South Sudan has a new tool in the fight against maternal mortality: motorbike ambulances, complete with sidecar and padded bed.
They might look a little unusual, but in remote parts of a country where — according to the United Nations — a 15-year old girl has a greater chance of dying in childbirth than finishing school, they have brought new hope of a reduction in avoidable deaths.
“It is appalling to note that southern Sudan has the highest maternal mortality rate in the world,” said Peter Crowley, south Sudan head of the UN Children’s Fund (Unicef), which donated the bikes.
“A woman in southern Sudan has a one in six chance of dying during her lifetime from complications during pregnancy or childbirth,” he said.
Yet many deaths are easily avoidable, if better access to even basic healthcare had been possible.
“The motorcycles will help bring pregnant women to health facilities,” said Florence Otto, health minister of East Equatoria state, where a first batch of five bikes has been deployed.
The region was one of the hardest hit during Sudan’s bloody 22-year north-south civil war, and wrecked military trucks and tanks still line the potholed roads.
For many years, rebel Lord’s Resistance Army (LRA) fighters from neighbouring Uganda also used the thick bush and rocky hills as bases to raid surrounding villages.
“The roads here are so bad, and some live far from the tracks, so it is very hard for them to reach the clinics in time,” Otto added, speaking at the launch of the first bike in the small and dusty village of Hiyala.
“People sometimes realise it is an emergency too late to travel the distance to get help,” she added.
Sudan’s north-south civil war ended four years ago, but the region remains underdeveloped and lacking in the most basic services.
“My children often get sick, but I don’t have the money to help them properly,” said Joyce Warrida, a mother with three children.
Ninety percent of people live on less than a dollar a day and many cannot afford transport to the clinics. According to the UN, only 10% of all deliveries in south Sudan are assisted by skilled health personnel.
Another mother waves at the thatch huts that make up the village.
“We gave birth to our children in places like these,” she says.
In the motorcycle sidecars, a patient can sit or stretch out comfortably, while there is still space for a health worker to sit behind and provide support if needed.
Seat belts for the waist and legs strap the patient in securely, and strong suspension helps the bike handle rough roads, which often become impassable to normal vehicles during the rainy season.
“The advantage of the motorbikes is that they can easily be managed at a lower level health facility,” said Joyce Mphaya, a safe motherhood specialist for Unicef.
“It is cost effective in terms of fuel and you can easily move with the motorbikes to remote places, where there are no roads, where cars cannot go,” she added.
Five bikes — each costing $6 000 — have been sent to remote health centres as part of a pilot project. If successful, more bikes will follow.
In other African countries, Unicef says, the initiative has already shown good results.
“The use of motorcycle ambulances to improve maternal and newborn care is a new initiative for Sudan, but has proven its effectiveness in countries such as Malawi and Uganda,” Crowley added.
In Malawi, the bikes nearly doubled the number of women giving birth in health facilities, and cut the number needing emergency caesarean operations by half, according to Unicef statistics.
Government officials have expressed their support.
“I don’t know how it will negotiate the mountains, but if it works, we are in for it, we will expand it,” said Atem Nathan Riek, director general of primary healthcare for south Sudan. – AFP