Czech mobile ambulances help herders in Mongolian steppes

Mongolia has one of the sparsest populations in the world. Due to harsh natural conditions, only 3 million people live in an area twenty times larger than the Czech Republic. People who live in remote parts of Mongolia, in traditional yurts called ger, only have very limited access to the city as well as to services and healthcare. When a family member living far from the city becomes ill, they have to drive up to 200 km to the closest medical centre and possibly another 200 km to a general hospital with better facilities, from where they can even be sent to Ulaanbaatar that is 1 000 km away. It is therefore not surprising that Mongolian herdsmen only go see a doctor in the most acute cases. Since 2011, PIN with the support of the CzDA therefore helps improving access to health services to people from remote areas of the country.

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The journey to the hospital takes up to 12 hours

“We equipped several vans with the necessary medical equipment. The medical vans leave twice or three times a year to remote areas of Mongolia, carrying professionally trained staff who diagnose illnesses, perform basic medical procedures, and treat minor illnesses with the help of special equipment,” explains Quentin Moreau, the head of People in Needs’ Mongolian mission.

 In three years, PIN deployed mobile ambulances to 6 out of the total 21 provinces or aimags, covering around 30% of the country. Urban areas were deliberately omitted, as they are not in need of this service.

“We are trying to make health care accessible even for people in the most remote parts of Mongolia. In some regions, basic health care was available, but in case of any complications, people still have to travel for hours to reach any specialized facilities. That is why we provided modern field equipment including all the necessary diagnostic machines and material for six provincial hospitals in Arkhangai, Uvurkhangai, Bayankhongor, Zavkhan, Khuvsghul and Umnugobi,“ says Lucie Chudá, coordinator of Mongolian projects of the Czech Development Agency. “Thanks to these mobile ambulances, the hospitals are able to provide care directly in patients’ homes, so they do not have to endure the difficult journey to the provincial health centers. Czech Development cooperation in Mongolia thus helps to save lives and improve quality of life of local residents,” adds Lucie Chudá.

“For people who live 300 to 400 km from a hospital, a doctor visit means up to a 12-hour car ride. That is why they do not consult a doctor unless it is absolutely necessary. A flu, of course, does not present such a problem, but liver cancer, for instance, necessitates early detection and treatment. And thanks to our mobile service, it is possible to examine and diagnose patients before the disease fully manifests itself. If the illness is caught early enough, doctors in Mongolian hospitals are able to cure it successfully. I can therefore say that our mobile clinics save human lives,” Quentin Moreau adds.

Thousands of people were examined by ultrasound and ECG

After three years, the results of the project’s evaluation were very positive. Out of five thousand people examined by ECG from 2011, 20 heart conditions were diagnosed and later treated at the hospital in Ulaanbaatar. In the past year, another 11 600 people were examined by ultrasound, out of which twenty were diagnosed with liver cancer and subsequently underwent treatment. When the vans are not dispatched, the medical equipment is used by hospitals in regional cities, while the vehicles are used as ambulances for more remote areas. A recent visit of PIN staff at the hospital in Tsetserleg in the Arkhangai region confirmed that the equipment is in perfect condition and ready for dispatch or for use at the hospital.

Individual provinces are very satisfied with the service. It even turned out that they have been already running similar activities according to their possibilities and resources. “Between the years 2011–2013, Caritas Czech Republic also operated a similar project in Mongolia, although their aim was slightly different. They attempted to create a continuous service – permanent clinics at the lowest administrative level that people could go to regularly. We decided to collaborate. Caritas has its model and People in Need has its own model, so we offer it to individual provinces and let them decide which service they choose,” Quentin Moreau describes. PIN’s concept of mobile medical services also impressed the World Health Organization that later decided to support the project’s expansion and contribute to its institutionalization, so that it can be independently implemented even in other provinces and health centres in Mongolia.

Information about the arrival of mobile clinics spreads quickly among people

The nomadic life of Mongolia’s population is entirely different from western way of life. The common way of providing health services and nomadic life simply do not go together. Mobile clinics providing early diagnoses of possible illnesses thanks to needed equipment and trained staff have proven to make great progress. “It would be very expensive and complicated to drive all patients to hospitals in ambulances. This way, people from the village learn about the arrival of our clinic and then they all gather there. The information spreads very quickly among the locals,” says Quentin Moreau. “We have had excellent results so far. We now even cooperate with the local ministry and we try to implement similar services in individual provinces at the national level,” he adds.