Johannes Basheka, a bodaboda rider in Mwanza city, has for years been troubled by public’s negative perception towards bodaboda operators. They are perceived as reckless and the source of accidents in the country.
He says most of them are blamed for being less concerned about their passengers’ safety. They are also accused of usually abandoning the passengers when ‘they cause accidents’ and it happens they themselves are not injured, regardless of how serious the passenger might be.
This, according to Basheka, has made people to hate bodaboda operators to the extent that they don’t sympathise with them when they get involved in accidents believing it is always their fault.
The perception, however, is slowly changing now that bodaboda riders in Mwanza have taken up a new role to save lives. Under the Huduma ya Kwanza kwa Jamii project by Tanzania Rural Health Movement (THRM), a community local organisation, the bodaboda riders have been offering emergency medical services during accidents. They stabilise the accident victims before they are taken to hospital and their service contributes greatly in the reduction of deaths and disabilities.
“We are equipped with skills to offer pre- hospital emergency services to accident victims,” says Basheka who has been in the bodaboda business for three years.
Laurent Mwombeki, 23, another bodaboda operator, says it’s true that before they joined the project and became responsible citizens, some of them would abandon passengers and run to safety during accidents.
“In turn, we would bear the brunt whenever we got injured because nobody would be ready to help us,” Mwombeki says.
Mwombeki adds that today when accidents happen, bodaboda riders are the first responders as they go to the accident scene immediately and offer assistance in order to avoid further medical complications to the victims.
“Our involvement in the programme has indeed helped us and it has changed our behaviour to the better. This has in turn helped change public’s perception towards us and our work,” says the father of one.
Basheka and Mwombeki are among several other bodaboda operatorss trained to provide free pre-hospital care to patients involved in road accidents or fire outbreaks under the Huduma ya Kwanza project.
“Road crashes had increased exponentially leading to pre mature deaths of the Tanzanian work force with no pre-hospital care provided to those involved in the accidents,” says Dr Marko Hingi, Executive Director of THRM.
In a city where 375 lives were lost in 910 accidents leaving hundreds others with permanent disabilities within a period of nine years from 2008 to 2016 as per data from traffic police headquarters in Dar es Salaam, introduction of pre-hospital services was of high importance.
While there can be numerous factors attributed to the fatalities, the absence of reliable emergency medical systems in the city contributes greatly to the occurrence of preventive deaths and disabilities, says Dr Hingi.
A study published in the Journal of Trauma Management & Outcomes in 2012 titled Injury Characteristics and Outcome of Road Traffic Crash Victims at Bugando Medical Centre in Northwestern Tanzania reports that more than 60 percent of severely injured patients reported to the Accident and Emergency department of Bugando Medical Centre between March 2010 and February 2011 within 24 hours after injury.
None of these patients, the study notes, received any pre-hospital care and 76.5 percent of them were brought in by relatives, friends or Good Samaritans, 22.6 percent by police and only 0.8 percent patients were brought in by ambulances.
Inspired to be a changemaker
Concerned by the absence of reliable emergency medical services, Dr Hingi was inspired to be a change maker by intervening using boda bodas as paramedics.
“We decided to use boda bodas as first responders due to their nature of being able to penetrate anywhere where it may be difficult for an ambulance or rescue vehicle but also because there are plenty of them and the fact that they are affordable and readily available resources for the service,” says Dr Hingi.
The motorcycle riders go through 16 hours of rigorous training which includes 8 hours for basic first aid training, 4 hours on beacon software training and 4 hours for assessment to qualify for service provision.
“The project has trained 118 community first responders including 45 fire fighters, 24 traffic police, 32 bodaboda riders, and 17 TRHM volunteers,” says Hingi adding, “In 2016 alone we responded to about 150 incidents and saved 136 patients from trauma and obstetric cases.”
Omar Juma, 23, a resident of Ifungiro, Mwanza is one of the people who were saved by the bodaboda operators when he was involved in a motorcycle accident.
“I sustained serious injuries to the point of passing out,” says Juma adding that he was lucky that the bodaboda rider he had hired knew one of the first responders therefore he contacted him for help. “It only took about ten minutes for the responder to arrive and he took me to Bugando Hospital. I just cannot imagine what would have happened had it not been for the quick responce,” Juma recalls.
Azimio Arkabi was riding his motorcycle to a petrol station, when a bodaboda ran into him.
“I fell down and fainted,” says 45-year-old Arkabi adding that when he regained consciousness he found himself in hospital with a broken shoulder.
“I could probably have died were it not for these bodaboda first responders since I was bleeding uncontrollably and there was no ambulance to rush me to hospital,” recounts the father of four thankfully.
Mniko Samson, 30, one of the motorcycle first responders has saved a good number of accident victims. He says that he and his fellow first responders are normally notified when there is an incident which requires their attention.
“We have provided members of the public with the emergency toll free number, 114, which is controlled by the fire and rescue department in the region. They can call the number incase of anemergency after which we are notified about the incident and the person who is nearer to the scene responds immediately,” says Samson.
Offering first aid
After we are notified of an incident, everyone of us responds by stating their location and the most nearest responder to the scene heads there for intervention. Samson says it usually takes five to ten minutes to arrive at the scene for offering first aid.
“Once there, I check the surroundings and the victims’ condition and attend to them accordingly, an exercise that takes about ten minutes until rescue people come and take them to hospital and my works end there,” the father of five says proudly.
The system used to take the incidents’ reports from the public to the assignment of the first responder to go and offer emergency service is done through a technology known as Beacon Software- SMS-based emergency medical dispatching software designed specifically for communities where dispatching technologies used in western countries are either inappropriate or unaffordable.
Jason Friesen is founder of Trek Medics International, a US-based nonprofit organisation that develops emergency medical care systems in low-resource communities globally. The organisation has facilitated the technology that THRM uses to carry out the free pre-hospital services.
Friesen says what makes an emergency response system effective is its ability to coordinate resources at a moment’s notice, and that’s achieved through efficient communication.
“With Beacon, communities can ensure that 90% of people requesting emergency assistance will be attended to by trained responders with access to transport in less than 10 minutes in urban centres and in 30 minutes in rural communities, and anywhere there’s a mobile phone signal,” says Friesen.
The way the software works, Friesen says, is that trained community responders have their personal phone numbers registered on the Beacon.
“When someone needs help they can call the local community service to give their location – maybe it’s the fire department, or the hospital, or the bodaboda riders,” he says. (In Mwanza a person in need of assistance calls 114 to the fire department which is the dispatching centre).
Then the operator enters that information into the software which relays it to all of the trained responders as a text message, asking if they can help.
After that, Friesen says, the software automates the entire response sequence through simple text messages to ensure that the closest and most appropriate resources are able to locate, stabilise and transport the patient to the hospital using simple and predictable instructions via text message.
Mr Andrea Mbata, the Fire and Rescue Force Commander in Mwanza Region says, “We are indeed benefiting from bodaboda first responders and the beacon technology in general as we have saved a big number of people who were involved in major accidents, something that would have been difficult in the absence of the technology.”
He says pre-hospital emergency services are paramount given the increasing occurrence of accidents. Dr Hingi says plans are under way to scale up their operations to reach other regions across the country so they can also benefit from the technology.