Josephine Mupeta potentially saved four lives when she carried two pregnant women to a health facility. Josephine is one of the volunteer riders using bicycle ambulances to transform the lives of communities in sub-saharan Africa. 

It was November, just a few weeks after the bicycle ambulance arrived in the community. Josephine – a volunteer health worker from Serenje District in Zambia – was on her way to collect a woman with a complication in labour to take her to the health facility when she heard a second woman also needed emergency transport.

When she reached the second woman, after collecting the first woman, she realised she was in a far more serious condition, so she moved the first woman onto the parcel carrier at the rear of the bicycle and placed the other woman on the bicycle ambulance’s stretcher.

She then continued cycling for a couple of hours to reach the health facility where both women received treatment and safely gave birth to their babies.

That day, Josephine cycled that bicycle ambulance like she does every time she is needed – motivated by the opportunity to save the lives of mothers and their babies.

The More MAMaZ programme

In Zambia, the risk of a maternal death is 1 in 79, compared to 1 in 5,800 for women in the UK, according to World Bank data. Add to this a striking urban-rural divide – only half of rural births are attended to by a skilled healthcare provider, compared to nearly nine in ten urban births.

Between Josephine and the other 199 bicycle ambulance riders trained in the programme, a total of 4,105 mothers were transferred to health facilities in less than two years.

The transport industry funded the original research into bicycle ambulances. The More MAMaZ programme is funded by Comic Relief and supports work by the Ministry of Health. Transaid implements this project with a consortium that includes Health Partners International, Development Data, and Disacare.

Facts from the More MAMaZ programme include:

• 4,105 women have been transferred to a health facility by Emergency Transport Scheme (ETS) drivers, one of the factors leading to a rise in institutional delivery rates at 89%.

• 82,205 door-to-door visits have taken place at homes of pregnant and newly delivered women by Community Health Workers and 89% of women and girls feel empowered to achieve a safe pregnancy.

• The programme has also tackled other important community issues – 89% of men and 88% of women report a decrease in gender-based violence (GBV).

Albert Banda transformed his life, the lives of his family, and the lives of drivers across his country when he became a driver trainer. Albert is changing the face of road safety in Zambia. 

The 43-year-old, who works on the professional driver training programme at the Industrial Training Centre Trust (ITC) in Lusaka, Zambia, says: 

“I never saw myself becoming what I am right now. I have come to realize that it’s through such programmes like this that you’re able to make an impact in society.”

The father-of-one started his working life as a mechanic, but changed career after joining ITC in 2008. He now trains hundreds of drivers a year and has contributed to the Zambian Road Safety Agency’s National Driver Training Syllabus and Highway Code.

“It makes me feel good. When I see my name on the syllabus, I feel important.”

The opportunity also inspired him to start a Bachelor of Science course in logistics and transport management, which he attends seven days a week, after his full-time work as a trainer has ended.

Road safety is a huge issue for Albert, both professionally and personally.

An accident devastated his family when his cousin was injured in a crash in Nyimba. A Lusaka-bound Zambia-Malawi bus collided head-on with a truck and 34 people died.

Albert has also spent time driving a truck for long distances and saw first-hand the dangers drivers face through lack of training.

“For half a year I drove a truck, a friend trained me for a week and then I got my licence. [Back then] speed and space, for me, was not as issue. I came to realise later that I wasn’t doing the right things.”

Albert is concerned that drivers in Zambia are expected to work for long hours and make quick returns from trips, making lack of rest an issue. Truck drivers may drive across borders for up to 19 hours a day and be away for weeks at a time. They put their lives at risk due to the dangerous conditions of the roads, and are targeted for the theft of goods. Bus drivers are also pushed to their limits with lengthy days and quick returns. A bus driver could leave at 4am in the morning, drive until 9pm, then be expected to return at 4am the next day.

The many challenges the drivers face on a daily basis highlight how crucial the driver training programme is.

“When you see they are appreciating the knowledge or discovering new things in the driving profession, this gives me a sense of satisfaction.”

