SUDAN: Biking for safer childbirth

Photo: Peter Martell/IRIN

A motorbike ambulance is test driven in South Sudan at the launch of a pilot project aimed to cut maternal mortality

TORIT, 1 April 2009 (IRIN) - 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.”

Photo: ReliefWeb

A map of Sudan highlighting Eastern Equatoria region

If successful, the pilot project of five eRanger 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 are being employed, and they will train local mechanics in the bike’s unique features.

Access problems

Only 10 percent of all deliveries in South Sudan are assisted by skilled health personnel, according to the UN Office for the Coordination of Humanitarian Affairs in South Sudan.

Poor road conditions – or no roads at all in some areas – mean it is difficult for those needing emergency support to reach even basic health clinics.

In the rainy season, many roads become impassable to heavy vehicles, but it is hoped the lighter bikes will more easily negotiate narrower paths around flooded tracks.

They are also cheaper and easier to maintain in remote areas, experts say.

With more than 90 percent of the South living on less than $1 a day, few can afford to hire transport even if they become sick. The new service will be free to pregnant women.

“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 with 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 or where cars cannot go.”

Photo: UNICEF

Southern Sudan is seeking to improve maternal mortality rates (file photo)

Southern Sudan is still recovering from a 22-year civil war with the North, which ended in a 2005 peace deal.

Eastern Equatoria was fought over by both northern and southern forces, while rebel Ugandan Lord’s Resistance Army (LRA) fighters also used the region as a base, terrorising a wide area through their brutal raids.

“Life for a woman here is very hard,” said Mary Emmanuel, who had three children in her village without professional help. “The clinic was too far to get to, so perhaps these motorbikes could help change that.”

Sudan is not the first to use the bikes - other nations include Uganda and Malawi.

In Malawi, the bikes helped raise the number of women giving birth at health facilities from 25 to 49 percent 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.

The bikes will be evaluated by the Ministry of Health for their success. They will be tested in health facilities run by both the government and international aid agencies.

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