Southern Sudan has introduced motorbike ambulances to its remote Eastern Equatoria region in a pilot scheme aimed at cutting rates of maternal mortality. Five powerful scrambler motorbikes with a sidecar “bed” have been deployed by the Ministry of Health to boost access to health facilities for pregnant women, officials said.

“We have a problem bringing critically sick people to the few referral facilities available,” said Atem Nathan Riek, director-general of primary healthcare for Southern Sudan, which has among the worst rates of maternal mortality in the world. A woman in the South has a one in six chance of dying during the course of her lifetime from complications during pregnancy or delivery, according to the UN Children’s Fund (UNICEF).  Sudan’s overall maternal mortality ratio is 1,107 deaths per 100,000 live births, but rates are far higher in the South, rising to 2,243 deaths per 100,000 live births, according to UNICEF.

Lack of services is one reason – but so too is lack of transport to reach the few services available. “We have in our budget this year at least one ambulance per county, but even that one ambulance will not be enough,” Riek added. “So there is room for any other innovative activities like these motorbikes.” If successful, the pilot project of five motorbikes will be extended to the rest of the country, officials said.

The motorcycles, donated by UNICEF, cost about US$6,000 each, with space for the patient to sit or lie down on the cushioned bed on wheels, and seat belts for legs and waist. There is also space for a health worker to sit behind the patient to provide care and support. Two mechanics will train local mechanics in the bike’s unique features.

Motorbike ambulances are also being used in Malawi, eastern South Africa, Kenya, Ethiopia, Uganda, Zambia, and Afghanistan.

A motorbike ambulance donated by the NHS in Wales in February 2009 recently helped to save the life of a young mother in southern Ethiopia. Shemsia Sultan, 18, who lives in the village of Chobare, was pregnant with her first child and was becoming weaker and weaker as her labour progressed but without any sign that the baby was coming.

The closest medical help was the Alaba health centre 40km away along poor roads and the nearest hospital was more than 100km away. Shemsia’s family, who had heard of the recent arrival of the motorbike ambulance in Alaba health centre and the training of the midwives there, telephoned the health centre in the middle of the night and the motorbike ambulance was sent out to Chobare. Shemsia gave birth in the health centre later that evening, with help from the trained midwife, to a baby girl weighing 3kg.

The two motorbike ambulances donated by Gwent Health Link to Yirgacheffe and Alaba health centres have made 50 similar journeys in the last two months. A third motorbike ambulance is being sent to the Wondogenet health centre.

In Malawi, where the motorbike ambulances were introduced in 2005, they have helped raise the number of women giving birth at health facilities from 25 to 49% over a period of four years, according to UNICEF. The service also helped to reduce maternal mortality rates from 586 to 236 per 100,000 live births.

Twenty motorbike ambulances recently began operating in Beijing, China. In 2006, Edinburgh, Scotland, introduced a motorbike ambulance for emergency health care that is used during large public events that cause traffic congestion.

This story was compiled from a variety of sources: SUDAN: Biking for safer childbirth, Torit 1 April 2009, IRIN News; Magunga's baby bikes in Motorbikes and Midwives: Delivering better care for Kenya's mums, DFID March 19, 2009; Malawi  Motorbike Ambulances and Rural Maternal Health by Rebecca Crouch;  Gwent motorbike ambulance saves lives in Ethiopia, Feb. 9, 2009, by Madeleine Brindley, Western Mail; and information about the motorcycle ambulance on the E-ranger site. The Ranger Production Co. Ltd. in Yorkshire, England, which makes the ambulances, also makes mobile immunization and emergency water units.

The picture at the top left shows the motorbike ambulance in Ethiopia and comes from the Ethiopia-Gwent website. The picture at the centre right shows drivers being trained in Dowa, Malawi, and comes from a case study about Malawi found on the e-ranger site. The video, which focuses on health care in Magunga Health Centre, in Nyanza district in northwestern Kenya, which has five motorbike ambulances, was posted on YouTube by DFID, the UK's Department for International Development. The picture at the bottom left comes from the e-ranger website.

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