AP PHOTOS: Sidecar ambulances help mothers give birth in India


December 22, 2022 GMT

NARAYANPUR, India (AP) — The motorcycle roared as it struggled to carry the ambulance sidecar up a steep river bank. The bike’s rear tire whirred into place, kicking up water and mud as the sidecar, a hospital bed on wheels, under a white canvas canopy, rocked dangerously. Two health workers, who had been following him on foot, tried to push him, but he did not move.

Eventually, the three of them gave up and settled for digging a new path.

After 40 minutes of digging and a push to lift the vehicle from the riverbed onto the muddy road, the team was back on track. The bicycle ambulance resumed its nine-mile journey through the forest known as Abhujmarh, or “the unknown hills”, to reach 23-year-old Phagni Poyam, nine months pregnant in the isolated village of Kodoli.

When the team arrived, Poyam was waiting with her sleeping 1-year-old son, Dilesh. Like many babies in Kolodi, Dilesh was not born in a hospital, both because of the distance and mistrust of the authorities. But in recent years, Poyam said, he has seen women or their babies die in childbirth and doesn’t want to take any chances.

“My baby will be safer,” she said in Gondi, a language spoken by some 13 million members of the Gond indigenous community.

Motorized ambulances are helping mothers give birth in the Naryanpur district of Chhattisgarh state in central India. The densely forested district is one of the most sparsely populated in India, with some 139,820 people spread over an area larger than Delaware. Many local villages, such as Kodoli, are 10 miles (16 kilometers) or more from motorable roads. The state has one of the highest rates of pregnancy-related maternal deaths in India, about 1.5 times the national average, with 137 pregnancy-related maternal deaths per 100,000 births.

While authorities and health workers agree that bicycle ambulances do not offer a long-term solution, they are making a difference.

The state health system has had trouble reaching remote towns. Kodoli residents usually walk the 20 kilometers (12 miles) to Orchha, the nearest market town. It takes about two and a half hours. The lack of roads often forces villagers to resort to makeshift palanquins to transport the sickest.

Although the government has been trying to build a road network, roadworks are often targeted by armed rebels, who have been operating in the region for four decades. The rebels say their fight is for the rights of indigenous communities, who make up 80% of the population of Chhattisgarh state.

The ambulance bikes were first deployed in Narayanpur in 2014. Currently, there are 13 ambulance bikes operating in three districts of Chhattisgarh, run by local authorities and a non-profit organization called Saathi with support from UNICEF. The idea came from a similar project in Ghana, said Saathi’s Bhupesh Tiwari. Ambulances are focused on taking mothers to and from the hospital, but have also been called in to transport victims of snakebite and other emergencies.

Since 2014, the number of babies being born in Narayanpur district hospitals has doubled to an annual average of around 162 births each year, down from just 76 in 2014. The bicycle ambulances have helped nearly 3,000 mothers and their babies in the 99 scattered villages of Narayanpur. district.

Once Poyam and her son were safely on board, the motorcycle ambulance retraced its route back to Orccha and took Poyam to an early referral center near the hospital where mothers-to-be can stay under observation and see the babies. doctors. Mother and son had to disembark several times while the ambulance motorcycle navigated a tricky slope or a rocky river bed. Sometimes the driver, 24-year-old Sukhram Vadde, had to lift large stones that threatened to get stuck under the carriage.

When they reached Orccha, it was already dark. Lata Netam, the health worker in charge of the center, called ahead when they left the town of Poyam to make sure dinner was ready. Dilesh, one year old, gurgled happily, playing with others who work there, while Netam answered Poyam’s questions: “What will the doctor ask me? Do I need documents? Can my husband come visit me?”

“We are from here. We know these towns. We want mothers to feel like they haven’t left home,” she said.

Trust in hospitals and modern medicine is growing. In the villages, there are mothers who speak enthusiastically about the hospital. At Orccha’s weekly market, where hundreds of people from remote villages gather to buy basic necessities or attend the hotly contested cockfighting tournament, government health workers are busy screening people for diseases like diabetes and malaria.

Blood tests revealed that Poyam’s iron levels were dangerously low, likely due to a poor diet. This can lead to complications, such as excessive bleeding during labor, so doctors prescribed supplements to help.

Dilesh also tested positive for malaria. He was immediately hospitalized and treated for the virus, which kills thousands of children each year.

Dilesh has since returned to the village to stay with his father. Regular meals, boosted with supplements, have raised Poyam’s iron levels and he has gained 9 pounds.

And a little after 2 am on Wednesday, she gave birth to a healthy boy.


The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute Science and Educational Media Group. The AP is solely responsible for all content.

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