Albert’s work at an individual and national level is changing the face of road safety in his country and he is proud of the opportunity Transaid created for him.

“With this [Transaid-facilitated training], I’ve been able to become what I am. I’ve learnt a lot in terms of knowledge and skills, and the income has really helped.” 

The Professional Driver Training programme

In August 2008, Transaid partnered with the Industrial Training Centre Trust (ITC) – the only public commercial driver training centre in Zambia – to build capacity to deliver professional HGV driver training to internationally recognised standards.

Transaid provided a Programme Manager to oversee the daily running of the project and coordinate inputs from professional volunteers which included driver training and teaching techniques, tyre management and safety, maintenance, defensive driving, hazardous chemical training, and bus, coach and forklift truck driver training, and human resources. 

Following the success of the Zambia Professional Driver Training initiative, the programme was expanded into Tanzania, Uganda, and Malawi.

In the last 12 months alone*, Transaid and its partners:

• ∙ Trained 5,929 PSV, HGV and FLT drivers in Zambia and Tanzania and 24 driver trainers. 

• ∙ Facilitated 12 professional volunteer placements across our programmes

• ∙ Developed a new HGV/PSV curricula and instructors’ manual, to be used in Burundi, Kenya, Rwanda, Tanzania and Uganda.

* Statistics cover 1 May 2015 – 30 April 2016

“Women are no longer dying. All women in our community are now delivering at facilities and go now in time for antenatal care.”

Feedback from members of a community whose lives have been transformed by the More MAMaZ programme demonstrates how much of an impact the initiative has had.

In Zambia, the risk of a maternal death is 1 in 79, compared to 1 in 5,800 for women in the UK, according to World Bank data. Add to this a striking urban-rural divide – only half of rural births are attended to by a skilled provider, compared to nearly nine in ten urban births ­– and the significance of the programme results becomes clear:

4,105 women have been transferred to a health facility by Emergency Transport Scheme (ETS) drivers, one of the factors leading to a rise in institutional delivery rates at 89%.

“MORE MAMaZ has changed our way of thinking. Now that we have been sensitized about the danger signs, women no longer deliver in the community but choose to deliver at the facility, and we all support them.”

82,205 door-to-door visits have taken place at homes of pregnant and newly delivered women by Community Health Workers and 89% of women and girls feel empowered to achieve a safe pregnancy.

The programme has also tackled other important community issues – 89% of men and 88% of women report a decrease in gender-based violence (GBV).

“I, as the owner of my body, now makes the decision on if and when [I] go for care. It is no longer my husband or family. I make the decision and tell them and they support me.”

Check out our Knowledge Centre for MORE MAMaZ reports and case studies here. The programme is funded by Comic Relief and supports work by the Ministry of Health. Transaid implements this project with a consortium that includes Health Partners International, Development Data, and Disacare.

A forklift donated by Cat® Lift Trucks and delivered by Impact to support the work of Industrial Training Centre (ITC), a partner of Transaid, in Zambia has already helped 80 people qualify as forklift truck operators.

The three-tonne DP30N machine was specially tailored by Impact to protect it against dusty environments before it was gifted to the Professional Driver Training Project, which works to provide UK-standard training in Africa.

Forklift Truck Trainer Grieves Kachingwe said “The generous donation from Impact means we are able to train a greater number of operators, and give them more in-depth knowledge of operating forklift trucks. Once they qualify as trainers, they will be able to pass that knowledge on to their students, so it really is an invaluable gift.”

Kachingwe, who is based at the ITC, has first-hand knowledge of the project’s importance, having completed Transaid’s training programme in 2010.

He said: “Transaid’s Professional Driver Training Project has helped me to develop a worthwhile and rewarding career. It’s satisfying to be able to share the knowledge I’ve gained over the years and ensure students can operate machines efficiently and safely.”

Since entering service in January, the forklift truck has supported the training of 80 students.

