The Land Rover Ambulance is equipped to travel to remote villages in the Western regions of Nepal, off-road if needs be. The ambulance usually carries medical volunteers, medicines, and equipment to free health camps. In emergencies the ambulance can carry patients quickly through mud and over hills to hospital.
Land Rover Ambulance
Responding to real needs!
There is no National Health Service nor for that matter, a free Ambulance Service in Nepal. Besides a minimal charity sector, people have to pay massively for medical attention – often being obliged to sell land or borrow (insofar as they can). This underlies particularly stark health statistics – even for a country as economically challenged as Nepal – and not least exaccerbated by late presentations.
This project was prompted by the experience of a woman in her thirties who had no money, no relatives and no one to help her. She suffered from a 15 cm long tumour in her spine which paralysed her legs. She literally dragged herself by her arms to Manipal Hospital from a remote village – with no means to pay for care – and presented herself on the steps to the main entrance of the hospital. It can be a five day walk to even the most basic medical attention in remote areas (and this was not remote).
Surgeons contacted the Mountain Trust and we agreed to pay the £200 to cover the scans, drugs and bandages etc. necessary for the operation and medical staff gave their work for free. The following day in post-op she could for the first time in years move one of her legs. She has since made a full recovery. Our question was ‘Why should patients have to crawl to hospital when medical facilities could be taken to them?’
How to do something about it was the brain child of our Vice-Chaiman, Andrew Ahmad-Cooke – to ship out a vehicle which could dispense medical care to the villagers in and around the Pokhara Valley in Nepal (and cope with the mountainous terain, fording deep rivers etc.).
In each outreach journey or Health Camp we can give free health education, diagnose and treat low level cases with the free time of hospital Staff – or if in an emergency – rapidly transfer the patient to Gandaki Medical College or elsewhere for free treatment. The Mountain Trust covers the running costs and the costs of consumables used in treatment. Our partners at Gandaki Medical College donate their time. We have established a 500 Pounds emergency fund so that patients requiring emergency treatment can receive attention subject to local clearance – without waiting for the time difference and clearance from the Mountain Trust in the UK.
Andrew first suggested the idea in October 2008. Within a week of returning to the UK, he had secured the generous gift of a 1997 long wheelbase Land Rover (a 3.5 lt V8 petrol version with a roof rack) Defender from Alex Van Someren.
It was a little in need of TLC but nonetheless perfectly serviceable. So we set to work finding kindred spirits who would be ready to help us turn the idea into reality and were astonished by people’s generosity – as you will see.
We initially contacted Land Rover Monthly magazine to see whether they might be able to help us persuade readers to donate spare parts we needed to restore the vehicle and convert it into an ambulance. We had planned to approach SAS or Territorial Army engineers to help with the restoration but Nick King took up the challenge and decided that this was a case deserving of Star Treatment – in inimitable LRM style! In quick succession, Nick brought Richard Tuck of RST Land Rovers as well as Richard Pigg and Paul Myers of Britpart on board and it was not long before the project was literally motoring. Nick and the team at LRM deserve special praise – not just for the way they saw the logic of the argument in the blink of an eye – but the way in which they found other people ready to help a worthwhile cause. They also put us in contact with some genuinely kind and compassionate people who pitched-in. That has been a big bonus throughout this project.
Here you can see the thousands of pounds worth of spare parts and off-road equipment donated by Britpart who have been extremely generous – not least since this took place in the depth of the credit crunch. Thanks to Paul and Richard, we were not only able to repair and refurbish the ambulance but enable it to reach parts of Nepal only accessible off road, through high rivers and over terrain other 4x4s cannot negotiate where we may literally have to winch our way to get patients to and from hospital.
The RST team were soon at work, stripping down the Land Rover, replacing components, repairing others and checking everything was set for the expedition to Nepal. Richard Tuck worked closely with Britpart and LRM to breathe new life into the ambulance. Richard and his crew spent many hours on the restoration, contributed parts and like LRM and Britpart, everyone went well beyond the call of duty. We cannot praise them highly enough for their generosity – or recommend them more strongly for their professionalism and integrity.
Here you can see the Land Rover stripped down following a complete re-spray in silver metallic paint. RST very kindly donated the time and resources to prepare it for its re-spray and to have it rebuilt afterwards. Tessa Reeve, Chairman of Sealmaster personally donated £1,000 to cover the cost of the paint. Sealmaster also covered the cost of insuring the vehicle in the UK prior to it being exported to Nepal. Andrew and David in the Sealmaster factory have also worked on a string of minor repairs and improvements.
Through the Chair of Addenbrookes Teaching Hospital and Evelyn Brealey of Addenbrookes Abroad, Cambridge, we made contact with Mike Coleman of Aid to Hosptals Worldwide (which recycles ex-NHS medical equipment and ships it to the so called ‘developing’ world). A2HW donated an impressive set of equipment. This included a folding stretcher, an oxygen bottle and mask, a heart monitor and defibrillator, dressings, blankets and other medical equipment – exactly what we will need when in the field in Nepal.
Here is the ambulance after its ‘Star Treatment’ courtesy of LRM, RST, Britpart and Sealmaster. For a twenty-two year old veteran, it has been transformed – primed with vim and vigour and standing testament to the unbridled generosity of an ever-growing community of like-minded and compassionate people. Meeting people ready to help has been an unexpected benefit of working on this project. The beauty of it being that everyone has been self-selecting. Everyone who has helped should be very proud of their intervention(s).
