Moto Meds Providing essential nighttime healthcare to children in low resource settings
As COVID-19 spreads across the globe many healthcare facilities are closing or forced to make major operational changes in order to ration scarce resources and reduce risk of exposure. MotoMeds is uniquely positioned to respond to this new healthcare environment.
The MotoMeds model of decentralizing healthcare to the level of the household allows clinics and hospitals to focus on more urgent cases.
Patients can reduce exposure to COVID-19 by avoiding clinic waiting rooms.
Knowledge gives communities power to fight COVID-19. The nurses educate on social distancing, danger signs to monitor, and low-cost steps that can avert emergencies for children and their household contacts.
The MotoMeds pediatric call center and mobile pharmacy service prevents pre-emergent illnesses such as fever and diarrhea from transitioning into emergencies during the nighttime hours – a critical healthcare service where medical resources are often prohibitively expensive and inaccessible in places like Haiti.
While conducting research in Bangladesh and responding to the 2010 Cholera outbreak in Haiti, Dr. Eric Nelson consistently observed severely dehydrated patients lining up outside the clinics in the morning. These clinics were crowded with patients who had become ill during the nighttime hours but had no other option except to wait until the morning. For some illnesses, (eg. cholera), and some populations (eg. young children) waiting until the morning could be the difference between an easily treatable patient and one with a life threatening emergency. Dr. Nelson started thinking about ideas on how to fill the nighttime gap in pre-emergent healthcare. The idea for MotoMeds was born.
“The idea for MotoMeds was inspired by experiences from the 2010 cholera outbreak in Haiti. In the morning we would see patients arriving at the clinic severely dehydrated because they were isolated from access to oral rehydration fluid and sound clinical advice during the night. While MotoMeds is Haitian inspired, once validated, we hope will serve as a model for global deployment.”
“I am especially drawn to the work being done at the Nelson lab because of its focus on bridging the gap between research and actionable public health improvements and I am excited to have the opportunity to contribute to this endeavor.”
The MotoMeds call center is currently staffed by a team of dedicated Haitian nurses. While MotoMeds has a well developed set of protocols and clinical guidelines the nurses can be called upon to apply their clinical knowledge and experience during the consultation process. They are backed by a set of on-call doctors whom they can consult when more complicated scenarios arise.
Our delivery drivers are the key to elevating MotoMeds beyond an ordinary telemedicine service. The drivers use their extraordinary local knowledge to navigate to households in the dark, at night where there is no address system.
You can help support MotoMeds mission by making a contribution today.
How it works
A parent with a sick child places a call to MotoMeds (open 6PM-5AM).
Using MotoMeds guidelines a nurse asks the parent a series of targeted questions about the child, their symptoms, vital signs, and medical history.
Based on the responses to the questions, the nurse makes an assessment about what illness the child has and creates a treatment plan (how and where to be treated.)
If the child lives in the MotoMeds delivery zone, a motorcycle will deliver basic medications/fluids.
“There was a child who received a medication delivery for a fever and cold. When we called the mom to check on the child she said it was God that sent the service for them because she felt the medicine MotoMeds prescribed was so effective. I was happy to hear this and I know it was not just the medicine that is effective but also the clinical impression was more or less exact.”
“We had a parent call about a child who had a fever and cold so we went to their house for a delivery. The neighbors came over and commented that the mom must be a very important person to receive such amazing medical care delivered to her home at night.”
“MotoMeds allows children to access care during the night, especially the type of children whose families do not have many resources.”
“I like when I am on a household visit and the neighbors come over to see what is going on. They learn how great the service is and they want to call us too, at that very moment. Also because of MotoMeds parents know what actions to take when their kids have certain illnesses (fever, cough) because we do a lot of education.”
“Working with MotoMeds has caused me become more compassionate. It has given me the opportunity to get closer to people in the community and understand them.”
“When I’m out on a household delivery parents tell me what they like about MotoMeds is that they can call at any time and reliably reach a nurse. The families trust the consultations and have confidence in the medications.”
“More often than not parents are still surprised that we actually work at night because our community usually associates nighttime with bad ideas like danger and darkness. “
In September 2019 a feasibility study was launched in Gressier Haiti. We began evaluating the safety of the MotoMeds assessment tools and clinical guidelines as well as establishing the infrastructure necessary to operate a call center and delivery service.
The call center was established in Gressier Haiti, a semi rural area about 30 miles outside the capital, Port au Prince. Children who live within a 5km radius of the call center are eligible for medication and fluid delivery.
Parents have called MotoMeds for children ranging in age from 10 days to 10 years. Over half of the patients have been under 2 years, a very vulnerable stage for children in Haiti.
Almost half (42%) of parents call MotoMeds because their child has a fever as the chief complaint. Other common symptoms parents report are respiratory (67%) such as coughing and nasal discharge, vomiting (22%) and skin problems (19%). Patients have an average of 2 symptoms.
Motorcycle tracks from 2 months of household medication deliveries. Our delivery drivers work as motorcycle taxis during the day, bringing kids to school and transporting women to the markets to sell their goods.
Connect with us
Contact us about partnership and other opportunities to get involved!
Eric Nelson, MD, PhD
PO Box 100296
Gainesville, FL 32610
Molly Klarman, MPH
EPI, University of Florida
2055 Mowry Road
Gainesville, FL 32611