In addition to donating the DP30N, Impact’s lead forklift truck instructor, Mark Prickett spent a week in Zambia training ITC staff in correct maintenance procedures. Impact’s partner, First Industrial Tyres – a specialist in industrial fitments – has also donated a new set of tyres for the forklift truck.

Impact has provided corporate support to Transaid since January 2015, including annual financial support which contributes to the testing and implementation of new ideas and pilot projects. Impact has also raised awareness of Transaid’s work among its staff, as well as donating employee time and equipment.

Transaid aims to raise the quality of life for people in the economically developing world by improving or implementing local transport systems, providing comprehensive HGV, PSV and forklift truck operator training, and promoting road safety awareness.

For more information about Impact visit www.impact-handling.com

 

 

In March 2015, Transaid was asked to provide technical support to the MANI project (Maternal and Newborn Health Improvement project in Bungoma County, Kenya) to assess transport barriers to maternal health services as well as design an appropriate referral system to facilitate the transfer of pregnant women from their homes to health facilities. The MANI project is being delivered by a consortium of organisations and other partners including: Marie Stopes International, Options Consultancy Services, AMREF, CARE, the Institute of Health Policy, Management and Research, KPMG IDAS, MannionDaniels, and the Population Council.

 

The aim of the MANI project is to strengthen core health systems in Bungoma County in Western Kenya and to increase the survival rate of mothers and newborns by enabling poor women to access affordable and quality health services throughout the county.

During a one month project Transaid conducted a transport mapping exercise in a sample of communities in Bungoma to confirm what types of transport are available and what the obstacles to pregnant women using them are. This was followed by a review and strengthening of the initial design of the project that proposed a transport voucher scheme. Transaid also made recommendations for potential innovative transport solutions to be funded through the challenge fund in Bungoma and other similar counties in Kenya.

 

A combination of qualitative and quantitative data was collected through stakeholder meetings, focus group discussions and individual interviews with key stakeholders. This led to a recommendation to establish an Emergency Transport Scheme (ETS) which would reduce the cost and delay associated with organising transport from the community to the health facility.

The ETS will commence with the recruitment of Boda Boda riders (motorcycle taxis) from each identified Community Unit. Recruitment will be undertaken by a group consisting of community members, Community Health Volunteers (CHVs), Village Elders and local Chiefs. Only riders of good standing, who own their own motorcycle, a license, a phone and helmet will be eligible. With support, these riders will develop strong linkages between communities and health facilities; working with CHVs, ETS riders will become aware of who the pregnant women are, where they live, and when they are expecting to give birth. Riders will get to know the woman and her family so that, if at the time of labour the woman needs to be transported on credit, the ETS rider will do so knowing that he will be able to collect funds later. CHVs will be the liaison person between the pregnant woman, the ETS rider and the health facility.

 

With agreement from the riders, communities and the riders’ representative association, prices for transporting pregnant women will be fixed at a rate as close as possible to the market rate. A day rate and a night rate will be agreed in order to cease any exploitative pricing by Boda Boda riders for transporting pregnant women. Phone numbers of ETS riders will be shared with communities, and will be available at dispensaries, health facilities and will also be carried by CHVs.

 

For selected communities in specific Community Units, a Tapered Voucher Scheme (TVS) will be implemented. The TVS will provide vouchers to pregnant women and, for the first 12 months, will cover the whole cost of referral from their community to the health facility. For the second 12 month period the vouchers will cover 50% of the cost of using the ETS to reach a health facility. Frontline SMS (or a similar system) can be used as an SMS platform for managing and verifying the voucher system.

 

Transaid has a long experience in managing community transport systems. Similar programmes operated by Transaid in Uganda and Nigeria have already highlighted the potential for establishing formalised referral schemes using private sector transport resources. In Kenya, the impact of the proposed approach is expected to achieve a reduction in maternal and stillbirth/neonatal deaths as a result of delays in reaching health facilities.

Last night, Monday 2 March, a major Transaid project, the MORE MAMaZ programme, was showcased on national television during BBC Two’s Let’s Play Darts for Comic Relief, as part of the build-up to Comic Relief, taking place on Friday 13th March 2015.

