Case for dedicated ambulance lane over rapid busway

On Sept 20, 2023, Nepal launched its first Bus Rapid Transit (BRT) lane, connecting Bhaktapur’s Suryabinayak to Kathmandu’s Ratna Park. This initiative was introduced with the aim of improving public transportation efficiency, particularly during peak hours (9–11 am and 4–6 pm), by reducing traffic congestion and ensuring faster travel times for commuters. While the BRT lane represents a significant step toward addressing Kathmandu’s chronic traffic problems, it has also sparked a debate about its necessity and effectiveness. Could the resources allocated to this project have been better utilized to address more pressing urban challenges, such as the delays faced by emergency medical services? This question is particularly relevant in a city where traffic congestion often prevents ambulances from reaching hospitals in time, putting lives at risk.

The BRT lane was conceived as a solution to Kathmandu’s worsening traffic congestion, which has long been a source of frustration for residents and a barrier to economic productivity. According to experts from the transport ministry, the dedicated bus lane was designed to streamline public transportation, reduce delays, and provide a more reliable alternative to private vehicles. By separating buses from general traffic, the BRT lane aimed to ensure faster and more predictable travel times, especially during rush hours when the city’s roads are most congested.

However, the success of the BRT lane depends heavily on effective management and enforcement. While the initiative has shown some promise, its impact has been limited by underutilization outside peak hours and the persistent challenges of traffic management in Kathmandu. Buses often remain stuck in traffic, disrupting schedules and frustrating both passengers and drivers. This raises questions about whether the BRT lane could have been designed to serve a dual purpose, such as accommodating emergency vehicles during non-peak hours.

While the BRT lane addresses the issue of public transportation efficiency, it does little to alleviate the challenges faced by emergency medical services. In Kathmandu, ambulances often struggle to navigate through gridlocked streets, leading to delayed response times that can have life-threatening consequences. The sound of ambulance sirens is a common yet distressing feature of the city’s soundscape, serving as a constant reminder of the urgent need for better infrastructure to support emergency services.

Jamali Tamang, a regular bus commuter, shared her observations: “I’ve seen ambulances stuck in traffic during peak hours. It’s frustrating and heartbreaking. Dedicated lanes for emergency vehicles could save lives.” Tamang also emphasized the importance of public awareness campaigns to educate citizens about the importance of keeping such lanes clear. She suggested that the BRT lane could be repurposed for ambulance use during non-peak hours, allowing both buses and emergency vehicles to coexist without compromising efficiency.

Ambulance drivers, who are on the front lines of this crisis, echo these concerns. Nim Bahadur Oli Chettri, four years experienced ambulance driver, recounted his struggles: “It’s incredibly challenging to navigate crowded roads. While some drivers make their way, others ignore us, wasting precious minutes.” Chettri, who previously worked as a bus and truck driver in Saudi Arabia, highlighted the stark contrast in infrastructure and policies between the two countries. “In Saudi Arabia, emergency services are systematic and efficient. Here, the lack of clear policies and infrastructure makes it much harder.”

Several cities around the world have successfully implemented measures to prioritize emergency vehicles, offering valuable lessons for Kathmandu. In Japan, for instance, there are no dedicated ambulance lanes, but strict road rules require drivers to yield to emergency vehicles. This culture of discipline and respect for emergency services ensures that ambulances can navigate through traffic with minimal delays. Similarly, Singapore has experimented with converting certain lanes for emergency use during peak hours, while the UK allows ambulances to use shoulders or middle lanes when necessary. In South Korea, designated lanes in some areas ensure faster emergency responses, particularly in major cities like Seoul.

These examples demonstrate that with proper planning and enforcement, emergency lanes can significantly improve response times. However, implementing such measures in Kathmandu presents unique challenges due to the city’s inadequate road infrastructure and lack of clear policies.

Kathmandu’s road infrastructure remains ill-equipped to handle the growing number of vehicles on its streets. Narrow roads, haphazard parking, and poor traffic management exacerbate congestion, leaving ambulances stranded in traffic. Ganesh Man Singh Rai, an Information Officer at the Department of Transport Ministry, acknowledged these challenges: “Our limited resources and road capacity make dedicated emergency lanes seem almost impossible. However, traffic officers do their best to prioritize ambulances.” Rai emphasized the need for improved road infrastructure and stakeholder collaboration to make such initiatives feasible.

“Designating a dedicated lane for emergency vehicles is undoubtedly a good idea, but the challenge lies in ensuring its effective implementation across the numerous roads we have. The real solution, however, also depends on the honesty and discipline of drivers and riders. When they responsibly move aside to allow emergency vehicles to pass, significant improvements become visible, enabling ambulances to navigate more efficiently”, he added.

SP Sanjay Bahadur Raut, Spokesperson of the Kathmandu Valley Traffic Police Office, echoed these sentiments. “While dedicated emergency lanes are a good idea, their implementation is challenging due to narrow roads and increasing vehicle numbers. A balanced approach is essential to accommodate all road users.” Raut highlighted the efforts of traffic officers to clear paths for ambulances, even creating space from opposite lanes in urgent situations. “Every second counts in emergencies, and we prioritize getting ambulances through as quickly as possible.”

He shared, “In urgent situations, when there is high traffic, some of us may even go as far as creating space from the opposite side of the road. This is a rare and considerate act as we prioritize the safety and speed of emergency responders.”

The consequences of delayed emergency responses are dire. Dr. Manoj Yadav, an emergency medical officer at Everest Hospital, shared alarming insights: “We’ve seen patients’ conditions worsen due to traffic delays. Dedicated ambulance lanes could save lives.” He explained that ambulances in Nepal vary in functionality, from basic models to advanced units equipped like mini ICUs. However, even the best-equipped ambulances are rendered ineffective if they cannot reach patients in time. “Many patients die en route to hospitals, especially when traveling from distant locations,” Yadav added.

Yadav also highlighted the disparities in ambulance services across the country. “The hospital provides ambulances with some facilities, but many vehicles from other hospitals only offer oxygen, and some don’t even provide that. There are three types of designated ambulances: the general ambulance, which has no special facilities and is used only for non-emergency cases; the semi-ambulance, which includes basic support for minor injuries and accidents; and the advanced ambulance, which is equipped with ECG, ventilation, and designed like a mini ICU for more critical patients.”

The growing urban challenges in Kathmandu demand innovative solutions. Repurposing underutilized transit lanes for emergency vehicles could address critical gaps in the city’s emergency response system. Strict enforcement mechanisms would be necessary to prevent misuse, ensuring these lanes remain clear for life-saving purposes. Public awareness campaigns could also play a vital role in fostering a culture of responsibility among drivers.

Ultimately, the BRT lane represents progress, but its limitations highlight the need for a more holistic approach to urban planning. By prioritizing emergency services and improving road infrastructure, Kathmandu can transform its transportation system into one that not only moves people efficiently but also saves lives. The time has come to rethink idle transit lanes and turn them into pathways that serve the greater good.

The introduction of the BRT lane in Kathmandu is a commendable effort to address the city’s traffic congestion. However, its underutilization outside peak hours and the pressing need for better emergency response infrastructure suggest that a more balanced approach is needed. Dedicated ambulance lanes, combined with improved road infrastructure and public awareness campaigns, could save countless lives and ensure that emergency services are not hindered by traffic. As Kathmandu continues to grow, it is imperative that urban planning prioritizes not only efficiency but also the well-being and safety of its residents. By learning from global examples and fostering collaboration among stakeholders, the city can create a transportation system that truly serves the needs of all its citizens.