Riding to the rescue across rough terrain
UNICEF-attached innovative, cheap motorcycle ambulances save lives
Just as the idea for BMW’s iDrive dashboard control system came from the gaming industry and Nike’s Shox shoes were adapted from Formula One racing shock absorbers, some remarkable healthcare innovations have been inspired by other industries.
One such idea, the Ranger LifeCycle Ambulance, was a focal point at the recent World Innovation Summit for Health (WISH) in Doha. Essentially a motorcycle ambulance with a sidecar stretcher and a roll cage as protection, the Ranger LifeCycle is built to meet the medical needs of rural areas in developing countries because it is capable of negotiating difficult terrain.
The LifeCycle was designed by Mike Norman, managing director and founder of eRanger, which makes the products. He says his initial idea was inspired by a TV appeal many years ago, in which a charity was raising funds for Land Rovers to be used by health workers in Africa.
“Being an avid motorcycle racer and bike designer, I felt that a motorcycle-based unit could do a similar job at a much reduced cost,” Norman says.
“This idea lay dormant for many years until I was in a better position in life — older and wiser — to take up the challenge. So one cold winter morning in my motorcycle workshop in the UK I picked up my hacksaw and made the first cut. That was some 16 years ago.”
eRanger sells the ambulance for around $6,000, less than 10 percent of the average cost of a four-wheel-drive ambulance. In the past few years, it has been used in Afghanistan and in many African countries where it carries patients and pregnant women to healthcare centers.
According to company data, since the motorcycle ambulances were deployed in 2005 in the Dowa district in central Malawi, southeast Africa, death rates among local mothers have dropped 60 percent.
The first prototype of the ambulance was made in 1997. After a two-year trial run in Zimbabwe, Norman’s invention won the Shell Technology for Development Award in 1999.
This led the company to its major sponsor, Prince Bandar Bin Sultan Bin Abdulaziz of Saudi Arabia, and to Nelson Mandela, who became the company’s patron and supported it in expanding its operation in South Africa.
Since then, eRanger has carried out projects, mostly in 20 African countries, plus one in Asia and one in the Caribbean. The company has also signed a long-term agreement with UNICEF, the United Nations’ children’s fund.
The majority of manufacturing moved from Britain to eRanger’s factory in South Africa in 2004 to better supply the local market.
“Also, we want to transfer skills and education to the local people,” Norman explains.
The motorcycle used in eRanger’s ambulance is made in China, modeled on the Chongqing-based motorcycle maker Jialing’s AG 200. Norman says the motorcycle supplier builds them to specification. Once the factory receives the bikes, it carries out further modifications.
“All the fabrication for the sidecar and motorcycle components is carried out in-house with the exception of rain covers, mattress and some plastic components. These items are subcontracted locally,” Norman says, adding that the bikes are built to order, because some countries are left-hand drive and some are right-hand drive.
The company so far has only one operation in Asia, in Kabul, to help in increasing landmine awareness and HIV education.
Four eRanger units designed to carry education and presentation materials and two eRanger ambulances have been used in the Afghan capital since 2006. Norman says the idea is to educate young children about landmines, because thousands of mines still litter Afghanistan after decades of conflict in the country.
The education units are operated by No Strings International, a non-governmental organization (NGO) that uses puppet films to help educate children around the world.
More than 25,000 children in more than 300 schools have seen such educational films in Afghanistan. “In Afghanistan, landmines are a major threat to many children’s lives and wellbeing,” says Rosie Waller, program manager of No Strings International.
Waller says based on the good feedback from Afghanistan, her organization would like to extend the collaboration with eRanger in other parts of the world.
“For example, we have a natural disasters preparedness and safety program for children in Southeast Asia and are about to work with children in West Africa on messages around water, sanitation and hygiene,” she says.
Meanwhile, two ambulances are operated by the Organization for Mine Clearance and Afghan Rehabilitation, which looks after the bikes with regular maintenance.
The ambulances can work in far more hostile terrain than other vehicles.
“The bikes transfer injured mine clearance workers to a suitable road where an appropriate four-by-four type ambulance can function for transfer to full medical aid,” Norman explains.
According to eRanger, the ambulances in Afghanistan have made more than 100 trips, benefiting more than 700 families.
Ambulance drivers can be trained locally by eRanger’s team. The company also has training facilities at its South African factory, including a test track to replicate driving conditions and a classroom to train personnel in practical situations.
The company keeps live data such as the drivers’ names, response times and patient outcomes during the journey to health centers to ensure that the vehicles are used in the most effective way.
This data collection is also supporting medical research in institutions, such as the Johns Hopkins University in Baltimore in the United States, and many NGOs.
Norman tells how the company once arranged a team of drivers to drive the eRanger ambulances from Egypt to Swaziland over a three-month period and some 10,000 kilometers to test how durable they are.
In daily usage, however, the bikes do not suffer so much punishment. They usually travel a maximum of 30 to 40 kilometers from where the patients are to the nearest health centers.
“The concept is that the eRanger ambulance is based in a rural health center and reaches out to the edge of the population catchment area that the health center covers,” Norman says.
But he explains that if transfer from the health center to a higher level of care, such as a hospital, is necessary, the vehicle can still be used.
“The issue is that if the patient is a trauma case, there is only a small window of time, a maximum of two or three hours, to reach an appropriate level of care,” he says. “Much longer, the final outcome of the patient would be poor.”
The company has another product, the Mobile Clinic. This vehicle is able to carry more drugs and equipment and can transport two rural doctors from the health center into the field to quickly set up primary healthcare such as postnatal checks and white blood cell monitoring.