Roberval Tavares
Ashoka Fellow since 2014   |   United States

Christopher Ategeka

CA Bikes
CA Bikes is enabling the rural poor, particularly women and children, to access critical healthcare services through the manufacture, assembly and distribution of high quality bicycle-ambulances. At…
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This description of Christopher Ategeka's work was prepared when Christopher Ategeka was elected to the Ashoka Fellowship in 2014.

Introduction

CA Bikes is enabling the rural poor, particularly women and children, to access critical healthcare services through the manufacture, assembly and distribution of high quality bicycle-ambulances. At the heart of Chris’ idea for CABikes, is the philosophy that “saving lives begins long before, and lasts long after, an expectant mother arrives at the hospital.” Before a successful birth can take place, expectant mothers require safe, reliable and cost-efficient transportation to and from a hospital. CABikes serves to faciliate this access for marginalized and underserved rural populations

The New Idea

The core idea is to build products locally to save lives in the local community using recycled materials, while creating employment opportunities. We are different because we are local manufacturers who not only understand the problem first hand but also use locally available recycled materials to make our products which has a great environmental impact. Here are some examples of some orgnizations in our space: Bikesnotbombs: They collect used bikes in USA and distribute them in some African countries. These products were made for Western world road conditions; they dont last that long without forgetting that they are very expensive to import into a country. Worldbike relief: They contract indian bike manufacturers to make and deliver products to some African countries. Very inefficient, expensive and do not put local conditions in mind.

Unlike the imported status quo cheap and sometimes used products from western countries CA BIKES products can take a beating. They can be baked by the sun or pounded by the rain. They can be dragged over HUGE potholes in our Ugandan dirt roads or pushed down rocky surfaces and still remain standing. And most important of all is that all products are LOCALLY MADE from recycled materials. In addition, we make and distribute variety of products hence a greater impact; this is what makes us unique.

The CA Bikes bicycle ambulance, which is a covered bed that attaches to the back of bicycle or motorcycle, provides a cost-effective and reliable transport method that guarantees expectant mothers in remote rural areas arrive at the hospital in a timely manner.As a result, distances of upto 10 miles that would normally take several hours, are now covered in as few as 30 minutes. Chris believes that the time saved on such a journey to the hospital can literally mean the difference between life and death for the mother and their child.

The Bicycle Ambulances retail at a cost of $1,500 compared to $100,000 for the vehicle Ambulances. They are also locally built hence simpler to operate and maintain, durable and therfore suitable for the rural terrain. CABikes partners with aid and humanitarian organizations such as the RedCross to provide the ambulances in communities where they work. Such partnerships are crucial to enabling CABikes focus on the design, manufacture and other aspects of product development.

Aside from the Bicycle Ambulance, CABikes is developing Mobile Clinics which are refitted buses that will bring healthcare to villages during the market day. Each Mobile Clinic will have a doctor, pharmacy and specialized services with the idea to bring better, more affordable services directly to the rural poor. The Mobile Clinics will be placed in a rural parts of the country and rotate between different villages based on their market days.

The Problem

We work hard to connect individuals and communities in rural Uganda to critical health and education services by building and coordinating the distribution of locally made transport vehicles, such as wheelchairs, bicycles and bicycle ambulances. There are 34 Million Ugandans leaving in poverty and the number is on the raise and 80% of the population leave in rural areas. There is 1.4 million Ugandans leaving with HIV/AIDS; 2.7 million orphans, one of the highest rates in the world and more than 5 million persons with disabilities, many of which live in rural areas, miles away from education and health care services.CA Bikes focuses on local manufacture, assemble and distribution of high quality products designed locally, by the locals for the locals with local conditions and resources availability in mind.

