Biker doctors: Ensuring nomadic families don’t miss out health care

@ UNICEF Mongolia /2015

Earlier this year three-year-old Bat-Ireedui needed to see a doctor urgently. “My son got sick and his legs became paralysed,” his father Bayardalai explains. “We called the bagh doctor, he came to our home straight away, examined Bat- Ireedui and took him to Murun for further medical assistance.”

While Bat- Ireedui received medical treatment in Murun and his paralysis subsided, his condition is ongoing, needing constant monitoring and regular visits from the doctor.

Bat- Ireedui and his family, father Bayardalai, mother Shuren-Erdene, who is five months pregnant, and sister Nandintsetseg, four, a nomadic herders in Khuvsgul province, northern Mongolia. While they live approximately 30 kilometres from Murun, Khuvsgul’s provincial center, at the moment, it takes nearly an hour to drive there in good weather and the location is very isolated.

Providing medical care to nomadic families in Mongolia is challenging. Doctors must be able to travel long distances, over difficult terrain, in all types of weather. And sometimes it can take all day to reach one family.

For Bat- Ireedui’s family they receive primary health care from the local bagh doctor. Each bagh in Mongolia, a sub-district which groups nomadic families in one small area together, has a local doctor who is responsible for the primary health care of all the families in their area. If cases require further attention, they are referred to the soum (district) and provincial health services.

“Our local bagh doctor is Davaasuren”, Bayardalai says. His a good local doctor. Whatever happens, we call him. If we need medicine, or someone has a fever or is sick, we call him. Whenever we call him he comes right way.”

Davaasuren provides over 140 households with primary health care, with regular visits to check on people’s heath and responding to emergency calls. He says he spends a lot of time travelling to and between families to provide them with medical care.   

Reaching people in need

@ UNICEF Mongolia /2015

Until recently Davaasuren was not provided with any form of transportation and would have to find his own way to reach his patients.

“For a bagh doctor, transportation is the most important thing,” he explains. “When you have good transportation you can reach patients in a timely and safe manner, and you can be a better doctor.”

However this changed when he and all the other bagh doctors in the district, were provided with motorbikes. The motorbikes were funded by the local development fund (LDF).

Since getting the motorbike, Davaasuren says he is able to provide better medical care to the families in his bagh. “With the bike I can go anytime to do routine visits and respond to emergencies,” he explains. “It has made such a difference. I can reach all the families, and if I need to transport a patient for further medical care, if they are not too sick, I can take them on the motorbike.”

And his patients have noticed a positive difference since Davaasuren got the motorbike. “We see him more now,” Bayardalai says. “He comes a least once a month to check up on us and share information about how to stay healthy and prevent getting sick.”

Local Development Fund

The motorbikes were purchased with money from the LDF. The LDF is an initiative that provides additional funds to local governments but stipulates that local communities must be involved in the decision making and budgeting processes of how these funds will be used.

In the case of the motorbikes for the bagh doctors, the local community had identified the lack of transportation as an issue that affected the quality of medical services and prioritized buying motorbikes for the doctors.

Bayardalai was part of the process that decided to give the bagh doctors a motorbike. “We received a short survey and filled it out,” he explains. “It asked us what we wanted to spend the LDF on and we said motorbikes for the bagh doctor. After the surveys there was a vote about how to spend the LDF. There we voted for the bagh doctors to get the motorbike and they did”.

Just like in Erchim bagh the LDF puts decision making and budgeting power back into the hands of local communities, who prioritize funds based on their individual needs. It is part of the efforts by the Government of Mongolia to decentralize the country’s budget.

UNICEF Mongolia’s social policy chief Enkhnasan Nasan-Ulzii believes communities across the country can use the LDF to improve the lives of children. “What Erchim bagh did was to use the LDF to improve access to health care for vulnerable children and their families,” she says.

“Other communities can use the LDF to fund projects for children,” Enkhnasan continues. “UNICEF has been actively engaging local government and communities to encourage them to use the LDF to improve the lives and situation of children, and we are hopeful that we will see more great projects like the motorbikes for doctors that benefit children being funded by the LDF”.

Author

Zetty Brake, Communications and External Relations Officer, UNICEF Mongolia