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Bicycle Ambulances Helped Cut the Malaria Death Rate in Zambia by 96 Percent

For families living in rural communities, traveling to the nearest health center can be an hours-long trek.
Image: Transaid

When a child gets sick with severe malaria, access to a hospital can mean the difference between life and death. A recent year-long trial in Zambia has shown just how critical this access is: the number of deaths due to severe malaria in the pilot area dropped 96 percent last year, in part due to the use of bicycle ambulances.

For many families that live in rural communities in the malaria-endemic regions of East Africa, the closest hospital is eight miles or more away, and the only way to get there is to walk. Studies have shown that in Kenya, for example, 40 percent of the population must travel in excess of an hour to reach the nearest primary health care facility. Sometimes they can get access to a motorbike or oxcart, but it’s not a guarantee, and when a child’s fever is spiking time is of the essence.

To try to close the window between when a child first gets sick and when they can get to the hospital, two healthcare nonprofits sponsored a yearlong trial project that took a two-pronged approach. First, using rapid diagnosis, field health care workers were able to identify children with malaria and give a first dose of medicine. Next, communities were equipped with specially designed bicycle ambulances with a flat, bed-like cart that tows the child behind a bike to speed up the journey to the hospital. Throughout the year, 70 percent of patients were transported to the hospital using these bicycles.

“During the pilot, severe malaria child case fatality was drastically reduced from 8 percent to 0.25 percent,” said a press release from Transaid about the trial. “[There were] three recorded deaths during the 12-month study period compared to 97 deaths that would have been expected in this period.”

An international effort to curb malaria has helped reduce the disease’s impact over the past two decades, but malaria still kills nearly half a million people every year, mostly children, according to the World Health Organization. After much progress fighting the disease, the final challenges will require creative solutions, and as this study shows, sometimes that’s as simple as strapping a cart to the back of a bike.

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