A Partnership to Enhance Ambulance Services through Social Cryptos

This innovation by IBF Net is motivated by Indonesian media reports about a severe shortage of ambulance services in the city of Jakarta during the hard days of the pandemic. Research by the internal team at IBF Net led to a realization that this may indeed be the case.

Jakarta, officially the Special Capital Region of Jakarta is the capital of Indonesia. It lies on the northwest coast of Java (the world’s most populous island). Jakarta is the centre of the economy, culture and politics of Indonesia. It has province level status which had a population of 10.56 million as of 2020. Although Jakarta extends over only 699.5 square kilometres, and thus has the smallest area of any Indonesian province, its metropolitan area covers 6,392 square kilometres, and is the world’s second-most populous urban area, after Tokyo. It has a population of about 35.934 million as of 2020.

Click on the icon to find data relating to the given province.

The map prepared by the IBF Net team above shows the province-wise availability of hospitals and ambulance assets across Indonesia. A surprising revelation about DKI Jakarta was that it had the smallest number of ambulance per hospital. Total number of hospitals was an impressive 203 while not every hospital had an ambulance attached to the same. At 127, the number of ambulances seems to be grossly inadequate to serve such a large population, especially during the pandemic.

Emergency Response in Jakarta

The Emergency Ambulance Service (AGD) was established by the government of Indonesia in the early 2000s to assist disaster response teams, such as the National Disaster Management Agency (BNPB), the National Search and Rescue Agency (Basarnas) and the Indonesian military. Previously, the Disaster Guard Team (a special unit within AGD) was semi-inactive as it only handled extraordinary events or natural disasters on a national scale.

In Jakarta, AGD’s first responders have 67 ambulances only. The average response time of an AGD ambulance ranges from 30 to 40 minutes, which is considered too long for patients requiring emergency response. An erosion of public trust in the service is also reflected in the report that ambulance requests during the pandemic are dominated by hospitals that want to refer a patient to another hospital and need transportation as compared to the general public seeking services, notwithstanding the emergencies they faced. Because of the small size of its fleet, AGD has queues of dozens of requests for ambulances every day and looks forward to not-for-profit and charity organizations for support. In addition to the minimal number of ambulance units, not all ambulances are equipped to transport patients who may have coronavirus. Observers feel if the health system in Indonesia can be optimised, the average death rate from coronavirus should certainly decline significantly.

Research Study at Cardiff

Indeed the situation has warranted systematic study of the problem and a search for optimal solutions. A study currently underway at the Data Innovation Research Institute, School of Mathematics at Cardiff University by a team comprising Dr Paul Harper, Dr Daniel Gartner, Dr Vince Knight, and Sarie Brice have proposed new mathematical models that will be used to overcome Indonesia’s unique challenges in this field. Working with the Indonesian National Emergency Ambulance (118) Service, the research team hopes to bring about life-saving improvements to the health care system, lowering patient waiting times, increasing patient outcomes and survival rates for all in society. The Welsh Ambulance Services NHS Trust (WAST) will support the project, offering guidance and paramedic training to their Indonesian partners. Professor Aryono Pusponegoro, Director and Founder of the Indonesian 118 Emergency Ambulance Service Foundation, and Dr Justin Boutilier, MIT (Humanitarian Supply Chain Lab at the MIT Center for Transportation and Logistics) will also be supporting the project.

IBF Net X DDR Partnership

The immediate response of the IBF Net team to this problem was to identify a top Indonesian non-profit organization, such as, Dompet Dhuafa Republica and donate an ambulance, strengthening their existing fleet of ambulances in an attempt to study the problem better, which is the first step in identifying any solution. Currently, DDR operates a fleet of 17 ambulances to serve Jakarta and nearby locations. However, a visit to the premises of DDR by the IBF Net team in this connection and discussions with their officials in the health care division showed the potential to do a lot more under a productive partnership.

