Zomba District, Malawi
In many rural parts of the developing world, basic services such as health care are out of reach. Often the biggest obstacle is transportation. The majority of rural Malawians must walk 15 km or 3-4 hours to the nearest Health Centre. This is a significant reason why rural Malawians are delaying care and disease is spreading. Home-based care initiatives are revolutionizing the Health System in Africa. Community Health Workers are traveling into remote villages to deliver vital health services, acting as traveling Health Centres. Community Health Workers go from village-to-village, house-to-house, walking upwards of 5 hours a day. Workers lack the transportation network to be able to access all the rural or remote communities where they are needed most. As a consequence, many of these communities receive woefully inadequate health care. Health Workers simply lack the means to reach these communities.
Bikes Without Borders invests in the infrastructure of communities by providing new bikes and bicycle ambulances to Community Health Workers. Having access to a reliable bike means these workers can cover greater distances, reaching more patients, and increasing the health of rural communities.
Phase 1: Completed Summer 2010
Our Pedal Powered Hope Project began with forty new local Indian Roadster Bicycles and Twenty bicycle ambulances being distributed to Community-Based Organizations who co-ordinate the efforts of Community Health Workers (CHWs) in Zomba District, Malawi, Africa in January 2010.
Collaboration and local partnership with YONECO, Africycle Malawi and Sakaramenta (local bicycle-ambulance manufacturer).
Needs assessment, new bike and bicycle-ambulance transport to local villages, community distribution ceremonies, signed agreements, repair and maintenance workshops, log books, monitoring & evaluation, transportation & health research component with surveys and focus groups District-wide.
Through extensive surveying District-wide in Malawi, we learned that:
- CHWs with bikes visited 13% more patients a day and spent 46% less time traveling to deliver healthcare compared to CHWs without bicycles.
- Incomes for people with bikes were 44% higher than those without bikes. Respondents with bikes were more engaged in the business sector and more likely to be selling more goods on market days.
- Mothers were 3x more likely to give birth in a Health Centre if there was access to a bicycle ambulance. If there were complications this would be life-saving. In the local language, Chichewa, the word for pregnancy = between life and death. In Malawi, the majority of pregnant mothers give birth alone without support or medical assistance and the country suffers from the 3rd highest maternal death rate.
- Rural Malawians were significantly more likely to be screened for Tuberculosis, educated about HIV/AIDS, receive regular check-ups and support, and have access to life-saving health services if Community Health Workers had access to a bicycle to reach their community.
Click here to learn more about our experience in Malawi based on our research during Phase 1.