P3 ambulance/carrier in Okau

Picture 268

Originally uploaded by aaronforest.

Meme Terefina tried out the new ambulance/carrier in Okau. These HBC volunteers tested the first ambulance for two months, and then chose to use the next prototype for comparative testing.

Update, January 31, 2007

January 31, 2007

I just returned from another trip to the North, to deliver a second ambulance prototype, collect usage information on the first ambulance, delivered 2 months ago, get started with the monitoring and evaluation component of the ambulance project, and help Michael, Jonas, and Hilya train 20 Catholic Aids Action Home Based Care (HBC) volunteers in bicycle repair and maintenance—310 CAA HBC volunteers received shiny new California Bikes, designed by ITDP, to help with their transport needs as HBC workers. The project was funded by Axis, a South African Computer company with a Namibian office, and Catholic Aids Action, the largest network for HBC workers in the country. I’m going to botch the numbers, but I think they have somewhere around 6000 HBC volunteers thought the country. 310 bikes is a start…

The first ambulance, p1, had been delivered in November to a group of TKMOAMS HBC volunteers in Okau, a village 15 km from the main road, and another 20 km to Oshakati from there, the closest big town/city. Okau has a medical clinic which serves the surrounding villages, and the HBC volunteers primarily serve clients within 5 km from the clinic. In the first 2 months of field testing and use, the bicycle ambulance was used 45 times to transport clients—about 1.5 times per day. 6 different HBC volunteers were operating the ambulance, with 5, 5, 6, 6, 8, and 15 ambulance trips. Meme Terefina, the chairperson of the Okau TKMOAMS volunteers, keeps the ambulance in her home, and each day the HBC volunteers take it to the clinic, so that it is easy to access. Trips generally ranged from half an hour to 2 hours, and from 1 km to 5 km. Most trips were from the client’s home to the clinic, and the HBC workers were usually notified of the transport need by sending children. There is cell phone reception in much of the region, where SMS-ing works at least (if voice doesn’t), but very few land-lines and phones are quite expensive. I was told that the clinic doesn’t even have a phone, although I believe the nurse who works there has a cell phone.

The TKMOAMS volunteers were quite keen on the new ambulance, except for the lack of wheel-coverings, and agreed to take this ambulance instead for a month of comparative testing, as long as they could get the other one back if the new one, p3 (p2 is still on the welding table, waiting for upholstery), didn’t meet their needs. I am fortunate to be in a position where I can do this kind of comparative design testing, while also working to meet the needs of the users as customers, not just as product testers.

I took p1 and delivered it to the Waapandula Noyaka Centre, where they will use it to transport their patients to the hospital. It is only 700 meters away, but transport is difficult in the night. I don’t think the ambulance will get much use, but with Oshakati as a central location, other CBOs and NGOs will be able to view and test the ambulance.

On the Catholic Mission in Okatana, where the bike maintenance training and assembly was focussed, the trainees learned basic bike repair quickly, although there is only so much that you can learn with only one kind of bicycle, in new condition. They now have the tools, literally and figuratively, to progress with their skills and contribution to the HBC community. We don’t ship bicycles without repair training, which adds to the cost per unit, but significantly increases the usefulness and longevity of the project. The HBC volunteers are on their own to buy parts, though, even if they can now get free service.

Staying in the north for 8 days was refreshing after 2 months in Windhoek. It would have been a miracle if interpersonal issues didn’t come up, but they did, of course, and worked themselves out well enough. I roomed with Jonas, who turned out to be a funny and interesting room mate. Spending time closer with the mechanics helps me understand their relationship with BEN Namibia and Michael, as well as their work. One lasting effect of Apartheid is the silence of non-white workers in regards to their working conditions, particularly with white employers. It’s no different, I’m sorry to say, at BEN Namibia, although the conditions themselves are generally fairly decent. I’m reaching a point where I feel slightly more comfortable expressing constructive criticism to my organization, though I still hope that it doesn’t bite me in the foot.

