Nigeria | Saving lives in a three-wheeled ambulance

Around the world, three-wheelers offer a cheap means of urban transport.

In Gwoza, northeast Nigeria, the small three-wheeled vehicles known locally as keke napeps are more than just a means of public transport, they are a means of saving lives.

Every month around 260 patients are transported to the hospital in keke napeps, which are used as makeshift ambulances.

Movement restrictions

There are around 75,000 people living in Gwoza. After years of conflict between the Nigerian army and Boko Haram, most people are completely dependent on humanitarian aid to survive.

Restrictions of movement and a curfew at night mean that urgent medical aid is often unavailable for patients in Gwoza. Pregnant women frequently deliver their babies at home, leading to complications and the loss of life.

“Time is of the essence in emergencies and operating heavy vehicles is difficult," says Yaya Ramde, MSF project coordinator in Gwoza.

An MSF 'keke napep' in the camp for displaced people in Gwoza

"Bringing people to the hospital at night requires military clearances and this often results in births at home, people not being able to access our hospitals and hence deaths. So we need to find solutions.”

Keke napeps are lightweight, low-cost, easy to manoeuvre and aren't viewed as a threat by the military. White coloured kekes on the streets of Gwoza are easy to spot, have clear MSF identification markings and are unlike any other vehicle in town.

Navigating narrow streets

In the narrow, dirt roads of the settlements and camps in Gwoza, the kekes can access areas and houses not easily reached by even the trusted Land Cruisers normally used by MSF.

We have converted a fleet of six of these vehicles into makeshift ambulances and placed them at strategic points around the town. The drivers are trained in basic first aid and are equipped with a wireless radio set and a first aid kit.

“We have better access to our patients. We still need permission from the military to move in the night during curfew hours, but the kekes have definitely made a difference,” says Ramde.

The problem of easy, round the clock medical access continues. We still need clearances from the military to move patients at night. But the use of keke napeps has drastically reduced the time taken to ferry patients from their homes to the hospital.

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