Motorbike sidecar ambulances and clinics are one of the best things to come out of the Eastern Cape. Yet certain quarters are trying their best to bludgeon the life out of this initiative that reaches into the heart of rural areas. You have the power to decide for yourself.
An African solution from the Eastern Cape
For the past 15 years, motorbike sidecar ambulances and clinics, manufactured in a Fabkomp factory in Zwelitsha outside King William’s Town in the Eastern Cape of South Africa, have been distributed and used throughout Africa and now in the Middle East and Asia.
The very first of these vehicles were launched at Nelson Mandela’s home in Qunu in the former Transkei Bantustan in the Eastern Cape in 2003. The sidecar ambulances and clinics have been used in small projects with non-governmental organizations in South Africa, but never took off on a big scale in the country.
It’s another story for African countries. Buyers and distributors include UNICEF (Uganda, Ethiopia, Sudan, Zambia, Liberia, Guinea, Zimbabwe, Sierra Leone), the Clinton Health Access Initiative (Zambia, Ethiopia, Malawi), the Salvation Army (Kenya), the United Nations Population Fund (Cameroon), USAID (Zambia), DFID (Malawi, Zambia, Zimbabwe, Kenya), Save the Children (Ethiopia, Philippines), UNDP (Tanzania), the Gates Foundation (Zambia, Zimbabwe) … I could go on, but that would fill this page and more. You get the picture.
Fabkomp has quietly gone about its business, supplying these markets from the Eastern Cape, as creaky as this province is. But when it won a tender to supply 100 motorbike clinics (note: not motorbike ambulances) to the Eastern Cape Department of Health, the knives came out; so did the hammers and axes. It became a feeding frenzy of sheer nastiness, apparently with an agenda or two involved.
It’s been more than disturbing. It’s been unethical in the extreme, in my view. However, my intention in this post is to tell the story, without a spin, because you are smart enough to make up your own mind about these vehicles and the debacle they’ve been plunged into.
I’ve broken it into chunks to make it easier to read and concluded it with a breakdown of costs because the price has drawn some of the loudest critics. I base the post on information that Fabkomp director Brian Harmse has made available to the media, my conversations with Brian, and my own research.
And the best way to tell a story such as this is to start at the beginning.
About Fabkomp and eRanger
Fabkomp, which makes components and other products for the automotive and engineering industries, has been in business for 37 years. About 160 people work in the Zwelitsha factory. These are good, solid jobs in South Africa’s “basket-case” Eastern Cape province, where unemployment is rife. Each year, it trains 48 Walter Sisulu University engineering students doing their P1 and P2. It also trains around 15 apprentices at any given time.
Brian bought Fabkomp in 2000 and implemented broad-based black economic empowerment shareholding: 60% is owned by DEmPower LD, which is black owned (100% are people with disabilities and 54.55% are women); and 40% is owned by Choice Decisions 52 (Pty) Ltd, of which Brian is the owner and managing director.
Brian is also a director of eRanger (the Ranger Production Company), based in King William’s Town. Fabkomp owns 49% of eRanger and international shareholders own 51%. eRanger imports and exports units. Fabkomp sells to the South African market as it has the NaTIS certification from government to do so.
In 2003, Brian met eRanger managing director and inventor Mike Norman. Mike was launching the first units in South Africa at Nelson Mandela’s home, and he was looking for a partner in South Africa. He found his partner: Fabkomp.
Putting it all together
eRanger imports the 200cc motorbikes in semi-knocked-down (SKD) form. It brings in full containers to maintain stock levels. “Not a single motorbike in South Africa is made from scratch,” Brian says. “We simply don’t have the volumes.”
When it receives an order, Fabkomp buys the bikes from eRanger. It then adapts and modifies the motorbikes and manufactures the steel structure and suspensions systems. This includes casting the sidecar wheel from aluminium in its own foundry. The bikes have to be adapted to be able to work with a sidecar in off-road conditions, including dirt roads in bad repair.
