Milward's
Millennium Motorcycle Ride

Health For All


Health for All is an officially registered Indonesian NGO with Statutes. It's sole project

The Flores Project

introduces the proven Riders for Health (RfH) African system to Asia for the first time. RfH has won awards for its work which has resulted in a 500% delivery rate improvement of crucial vaccinations etc in out of reach communities. RfH pioneered the idea of motorcycles saving lives in the world's poorest rural areas.

map

Flores Islands / EAST NUSA TENGGARA

 

Primary Healthcare Delivery by Motorcycle

Flores Project

Prepared by Simon Milward
December 2000
Singapore

    Contents
  1. Foreword by Simon Milward
  2. Description of East Flores region & implementation plan by Wilibrordus Bala
  3. Training schedule for Mr Bala in Harare Zimbabwe by Alfred Gonga
  4. Curriculum Vitae of Wilibrordus Bala
  5. Budget considerations

I. Foreword

The Millennium Motorcycle Ride is my two and a half year solo motorcycle ride around the world. I left Europe on 1.1.2000 and will arrive back home in July 2002 after visiting 70 countries. The main aim is to raise US$100,000 for two medical aid charities: Médecins Sans Frontières and Riders for Health. After eleven months on the road and twenty countries I have raised US$17,000. The former group received the Novel Peace Prize in 1999 for its humanitarian work for populations in crisis. The latter group provides for training of health workers in reliable delivery of services by economical motorcycle in rural Africa. When motorcycles are operated within a system, health delivery is improved by a staggering 400-500%.

I am a keen motorcyclist, being the General Secretary (on sabbatical) of the European street riders' association FEMA in Brussels Belgium, which defends and promotes the interests of riders at the heart of the European Union. During the ride it has become clear that there is an enormous demand for the Riders for Health system in Asian countries: motorcycles can play a major role in saving lives across the region. So although most of the funds raised will be presented to the charities after July 2002, some will be used immediately on a new project on the Indonesian island of Flores.

Some money donated to Riders for Health under the Millennium Ride banner, will be used to send Mr Wilibrordus Bala to the Riders for Health training Academy in Harare Zimbabwe. This was agreed by all concerned. This takes place in January 2001 costing in the region of US$5,000 (or $2000 if RfH waive the training costs).

I hereby request your support for this initiative. If successful it may help millions of people in Asia break the curse of the poverty cycle that lack of access to basic health services means.

Simon Milward
www.millennium-ride.com

water storage
[989x673 108kB] A community organizer shows a never-used water storage due to the poor construction (the lack of clean water is another problem in the villages)

II. Description

INCREASE ACCESS TO PRIMARY HEALTH CARE THROUGH HEALTH FOR ALL (FLORES PROJECT)

CONTEXT

As in other developing countries, the problem of health in Indonesia in general is one that needs special attention. Imbalance between the population and existing health facilities brings about numerous health problems. Good health facilities are only found in big cities where people who have money can access such facilities while the poor must face all health risks due to limited access to good health service.

Eastern Indonesia is known as a less attended part of the country. Since the 1997 monetary crisis, it is estimated that 80% of the population here is categorized as poor. This poverty makes their access to good health services more and more difficult. Such a situation deteriorates with limited health facilities. Most health facilities such as public health centers are located in the capital of sub-districts. There are local branches but are not found in all villages, and are difficult to reach due to lack of transport.

water storage   [673x989 116kB] A community organizer relies on his often problematic bicycle in his community works

It is known that transport is a determining factor to facilitate the people in gaining various accesses including health access. Normally in every village there are roads, although not in good condition, but passable by motors. The problem is most public transport passes on main roads, while entry to the villages must be by foot. Such a situation shows the general picture in villages in Eastern Indonesia.

East Flores located in East Nusa Tenggara Province is part of Eastern Indonesia. East Flores consists of 2 districts namely East Flores and Lembata districts. In both districts there are 249 villages with the population of 276.073 people. In this region there are 1 general hospital, 2 private hospitals, 1 private hospital for lepers and 20 public health centers. Medical doctors are only based in the hospitals.

This data depicts the limited health facilities, while the people are confronted with great health problems such as high rates of malaria, bronchitis, maternal and infant mortality. In addition the cases of STDs are also high considering that many people from East Flores become immigrant workers abroad.

Providing health services that can reach the people especially those living far from the hospitals and public health centers is an effort to help people overcome health problems. The concept of Health for All is a promising and interesting alternative in East Flores, taking into account that many health providers could drive motors and road conditions could allow the riders to reach remote villages.

