AP PHOTOS: Sidecar ambulances help mothers give birth in India

AP PHOTOS: Sidecar ambulances help mothers give birth in India
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22 December 2022 GMT

NARAYANPUR, India (AP) — The motorcycle roared as it struggled to carry the ambulance cart up a steep riverbank. The cart—a wheeled hospital bed under a white canvas canopy—swayed dangerously as the motorcycle’s rear tire spun in place, blowing up water and mud. Two paramedics, who were following on foot, tried to push, but did not move.

Eventually, the three of them gave up and decided to dig a new path.

After 40 minutes of digging and a push to get the vehicle out of the riverbed onto the muddy road, the team was back on the road. The bicycle ambulance continued its nine-mile trek through the forest known as Abhujmarh or “Unknown Hills” to reach Phagni Poyam, 23, who was nine months pregnant in the isolated village of Kodoli.

When the team arrived, Poyam was waiting next to her sleeping 1-year-old son Dileş. Like many babies in Kolodi, Dileş was not born in the hospital due to both distance and distrust of the authorities. However, Poyam said that she has seen women or their babies who died during childbirth in recent years and did not want to leave anything to chance.

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

Ambulances with motorcycles assist mothers in giving birth in Naryanpur district in central India’s state of Chhattisgarh. The densely forested region is one of the most sparsely populated areas in India, with a population of approximately 139,820 spread over a larger area than Delaware. Many local villages, such as Kodoli, are 16 kilometers (10 miles) or more from motorized roads. The state has one of the highest pregnancy-related deaths for mothers in India, with 137 pregnancy-related deaths for mothers per 100,000 births, nearly 1.5 times the national average.

While authorities and health professionals agree that bike ambulances do not offer a long-term solution, they do make a difference.

The state’s healthcare system struggled to reach remote villages. Residents of Kodoli usually walk 20 kilometers (12 miles) to the nearest market town, Orchha. It takes about two and a half hours. The lack of roads often forces the villagers to resort to makeshift litters to transport the very sick.

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

Bicycle ambulances were first deployed in Narayanpur in 2014. Today, there are 13 bicycle ambulances operating in the three districts of Chhattisgarh, operated by a non-profit organization called Saathi with support from local authorities and UNICEF. Bhupesh Tiwari of Saathi said the idea originated from a similar project in Ghana. Ambulances focus on bringing mothers to and from the hospital, but have also been called in to transport snakebite victims and other emergencies.

The number of babies born in hospitals in the Narayanpur district, which was just 76 in 2014, has doubled since 2014, reaching an annual average of about 162 births. Bicycle ambulances assisted nearly 3,000 mothers and their babies in the 99 scattered villages of Narayanpur. district.

After Poyam and her son were safely on board, they took the motorcycle ambulance route back to Orccha and took Poyam to an early referral center close to the hospital, where expectant mothers could see doctors while under observation. The mother and son had to disembark several times as the motorcycle ambulance drove up a difficult slope or over a rocky riverbed. At times, 24-year-old driver Sukhram Vadde had to remove large stones that threatened to get stuck under the car.

It was dark when they reached Orccha. Lata Netam, the health worker in charge of the centre, had called before leaving Poyam’s village to make sure dinner was ready. One-year-old Dileş played with the staff there and grunted happily, and answered Netam Poyam’s questions: “What will the doctor ask me? Do I need documents? Can my husband come to visit me?”

“We are from here. We know these villages. We want mothers to feel like they have never left home,” she said.

Confidence in hospitals and modern medicine is growing. There are mothers in the villages who speak highly of the hospital. At the weekly market in Orccha, where hundreds gather from remote villages to buy essentials or participate in fiercely contested cockfighting tournaments, government health workers are busy screening people for diseases like diabetes and malaria.

Blood tests revealed that Poyam’s iron levels were dangerously low, possibly due to malnutrition. This can lead to complications such as excessive bleeding during childbirth, so doctors prescribe supplements to help it.

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

Dileş later returned to the village to stay with her father. Regular meals supplemented with supplements raised Poyam’s iron levels and gained 9 pounds.

And she gave birth to a healthy baby boy a little after 2 p.m. Wednesday.


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

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