 patients with the help of 937 ambulances across the region." Asked about the shortage of ambulances affecting both citizens and hospitals, he said, "The number of ambulances was determined based on a ratio of one per lakh population, in line with the 2011 census, which recorded Maharashtra's population at 9.37 crore. However, the situation has changed significantly since then, with the population increasing substantially. To meet the current demand, we need more ambulances, and we are actively working towards addressing this gap."
Out of service
Several state-run hospitals that mid-day spoke to reported a common issue - at least one or two of their 108 MEMS ambulances are frequently out of service, either under ârepair' in the âgarage', or in poor condition. "The ambulances are old and in terrible shape. Even if they manage to reach the patient on time, they often break down while transporting them to the hospital," said an official from Lokmanya Tilak Municipal General Hospital, commonly referred to as Sion hospital.
Rahul Indate, Harshvardhan Nagar resident who allegedly lost his life after an 108 ambulance allegedly failed to show up on time
He added, "Many patients, if they are capable of walking, prefer taxis or even bikes. Others simply wait for the 108 ambulances - if they can afford to wait." An official from Chhatrapati Shivaji Maharaj Hospital, another state-run hospital, located in Kalwa near Thane, cited similar issues. "One or two ambulances are always in the garage, getting repair work done. This activity takes months, and the frequency of this has increased as the ambulances are old. Patients who are not in critical condition often prefer autorickshaws." Asked about patients in critical condition, he said, "Some NGOs provide ambulances either for free or at a very minimal cost, and they come in handy. Private ambulances charge way too much for the budget of most patients, which is why they don't prefer them."
Avoidable suffering
In Ulhasnagar, the shortage of ambulances led to two major incidents, one of which resulted in a patient losing his life while waiting for an ambulance. "We started dialling 108 at 2 pm, but they kept assuring us that an ambulance would arrive in 15 to 25 minutes. However, even by 8 pm, no ambulance had arrived. Eventually, my brother, in unbearable pain, passed away," said Vandana Surwade, sister of Rahul Indate, who died on January 23 at Ulhasnagar Central Hospital. Rahul had gotten himself admitted a day earlier after experiencing stomach pain and was diagnosed with acute pancreatitis with splenic vein thrombosis and ascites. Doctors had advised the family to shift him to Kalwa's municipal hospital, but they waited for over eight hours for an ambulance that never arrived. He succumbed.
In the other incident, a woman in her early fifties fell onto the tracks near Ulhasnagar railway station. It is yet to be determined if it was an accident or a suicide attempt. She ended up waiting at the platform for two hours for the ambulance to arrive. After shifting to the hospital, the hospital suggested the family move her to Sion Hospital as her injuries were grave, but two hours later, no ambulance arrived. The family resorted to a private ambulance which cost them Rs 3500.
On December 26, 2024, 69-year-old textile businessman Rama Shankar Singh collapsed outside Bandra station. His son called the 108 emergency service, but despite records showing an ambulance was dispatched, Singh died while waiting.
âAssessment needed'
Social activist Shivaji Ragde criticised the lack of accessible emergency healthcare, stating, "A poor family cannot afford the high charges of most private ambulances, leading to further suffering. There is no access to basic healthcare in our city. The government should assess the condition of ambulances and the control rooms of the 108 ambulance service to identify gaps in their operations and address the challenges they face to find a viable solution." Dr Shelke, meanwhile, also revealed that the government is now planning to introduce bike, boat, air and VIP ambulances services, all of which are in the pipeline.
High court order goes ignored
In 2014, the Bombay High Court directed authorities to station ambulances at all suburban railway stations in Mumbai to ensure immediate medical aid for commuters in emergencies. The order aimed to reduce fatalities caused by delayed medical assistance, particularly for accident and health-related cases at railway premises. However, several railway stations have failed to follow the court order.
Emergency centre
The Central Control Room or Emergency Response Centre of MEMS is located at Chest Hospital in Aundh, Pune, according to the National Health Mission's website. It operates with 60 call assistants per shift who coordinate with emergency patients and hospitals across Maharashtra, using real-time GPS-GPRS tracking to monitor ambulance locations.
Ambulance service providers in state
>> 108 MEMS
>> Municipal corporation-run ambulan ces: BMC (Mumbai), TMC (Thane), KDMC (Kalyan-Dombivli), UMC (Ulhasnagar), NMMC (Navi Mumbai) and railway station ambulances
>> Private hospitals
>> NGOs and charitable trusts
