Tag: Community development

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African Bicycle Ambulances

The research I looked at today was how African bicycle ambulances are being used to provide a more effective maternal health services.

 

This is an area of health services that has a high priority within the UN Millennium Development Goals and in Africa, this is an area of significant concern and where much aid effort is concentrated. One older Transaid project from Zambia, which implemented a number of bicycle ambulance projects in various regions in Africa, stood out for me in particular, so I thought I would share the project highlights with you.

 

Background to African Bicycle Ambulances

Transaid is a charity organisation established by the Charted Institutes of Logistics and Transport in association with Save the Children Fund. Its primary objective is to address major transportation issues faced by poor rural African health services. This project focuses on maternal health, as these indicators provide a solid representation of the efficiency of the overall health care system in a given area. Rural Africa faces severe patient mobility issues, even for short distances, with access and cost being the most critical factors, especially in emergencies and fistula cases. Additionally, the further demand and requirement for Immediate Modes of Transport (IMT) ‘is significant among maternity cases’ and this is most significant given that ‘one of the biggest reasons for the large number of maternal mortalities in developing countries is the time and distance pregnant women have to travel to the nearest clinic to receive proper care’ (Forster, Simfukwe, & Barber, 2010, pg 13). One example of the seriousness  of this situation comes from an Ethiopian Fistula Hospital, which reports that it takes women in labour an average of 11 hours to reach a health facility that can provide for their needs – and this is in the urban capital city of Addis Ababa!

 

Project

To increase access to urgent health care services, 40 bicycle ambulances were provided to rural communities in Zambia in 2008, which provided a free bicycle ambulance service for community members. This project was better thought out than a number of others I have read, mainly as the bicycle ambulances were allocated to community-based home carers (personal) and not assigned to be stored and/or work out of a health clinic (location). This is much more appropriate, as location issues such as access to a bike (if they are in a room or shed on location which is locked), or only having one particular staff member who has a key, limited clinic opening hours or collecting oxen to be hitched to a cart from surrounding areas, – have all often hampered response times in similar projects. Additionally, ten local field mechanics were trained to construct and service the ambulances, which was found to be a major success factor.

Bicycle Ambulance Design considerations: Three different bicycle ambulance designs were trialled and assessed. A design with a stretcher, full canopy and a non-flexible hitch was the considered the most comfortable and popular by riders and patients. Other interesting feedback considerations were:
• The bicycle should be permanently attached to the ambulance to extend the life of hitch apparatus.
• Rear wheel post frame hitching made turning more difficult than seat post hitching.
• Provision for a pump, basic maintenance tools and a first aid kit is needed.
• Lights were required for night-time call-outs.
• Bicycles needed to be lighter or adequate gears used for uphill trips.
• Clothing should be provided such as a high visibility vest and a rain jacket.
• The size of local door frames was an issue as the original prototype ambulance was too wide to fit through a standard Namibian door frame – which impacted on patient transference.

 

 Results
• During the whole program, the bicycle ambulances took 251 life-saving journeys – the longest trip being 40 km.
• During the pilot program (first 4 months), the bicycle ambulances were used 82 times to transport patients to health care facilities.
• By having a personal bicycle ambulance, 96% of the recipient caregivers were able to be more effective in their work.
• Travel time was significantly reduced (from 2.5 hours by ox-cart down to 30 minutes) by using bicycle ambulance.
• Patient safety and comfort increased – they could lie down on the bicycle ambulance instead of sit (or ride) on a personal bike.
• The bicycle ambulance canopy provides shelter (rain, mud, sun, animals) and privacy for patients (especially important for women who are nearing birth – i.e. waters breaking etc).
• Having a stretcher attached meant that river crossings were much safer and easier and the bikes were able to take walking paths that oxcart transportation was unable to manage.

 

Comment

There has not been any further monitoring and evaluation data from this particular project – but as it stands, this project seems to be a step in the right direction. It is encouraging to see bicycles being utilised to help address some of the most pressing and urgent health issues that disadvantaged poor African women face. It is incredibly important that such initiatives are investigated, promoted and disseminated. It is also a very humbling reminder for people living elsewhere, (like Australia) who can often forget how significant and urgent basic (community) health services can be.

 

Source: Transaid

Forster, G., Simfukwe, V., & Barber, C. (2010). Bicycle ambulances have impact. Appropriate Technology, 37(3), 13.

