In northern Uganda, the ambulance is a bicycle

30-05-2008 Feature

What to do when the patient is too sick to walk and there is no money to pay for an ambulance? Just send a family member to the nearest health centre to fetch the special bicycle donated by the ICRC. Iolanda Jaquemet reports on this new and affordable mode of medical evacuation in northern Uganda.


Pawel camp for the internally displaced, Amuru district. John Owor was evacuated by the bicycle ambulance after suffering from a bacterial infection in his leg that left him unable to walk.    

One day in early April, the pain that was gnawing at John Owor's badly swollen and ulcerated leg became too big to bear. " I had just buried my father and did not have any money left to pay for transportation. One month earlier, there would have been no way out for me, " he says.

But now, his brother walked to Pawel health centre, a few kilometres away, and came back with a bicycle towing a stretcher on wheels, complete with a foam mattress. At the health centre, John Owor was diagnosed with Buruli ulcer, a bacterial infection causing extensive destruction of skin and soft tissue. " They gave me some tablets and an injection, which relieved the pain, " he says. In a few weeks, the father of eight will undergo an operation in Gulu hospital.

 Bicycle is free, but must be maintained  

" Health centres used to have these bicycles years ago, but with the conflict in northern Uganda, they were not maintained, " says Dr Stephane du Mortier, the ICRC’s medical coordinator in Kampala. " We have already donated 15 of them and will donate an additional 15 soon to health centres and villages in the districts of Amuru, Gulu, Kitgum and Pader. " The agreement is that the use of the bicycle is free of charge. In exchange, the community around the health centre commits to collecting small sums from its members, which will be used to maintain the vehicle.

Further north, near the Sudanese border, is Bibia, another health centre supported by the ICRC. Charles Okwera, who represents the district health authorities and is visiting today, is full of praise for this novelty.

" We have just one ambulance for the whole district of Amuru, and then the patient's family has to pay for the fuel. But most of our people here are very poor and the cost is unaffordable. The bicycle is great in case of a cholera outbreak, for women in labour, for elderly people and others who cannot walk. You just put them in the carrier and roll them to the health centre. A relative can easily pedal anywhere between 15 and 30 kilometres. "

 The omnipresent bicycle  

Pawel camp for the internally displaced, Amuru district. The bicycle ambulance donated by the ICRC.    

In a country where bicycles are used for everything from vaccination campaigns to transportation of various people and goods – from grandmothers to huge bags of cassava to pigs for the market – it was only natural to go the extra step to medical evacuation.

For Margaret Arac, the medical evacuation to Bibia was a matter of some urgency. Her 15-year-old son had suddenly died, in an unexplained way. A terrible blow for any mother, let alone for one who had previously lost her first born, her home and her fields to the protracted conflict in northern Uganda.

" I do not remember what happened after the death of my son. The next thing I knew was that I was on drip in the clinic for 48 hours. " The bicycle had transported her while in a deep state of shock.

As for John Owor, he lies in front of his hut, his crutches by his side, his right leg bandaged in a blue cloth, a resigned look on his face. He can hardly wait for the operation to recover a limb that is not painful now, but that " feels as if is not a part of my body anymore. "

He found the bicycle with the stretcher " very comfortable " . But the 50 kilometres that separate his camp for internally displaced people from Gulu hospital are too much of a distance. This time, an ICRC car will take John Owor to what he hopes will be the beginning of a new life.

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