The Problem
One of the most visible manifestations of economic ascent and the
concomitant growth of the middle class is car ownership, which is Sáo
Paulo in a curse as well as a blessing. On Friday evenings, when
rush-hour mayhem reaches its peak, tailbacks out of the city can reach
up to 183 miles in total. Of course, the misery is not just confined to
commuters: in a city of 11 million and one of the most overcrowded road
networks in the world, what hope is there for an ambulance service and
the people it is supposed to serve?
In 2007, the average response time for ambulances from Sáo Paulo’s
Serviço de Atendimento Móvel de Urgência (SAMU) was almost 30 minutes,
compared to London’s 14 and Montreal’s 10 (the international benchmark).
The desired trade-off between extra cost and superior efficiency does
not automatically ensue, hence investing in more ambulances was not
viable. Neither was opening new ambulance stations; finance, building
space and bureaucracy put paid to that. Mobile stations, however, are
cheaper and can be relocated to ensure good coverage.