Lack of mobility prevents people living in extreme poverty from accessing vital services to help them move out of poverty. Dirt roads,extreme weather, long distances and lack of infrastructure prevent people from accessing basic life services such as healthcare and education. In rural Uganda, lack of viable transportation vehicles and poor infrastructure means that expectant mothers have to walk long distances to the hospital to access delivery services. In some cases they are pushed in a wheelbarrow to the hospital whereas in most cases they opt to deliver at home. Not only is the process long and arduous, but introduces unnecessary stress and health risks that can adversely affect both the expectant mother and prenatal child.

Chris is especially concerned about the problem of lack of access to medical care in rural Uganda which causes high maternal and infant mortality rates. Uganda’s maternal mortality rate is estimated at 310 deaths per 100,000 live births while the child mortality rate is even higher at 450 deaths per 100,000 live births which are some of the highest rates in the world. For every maternal death, at least six women survive with chronic and debilitating health due to childbirth complications. This is due to the fact that only 52% of women in rural Uganda having access to a skilled attendant at birth.

Chris believes that children in Uganda face some of the toughest conditions and lowest survival odds of any place on earth. In 2012 alone 130,000 Ugandan children died under the age of 5. This is according to UNICEF. However, majority of child deaths under the age of 5 in Uganda are actually preventable. The leading causes of death for Ugandan children are malaria, early neonatal conditions, meningitis, pneumonia and HIV/AIDS, which are all either treatable or preventable with proper medical treatment.

According to the 2013 Millennium Development Goals Report, Uganda’s goal to reduce mortality by 75% between 1990 and 2015 was deemed “stagnant” while its goal to achieve universal access to reproductive services judged to be “slow”. In fact, since the previous report in 2010, there has been “no statistically significant change in the maternal mortality ratio.”

The Strategy

CA Bikes long-term goal is to help orphans and other vulnerable children acquire mobility allowing them greater access to health and education. Already we are seeing tremendous impact; With the help of our products, pregnant mothers are giving birth to healthy babies; we are helping fight HIV and Malaria; 95% improvement in school attendance and performance among our recipientsand we do not want to stop here. We are working with over 20 Global and local non-profits and community based organizations to spread our impact. We continues to work with schools and hospitals, forming strategic partners as we grow. CABikes in 5 to 10 years, Success equals recipients breaking the poverty barrier and starting social initiatives and solving there own community problems. We believe in exponential impact.

We have locally manufactured and distributed over 400 bicycles and wheelchairs. Its not uncommon in Africa to find 3 and sometimes as many as 5 kids riding on a bicycle to school. 2. One Ambulance at a village clinic serves about 50-70 people/month at any given clinic, thus with 250 ambulances set to be in the hands of the final user this year, we will be serving up to 150,000 people by the ambulances alone and this is being very conservative. In addition, there is a 95% increase in attendance and school performance among all of our recipients. Finally, 85% of persons with disabilities that have received our product are now attending school.

CA Bikes assembles Bicycle Ambulances which are then deployed through key partnerships with aid organizations working in rural Uganda. The organization is currently producing 150 new ambulances with the plans to launch a Mobile Clinic in a few months. CA Bikes has already spread nationally with an in-country office in Kampala that handles the logistics of ambulance production and Mobile Clinic prototype. Working with other NGO partners for the ambulance distribution CABikes has managed to covere most of the country. CA Bikes has a full time team of 10 Ugandans with the expertise to handle all matters of the organization including identifing potential partners, scouting for potential villages where an ambulance could be used and working with the manufacturers to build the ambulances. Chris has also created the role of a Village Ambulance Overseer who is posted in each village to maintain and repair the ambulances.

