Design of bicycle ambulances for Zambia

Abstract

In developing countries, people are dying from treatable diseases because they cannot reach medical care when they need it most. Typical methods of transport, such as wheelbarrows or motorcycles, are too slow, dangerous, or expensive. The bicycle ambulance is a locally produced and maintained, fuel-less vehicle that provides safe, affordable transport. The design of this appropriate technology varies greatly between countries because of the variability in local conditions, such as terrain, cultural stigmas, and availability of materials.This thesis describes the development of a bicycle ambulance (Zambulance) designed for Zambia. The Zambulance is a two-wheeled trailer that carries a sheet metal stretcher, and can be towed by common bicycles. The ambulance is fabricated from standard bicycle components and steel stock, such as 25mm round tube that can be easily bent to minimize cuts and welds. A single rider can transport one patient at average speeds of 25kph for distances up to 35km on passable B-grade roads. The trailer is 200cm by 98cm and weighs 22 kg, while the stretcher is 200cm by 65cm and weighs 20 kg. The Zambulance costs 1,200,000 Zambian Kwacha or about 315USD (based on exchange rate on December 27, 2007). One Zambulance can be fabricated in about 20 hours, which are usually spread over 5 days.There are currently forty-seven Zambulances in Zambia, and more are being produced by Disacare Wheelchair Center in Lusaka, Zambia. From January 2006 to August 2007, one bicycle ambulance was used over 125 times to transport patients from their homes to the nearby clinic and hospice. According to records, the ambulance carried men and women between the ages of twelve and ninety who were suffering from various ailments including cholera, tuberculosis, HIV/AIDS, blindness, broken bones, anemia, and pneumonia.

A production manual, user manual, and assessment material is available online for free downloading at http://cadlab6.mit.edu/bike.ambulance. Long-term monitoring and evaluation of the design is needed, but current data suggests that the Zambulances are already saving lives by closing the transport gap between patients and healthcare.