In his haunting poem ‘Ambulance’, Philip Larkin paints a quiet, chilling portrait of mortality: the ambulance not just as a vehicle of rescue, but as a symbol of our shared vulnerability, the inevitability of death that “brings closer what is left to come”. Similarly, in Bangladesh today, the ambulance no longer, in many cases, symbolises swift rescue or even dignified passage; it rather has become a vehicle caught in the grip of corruption, control and cruelty. The recent death of a new-born in Shariatpur, not from illness but from deliberate delay, is a tragic illustration of how far we have strayed from compassion. That a child died not from the illness he was born with, but because an ambulance was stopped, held hostage quite literally, for ninety crucial minutes for the crime of violating an unwritten “syndicate rule” has laid bare the dark underbelly of ambulance business, where profit trumps life, and human compassion has been thrown to the wind. While Larkin’s ambulance evokes existential reflection, this one exposes something far darker: a system where the very symbol of emergency aid has been corrupted into a tool of control and extortion, where human life is subordinated to territorial greed and where death is no longer just inevitable but orchestrated.

The child, born with cold-related complications at a private clinic, was being urgently transported to Dhaka for better treatment. But on that night, time (the most precious currency in a medical emergency) ran out. A group of self-serving ambulance operators intercepted the vehicle, dragged the driver out, confiscated the keys, and delayed the journey until it was too late. What was the reason? The ambulance was not “one of theirs”. It did not belong to the local syndicate that controls who can and cannot save a life.

This is not a scene from a dystopian novel but is happening right under our noses. What was once a public service, a lifeline for the critically ill, has morphed into a ruthless business empire, ruled by syndicates that prey on the helpless. These are not isolated cartels. From district towns to remote upazilas, these informal but powerful groups operate with near impunity, dictating who lives and who dies based not on medical urgency but on money.

In many regions, these ambulance mafias are entwined with hospital staff, unscrupulous clinic owners and, alarmingly, local administration. They maintain a monopoly by obstructing external ambulances, often through coercion, threats or outright violence. Families in crisis are forced to pay exorbitant rates or risk delay, harassment or worse. Stories like the one in Shariatpur have echoed throughout the country. In 2022, a cancer patient in Narsingdi died after a similar standoff. In 2023, an elderly man was forcibly removed from an ambulance in Chattogram because the vehicle was, again, not part of the local “approved” fleet.

One cannot help but wonder: when did we fall so far from grace? How did we arrive at a place where a child’s life is worth less than a petty dispute over fare? When a driver says, “You take the patient then”, it is not just frustration speaking; it is surrender to fear, to intimidation and to a corrupt system that punishes integrity and rewards brutality.

The rot goes deeper than just the ambulance drivers. The entire referral and emergency care ecosystem is marred by inefficiency, extortion and apathy. And when tragedy strikes, accountability is nowhere to be found. After the Shariatpur incident, the police’s response was that no complaint had been filed. The civil surgeon claimed ignorance. This is not just shirking responsibility but a glaring indictment of a system that is failing its most vulnerable citizens.

Let us not mince words: this is murder. Not in the traditional sense, but morally and ethically. It is nothing short of manslaughter. Denying emergency medical transportation for the sake of greed is more of a crime against humanity than a dereliction of duty. And yet, justice remains elusive. The culprits hide behind political ties, bureaucratic indifference, or simply the knowledge that victims rarely come forward because of grief, fear, or the futility of legal recourse.

To turn the tide, we must act swiftly and decisively. There is no alternative to establishing district and upazila-level ambulance control committees, comprising members from the administration, police, health departments and civil society. Every ambulance, whether private or public, must be registered under a centralised digital database with real-time monitoring. Anti-syndicate legislation must be enacted, criminalising the obstruction of emergency services and ensuring that offenders are prosecuted to the full extent of the law. Most importantly, victims’ families must be provided with legal aid and compensation, not merely offered condolences and forgotten.

The child who lost his life in Shariatpur will never return. But his death must not be in vain. It must jolt us into action. If we continue to turn a blind eye, the next casualty could be someone we know: a friend, a parent or a child. In the fight between greed and humanity, we must pick a side. The clock is ticking. It is time to speak up, to clean house and to ensure that never again does a child die in the back of a stranded ambulance not because of disease but because of human cruelty masquerading as business.