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) — A motorcycle rumbled as it tried to pull an ambulance up a steep riverbank. The bike’s rear wheel spun in place, kicking up water and mud, the sidecar—a hospital bed on wheels, under a white canvas cover—rolled dangerously. Two paramedics following on foot tried to push him, but he did not move.

Finally, the three gave up and decided to dig a new path.

After 40 minutes of digging and pushing the car out of the river bed onto the muddy road, the team set off again. A bicycle ambulance continued its nine-mile trek through the forest known as Abhujmarh or “Unknown Hills” to reach 23-year-old Phagni Poyam, who was nine months pregnant in the isolated village of Kodoli.

When the team arrived, Poyam was waiting next to the sleeping 1-year-old Dilash. Like many babies in Kolodi, Dilash was not born in a hospital due to both distance and mistrust of the authorities. But it is Poyam who says that in recent years, he has seen women or their babies die during childbirth and he does not want to take the risk.

“My baby will be safer,” she said in the Gondi language spoken by about 13 million members of the local Gond community.

Motorcycle ambulances help mothers deliver babies in the Naryanpur district of the central Indian state of Chhattisgarh. The heavily forested region is one of the most sparsely populated in India, with about 139,820 residents spread over an area larger than Delaware. Many local villages, such as Kodoli, are 16 kilometers (10 mi) or more from highways. The state has one of the highest maternal mortality rates in India, nearly 1.5 times the national average, with 137 maternal deaths per 100,000 births.

While officials and health workers agree that bicycle ambulances do not offer a long-term solution, they do make a difference.

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

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

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

Since 2014, the number of babies born in hospitals in Narayanpur district has doubled to 162 on average every year from just 76 in 2014. district

Once Poyam and his son were safely on board, the motorcycle ambulance returned to Orccha and took Poyam to an early referral center near the hospital where expectant mothers could remain under observation and see doctors. Mother and son had to disembark several times as the motorcycle ambulance negotiated a difficult slope or rocky riverbed. Sometimes the driver, 24-year-old Sukhram Vadde, had to lift large stones under the carriage, which caused a traffic jam.

It was dark when we reached Orkcha. Lata Netam, the medical officer in charge of the center, had called ahead when she left Poyam village to ensure that lunch was ready. One-year-old Dilash hums happily playing with the others who work there, while Netam answers 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 haven’t left home.”

Confidence in hospitals and modern medicine is increasing. There are mothers in the villages who speak glowingly of the hospital. At the weekly Orccha market, where hundreds of people gather from far-flung villages to buy essentials or take part in a fiercely competitive cockfighting tournament, government health workers are busy screening people for diseases like diabetes and malaria.

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

Dilash also gave a positive result for malaria. He was immediately hospitalized and treated for the virus, which kills thousands of children every year.

Dilash has since returned to the village to stay with his father. Regular meals fortified with supplements boosted Poyam’s iron levels and he gained 9 kilograms.

A little after 2am on Wednesday, she gave birth to a healthy baby boy.


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

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