Why was there no effective ambulance service in India?

Shaffi Mather and his childhood friend, Ravi Krishna, experienced several personal tragedies that prompted this question. First, Mather’s mother choked in the middle of the night and needed an ambulance to take her to the hospital. But the trip took nearly 45 minutes. (His mother survived.) Around the same time, in New York City, Krishna’s mother had a heart attack but was delivered to a New York City hospital in four minutes. Then a mutual childhood friend bled to death after a traffic accident in India because there was no ambulance to transport him to the hospital.

After the funeral, Mather and his partners agreed: “Let us take one step, at least, and do something.”

Speaking in November at the Nand and Jeet Khemka Distinguished Speaker Forum, sponsored by the Chazen Institute of International Business at Columbia Business School, Mather told how, in 2004, he and his partners launched a private ambulance service operating in Mumbai with the purchase of one modern ambulance and the creation of a 24-hour dispatch center. Today, Dial 1298 operates nearly 300 ambulances in five states and serves as the only effective ambulance service in India.

Before Dial 1298 was established, India lacked a universal access number for emergency response vehicles. “If you needed an ambulance, you had to call multiple numbers to try to figure out if a vehicle was available and capable of reaching you,” Mather explained. Ambulances available at the time were simply for transportation, and drivers weren’t trained in emergency response or medicine. As Mather and his partners investigated the ambulance industry in India, they uncovered another shocking fact: 90 of revenues came from operating as a hearse — transporting dead patients.

Mather’s business model was unconventional in several respects. His first innovation was a two-tiered pricing model. Mather charged patients who were transported to public hospitals 50 less than those who were transported to private hospitals. For patients in major accidents, the service was free.

Dial 1298’s second innovation was advertising. Mather convinced Indian companies to buy advertising space on ambulance truck panels. This helped smooth cash flow in an unpredictable, demand-driven business. In fact, at one point Dial 1298’s ambulances were known as ‘Formula 1 Ambulances,’ with every inch of advertising real estate on the vehicle sold to advertisers.

Mather is currently pursuing other social enterprises. One is “Education Access for All,” a network of schools set up in rural villages across India with subsidies for economically underprivileged students. And Bribebusters.com is a new concept that proposes a fee-for-service system to fight demand for bribes from government officials in India.

Said Mather of his continuing efforts, “The new buzzword of social entrepreneurship — as a separate concept from NGOs, charities, and enterprise — is something which has gone beyond value creation. I call it the social mission driven organization.”

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