House of Flags Solutions Ltd get so many requests for charitable help that they have a polite but standard letter to say sorry but we cannot help everyone. However, HoF Solutions made an exception in our case – thanks to Fran Henthorn on their Public Relations and Marketing side. Perhaps it was because one of our colleagues at Sealmaster was married to one of hers at House of Flags Solutions or perhaps it because we made an exceptionally persuasive case, she supported us.
Fran secured the agreement of her Director and the help of Martin in the HoF Graphics Department. It was not long before HoF Solutions had printed and fitted all of the logos and striped markings without charge. Fran joined us at the official handover ceremony at RST and along with all the other key players received a Letter of Appreciation on handmade Nepali paper from our colleagues in the Mountain Trust (Nepal).
Richard Tuck of RST Land Rovers puts it through its paces after its restoration, off-road on the Essex coast. Both he and Richard Howell-Thomas (Editor of LRM) commented on how smoothly the engine runs (despite 133,000 miles on the clock) and they are right. Mounted atop, are the lights and siren which along with an alternate headlamp flashing unit were donated by Vision Alert Ltd., with the generous help of Katherine Reynolds. The tinted sunvisor with AMBULANCE in reverse was donated by Sign Grafix Ltd.
Nearby West Mersea on the Essex coast in England, the ambulance is driven up a steep sea defence both to test it for the unforgiving terrain it will need to deal with in Nepal and to capture one of the final stages of preparation in the UK for Land Rover Monthly magazine before it is shipped by sea to India and then on by rail and road to Nepal to begin its work lengthening and saving lives. Thankfully, Richard (Editor of LRM) had the courage we lacked to actually drive it up the 45 degree embankment!
Here is a unique collection of people – most of whom had not met before this project got underway. More are behind the camera but left to right are: Nick King (Land Rover Monthly), Richard Tuck (RST), Keira Rose Tuck (Richard’s delightful ‘little RST’, after whom we named the ambulance), Andrew Ahmad-Cooke (Vice-Chairman) and his daughter, Rubi, Charles & Melanie Malcolm-Brown (Trustees), Ric Alston (Honorary Trustee) and Fran Henthorn (House of Flags). Here we are enjoying a glass of fizz to celebrate our quite amazing achievement.
Ruth and Chris from North Yorshire in the UK decided that they would make a difference when they got married by asking their guests to make a donation towards this goal instead of giving them wedding presents. They raised a magificent £1,100 (which is nearer £1,300 after Gift Aid Relief). This was enough to cover the cost of rail freight between Calcutta and Nepal – with sufficient spare to help put children through school as well. Thanks to another magnificent group of people, we were by now well on our way. We even persuaded the Granta Weigbridge in Whittlesford, Cambridge to issue a certificate of weight we needed for shipping without charge.
By this stage, we had been gifted something in the region of 15,000 Pounds worth of goods and services in kind – plus another 4,000 Pounds for shipping etc. No mean feat by any measure!
Having been strongly advised by a Nepali Import Agent to abandon any idea of importing an ambulance into Nepal out of hand (as so many Customs officials were ‘difficult’) we took political soundings and carefully calibrated the risks. We concluded we had a 90-95% chance of getting it through so on a cold November day, we watched it being loaded into a container at Felixstowe Docks, bound for India – not fully sure we’d ever see it again. It cost just over 3,000 Pounds to ship to India, raised by Students at Bullers Wood School, Bromley, Kent, UK.
It duly arrived by sea to Calcutta, India but Customs there required additional paperwork. We provided it and the Ambulance was freighted by rail up to Gorakpur – the end of the line just south of the Nepali border. We arranged a driver and insurance to have it driven to Sunauli on the border and from there to Bhairahawa – the main Customs depot where it was immediately impounded – again! This time because it was ‘not an ambulance but a Jeep’! We pointed out that a Jeep was orginally an American term referrring to a ‘GP’ or general purpose vehicle dating from the Second World War and that our vehicle had been officially redesignated as an Ambulance by the UK Government. That didn’t wash with them for a moment.
Customs there had a singularly narrow definition of an ambulance – which meant there should be no seats behind the front row, a fixed stretcher rather than one which folded up – and the word ‘Ambulance’ on the rear as well as on the front!
So we had the seats behind removed, a fixed stretcher installed and the word ‘Ambulance’ painted in Nepali on the back. And we looked set to go… but oh no!
The officials managed to find another ambiguity in the law whereby no vehicles were allowed to be imported if they were over 20 years old (the intention being to prevent Indians dumping old vehicles on the Nepali market). However, the Ambulance was some 22 years old. At the same time, there was a legal excemption for fire tenders and ambulances which did not specify a cut-off age for the vehicle. We were in a legal limbo not uncommon in Nepal. So we called on heavy-weight political contacts who leant on Customs to let the vehicle through. They did – and common sense prevailed.
We then went through a similar exercise in trying to register the vehicle in Nepal. After much effort, again common sense prevailed.
Since then, the Ambulance has treated over 2,000 patients otherwise unable to afford treatment at a series of Health Camps. The Trust has a Memorandum of Understanding with the Gandaki Medical College, Pokhara to share the costs of regular health camps, health educational and other outreach work – putting the Land Rover to good use. Its powerful 3.5 litre petrol engine is very expensive to run by local standards but it can reach places local 4 x 4s cannot. We hope eventually to convert the engine to run on gas.
A growing number of Medical Interns working with the Trust have participated in this side of our work.