Sidecar ambulances help mothers give birth in India

NARAYANPUR, India (AP) — The engine roared as it struggled to carry the ambulance’s sidecar up a steep river bank. The motorcycle’s rear tire whizzed into place, splashing water and mud, while the sidecar—a hospital bed on wheels, under a white canvas canopy—swayed precariously. Two health workers, who had followed on foot, tried to push it, but it didn’t move.

Finally, the three gave up and decided to dig a new path.

After 40 minutes of digging and a push to lift the vehicle from the river bed onto the muddy track, the team was back on the road. The bicycle ambulance resumed its nine-mile journey through the forest known as Abhujmarh, or “the unknown hills,” to reach 23-year-old Phagni Poyam, nine months pregnant, in the remote village of Kodoli.

When the team arrived, Poyam was waiting next to her sleeping 1-year-old boy, Dilesh. Like many babies in Kolodi, Dilesh was not born in a hospital, both because of the distance and distrust of the authorities. But in recent years, Poyam said, she’s seen women or their babies die in childbirth and she doesn’t want to take any chances.

“My baby will be safer,” she said in Gondi, a language spoken by an estimated 13 million members of the Gond indigenous community.

Motorcycle ambulances help mothers give birth in Naryanpur district, in the central Indian state of Chhattisgarh. The heavily forested district is one of India’s most sparsely populated, with approximately 139,820 residents spread over an area larger than Delaware. Many local villages, such as Kodoli, are 16 kilometers (10 mi) or more from motorized roads. The state has one of the highest rates of pregnancy-related maternal deaths in India, about 1.5 times the national average, with 137 pregnancy-related maternal deaths per 100,000 births.

While authorities and health professionals agree that bicycle ambulances are not a long-term solution, they are making a difference.

The state’s health system is struggling to reach remote villages. Kodoli residents usually walk the 20 kilometers (12 mi) to Orchha, the nearest market town. It takes about two and a half hours. The lack of roads often forces villagers to resort to makeshift palanquins to transport the seriously ill.

Although the government has tried to build a road network, roadworks are often targeted by armed rebels, who have been active in the region for 40 years. The rebels say they are fighting for the rights of indigenous communities, who make up 80% of the population of Chhattisgarh state.

Bicycle ambulances were first deployed in Narayanpur in 2014. Today there are 13 bicycle ambulances operating in three districts of Chhattisgarh, run by local authorities and a non-profit organization called Saathi with the support of UNICEF. The idea came from a similar project in Ghana, says Bhupesh Tiwari of Saathi. The ambulances focus on taking mothers to and from the hospital, but have also been called upon to transport victims of snake bites and other calamities.

Since 2014, the number of babies born in hospitals in Narayanpur district has doubled to an annual average of about 162 births per year, from just 76 in 2014. The bicycle ambulances have assisted nearly 3,000 mothers and their babies in the 99 scattered villages of Narayanpur. neighbourhood.

Once Poyam and her son were safely on board, the motorcycle ambulance returned to Orccha and took Poyam to an early referral center close to the hospital where expectant mothers can remain under observation and see doctors. Mother and son had to disembark a few times as the motorcycle ambulance drove over a tricky slope or a rocky river bed. Sometimes the driver, 24-year-old Sukhram Vadde, had to lift large stones that threatened to get stuck under the carriage.

It was dark by the time they reached Orccha. Lata Netam, the health worker in charge of the center, called as they left Poyam’s village to make sure the food was ready. Year-old Dilesh gurgled happily, playing with others who work there, while Netam answered questions from Poyam: “What will the doctor ask me? Do I need documents? Can my husband come visit me?”

‘We come from here. We know these villages. We want moms to feel like they haven’t left home,” she said.

Confidence in hospitals and modern medicine is growing. In the villages there are mothers who speak highly of the hospital. At the weekly market in Orccha, where hundreds of people from remote villages gather to buy basic necessities or attend the hotly contested cockfighting tournament, government health workers are busy screening people for diseases such as diabetes and malaria.

Blood tests showed that Poyam’s iron levels were dangerously low, probably due to a poor diet. This can lead to complications such as excessive bleeding during childbirth, so doctors prescribed supplements to help her.

Dilesh also tested positive for malaria. He was immediately hospitalized and treated for the virus, which kills thousands of children every year.

Dilesh has since returned to the village to stay with his father. Regular meals, enhanced by supplements, have increased Poyam’s iron levels and she has gained 9 pounds.

“We expect her to give birth any day,” said Netam, the health worker.


The Associated Press Health and Science division is supported by the Science and Educational Media Group of the Howard Hughes Medical Institute. The AP is solely responsible for all content.

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