Recipient of a £1.83million grant from Comic Relief, Transaid’s MORE MAMaZ programme (Mobilising Access to Maternal Health Services in Zambia) aims to increase healthcare facility attendance rates among expectant mothers and newborn babies in remote regions of Zambia.

The MORE MAMaZ programme builds on the success of the original MAMaZ initiative run between 2010 and 2013. Implemented in association with Health Partners International (HPI) and Zambian organisations Disacare and Development Data, the project works towards eliminating barriers to access to health facilities in five remote regions including Chama, Mkushi, Mongu, Serenje and Chitambo.

The programme creates projects such as the Emergency Transport Scheme, which trains local community volunteers in areas where emergency transport is unavailable or unaffordable to drive bicycle ambulances. These can then be used to transport women in labour to the nearest health facility at little or no cost.

Other elements of the programme include savings schemes, food banks and a network of mothers’ helpers, all contributing to make access to necessary healthcare possible for those living in isolated villages.

Gary Forster, CEO of Transaid says: “The original MAMaZ programme was hugely successful in creating a viable transport system, resulting in increased numbers of women delivering their children in hospitals or clinics.

“We’re grateful to Comic Relief for providing us with the funds to be able to expand the project and we’re proud that we’ve been able to share the programme’s success with the nation, highlighting the serious issues communities in remote parts of the world face in accessing vital healthcare,” he adds.

The Transaid video was broadcast at the 25 minute mark in the BBC’s Let’s Play Darts for Comic Relief programme. To watch the video please click here. https://www.youtube.com/watch?v=0iHSd2JgsX0

Her Royal Highness the Princess Royal praised the life-saving work of international development charity Transaid, after the organisation revealed at its annual showcase it is now delivering more programmes in more countries to help improve road safety than ever before.

As patron of the charity The Princess Royal addressed a room of transport and logistics professionals in Canary Wharf yesterday (Wednesday, 19 November). She said: “When Transaid first started it was very much following the Save the Children’s ‘Stop Polio’ campaign, where logistics and transport were crucial to the delivery of the vaccine and it was the idea of getting expertise into the system that created Transaid.

“Transaid has taken on that role, but also has a real understanding of where you can make a difference through organising better transport and logistics, as well as through driver training – and that has really stood the test of time, in terms of the quality of its work and people coming back for more advice.”

The charity shared a number of shocking figures at the event which was sponsored by Barclays, including approximately 1.24 million people are killed on roads worldwide each year. This figure equates to 3,500 road-related deaths every day, and around 3,000 of those killed are from developing countries. The Princess Royal called the figures frightening, stating it was ‘horrific’ that more people die from road traffic accidents than Malaria in Africa.

Transaid also used the occasion to highlight some of its main achievements over the past 12 months, including receiving a £1.89 million grant from Comic Relief to help improve maternal health in Zambia, the addition of two new corporate members, Yusen Logistics and Malcolm Logistics – the charity also celebrated the fundraising efforts of its supporters who took part in its London to Brussels bike ride in September raising £67,000.

Acting Chief Executive Caroline Barber said: “Transaid has had a very successful 12 months, running projects in seven countries. At Buckingham Palace last year we announced the award of a substantial grant from Comic Relief for our emergency transport work in Nigeria. That programme is going extremely well despite the security challenges in the north of the country. So far over 700 drivers have received comprehensive emergency transport training and as I speak are busy performing their roles as ‘lifesavers’ in their communities.”

Two trucks, a trailer and a container have arrived at the Industrial Training Centre (ITC) in Lusaka, Zambia to further the development of the Professional Driver Training Project.

The vehicles donated by MAN Truck and Bus and Britcom International were shipped to South Africa by Wallenius Wilhelmsen Logistics and also contained spare parts for the existing vehicles at the centre.

This marks the third donation of its kind, enabling students to benefit from even more practical training. The addition of a third trailer and a container will now give drivers the added experience of practical driving with a physical load. This experience is vital to creating safer drivers who are more risk aware, especially when carrying loads of up to 50 tons of steel.

