Introducing the Malagasy eBox

In 2015 Bikes for the World arranged to ship two containers of used bicycles and parts to Madagascar through the USAID funded MAHEFA program. This project focused on bringing affordable health care to northern and western Madagascar.  Several challenges were identified as the program evolved, each defined, studied, and addressed through MAHEFA.

Distance was by far (no pun intended) the most encompassing challenge. MAHEFA developed solutions to this issue from several angles to ensure life saving health care could reach the most rural families.

Community Health Volunteers (CHV) provide an essential role in the delivery of health services to residents in isolated and under-served areas of Madagascar. These health workers are recognized and approved by the government, although not paid for their services.

Through the effort of CHVs, patients living a great distance from their nearest health clinic were now receiving basic health care. These services included child health, family planning, STD treatment and prevention, hygiene and nutrition.

However, because CHVs are unpaid, MAHEFA encountered a high turnover rate which greatly affected the quality and continuance of care in these rural areas. MAHEFA identified the two top reasons CHVs quit were motivation and mobility.

MAHEFA then introduced bicycles to select CHVs to ease the burden of traveling to see patients. Over 1,000 new bikes were given to these volunteers to assist in delivering life saving practices to entire communities. CHVs arriving on bikes were even seen as more 'credible' or trustworthy because they had bikes.

This introduced a new issue, one of repairs. While CHVs also received training in basic bike maintenance they still lacked the necessary parts and more complex tools to do serious repairs on bikes. So MAHEFA introduced the eBox.

An eBox is a permanent bike shop established in areas where little to no bike services are offered. Community members (often CHVs themselves) were trained in mechanics and sales. This micro-enterprise, operated at the community level, would provide jobs and income and ultimately support the health initiative MAHEFA created.

Additionally, the four eBoxes established through MAHEFA, would also provide support to the Emergency Transport System (ETS) which had previously been implemented through this project. ETS is a multi-modal system of patient transport, basically a 'creative' (and effective) ambulance. One particular approach is a bicycle ambulance, which would also need routine bike maintenance and parts.

Through these donation-supplied bike shops, job are created, income generated, transportation provided, and services and parts readily available. EBoxes addressed the issues of motivation AND mobility. Most newly trained staff also report a sense of pride in their community through their new skills and this brand new venture.

Bikes for the World donated and shipped 1,000 bikes in two containers over the past year to support this effort. Additionally, we helped place another 450 bikes in this project through sister organization Working Bikes from Chicago. Both BfW packed containers, were donated directly to the co-op known as Miandrivazo in Menabe.