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PROVIDE MOTORCYCLES FOR HEALTH WORKERS
IN ILEAPE AND WULANG GITANG SUB-DISTRICTS,
FLORES INDONESIA

July 2001 - June 2004

Submitted by:
Yayasan Kesehatan untuk Semua
(Health for All)

Jl. Wch. Oematan 18A, Walikota,
Kupang - Indonesia
Telp: 62-380-827049
Fax : 62-380-833257
Email : hfa_flores@telkom.net

    Table of Contents
  1. Background
    1. General view of health condition in East Nusa Tenggara Province
    2. The System of Health Care of Indonesia
    3. The Effect of regional autonomy policy on the Quality of health care
  2. General View of Ileape and Wulang Gitang Sub-district
    1. The condition of the people in Ileape and Wulang Gitang Sub-district
      1. Condition of the people of Ileape sub-district
      2. Condition of the people of Wulang Gitang subdistrict
    2. Road condition in Ileape and Wulang Gitang sub-district
    3. Health condition in Ileape and Wulang Gitang sub-district
  3. Profile of Health for All
    1. What is Health for All?
    2. Vision
    3. Mission
    4. Place or Operation
    5. Board members
  4. Goal and Objective of the program
    1. Goal
    2. Objectives
  5. Logical Framework
  6. Implementation of the activities
    1. Duration of the Project
    2. Strategy of Health for All
      1. Collaboration with MoH in district and sub-districk level
      2. Staff development of Health for All staffs
      3. Provide motorcycles for health workers
      4. Build network with NGOs, POs, Community Leaders
      5. Provide and Multiply the material of health information
    3. Role of MoH, NGOs,POs, Community Leaders, Health for All and Riders for Health
    4. Work Plan (separate sheet flo01wrk.xls 28kB)
  7. Budget (separate sheet flo01bud.xls 79kB)
  8. Contact Person and Reference Persons
[this document flo01pro.rtf 97kB or read below]

I. BACKGROUND

A. GENERAL VIEW OF HEALTH CONDITION OF THE PEOPLE IN EAST NUSA TENGGARA PROVINCE (NTT)

East Nusa Tenggara province is one of the poorest provinces in Indonesia, because the inequitable economic development practiced by Soeharto's (former Indonesian President) regime has made this province become a region having numerous limited social facilities, such as limited means of transportation, school, and health facilities. East Nusa Tenggara up to 2000 there are 208 public health centers and 24 hospital providing service for 3,5 million people. The number of doctors and para medical staffs who run those hospital are 137 doctos, 2.555 paramedical staffs and 1578 midwives. Most doctor work in Kupang municipality, numbering 20 doctors while the rest spread in the 13 districts of East Nusa Tenggara. The quality of service is also quite alarming, such as the complaint concerning inhospitable attitudes of medical staff and insufficient information offered to the patients who need it badly.

nurse
[957x657 78kB] A nurse in a Branch of Public Health Center gives service for around 3.000 population without means of transportation

From the analysis of health care budget in East Nusa Tenggara, it also shows a drastic decline for the last three years. Before the monetary crisis taking place in 1997, health care budget was US $ 12.00 per person (US$ 4.00 was subsidized and US$8.00 was shouldered by the people themselves). During the present crisis, it decreases to US$ 4.40 in East Nusa Tenggara. It obviously indicates the decline of the quality of service which is also aggravated with the decrease of people's ability to earn for their own health care. The limited health facilities as well as low people capacity contributes to the decline of people's health condition in East Nusa Tengara. If this situation is not overcome immediately, it will have the impact on the production of unhealthy generation and will absolutely weaken the capacity of human resources in East Nusa Tenggara. Eventually such a situation could be detected at the moment but the government understanding of health as a huge investation is never thought and explored thoroughly. At present East Nusa Tenggara has the highest maternal mortality rate, that is 9,11 out of 1000 alive delivery compared with maternal mortality in national level that is 4,5 out of 1000 alive delivery. Compared to other ASEAN countries, Indonesia also has the highest Maternal mortality rate, namely 425-650 out of 100.000 alive delivery. This show how women's health is managed so far. The perception that a mother's health is her own responsibility is a predominant factor causing so many mothers to shoulder their own sufferings without help of the husband or of close relatives.

nurse
[957x657 89kB] A Suzuki XS in a bad condition, owned by the husband of a nurse is at times used to go to the villages

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