Transport trouble

One of the constant demands and problems for people here is transport --
with distances that range up to 70 kilometers and no regular public
transportation, even no people with a car that live out that direction,
people have to cobble together whatever means of transport they can find
-- bicycles, finding a ride with the mining trucks, various people going
around or good samaritans willing to give them a ride. Today we had a
case that highlighted that for me: we are the referral hospital for two
district hospitals that don't have a surgeon or higher care. An HIV
woman was admitted to one of these hospitals with severe diarrhea a week
ago; they decided that they needed us to treat her more aggressively, so
they wanted to send her on. They have been having troubles with their
ambulance, so they sent her on a Bethlehem-like journey on the back of a
bicycle for a three-day journey to arrive here today, weak, dehydrated,
and very ill. Now this is mostly just plain negligence to transport a
very sick person that way, but it also highlights the difficult
decisions that they have to make without a working ambulance and without
other options.