Zambulance is a bike-trailer ambulance that transports patients from rural areas to healthcare centers.
Regions targeted for distribution include: Burundi, Democratic Republic of Congo, Kenya, Malawi, Mozambique, Rwanda, South Sudan, Tanzania, Uganda, Zambia
Distributors include: Zambikes and Disacare, a Zambian NGO led and operated by Zambians with disabilities. Disacare has produced over 200 Zambulances, and is continuing to design. Nonprofits in Namibia, Malawi, Madagascar, and other countries are also modifying and using the design.
Implementers include: Transaid, World Vision, USAID Plan, Malaria Consortium, Catholic Relief Services, Samaritans Purse, Care International, Africare, Willow Creek Church, Rolling Hills Covenant Church, Solon Foundation, and many other organizations.
Zambulance are locally built. Zambikes has production facilities in Zambia and Uganda with a united capacity of 2000 zambulances/year.
Manufacturing guidelines are provided via an open-source production Manual available for download here.
How many patients can be transported per trip
Zambulance is a two-wheeled ambulance trailer featuring a steel frame and motorcycle wheels.
The stretcher is removable from the trailer to facilitate transport of the patient through narrow passages. The body of the stretcher is made from sheet metal as it is more durable and easier to clean than high-quality fabrics. The canopy frame is fashioned from rebar welded to the stretcher’s rear panel, where a waterproof canvas can be strapped on as rain and sun protection for the patient. It also has a cushion and a reclining backrest. The hitch attaches the trailer near the bicycle’s rear axle by clamping onto the seat stay and chain stay.
Production Manual and User Manual with full specifications is available for download here.
Additional schematics are available in the Production Manual.
Zambikes provides on-site training and follow-up visits when a Zambulance is introduced to the user.
Local manufacturing ensures that locally available components are used and can be sourced for replacements.
At least 5 years
To enable faster and comfortable patient transport to the nearest clinic for patients in rural areas.
In 2008, Transaid implemented a bicycle ambulance project in three districts of Zambia’s Eastern Province. The project saw the production and
distribution of 40 bicycle ambulances. Transaid established a specific monitoring and evaluation framework for this project. Log book data showed that the average distance traveled on the bicycle ambulance in one trip was 13.7km. The longest distance for one trip, in Katete, was 40km. A performance weakness identified was that in some cases the stretcher had broken due to manufacturing errors.
World Health Organization field trials.
No listed hazards
The Zambulance can not function without the addition of a bicycle or motorcycle. Additional supportive devices include intravenous hangers.
J. Vechakul, 2008, Design of bicycle ambulances for Zambia, Massachusetts Institute of Technology
Nicholl, J., West, J., Goodacre, S., Turner, J., 2007, The relationship between distance to hospital and patient mortality in emergencies: an observational study, Emergency Medicine Journal, 24(9), pp. 665-668.
Razzak, J. A., Kellermann, A. L., 2002, Emergency medical care in developing countries: is it worthwhile?, Bulletin of the World Health Organization, 80(11), pp. 900-905.
Kobusingye, O. C., Hyder, A. A., Bishai, D., Hicks, E. R., Mock, C., Joshipura, M., 2005, Emergency medical systems in low- and middle- income countries: recommendations for action, Bulletin of the World Health Organization, 83(8), pp. 626-631.
Macintyre, K., Hotchkiss, D.R., 1999, Referral revisited: community financing schemes and emergency transport in rural Africa, Social Science & Medicine, 49(11), pp. 1473-1487.
Fourneir, P., Dumont, A., Tourigny, C., Dunkley, G., Drame, S., 2009, Improved access to comprehensive emergency obstetric care and its effect on institutional maternal mortality in rural Mali, Bulletin of the World Health Organ,87(1), pp. 30-38.
V. Simfukwe, C. Barber, and G. Forster, 2009, Evaluation Report on the 2008-2009 Bicycle Ambulance Pilot Project Implemented in Three Districts of Eastern Province, Zambia, Transaid, London
No applicable international standards have been cited.
A study from the World Health Organization monitored the use of 40 Zambulances over the course of four months. Additional information was gathered in the study through interviews with caregivers and patients, and analysis of logbooks.
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