Contribution to MMI Annual Report 2014

Untill recently, the pregnant women of the Kinzamba healthzone (DR Congo) had to walk or cycle for tens of kilometers to reach a hospital. The dirt roads are in such a bad state that no car can pass. This is one of the factors explaining the high level of mortality in the region. That’s why Memisa put in place a system of motorcycle-ambulances. Thanks to this emergency transport system and the participation of the local population, there was an immediate impact. Every two days, a life is saved in Kinzamba.

Memisa is a Belgian medical NGO that promotes quality basic health care for people in the south. The main purpose is to provide essential and appropriate quality care, and to improve accessibility in particular for the most disadvantaged people, without distinction of race, religion or political beliefs. Memisa puts a focus on the most vulnerable groups being pregnant women and children under 5.

This is achieved mostly through sustainable development programs strengthening the local health systems, but also through small-scale initiatives promoting community involvement and through emergency aid complementary to the development programs in unstable areas. Memisa works mainly in Africa (DRC, Benin, Mauritania, Burundi, Congo Brazzaville) but also in India, and there are also some small scale initiatives in other parts of Africa, Asia and Latin America.

Our intervention in DRC is by far the largest (accounting for around 80% of the yearly budget), where we are supporting 31 health zones, covering around 4,5 million people.

Bad roads and effective ambulances

“It was my 7th pregnancy. My contractions started earlier than expected. So I went to the health center of Mosenge. It didn’t look good. That’s when I learned that a motorcycle-ambulance could take me to the hospital of Kinzamba where a ultrasound could be done. During my previous pregnancies I did the road by foot, it was long and perilous. So I was thrilled that I could count on the motorcycle-ambulance of Memisa”(Bavoka, age 30)

Organizing efficient referral systems from health centers to hospitals in rural DRC has always been a challenge in the fight against maternal mortality. Pregnant women have to walk or cycle for tens of kilometers to reach a hospital. The dirt roads are in such a bad state that no car can pass. This is one of the factors explaining the high level of mortality in the country.

Kinzamba, situated in Bandundu province, is an isolated village. Roads are in a very bad condition and there is no cell phone network nor public transport. It is a huge challenge for its 31.000 inhabitants to travel anywhere at all. Since transport is necessary to go from the local health center to the hospital, for example for an emergency caesarean section, many women walk or cycle the distance. There is an ambulance present in the zone, but the 4×4 jeep cannot access the most isolated areas due to impracticable roads.

Since 2014, Memisa has been trying to put in place an innovative system of motorcycle-ambulances in several rural health districts. A metal frame constructed locally into a carriage that can hold one person lying down in a relatively comfortable position, is being pulled by a motorcycle. This emergency transport system functioning with the participation of the local population has had an immediate impact. Lives are saved every day.

The transport of pregnant women to the hospital has become less dangerous and faster. This improves their chance of survival, both for the women and for their unborn child. In parallel, a radio-based communication system has been installed in the isolated health centers, allowing staff of the health center to contact the motorcycle-ambulance in case of emergency.

The local community has been mobilized to finance the functioning of the emergency transportation (through 4×4 or by motorcycle). For this purpose a communal financing mechanism based on solidarity between patients has been put in place. This works as follows. Every patient that receives a consultation at a health center or at the hospital pays 350 Congolese Francs (about 0,34 Euros) more in addition to the regular bill. This way everyone who uses the ambulance or the motorcycle-ambulance only adds 1.000 Congolese Francs (about 1 Euro) for the transport. This system allows the driver to be paid and to pay for the petrol and maintenance without further impoverishing the population.

More information:

For the occasion of mother’s day 2015, Memisa stimulates people to support
the motor-ambulance system through an online donation website:


Contribution by Memisa to the Annual Report 2014 of the MMI Network