From the start, the partners wanted to be absolutely certain that the sidecars would cope with the road conditions. With the support of the Automotive Industry Development Centre, they were sent to Gerotek in Pretoria to undergo rigorous independent testing. “The idea was to see what would fail in the accelerated testing process,” Brian says. “We identified areas that needed improvement and these changes were then implemented. We are confident that these units will work well in South African conditions, just as they do in other projects in many countries in Africa.”
On the ground
I grew up in the Transkei and I return there, to its deep rural areas, whenever I can. The roads and tracks, for the main, are very poor. They literally cut people off from markets, from services – and from health facilities. Often, traditional ambulances (if they are available) cannot reach homes.
The benefits these motorcycles hold for such areas are a no-brainer. And there’s a well-tracked history that speaks for itself. If you’d like to see some of it, take a look at this report and this report from Uganda, this report from South Sudan and this report from Kenya – these are all produced in the factory in Zwelitsha. The sidecar ambulance is the bigger seller. It is often used to move women who are having a difficult birth to the clinic.
Yet the motorcycle ambulances are actually not ambulances at all. They are intended to get people to a clinic or ambulance that will take them to a hospital or clinic. They are built for gravel (dirt) roads, not for tar.
So they are not meant to replace ambulances, but they are meant to replace wheelbarrows for transporting people who need medical help. A photograph of a woman pulling a man in a wheelbarrow, on the front page of the Daily Dispatch in 2013, etched itself into Brian’s head. “We must do better than that. We must treat people better than that,” he says.
The Eastern Cape angle
The Eastern Cape interest in the motorcycle sidecar clinics came long before COVID-19 turned our world upside down. According to Brian, it’s been on the Eastern Cape Department of Health’s budget for the past two years.
Fabkomp successfully tendered to supply 100 of the motorcycle sidecar clinics (tender number: SCMU3-20/21-0022-HO). It received a letter of award, but has not received the official order from the department, and nor has it received any payment. For 2.5 months during the lockdown, the Fabkomp factory did not operate and cashflow is tight.
Given the COVID-19 crisis – with the healthcare system breaking under the weight of the pandemic – Fabkomp plans to assemble 20 clinics. Once an order is received, the first 20 units will be supplied within a month. “We only have 85 motorcycles in stock and we’re waiting for the last 15 to arrive in SKD form. COVID-19 has created a delivery challenge. At this stage, we don’t know when they will land in South Africa.”
A chain of events
So what happened? On Tuesday, 9 June, the department asked Fabkomp to showcase sidecar clinics on the East London Esplanade on Friday, 12 June. “We did not have any clinics ready and we told the department that we had only four ambulances completed,” Brian says. “We also had a demo of the ambulance unit and the clinic unit. We were then asked to have these six units available for the demo.” The four ambulances used at the demo are now on their way to Kenya.
The storm hit immediately. Various Facebook groups waved the flag of condemnation, too. People generally don’t like to break rank and be a lone voice of dissent, I saw. These, I think, are some of the key moments:
- 12 June: One of the very first tweets is from the EFF’s Mbuyiseni Ndlozi: “So instead of building roads in the Eastern Cape to access all villages and households, you went to buy scooter ambulances? Pathetic government of ANC is truly beyond repair….” The tweet was shared 899 times and got around 3,300 likes.
- 15 June: Jane Cowley, the DA Eastern Cape Shadow MEC for Health, who had been at the demo, releases a statement: “Patients are dying on floors in our state hospitals and frontline workers have the highest rate of Covid-19 infections in the country, and what does out MEC of Health, Sindiswa Gomba, do? [She] decided to launch the procurement of 100 1920’s-style scooters ….” She adds: “This entire Scootergate saga smacks of corruption!”
- 16 June: EFF leader Julius Malema threatens: “if they (the motorbikes) are found in the village claiming that they are coming to fetch a sick person, fighters you know what to do with such a behaviour … I will tell you in our space and privacy.”