Ambulance donated by IBF Net to be operated by DDR under a benevolent partnership

Under a new proposed partnership IBF Net offers to (i) tokenize the ambulance-miles earned by DDR on its existing fleet of ambulances and (ii) tokenize every new ambulance that will be purchased in future to be part of the DDR fleet.

This may lead to several possible outcomes:

1. The existing portfolio of ambulances of DDR can earn impact-credits in the form of “ambulance miles” as they provide such services to the patients. These impact-credits can then be offloaded in favor of other organizations who make fresh donations against the impact-credits transfered to their accounts. These donations are ploughed back into the “ambulance portfolio” to expand the ambulance services of DDR. The donating organizations can instantaneously improve their respective impact profiles through such acquisition. They don’t have to go through the rather lengthy (and perhaps less efficient and effective) process of actually setting up an ambulance service to create a foot-print in the health care sector. An organization without the specialized competencies required to efficiently operate an ambulance service can now create an impact in the healthcare sector.

2. The portfolio of ambulances of DDR can receive new capital in micro amounts (facilitating micro-investments). This would require issue of “waqf security tokens”. The overall process is similar to the issuance of green waqf sukuk, where proceeds of the sukuk issues are designated to be invested in green projects. The ambulance waqf tokens will fund acquisition of new ambulances expanding the fleet and augmenting emergency patient care for the poor.

IBF Net and DDR partner in the project with the following respective roles:

DDR continues its healthcare/ ambulance services provision as before, but undertakes to provide “digital identity” to each ambulance via fixing EID device on each vehicle, closely monitor the services in terms of “ambulance-miles” (similar to airlines miles) and share this data with IBF Net at known intervals. It does what it is best at.

IBF Net as an award winning Islamic fintech company does what it is best at. a. It converts each ambulance-mile earned by DDR into social cryptos and makes available at its Impact Exchange. b. Subject to regulatory approval, it issues waqf security tokens for facilitating micro-investments in the ambulance portfolio expanding its size.

What is in it for DDR: a. proceeds of “ambulance-miles” which can go into fleet expansion; b. inflow of funds for new investments in ambulance fleet through issue of waqf security tokens

What is in it for IBF Net: platform fee to sustain its operations

What is in it for both: fulfilment of social-religious obligation and steady progression towards their common mission.

Shariah Considerations

What may be possible Shariah issues in the above scheme of things? The first and foremost reservation that the contemporary Shariah scholars may have around any token issue centers around the possibility of speculation with such tokens. The following statement of facts regarding the social cryptos should put such apprehensions to rest.

1. There is no actual buying and selling (of tokens) taking place — from a Shariah point of view — at negotiated prices between any of the parties, even while the transfer takes place through the Impact Exchange. Social cryptos issued against actual “ambulance miles” carry a fixed and pre-agreed dollar-equivalent-value. They will always be acquired and transfered at this value. There is no possibility of “buying low and selling high” for any party, ruling out any profit, whatsoever. The possibility of “illegitimate” profits is just not there, since there are no profits to be made in the first place.

2. The social cryptos derive their dollar-equivalent-value from a transparent accounting process based on the economic and technical life of an ambulance asset and its expected performance during its useful life. It is a notional value used for social accounting purpose only.

3. The use of social cryptos allows the parties to focus on “impact” that is now measured in terms of ambulance miles. Hence, the donor who cares about impact is encouraged to donate more, as s/he clearly sees the impact even prior to making his/her donation.

4. The use of social cryptos provides divisibility to ambulance assets and allows donation in small amounts — donation of ambulance miles and provides more ease and flexibility to the donor. The donor is no longer constrained by the lumpsum funding requirement that goes with a complete ambulance asset. Thus, there is a clear encouragement to a benevolent and charitable act in the line with the goals (maqasid) of Shariah.

5. There are no commercial contracts/ transactions involved in any part of the process. Hence, the possibility of riba/ gharar/ gambling does not arise at all.

Leveraging Research and Technology for a Halal Ecosystem