It looks like I’ll be travelling to the same places again in a month, with another ambulance and materials to establish working relationships with local businesses. Lorewo, a wheelchair fabrication and repair shop funded by NORAD, is located on the state hospital grounds. I haven’t yet figured out the exact connection with Whirlwind Wheelchair International, but there is some joint training through the Norwegian government. The wheelchair technician, Silvanus, knows Alida and Ralf from WWI, which was a lovely connection to make. Meme Kamboe, a PT at the hospital, also knows of Ralf’s work. It’s turning into a small world. I hope to establish a relationship with Lorewo, whereby they can do some part of the manufacturing and distribution process for the ambulances, from Oshakati.

Another small-world connection came my way yesterday. Laura Chesnut,who I was in middle school with in Strafford VT (it’s a small town—1000 people or so), is living in Namibia, at a desert training and research centre called Gobabeb. I’m almost not surprised, somehow. Things in Namibia just happen like that.

consider this a warrant

Picture 033

Originally uploaded by aaronforest.

This man stole a cargo trike from BEN Namibia, sold it for 10 Namibian dollars, and RETURNED to BEN to look for another. The security guard and I caught him, which led to a 3 hour long saga involving lies, tears, Michael, sisters, landlords, friends, driving all around–everything but the police, which I was resistant to call. We let him go with a promise to pay the next day–which he never did. I have his fingerprints, photos, name, and girlfriend’s address-but not plan of action. PS. the trike he stole had a broken rear axle, and I had been procrasitinating fixing it for a month.

mahangu and a homestead

Picture 289

Originally uploaded by aaronforest.

Meme Terefina rides a bike into the home of another HBC volunteer from TKMOAMS. Mahangu is growing in the field to the left, and the little huts on the right store last year’s mahangu grain. The fence on the left surrounds the homestead buildings.

P3 Carrier

Picture 456

Originally uploaded by aaronforest.

The p3 ambulance/carrier worked well in the sand with the wide tires and suspeded stretcher. The canopy here stretched too much in the rain, and should be waterproof, and the wheels need guards on top to prevent sand from entering the stretcher. The double-wide wheels worked well, as did the half-suspended stretcher. One side has loops of tube rubber, the other loops of twine. A piece of twine or rope laces the two sides together, and can be used to tighten the stretcher surface. This stretcher has a fixed backrest angle, although the stretcher does remove for ease of loading clients.

CA bike assembly

Picture 395

Originally uploaded by aaronforest.

One of the CAA bike maintenance trainees tightened down the brake on a new bike.

California Bikes waiting for distribution

Picture 428

Originally uploaded by aaronforest.

310 yellow bikes all in the same place is quite a sight, and that’s all I’m going to say about that!

Demo for CAA at the Oshikuku Catholic Mission

Picture 340

Originally uploaded by aaronforest.

I demonstrated both ambulances to the CAA Oshikuku staff. They liked this one most, largely, I think, because of the covered wheels–it was a wet day, which picks up the sand in the other ambulance, as I didn’t manage to cover the wheels before delivery.

Shall we call it roadworthiness testing?

Picture 199

Originally uploaded by aaronforest.

View out the end of the ambulance, in the bakkie (truck) on the way north from Windhoek to deliver this ambulance for field testing. I learned a lot about the effect of 800 km of road vibration on a loaded ambulance. Yes, my ankels did get a bit sunburnt.

frogs from the oshanas

Picture 347

Originally uploaded by aaronforest.

Late January, Oshana region: This is the one time of year, I am told, when children get to eat as much meat as they want. I’m still working on the details for culinary preparation. Along this 10 km stretch of road, I saw 18 children selling frogs, usually 6 or 8 per string, and often 3 or 4 bundles at a time. I’m told they’re a delicacy. These here were among the smaller that I saw. This bundle cost 10 NAD, about $1.30 USD.