When an emergency strikes, the difference between life and death can sometimes come down to minutes. For Dr Helen Gizachew and Dr Loza Admassu, that reality became clear just days after they arrived in Rwanda two years ago. The two Ethiopian doctors had come to the country for professional opportunities, but during their second week, they encountered an emergency involving someone close to them. As they navigated the emergency response system to get help, they began asking whether there was a faster way of reaching people in urgent need, particularly in places where conventional ambulances may struggle to arrive quickly. ALSO READ: Top funding initiatives available to local startups That question eventually led to Ambucycle, a motorcycle-based emergency healthcare model designed to reduce the time it takes for trained health professionals to reach patients. The doctors are now working to develop the model further, with ambitions to take the service beyond Kigali and closer to communities across Rwanda. An emergency that changed their thinking The idea did not begin with a business plan. Helen and Loza were already medical doctors and familiar with the clinical side of emergency care. But their experience during their second week in the country exposed them to another part of the problem: what happens between the moment someone needs urgent help and when a healthcare professional actually reaches them. “We were already here and we were doing a training, and we encountered an emergency call, not us but someone close to us, and we had to navigate the system to help them,” Helen recalls. “We noticed that something can be done about it. Then we started thinking about how people treat emergencies when it happens to you, what people do and how help gets to you and everything.” ALSO READ: Start-ups key to Rwanda’s future but need more support The doctors began examining Rwanda’s existing emergency response system and looking for a way to add value rather than create a separate system. There was already a central emergency response mechanism, ambulances and a dispatch system. They saw an opportunity to complement it. “We were working as medical doctors, so we know the side of the health professionals, but you don't know how this is navigated,” Loza says. “Here there is a system, there is a call centre, there is a way ambulances are dispatched and everything. So it was easy for us to develop a solution that can be integrated into this because there was already a system here.” The answer they began exploring was the motorcycle. Why a motorcycle? Motorcycles are already a familiar mode of transport in Rwanda. But the doctors saw another potential use for them in emergency care. Unlike larger ambulances, motorcycles can move through congested roads, narrow routes and areas where larger vehicles may face difficulties. “The problem that we're trying to solve is emergency response times,” Loza explains. “Every second that passes without help matters, and the chance of surviving accidents also depends on how fast help gets to you.” The motorcycles allow trained health workers to move quickly through traffic and reach patients while an ambulance can be mobilised for transportation when necessary. The concept was tested through a pilot project carried out with the Ministry of Health. During the pilot, the average response time was about 13 minutes. The team responded to 73 patients, stabilising many of them at the scene and assisting with emergencies including childbirth. “It was really good. It was very encouraging for us,” Helen says. “We could see that motorcycles could navigate congested areas and also get to areas that are not easily accessible by car.” ALSO READ: Key projects as Rwanda’s AI hub funding rises to Rwf25bn The doctors now want to bring the response time closer to eight minutes. Getting there first Ambucycle is not intended to replace Rwanda’s ambulance service. Instead, the doctors see it as another layer in the emergency response chain. When someone calls 911, motorcycle responders can be dispatched alongside an ambulance. Their role is to reach the patient quickly, assess the situation and begin stabilisation and treatment while the ambulance is on its way. In emergencies, those first interventions can be critical because a patient’s condition can change rapidly while waiting for help. “Whoever gets there first, it doesn't even matter whether it's on a motorcycle, whether these people fly, whatever resources we have, if we use them just to make sure that people get help within a few minutes,” Helen says. “Even a person trained in the household can save a life. This is how important emergency or out-of-hospital emergency care is, because not everything works until you get to the hospital.” ALSO READ: How Rwanda’s startups are overcoming barriers to grow The doctors say not every emergency requires immediate ambulance transportation. In some cases, what is needed first is a trained professional who can assess the patient, provide initial treatment and determine what should happen next. Working within the existing system The pilot covered parts of Nyarugenge and Kicukiro, but the team encountered a challenge common to emergency services: emergencies do not respect administrative