In Madagascar, 80% of the population lives in rural areas with difficult access to most health services. Using innovative designs in emergency transport methods, JSI’s MAHEFA program’s emergency transport system is enabling communities to connect patients in urgent need of treatment with their nearest health facility.

For sixty-year old Robin Erinesy of Antanambao, Morondava, falling seriously ill with no means of transportation to the nearest hospital was an agonizing experience for him and his family to go through. Hours passed before Robin’s family was able to convince a passerby on the road to drive them to the hospital.

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Several years later, when the MAHEFA program’s emergency transport system was introduced to Robin’s community, he was eager to provide transportation to community members in need.

“Knowing that I’m doing this for the good of those around me motivates me on a daily basis. I transport people with serious illnesses and also pregnant women who must travel to the basic health center for routine checkups or who are going into labor.”

Robin uses funds from his community’s mutuelle de santé, which pools the community’s resources to support the reimbursement of health care costs, in order to ensure that his cyclo-pousse is well-maintained and runs smoothly. This enables a quick response time should an emergency arise.

Although members of his community were at first reticent of the emergency transport system, Robin has garnered their trust by explaining to them the benefits of such methods.

“This is a completely new kind of transportation for this community. It has been important for me to gain people’s trust and help them understand how emergency transportation can save lives.”

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Robin and his cyclo-pousse have served as Bemanonga’s integral form of emergency transport since 2013. To date, he has saved over 70 people with life-threatening conditions across three communes in MAHEFA’s intervention regions.

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The USAID-funded Madagascar Community-Based Integrated Health Project, known locally as MAHEFA, was a five-year health program that provided basic, quality health care to isolated populations in six north and northwestern regions of Madagascar. The program’s overarching goal was to increase the use of proven, community-based interventions and essential products among underserved populations of Madagascar.

All photographs by: DDC Madagascar/JSI

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