What is eBox and ETS?

Health care in rural Africa is compromised by distance and accessibility. Communicating information and delivering basic health related supplies, some as simple as soap, are huge first steps in battling disease and even death in small rural communities.

Our partner in Madagascar, Transaid is an international development organization that transforms lives through safe, available and sustainable transport. Transaid enables those living in rural communities to reach health services when they are in need. They work with partners to strengthen emergency transport systems, provide access to appropriate forms of transport and also help community health workers reach the families who need them.

Transaid's work includes a number of Emergency Transport Schemes (ETS) to transport pregnant mothers, often with complications, as well as children suffering from severe malaria.

In regions of Madagascar many roads are poorly maintained and the terrain makes motorized transport challenging. Regions exposed to months of rain are also inaccessible nearly one third of the year. This makes preventive health care a challenge, not to mention urgent care. In addition to introducing Community Health Volunteers (CHVs) to these rural communities, Transaid identified a greater need for emergency transport, ensuring that patients had access to treatments and care not always offered by smaller community clinics.

The Emergency Transport Scheme developed and implemented by Transaid included several modes of transport including bicycle ambulances, wheeled stretchers, canoe ambulances, and ox-carts. These were placed within the communities where they were most needed to help save lives.

Of all the ETS modes, bicycle ambulances required the most maintenance given all the moving parts. Each emergency technician is responsible for the care and upkeep of their respective 'ambulance'. Identifying specific needs for bicycle ambulances, including bike parts and trained bike mechanics, Transaid sought to support the ETS on a more technical level.

*EBoxes were initially established in four regions of Madagascar to help incentivize CHVs and also help physically support the ETS. The idea was to bring mechanics and spare parts closer to the ETS operation to help support and facilitate the use of these bike ambulances. We are now assisting the project to expand this model to other communities.

Through the sale of bikes at eBoxes, co-ops can help support the cost of the ETS as well as the bikes themselves. It was understood that each co-op would help fund the ETS and *mutuelle (health insurance) through eBox profits. This synergy between community, ETS, mutuelle, and eBox was created in an effort to make this program sustainable.

Now, whenever care is needed, help is there. ETS makes transporting patients of every age and illness possible over any terrain or weather condition.

*The mutuelle helps families afford transport, care, and medicines to help keep their families strong and healthy.

*And the eBox is the micro-finance initiative behind the motivation and success of CHVs, ETS, and the mutuelle.

Content contributed through Transaid