Last Saturday, I visited two rural health clinics about 50 km outside of Lusaka. Both clinics had been given bicycle ambulances manufactured my Disacare in 2007. Our goal was to check up on them.

We first spoke to the staff at the clinics, and asked for feedback. Their biggest issue was maintenance. They said that the clinics don’t have the funds to maintain the bicycles and ambulance attachments, and that was the responsibility of the community health groups.

Then we visited one of the community health workers, Joshua, who drove the bicycle ambulance. When we arrived at his house, we found the ambulance disassembled and stored here:

This ambulance has been broken for a year and a half. It worked great for one year, but when the tires on the bicycle (which came with the ambulance) went flat, the whole set-up was retired. Why? No maintenance funds. The community won’t pay for it. They think it’s the health clinic’s responsibility.

Joshua has a personal bicycle that he uses for his own business. When I asked him if he would use the bicycle ambulance on his own bicycle he said no. “They community will think I’m using it for my personal use. I can’t take ownership of it. It’s not mine. It’s the community’s.”

In fact, no one will take ownership of it. Since it was introduced in 2007 as a donation to the clinic and community, people have perceived it as a government gift. And thus maintenance is a government responsibility. When the first tires went flat, people started pointing fingers, no one would contribute, and all was lost.

Unless this perception is changed, your technology will only last as long as its weakest joint.

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