Tuk Tuk Ambulance in Mozambique

What makes an ambulance system so challenging in Chiúre? The distances in this rural district are immense. There are hardly any suitable and affordable means of transport in the villages, which is why walking is the only way to get around. Nearly every second birth takes place at home in the village, without medical support. Most pregnant women have no choice in this matter, as they lack a vehicle and/or the money to pay for transport.

So there are no ambulances? Yes and no. Every district hospital has a vehicle that is sometimes roadworthy. This car will be used to transfer emergen­cies to a regional hospital. But the gap between the villages and their health centres, which are on average ten kilo-metres away, remains. 

There are ambulances everywhere in the world. Why not copy a system that works elsewhere? India has many systems, including very innovative ones such as “Uber for emergencies”. In Israel, “United Haztalah” provides impressive emergency aid through a huge network of volunteers. Such models are very important as inspiration. Everywhere in the world, however, the fact remains that ambulan­ces only reliably transport their patients if the necessary funding is in place. And in the economically desperate context of northern Mozambique, this is extremely difficult.

How do you approach this complex problem? SolidarMed has already done some crucial groundwork. More than ten years ago, the first bicycle ambulances were on the road, some of which are still in use today. These are not expensive to maintain, but their range is limited by the weather conditions and the huge distances involved. The experiences we gained with the bicycle ambulances gave rise to the idea of Tuk Tuk ambulances. Over the past two years, SolidarMed has been testing this system.

What came of this? During my three-week visit to Chiúre, I saw the potential of the Tuk Tuk ambu­lances. If you donate a vehicle, both the drivers and the patients benefit. The former can now earn a living and in turn, provide free emergency transport to pregnant women. Currently, we lack the funds to replace a Tuk Tuk when this becomes necessary. Solving this econo­mic challenge is part of my job.

Do you have any ideas yet? We have three starting points: There is an untapped need for transport and taxi services in Chiúre. If, for example, all ambulance taxis look the same, they will become better known and attract more customers. At the same time, we’re looking into what it would take to reduce the running costs. We’re revie­wing whether switching to solar-powe­red Tuk Tuks could work. But what’s most important to guarantee that this system lasts is a central organisation that manages everything.

And then SolidarMed withdraws? This is always the goal of the projects. What would make sense is a cooperati­ve. It would rent out functioning vehicles and ensure they’re maintained. To increase income, the taxis could provide additional services, like deliver­ing fish to the villages. The solar stations provide enough electricity to run a fridge to store fish. Last but not least, this is a contribution towards a more varied diet. As an engineer, I naturally dream of technical solutions, such as integrating a call centre in combination with GPS tracking to guarantee efficient journeys.

What are you wishes for the Tuk Tuk ambulance? If our interventions mean this model works in the long-term, this has enormous potential in terms of replicability, scalability and sustainabi­lity. Mozambique would have an ambulance system that works for this country, and this could help close the gap between the villages and the health facilities.

The Tuk Tuk Ambulance
As part of a pilot project, Solidar­Med rents out vehicles to local taxi drivers at favourable rates. They earn their living by transport­ing goods and people. In turn, they commit themselves to providing immediate and free transport to pregnant women from their villages to the nearest health centre in case of an emergency. GPS tracking helps to test and improve the efficiency of the Tuk Tuk.