To date the project has trained over 1000 drivers and has now begun training Transport Managers which is the next step to improving driver training capacity.  Transaid was also nominated as a Third Sector Awards 2010 Finalist under the category of small charity, big achiever for the success of the Professional Driver Training Project.

Zambian driver trainers Malikana Ailola and Peter Tembo visited the UK to take part in the first ever Transaid driver trainer study tour.  The trainers, based at the Industrial Training Centre (ITC) in Zambia, were hosted by several Transaid member companies to see how transport and logistics operations work in the UK.

The visit is part of an ongoing exchange of expertise and shared best practice between the UK and the Zambian Institute as part of Transaid’s Professional Driver Training Project to improve commercial vehicle driving standards in Africa. Participating companies have also sent volunteers to Zambia.

Peter and Malikana followed an intensive programme of training and observation which included a variety of warehouse visits, operating in a hazardous chemical environment, forklift truck and tyre safety training for trainers, and visits to truck manufacturers and bus operations.

This combination of additional training and shadowing of transport managers enabled the Zambian trainers to pick up additional skills and consolidate their learning further.  Senior Trainer Malikana, was greatly inspired by what he saw and will use the information generated to create new modules of training in Zambia.  The pair have also taken back what they have learned to share with other trainers.

There are now six qualified trainers in place at the ITC since the project began in late 2008 and over 1400 drivers and 70 transport managers have been trained.

Transaid is grateful to all the companies who supported this initiative including:  Bibby Distribution, Ceva Logistics, Clipper Logistics, Hoyer, MAN Truck & Bus, Michelin, Norbert Dentressangle, Stagecoach and Wincanton.

International development charity Transaid is expanding its successful Professional Driver Training Project (PDTP) into its third country, after the programme successfully increased standards of commercial driver training methods in Zambia and Tanzania.

The initial 12 month programme will be rolled out in Uganda – a country which has one of the highest road traffic fatality rates – with an estimated 28.9 road traffic deaths per 100,000 population, compared to 3.7 in the UK*.

Transaid will be working with the ‘Safe Way, Right Way’ Partnership and Central Corridor Transit Transport Facilitation Agency to implement the scheme during the rest of 2014, and will begin by conducting PCV (Passenger Carrying Vehicle) training of driver trainers in Kampala, followed by HGV training.

Transaid is ideally placed to conduct this type of training having supported the development of the professional driver training at the Industrial Training Centre in Zambia since 2008 and the National Institute of Transport in Tanzania since 2010. Traditionally driver training in Africa has been mainly theory based, but through the PDTP Transaid has increased the ratio of hands-on practical training, essential for developing safer drivers. The PDTP is supported by a management board consisting of representatives from the UK transport companies who contribute through secondment of volunteers, donation of training vehicles and providing strategic advice.

Gary Forster, Transaid’s Chief Executive, says: “The PDTP has been a hugely effective project in Zambia and Tanzania and Transaid has been at the forefront of changing the driving habits of literally thousands of commercial vehicle drivers. We hope to mirror the achievements of the project from those countries in Uganda.

“Key to the successful implementation of our projects is our fantastic team of professional volunteers and corporate partners who have been supporting the Professional Driver Training Project for the last six years. We gladly welcome any businesses in the transport industry here in the UK who are interested in getting involved.”

Transaid’s Project Manager for Road Safety Neil Rettie, adds: “Launching the scheme in Uganda is a major undertaking, but is a key step to creating safer roads in the country. Uganda has one of the highest road crash death rates in Africa, so projects like the PDTP are vital to increase education and awareness surrounding road safety which ultimately saves lives.

 

Transaid conducted a needs assessment which looks at the need for an Emergency Transport Scheme (ETS) in Western districts of Uganda. The project is funded by the American pharmaceutical company Merck and aims to improve understanding about the challenges that pregnant women have in accessing maternal healthcare and expand women’s access to promising solutions for postpartum hemorrhage (PPH), infection and pre-eclampsia).