- Some time in the fray: A seller on Alibaba offers a sidecar unit for R17,000, using a picture lifted from the eRanger website. There is no link to a company or website. Nevertheless, tweets of the Alibaba offering are shared hundreds, possibly thousands, of times as proof of massive profiteering, corruption and selling of inferior products. So who placed the picture on Alibaba and then disappeared?
- 19 June: The DA asks the SA Human Rights Commission to investigate the “Medical Motorbikes”, which “are not suitable for patient transport anywhere in the country, let alone in the rural Eastern Cape with little to no road infrastructure … This intervention by the Eastern Cape is denying access to healthcare and emergency care to those who will be confined to using this transport system.”
- 30 June: The Daily Maverick joins the now very frayed fray in a report about the shocking state of the health system, collapsing with COVID-19, in the Eastern Cape. “People are dying in the streets and mortuaries have run out of space,” it claims. Really? Reality is clearly not horrific enough. The reporter goes on: “… the most glaring example of wastage … must be the R10-million spent on rickety scooters …”
- This week: Brian learns that the Eastern Cape Department of Health has put the project on hold as the provincial health committee has raised questions about the tender. “The DA is asking the process to be checked out, which is fair,” Brian says. “We don’t have the order yet, only the letter of award, which we accepted. So we are happy with the process as we have done nothing wrong.”
I ask Brian where he thinks the outrage has come from and he points to political parties, notably the DA. Also, he thinks that South Africans, in general, are fed up with the corruption that has taken place and are convinced that every awarded tender is corrupt too.
Political point scoring and lack of trust in government makes sense. I think there is another reason: the motorbike sidecar ambulances and scooters are a useful symbol of all that is wrong in a province where there can be no good at all. A success story does not suit the narrative of people who have the need to point at other people and other places to make them feel that they’re not that bad off – and not that bad – themselves. It’s driven by fear – this scapegoating, this “othering” – and it is called stigmatisation.
The bottom line
So what do these vehicles actually cost? There has been much outrage at the price tag. Brian points out that he has, from day one, offered to play open book costing with the media, the DA and anyone who wanted to talk to him. This is his explanation:
Excluding VAT (the money that government takes in tax), a fully equipped clinic costs R82,250 and a sidecar ambulance costs R68,800. In comparison, a traditional 4×4 vehicle ambulance would cost around R1 million: like the sidecar ambulance, the traditional ambulance carries one patient. The cost breaks down like this:
eRanger costs for each motorcycle in South Africa
- Motorcycle price (via eRanger) – R15,500
- Shipping cost (via eRanger) – R2,750
- Labour costs to unbox and assemble – R1,175
- Overhead recover at 15% – R2,913.75
- Profit at 15% – R3,350.81
Total selling price of the motorcycle – R25,689.56
Fabkomp costs for each sidecar clinic unit
- Motorbike from eRanger – R25,689.56
- Helmets, spares, compressor, lights, rider jackets etc. (imported via eRanger, including 25% markup) – R5,381.25
- Cost of manufactured sidecar kit and mounting brackets – R3,159.50
- Front suspension fork set, complete – R1,718
- Cast sidecar wheel, complete – R2,650 (casting in aluminium foundry)
- Gazebo plus side panels, 2 chairs and decals etc. – R6,990
- Infant scale & cradle – R1,201
- Adult mechanical scale – R784
- Metal kidney and utility bowls, sharps container, etc. – R255
- Transport – R451.83
- Vacuum-formed ABS components, storage compartment, footwell, basin and toolbox – R9,600
- Labour – R5,125
- Initial training for licenced riders per unit (3 to 5 days) – R1,000
- Management support for 4 years at R21/month – R1,015
- Overhead recovery at 15% – R9,752.75
- Profit at 10% – R7,477.11
Total selling price for complete clinic sidecar package – R82,250
Total selling price for complete ambulance sidecar package – R68,811