boundaries. An ambulance assigned to one area may be dispatched elsewhere when another station is overwhelmed. The same flexibility, the doctors say, is needed for motorcycle responders. “Sometimes the ambulances get sent outside of their district because another district might be saturated,” Loza says. “So they may even go to Masaka and everything because they get saturated here and then they have to be sent from here.” That is one reason the doctors believe the model has potential beyond the areas covered during the pilot. Their longer-term ambition is to make Ambucycle available in communities where reaching a healthcare professional quickly can be particularly difficult. ALSO READ: Govt moves to address shortage of ambulances “We want the motorcycles to actually go outside of Kigali,” Helen says. “We hope we can embed Ambucycle in the community and make it affordable, so people can just call and have access to a healthcare professional, even when they're in the hardest-to-reach areas.” A motorcycle responder could reach a patient, assess the situation and intervene while arranging further transportation when necessary. Navigating health regulations The doctors say Rwanda’s entrepreneurial environment has provided opportunities to develop and test new ideas. However, working in healthcare comes with regulatory requirements that can be more complex than those involved in ordinary consumer products. Their biggest challenge, they say, has been navigating health policies and regulatory requirements. “We have the infrastructure. Even in funding, we had a few problems, but we also had a lot of help,” Loza says. “But policies in health are strict, and they are very important that they are strict. It's a very good thing, but it's also difficult for entrepreneurs to navigate them and to be able to innovate.” The team has worked with the Ministry of Health and Rwanda Medical Centre as it develops the model and explores how it can fit within the country’s emergency response structure. ALSO READ: Is Rwanda Innovation Fund relevant to local startups? Helen says they have been encouraged by institutions’ willingness to engage with new ideas. “One very good thing about Rwanda's health system is the fact that they are always encouraging innovations,” she says. “We did a pilot project with them and they are always innovating a way to include innovations into the system.” She believes there could be room for an even clearer pathway for health innovators to test and integrate new solutions while meeting safety and regulatory requirements. More motorcycles, more reach For now, the doctors acknowledge that Ambucycle does not have enough motorcycles to cover the country. “To say it's enough, then that would be a lie,” Helen says. “It's not enough, but we do have something to start with.” Their ambition is to expand the fleet and reach more communities. They are engaging health-sector partners, emergency response actors and health facilities as they work through the requirements for expansion. ALSO READ: Five things to know as Rwanda acquires over 100 new ambulances The need, they argue, is not limited to road accidents. Road traffic injuries account for many of the emergencies they encounter, but the motorcycles can also respond to medical cases such as complications related to diabetes and obstetric emergencies. “Nothing comes close to trauma,” Loza says of the emergencies they see. “It's very common to have accidents, either motorcycles, cars or pedestrians.” The doctors are keen to emphasise that their model is about complementing, rather than replacing, the existing emergency response system. “It is in a way adding one more fleet into the system that would make it faster and more efficient, especially for African countries,” Helen says. For patients, the novelty of being approached by a medical professional on a motorcycle can sometimes give way to appreciation once they understand the purpose of the model. The nurses working on the motorcycles have also had to adapt to providing care outside a hospital environment. “You need so many equipment, you need to call, you need to be calming stuff, you need all of those things,” Helen says. “And then our nurses, they put their maximum effort and they give the patients the maximum care.” From Kigali to the community For Helen and Loza, the next phase is about proving that the model can work at a larger scale. They want motorcycle responders to become part of communities, particularly in areas where access and response times remain difficult. The idea that began with an emergency during their second week in Rwanda has since become a longer-term effort to rethink how emergency care reaches patients. They know there are regulatory, funding and operational hurdles ahead. They also recognise that the number of motorcycles they currently have is far from enough for the coverage they envision. But the doctors believe the principle is simple: when someone is in danger, help should not have to wait for traffic to clear. For now, Ambucycle is starting with what it has while looking for partners who can help take the model further. Their hope is that one day, when an emergency call comes in, the first person at a patient’s door may not always arrive in an ambulance.
