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CÔTE D’IVOIRE: AN AMBULANCE BOAT TO IMPROVE ACCESS TO HEALTHCARE FOR LAGOON DWELLERS

Assinie-Mafia, Ivory Coast

 

A hundred kilometers east of Abidjan, Côte d’Ivoire’s economic capital, the lagoon that winds its way through the villages of the coastal commune of Assinie-Mafia, isolates its inhabitants and cuts off their access to emergency care.

The solution? An ambulance boat, commissioned in early June by the mayor of Assinie-Mafia, Hippolyte Ebagnitchie.

“We realized that 14 villages (out of 16) on the edge of the lagoon had difficulty accessing health establishments located on the coast, “an hour and a half” or “two hours” by pirogue from the most remote localities,” he explains.

When a patient needs to be taken to hospital, “the only possible link is by sea”, adds Athanase Anné Assalé, one of the two doctors in the commune of 25,000 inhabitants.

The ambulance boat, recognizable by its red and white colors and blue star of life, is the first of its kind in Côte d’Ivoire, a country in the western Gulf of Guinea with over 500 km of coastline and numerous lagoons.

Entirely financed by the town council and manufactured in the country, the boat and its equipment cost around 50 million CFA francs (76,000 euros). It can accommodate four beds and as many patients, as well as several doctors and relatives. “It’s not a luxury, it’s a necessity”, says the mayor, who points out that the service is free of charge.

On board are oxygen, a defibrillator and cardiac monitors: “everything you need to keep a patient alive is on this boat”, assures physician Athanase Anné Assalé.

– Canoe trip –
Before the boat was put into service, the inhabitants of remote villages used to reach the health centers by pirogue.

But these are privately owned and used for “lucrative activities”, are not always available, and the cost of a trip has to be negotiated, explains Mr. Assalé.

What’s more, the crossing in these precarious boats “is just a transfer. There are no medical staff inside the pirogues”, he adds.

If a seriously injured patient is not attended to in time – fishing accidents are frequent – “during the journey, he or she can bleed to death”, warns the doctor.

At the mouth of the lagoon and the Atlantic Ocean, a dozen colorful pirogues wait near the coconut palms that dot a beach in the village of Assinie France.

Catherine Djoka, a resident in her forties, watches them. A few years ago, she had to take her sick mother to the hospital in Bonoua, some 40 km away, forcing her to make the sea leg of the journey in a pirogue without a motor.

Assinie has four health centers and four maternity wards, but some facilities are lacking.

She remembers this trip, with her mother lying in the middle of the boat, for which she had to negotiate the price of the trip, around 1,000 CFA francs (1.50 euros).

 

“The main thing was that we got there so she could be treated. We had no other choice,” confides Catherine Djoka.

“We were scared, because the tide was a bit high. The time it took them to row was a bit long,” she continues.

The ambulance boat will also come to the aid of many Assinie women who regularly give birth in pirogues.

“We welcomed the ambulance boat with great joy. Conditions were so difficult,” laments Assinie France village chief Bertrand Kouamé.

In a nod to the local population, the boat has been named “Min N’Gouamin”, or “my health” in Essouma, the language of the ethnic group of the same name that inhabits the Assinian coast.

“The health personnel who will be using this boat will tell us what improvements need to be made,” says the mayor, with a view to perhaps building a second one.

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