Rural Transport

Bridging the language divide: sharing the experiences of French-speaking Africa

In an effort to ensure that transport practitioners in French-speaking Africa can also share experiences IFRTD –with the support of gTKP- has set up a French electronic discussion group called IFRTD Transport Rural. Set up on dgroups, the list serv is accessible via http://www.dgroups.org/groups/IFRTDtransportrural and is open for all (French-speaking) people interested in rural transport issues.

During three weeks in July a virtual discussion was held focussing on issues relating to rural transport services. The discussion centred around three issues.

1. What type of technology is best suited for what means of transport?
2. Improvements and the reliability of rural transport services 
3. Rural transport safety

Each week centred around one of these issues and every topic was introduced with background information, photos and sub-questions to allow the participants to share experiences, ask questions and trigger discussions. Moderated by Vero Razafintsalama from Lalana, an NGO based in Madagascar and specialised in transport issues, twenty-seven participants from eleven different countries followed and/or participated in the rich and lively virtual debates.

The first week focussed on issues around preferences, adopted technology related to transport needs. In Madagascar for example there have been successful bicycle interventions that were initially meant for transporting people and instead were increasingly used for transporting heavy goods over long distances. This was done without any adaptation and resulted in visible improvements in income for certain users.

In the Democratic Republic of Congo (DRC) it was noted that the existing hypothesis about increased motorised traffic after rehabilitation of rural roads proved false. Instead they observed that bicycle usage increased and were the main IMTs from villages and/or fields to the main road where big trucks were waiting to be loaded. In addition some traders preferred to travel by truck themselves while their cargo was transported on bicycles. ‘Bicycles are faster and can leave at once, while trucks have to wait until full’ was the logical explanation. As a local adaptation bicycles were lengthened to carry up to 200 kilos heavy load or a small sun umbrella to protect the cyclist from the harsh sun. It was common that the trader would walk alongside the bicycle often for long distances.

In North Cameroon the complementarity of various transport services was especially noteworthy. Buses operated by the municipality served very precise routes while taxis served outlying areas of the locality. The motorbikes served to extend the bus and taxi routes by serving more isolated zones. This complementarity also applied to costs and transport of cargo

The participants also discussed the various modes to transport the sick to health clinics. The pro’s and con’s of motorbike ambulances versus bicycle ambulances were discussed and various experiences of Ranger and Riders for Health shared.

Overall the discussions illustrated the big knowledge gap that exists between Francophone and Anglophone Africa and that not enough resources are available for translation and knowledge sharing through workshops. A positive development is the SDC/Skat workshop that will be organised in Chad in September 2007 to enable French-speaking transport experts to network and share experiences. This workshop combined with the new list serv will hopefully help reduce the gap a little but it is obvious that a lot more resources need to be invested in order to close the gap completely!

To join the discussions:

http://www.dgroups.org/groups/IFRTDtransportrural

Rural Access to Health Services: bridging the knowledge gaps

What do you do when having gone into labour, there are complications and the nearest clinic is 30 kilometres away, roads are in poor condition and means of transport are scarce or non existent?

Access to health care –particularly for pregnant women- is one of the main challenges in transport in general and in rural transport in particular. In the rural context we actually don’t know the full extent of the relationship between transport and (maternal) health. Yes obstructed labour due to obstructed transport is certainly a cause for high maternal mortality rates as the starting question implies but…. there are many others. Exploring these issues and links are at the core of the Mobility and Health programme, an international networked research programme carried out in 24 countries in Asia, Africa and Latin America to help increase the overall knowledge base. This month’s blog explores some of the preliminary findings the researchers have shared through www.mobilityandhealth.org

In Nepal the District Roads Support Programme (DRSP), an SDC-funded programme aiming to improve the district road network is researching the effects of restricted access on maternal health in rural remote and mountainous areas. In general, Nepal is a mountainous country, with an average poverty level of 42%. Due to inaccessible terrain and lack of transport infrastructure, poor people find access to health services very difficult and expensive. A number of programmes are addressing these issues, from the physical access and the health perspective, although not in an interdisciplinary way. Maternal mortality comprises a large percentage of deaths in Nepal and recent research suggests that this situation is exacerbated by restricted access.

The team led by Binjwala Shrestha found many women have experienced problems with access to a health centre. The story of Ansu (name has been changed for privacy reasons), a 40-year old mother of five who delivered her last baby at home is particularly telling. After a complicated birth the local health worker was called but due to an inaccessible road (poor condition and rainy season) and lack of transport, she could not come until the next morning. Sadly this proved too late for mother and baby. Ironically the house is only 10 minutes from the nearest road and 30 minutes from the nearest community.

In South Africa a team led by Mac Mashiri is assessing how to improve access to health care by researching the role of home-based care services in strengthening rural health care delivery. In Mpumalanga Province in the north they are undertaking field work by working with communities and home-based health care providers who are focusing their attention on families affected by HIV/AIDS. While interviewing one of the nurses the following complication was shared: “…When it is raining, the road to the clinic is so bad – so slippery that people coming to the clinic are forced to disembark from the taxi and walk the rest of the way to the clinic because they fear that the taxi can skid and cause a fatal accident…” This does restrict people’s access while seeking health services.

Finally in northern Peru Diogenes Ampan and his team members are collaboratively working on the role of river transport in accessing conventional and traditional health services in the rural rainforest in Cenepa. A big part of their methodology consists of organising participatory workshops with indigenous communities to sensitise them on the relationship between rural access and overall health care and explore how they can overcome some of these challenges.  Although the research is only half way and final results will be published in early 2008 some of the preliminary findings are already worth sharing.  In the Cenepa area the main problem with transport and health is the lack of access to fuel for emergency transport to health clinics. Many people do have access to boats but fuel for the motors is scarce and expensive. This applies to the extension workers of the various health posts as well as the remote communities, meaning that quite a few people are dependent on dugout canoes for their journey to the posts. This significantly delays their journey as well as increases the risk of drowning on the treacherous river rapids.

These snapshots drawn from the ongoing Mobility and Health research reveal real experiences relating to transport and health care. We strongly encourage you to visit www.mobilityandhealth.org for more details and contact me if you have any questions and/or comments!

See you next month!

PS If you are interested in writing a blog entry sharing your experiences in rural transport please contact me!