Mbaïki – Cyrille Bakake is a motorcycle ambulance driver at the Bagandou health centre, about 100 kilometers from Bangui, the Central African Republic’s capital. This 30-year-old father of four, a farmer by trade, became an ambulance driver in 2018. His work is similar to that of any other ambulance driver, but his vehicle is a motorcycle. 

In the six months since the mpox outbreak in the health district of Mbaïki, Bakake has transported 18 of the 41 patients treated at the centre. “Getting the sick to hospital is very important. Because if they stay at home, they can infecto thers, and even die,” he says.  “I am also helping to save lives.” 

On 20 July 2024, the Central African Republic declared an outbreak of mpox. By 22 December 2024, 89 confirmed cases and three deaths had been recorded in the country. Of the 89 confirmed cases, 35 are from the Mbaïki health district, including 22 from the Bagandou locality, where Bakake works. 

In this hard-to-reach area, motorcycles are one of the most common modes of transport. Mbaïki hospital, the only referral facility in the health district, has no ambulance. Motorcycles have proved to be the best alternative for transferring patients. 

Because mpox is a highly contagious infection, World Health Organization (WHO) is supporting ambulance drivers by providing them with personal protective equipment. Bakake, like other drivers, has also been trained in the means of protection, and the ways in which the disease is transmitted, with the support of WHO.

“Thanks to this training, and the protective equipment available to us, I remained safe and sound and was able to continue transporting patients,” explains Bakake. “After each journey, the motorcycle is disinfected.”

Motorcycle ambulances enable patients to be transported quickly to the treatment centre for early care, so avoiding complications and increasing their chances of survival.

“Given the poor state of the roads. and the contagious nature of the disease, we have opted for motorcycle ambulances to get patients from health facilities to the treatment centre quickly, so limiting the risk of the disease spreading. We are taking all the necessary steps to protect the drivers from contamination,” explains Dr Franck Bertin Beltoum, chief medical officer for the Mbaïki health district. “Thanks to the speed of the motorcycle ambulances, patients are treated very early and quickly recover their health. Without the motorcycle ambulances, we would have seen more deaths, because it’s difficult to get to the treatment centre quickly without this mode of transport.”

As part of the response to mpox in the Central African Republic, WHO has provided 1000 real-time PCR screening tests and 100 GeneXpert cartridges to strengthen the diagnostic capacities of the country’s two reference laboratories. 

WHO-support rapid response teams have been deployed to the health district to carry out in-depth investigations, contact tracing, case management and awareness-raising. WHO has also provided the Mbaïki district with four motorcycle ambulances, thanks to funding from USAID, and is also providing fuel.

“The realities on the ground have shown us that transporting patients by motorcycle ambulance between the health centre and the treatment centre is a valid and highly effective alternative,” says Dr Thomas Aquinas Koyazegbe, head of infectious risk management at WHO’s country office in CAR. “This innovative initiative, which adapts to local conditions, has been helping to save lives ever since, particularly during this mpox outbreak.”

In addition to the motorcycle ambulances and fuel, WHO, with financial support from the CAR Humanitarian Fund and other partners, has delivered emergency health kits to Mbaïki for the treatment of patients. These kits contain painkillers, anti-inflammatories, antibiotics, consumables for treating skin lesions and personal protective equipment. They can be used to treat 7000 patients over a period of three months. 

In Bagandou, Bakake’s motorcycle ambulance is reputed to have saved lives during the mpox outbreak.

“Without Cyrille's help, I would have succumbed to mpox, just like my late wife who was six months pregnant when she became infected with the virus,” says Ange Nzonpou, a patient who has recovered from mpox. “While I was alone in my suffering and no one dared approach me, he transported me on his motorcycle despite the difficulties related to the poor state of the road,” he adds. “It’s partly thanks to him that I'm still alive.”