Disacare and Jessica Vechakul
The Zambulance is a locally built ambulance trailer based on an open-source design that can be attached to any bicycle or motorcycle.
Regions targeted for distribution include: Uganda, Zambia, Congo, Malawi, Democratic Republic of Congo, South Sudan, Rwanda, Burundi, Kenya, Tanzania, Mozambique
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.
$1,000 USD donation supports the shipping, delivery, on-site training, follow-up visits, and basic tool kit of a Zambulance.
Traditional Ambulance service, PROTECT Taxi Service
Goal #3: Good Health and Well-Being
Individual operators servicing families and households in remote villages in which the nearest clinic or medical facility is 3-10 miles away.
Locally built and assembled on an individual basis. Manufacturing guidelines are provided via an open-source production Manual available for download here.
1150 Zambulances have been distributed as of 2013. Disacare has produced over 200 Zambulances.
The 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 because it is more durable and easier to clean than high-quality fabrics. The canopy frame made out of rebar is welded to the stretcher’s rear panel to provide a frame for a waterproof canvas to be strapped on as rain and sun protection for the patient. It also has a cushion, a reclining backrest, and a weatherproof canopy for the comfort and protection of the patient. 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.
Component view shown below. Additional schematics are available via the Production Manual – downloadable here.
Zambikes provides on-site training, follow-up visits, and a basic tool kit when a Zambulance is introduced to the user.
Local manufacturing ensures that locally available components are used and can be sourced for replacements.
Atleast 5 years
Enable faster and more comfortable patient transport to the nearest clinic in comparison to alternate methods such as back of bicycle, wheel barrow, hand carrying and local stretchers.
In 2008 Transaid implemented a bicycle ambulance project in the three districts in 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 travelled 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. The stretcher on the ambulance in Mzime had to be welded twice and currently there is a restriction of not allowing overweight persons. Additionally, a basic suspension system would help reduce vibrations and bumps which might exacerbate a patient’s
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.
How many patients can be transported per trip
J. Vechakul, Design of bicycle ambulances for Zambia Massachusetts Institute of Technology, Cambridge, MA, 2008.
Nicholl, J., West, J., Goodacre, S., Turner, J., The relationship between distance to hospital and patient mortality in emergencies: an observational study. Emergency Medicine Journal. 2007 Sep;24(9):665-668.
Razzak, J. A., Kellermann, A. L., Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ. 2002 Nov;80(11):900-905.
Kobusingye, O.C., et al., Emergency medical systems in low- and middle- income countries: recommendations for action. Bull World Health Organ. 2005 Aug;83(8):626-631.
Macintyre, K., Hotchkiss, D.R., Referral revisited: community financing schemes and emergency transport in rural Africa. Social Science & Medicine. 1999 Dec;49(11):1473-1487.
Fourneir, P., Dumont, A., Tourigny, C., Dunkley, G., Drame, S., Improved access to comprehensive emergency obstetric care and its effect on institutional maternal mortality in rural Mali. Bull World Health Organ. 20009 Jan;87(1):30-38.
V. Simfukwe, C. Barber, and G. Forster, Evaluation Report on the 2008-2009 Bicycle Ambulance Pilot Project Implemented in Three Districts of Eastern Province, Zambia, Transaid, London, 2009.
Unknown. No applicable international standards have been cited.
Field studies, including caregiver and client Interviews, analysis of logbooks, informal discussions with rural health workers (three months after distribution).
Impact is demonstrated via metrics such as number of mortalities) without Zambulance vs. with Zambulance’s presence.
Here is a report detailing the design of the Zambulance.
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