Many pregnant women in the rural areas of Uganda give birth to their babies at home without the proper health care needed. Combined, PPH, infection and pre-eclampsia, account for an estimated 52% of maternal deaths in Uganda. A primary constraint to rural communities accessing healthcare   is the availability and affordability of local transport services. Transaid has extensive experience in identifying, championing and implementing local transport solutions for rural communities across Africa, and due to this, was approached to take on this project. The assessments to date have looked at two districts, Hoima and Mubende, and will extend to 2 more districts in the 2nd year of the project. Initial research was done in Mubende.

The needs assessments were carried out over two weeks through face to face interviews and village based focus group meetings. The findings were analysed and then recommendations were determined for the way forward. Firstly, Transaid assessed the health clinics in the area gathering details about healthcare costs, catchment areas and their perspective on the transport challenges of people in their catchment areas. Then focus group meetings took place in villages 4-24 km away from the clinics. In this research the discussions were aimed at getting an overall picture relating to transport availability and affordability as well as establishing what the appropriate interventions might be. The focus groups were also used to gauge interest in intervention options.

During the assessment it was found that women would prefer to have their babies in the clinic but did not have finances to pay for transport or transport was not affordable.  Many women try to save some money to pay for transport at the expected time of birth but domestic and unexpected needs usually deplete these savings over time, leaving households little or no savings to deal with emergencies.  Furthermore, local motorcycle taxi (boda boda) operators often take advantage of emergency situation and charge pregnant women needing to get to the clinic at a higher rate. Based on this data, Transaid plans to implement solutions tailored to each of the target districts based on their specific needs revealed in our research.

Transaid is planning to implement the solutions in November and December 2013 as well as carry out the assessments for the expansion of the project into two further districts.

An engineer from the Freight Transport Association (FTA) has returned to the UK after a four-week secondment in Africa which saw him training Tanzanian Police to carry out HGV and PSV vehicle inspections at the roadside.

Wyn Skyrme, from Newport, Gwent, spent a total of 26 days in Dar Es Salaam during February and March 2012, supporting international development charity Transaid’s Professional Driving Training Project with the National Institute of Transport (NIT).

The primary goal of his visit was to train both NIT staff and Police vehicle inspectors to conduct commercial vehicle inspections and defect assessments to UK best practice standards.

Commenting on his experience in Tanzania, Wyn says: “My training was split between the classroom, NIT’s workshops and real-life inspections on the Tanzanian highways.  The work at the roadside was a massive eye-opener for me; it reinforced the importance of Transaid’s Professional Driver Training Project and the vital need to raise vehicle maintenance standards to help improve road safety.

“I found it overwhelming just how much respect the people of Tanzania have for what Transaid is doing.  I was inundated with messages of thanks from those I met – they really value the assistance being provided,” he explains.

Wyn put his 29 years of transport industry expertise and a copy of VOSA’s Inspection Manual to maximum use during his time in Tanzania.  He spent the first two weeks at the NIT, where he trained 12 HGV and PSV engineers in vehicle inspection procedures, diagnostics, workshop safety and environmental issues.

During the third and fourth week he teamed up with 28 police vehicle inspectors from across Tanzania to demonstrate how to carry out real-life vehicle inspections to UK roadside enforcement standards. This training marked a first for Transaid in Tanzania, helping to take the charity’s impact to a wider institutional level.

At the end of his visit, all those who had been trained were awarded certificates to recognise their new skills and provided with the information and resources to ensure this vital training can be shared and passed-on to colleagues nationwide.

Commenting on the success of the project, Gary Forster, Chief Executive of Transaid, explains: “Whenever we have a volunteer on the ground we challenge ourselves to make the maximum use of every hour of their stay.  Wyn’s trip is a prime example of just how much can be achieved in a short space of time.  His efforts have made a significant contribution in our efforts to raise training standards and road safety in sub-Saharan Africa.

“We are particularly encouraged by this support from a leading industry body and our sincere thanks go to Wyn and to the FTA for its generous donation of time and expertise.”