They also track individual usage of each ambulance by coordinating with their organizational partners in the field who help deploy the ambulances to the field. Each ambulance driver is required to complete a time sheet for each trip. The timesheets also help keep track of how many people are impacted by the ambulances as part of impact evaluation.Over the past 3 years, CA Bikes has placed 150 bicycle ambulances in 150 rural villages across Uganda. With each village constituting clsoe to 2000 people, CA Bikes estimates that its services have provided better access to healthcare for close to 300,000 people.A good example would be a village at the border of South Sudan and Uganda where CABikes recently placed a bicycle ambulance. In its first two weeks, the ambulance transported 54 mothers and children to and from the hospital. Two other Bicycle Ambulances placed outside of Kampala in early 2014 transported nearly 50 patients in the first 3 months.CA Bikes has developed partnerships with development organizations such as the Unicef, Red Cross, World Vision and Plan International, who share the urgent need for Ambulances in Uganda.

For the past three years Chirs has been working to perfect the CABikes products and model. In order reach the goal of building and distributing 150 new bicycle ambulances every year, he is implementing stringent interim objectives and milestones to monitor both the production process and the manufacturing and distribution partnerships to match the growing demand for the ambulances. Chris has identified that CABikes will be required to produce, on average, 13 ambulances every month moving forward, which is a remarkable increase from the current capacity. He is therefore working on a strategic plan to double production every 4 months over the next year.

Chris is also working towards launching the prototype of the Mobile Clinic with the target date for having the first one deployed in the field by July 2014. Thereafter the team will focus on a rigorous process of data collection, looking at patient need and product demand in order to determine the best balances of services and products for each village and to guide the scale up of the mobile clinics strategy.

The Person

My father died of a common cold in rural Uganda, he had HIV/AIDS, he was 34 years old and he left me when I was 7 years old. After he passed, I was left as a caretaker of my five younger siblings; and my brother died a year later on my back...while I was walking him to the hospital. These two cases had one thing in common...long distances between rural villages in Uganda and the nearest clinic or health center. On average the closest clinic or hospital is 7-10 miles away from the village which is as good as nothing in emergency situations.

Unfortunately thousands of people I rural Uganda and all over Africa die everyday over illnesses they could be saved from if they had faster means to access clinics. I was born & raised in Uganda and experienced all imaginable pain of this problem first hand. After many years of struggling, an orphanage (YES Uganda) led by Carol Adams came to my rescue. They sent me through High school in Uganda and eventually to college in California USA where i acquired a Bachelors of science, a Masters of Science and all the way to a Doctoral Candidate level in Mechanical engineering at the University of California Berkeley. Personally I used to walk seven miles to school everyday; but when i got my first bike, life changed drastically.

The journey became easier, my grades in school improved and i can tell you first hand I may not even be here if it wasn't for that bicycle. But While I was going to school, my mind has never stopped thinking about the issues that have affected me so much and continue to haunt my local community. With my life experiences and my Engineering ability. I founded CA Bikes to help thousands of under served people in rural Uganda access the much needed health care services. Already we are helping thousands of mothers give birth to healthy babies, help fight HIV and offer highly needed emergency services in rural villages of Uganda.I am passionate about this venture and helping other people going through the pain I endured.

Chris is a Mechanical Engineer from Uganda who studied at the University of California, Berkeley. He founded CA Bikes Uganda with a long term vision of establishing a non-profit organisation that would help orphans and other vulnerable children access critical services such as healthcare and education. Chris became an orphan at the age of 9 after losing his parents to HIV. Becoming a bread winner at such an early age led him to realize the importance of being able to move around in order to access critical services as well as opportunities.

On his 10th birthday, Chris received the gift of a bicycle from an uncle that enabled him to reduce his daily commute time to school, improve his grades and spend more time at home taking care of my younger siblings. He started his first informal enterprise providing neighborhood trash collection services and carrying out other hard labor jobs in the fields to support his family.

He became conscious of inequalities and injustices from a very young age. He lost both his parents at only 9 years of age, he was raised in extreme poverty with no electricity, no running water, often surviving on one meal a day. One of his younger brothers died of an unknown illness while on his way to a distant hospital, a loss that left Chris devastated with guilt and self blame. This became the foundation of his desire later in life to provide reliable and dignified form of transportation for marginalized rural populations living in extreme poverty.

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