GOING THE DISTANCE

Carrie Vogelsang, Peace Corps Response — Saving Mothers, Giving Life Lundazi, Zambia

“I was going to lose the patient, so it served the purpose of why it was sent here.” Amon Mwale, driver for Lundazi District Health, reflected on his decision to tell the hospital to change his vehicle to the Saving Mothers, Giving Life (SMGL) ambulance. Instead, he could have been using the older, run-down vehicle typically assigned to the valley region in the most remote areas of the district. The ambulance was funded through a cooperative agreement between MOH/ Provincial Medical Office (Eastern Province) and the CDC as part of the SMGL initiative.

The driver, Amon, received word in the morning at the district hospital that a woman was experiencing obstructed labor and needed to be picked up and transported back to the hospital. The over 300km (186 miles) round trip meant traveling on bad roads, which were often dried up river beds, and passing through the national park where elephants, lions and other animals roam. Leaving shortly before 10:00 Amon reached Mwanya Rural Health Center around 13:30 and returned to the hospital by 17:00. “I knew if I took the other vehicle that I could experience delay in reaching the hospital by another 3 to 5 hours.” This would mean missing an opportunity to return before nightfall since vehicles are prohibited from traveling through the park at night. The pregnant woman was already in distress when the ambulance arrived and the baby was lost en route to the hospital after the mother's uterus ruptured. Amon and the nurse on board knew that time was of the essence to preserve the life of the mother. “I increased the speed. I didn't mind the bumps,” Amon commented as he explained how the new vehicle allowed him to travel safer at higher speeds along the rough terrain.

The woman arrived in failing condition, was taken to surgery, and received 3 pints of blood. Time was key to saving her life and the new ambulance gave her the time she needed to survive. If she had arrived hours later, she would have been added to the hundreds of women who die from childbirth annually in Zambia. Instead the woman made a full recovery at the hospital.

The decision by the driver to use the SMGL ambulance played an important role in a health system that relies heavily on avoiding delays — delays in seeking care, delays in accessing care and delays in receiving care. Fortunately the resources were available to provide Amon with the ambulance to save the woman’s life. And the lives of future mothers will also be saved as SMGL continues to make an impact on all levels of the health care system.