Emergency healthcare transport

BEN Namibia's bicycle ambulance project began when we found that healthcare volunteers who had received bicycles through our projects were using the luggage racks to transport clients to hospitals and clinics. We had heard about the work of FABIO in manufacturing and distributing bicycle ambulances in Uganda, and thought that there was potential to apply the idea in Namibia.

The first prototype, a basic stretcher towed behind a bicycle, was demonstrated to HIV/AIDS home based care volunteers in Oshakati in 2005, who provided advice and encouragement. In 2006, Yelula-Ukai funded a prototyping phase that enabled us to develop a design appropriate for Namibian conditions.

The finished design features a robust steel frame, seat-post attachment system made from off-the-shelf nuts and bolts, pulling handle for crossing thick sand and stand-alone use, a removable stretcher with adjustable backrest, carry bag for basic medical supplies, sun shade and standard mountain bike wheels.

BEN Namibia partners with community based organisations throughout the country to deliver each bicycle ambulance. Healthcare volunteers receive training in use, maintenance and reporting on the performance of the ambulance. A participatory management session also helps partners address issues like storage, access and covering costs of maintenance.

Each time the ambulance makes a trip, a log book entry is made with trip details. A copy of the log book is sent to BEN Namibia periodically, helping us to understand how it is being used. Bicycle ambulances have been used to transport people for conditions ranging from HIV/AIDS-related illness to scorpion bites, and seem to be most used where they are located within 10km of a health facility, and where tracks are not too sandy.

The bicycle ambulance is not intended to replace motorised ambulances, but to fill a gap where no services are provided. Indeed, for most of Namibia, there is no public emergency ambulance system, and people often die because they can not afford to pay for private transport. Until Government is able to develop adequate policies and procedures on emergency medical transport, it seems that bicycle ambulances will have a role to play.

To date support from Bank Windhoek, the Australian High Commission in South Africa, and a partnership between The Rotary Clubs of ChinaTown Vancouver, Port Moody, Windhoek, Rotary International and Design for Development in Canada and individual donations has funded over 70 bicycle ambulances up until April 2008. We welcome further support for the project.