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CONS-U-ME BLUES Art Bike

The pre-loved high-end bike in the picture below was on sale at a property auction. No one wanted it – it was too old and daggy and from the reaction of the crowd appeared in no way cool enough to buy, let alone ride. I looked at this forlorn bike and thought of the previous owner who had purchased, loved (I hoped), and ridden this bike – then it has been cast out after however long and was now forgotten and miserable. It was a sorry sight to see; as it seemed that there was still so much more spunky and happy times to be had with it– yet here it was discarded and sad long before its expiry date.

Considering how rapidly bike technology, marketing and styles change, my heart broke: that no-one wanted this bike anymore, that this bike had been so quickly and uncaringly superseded – and although it was in perfect working order at auction, was regarded as objectionable and obsolete.

So I took pity on it and was the only person who bid on it – and got it for 50c.

On my way home from the auction, I found a bag of clothes someone had tossed on the side of the road. All the clothes were brand new – tags still attached, never worn. Amongst the clothes were a set of blue athletic work out tracksuits, not dissimilar to those I’ve seen people wear on an exercise bike. It felt very serendipitous and ironic acquiring these two items.

I was inspired to create this art bike as I acquired both passion (bicycle) and fashion (clothes) items on precisely the same day. As well, both were items I have bought on a number of occasions elsewhere. However, on this day, I was even more strongly, blatantly reminded of the immensely wasteful and consumeristic society we live in; personified by these two items presenting themselves so closely and prominently within the same hour. It was both saddening and humbling.

So I refashioned these two items together to generate a new, valued and wanted artefact, that urges us to be more mindful of products we buy and to be more prudent with our passion and fashion purchases.

As the title of this art bike CONS_U_ME BLUES identifies, this bike highlights how often our CONSUMErist society CONS YOU and ME into buying more and more products – the result of which, when honestly critiqued, makes many of us quite depressed and BLUE.

 

Please be more mindful and responsible with your purchases.

 

Art bike: CONS U ME BLUES by Nina Ginsberg
Art bike: CONS U ME BLUES by Nina Ginsberg
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Bicycle Washing Machine

Initiative: When Remya Jose was 14, she invented a bicycle –powered washing machine to help her do the family washing. With women traditionally doing the household chores, Remya and her sister had to take over the family washing after both parents were too ill to work. Hand washing Indian style is usually done in rural waterways that are away from the home and it is a time-consuming, physically demanding and labour intensive activity. Previously Remya’s family did not have a washing machine. After seeing other locals in her town of Kizhattoor Panchayat, India, use a few electrical washing machines, she fashioned her design based on the same principles, but added pedals as the power source so that no electricity was needed. The ‘washer’ is seated behind the machine on a seat so that when they cycle, a chain rotates a mesh cylinder inside a central aluminum box. It now takes Remya only about 20 minutes to soak, wash and rinse clothes. She designed it herself and with help, it was made from parts that were sourced locally.

 Effectiveness: This simple yet effective modification is a great example of what I consider to be the most effective, sustainable and powerful community change: one where the problem is self-identified by the community; a solution is self-initiated and implemented and  there is no reliance on external people, materials or skills in order to maintain the result. Such practices are a move in the right direction to reduce criticisms that aid perpetuates a culture of dependency and expectations, and that communities are best left alone to deal with and overcome their own problems without external intervention.

Connection: Furthermore, as Easterly (2008) points out, it is the people who are creative and experimental in trialing alternative ways to solving community problems (like Remya), who are usually more effective in alleviating poverty associated issues as opposed to those who invest copious amounts of energy, time and money into approaches that have no immediate results and/or are not locally contextualized.

Take away: This story is also a humble reminder for us Westerners of the lies we tell ourselves, like: ‘I don’t know how to fix it’, ‘I haven’t got the money’, ‘I don’t have the time’, ‘It’s quicker just to buy a new one’ – are all too easy and such thinking does not create positive change. But ingenious action will.

As this story exemplifies, training, education and money is often no match for being resourceful, shrewd and confident. I think it is a pity that such valuable skills are not promoted and taught within our community.

Where in your life do you apply cheap, innovative and functional solutions to problems?

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Easterly, W., 1957, & ebrary, I. (2008). Reinventing foreign aid (1st ed.). Cambridge, Mass: MIT Press.