Motorcycle training for health workers in Gambia

Riders for Health (Riders) are transforming the face of global health in Africa; transport cannot, and will not remain a barrier to the delivery of vital health care.

Over the past 25 years we have shown that reliable motorcycles can provide a critical tool in preventing and halting the outbreak of disease. A prime example of this is the development of a unique motorcycle courier service to tackle one of the unseen challenges in health care delivery: the transportation of patient samples from health centres to laboratories, and the timely return of results. It might sound obvious, but without this link patients cannot get the diagnosis they need to start life-saving treatment. But Rider’s Sample Transport service is turning this situation around. Building of the success of programmes in Lesotho, Zambia and Zimbabwe, in 2012 we expanded this system into seven districts of rural Malawi.

Thanks to Riders’ Sample Transport service, for 4.2 million women, men and children in rural Malawi, getting that diagnosis is now much easier

Replicating success to keep Liberia Ebola-free

As the world responded to the Ebola crisis throughout the last year, Liberia became overwhelmed by emergency medical assistance yet the prominent lack of reliable transport weakened the ability to rapidly respond. Available health services could be not be accessed by those in further away villages. During the outbreak, there was a need of reliable transport for delivering blood samples for diagnosing patients, referring patients to health centres and the monitoring and education of communities. Yet the weak health system could not respond to the demand.

After discussions with the Liberian Ministry of Health and Social Welfare, Riders now operate on national scale in the country. Our motorcycle couriers serve all 15 counties in Liberia driving down uncovered tracks to reach and connect with 268 health facilities. Mobilising a reliable health system, Riders are ensuring a rapid turnaround of patient samples from health centre to laboratory, ensuring fast diagnosis and treatment of diseases.

Further, Riders have established a comprehensive and well-managed health fleet of motorcycles, ambulances and trekking vehicles that can ensure that even the most rural communities can be reached with essential health care.  With sustainability at the crux of an organisation, our programme continues to train more drivers and ensure that our vehicle remain well-maintained.

Riders are proud to be providing the missing link to mobilise health care within this disaster-affected area, as Andrea Coleman, our CEO, expressed at the programme’s launch:

 ‘The Ebola outbreak showed the world what Riders for Health has been saying for a long time – reliable transport really is essential to a strong health system. Without the means to reach the most rural communities with health care and advice, diseases will continue to spread. We are delighted that we are able to extend our reach and work closely with the Liberian Ministry of Health to develop a strong transport system for delivering the country’s health care needs.’ 

The Liberian Ministry of Health have nominated Riders for the prestigious Hilton Humanitarian Award, for an outstanding contribution to the alleviation of human suffering,

Mobilising health workers in The Gambia

At Riders for Health our technicians are the backbone to our work. It is their high level of ability and competency that enhances Riders for Health's superb reputation across sub-Saharan Africa. 

In order to maintain a workforce capable of providing this essential service, it is imperative to train technicians for the future and not just today. These technicians of the future will be the legacy of the outstanding workers who currently uphold the 230 vehicles in operation in The Gambia. This is why in the latter stages of 2014, Riders launched a scheme that sought to provide training for seven female apprentices for three years, with the eventual aim that all seven women will gain a professional qualification as a ‘class one’ mechanic.

We hope that all the women will join Riders’ national fleet management at the end of their three years of training, serving rural communities and ensuring that health care continues to be mobilised effectively. This project is also aiding the national initiative to enhance the status of women in The Gambia. Through our work, Riders is able to provide women with an opportunity to succeed and embark on a career without the restriction of gender.

Well-maintained vehicles provide the missing link for emergency referral in rural communities throughout The Gambia. Jainabou Jawara from Sare Pirasu, 11km from nearest town, went into labour. Just under 7 miles, at home we can quickly drive to the nearest hospital or dial 999 for immediate assistance, The Gambia it is not that simple. Transport is essential and life-saving. Because of Riders, Jainabou was able to call the head of the Maternity Unity at Basse Health Centre to receive the immediate health care she needed for a supported delivery.

“Without this transport available on that night, I might have lost the babies or even myself as has happened to others previously”- Jainabou Jawara, Mother

A final word of thanks

Riders for Health is very proud of the courage and determination demonstrated by our teams across Africa, and the energy they put into getting health care on the road and out into rural communities. In fact, the effectiveness of Rider’s innovative solution the barrier to healthcare has been recognised and consequently Riders for Health were extremely pleased to be recently awarded the prestigious Lipton Prize, a celebration of leadership and innovation among organisations creasing social impact.

“Riders for Health is a stellar example of thoughtful and innovative leadership battling a global issue that carries enormous social impact: providing truly equitable healthcare to the world.”- Geoff Garrrett, Dean of the Wharton School, University of Pennsylvania

On behalf of everyone at Riders for Health, I would like to take this opportunity to once again say ‘Thank you’ for your support of Riders. Your generous support is vital us, and greatly appreciated. We look forward to keeping you updated on our work as we continue into the 2016.

Links:

• http://www.riders.org/where-we-work/the-gambia

• The Gambia (PDF)
  

RIDERS FOR HEALTH

Feedback report

In June 2015, Riders for Health added a project to Global Giving in an attempt to fundraise for vital motorcycle training. Three months on and Riders are doing some fantastic work across Africa.  Much of the work Riders do would not be possible if we failed to train motorcycle riders effectively and professionally. Your kind donations will mean we are able to continue delivering our life-saving service across our programmes, reaching 21.5 million people a year.Thank you.

Helping to control the spread of HIV/AIDS and tuberculosis (TB) in Malawi

The Ebola outbreak has provided a highly visible illustration that the health of remote villages in West Africa is directly connected to the rest of the world. The world has a responsibility to improve the health systems in all countries – and especially the provision of public health, and Riders is proud to be part of this process. Over the past 20 years we have shown that reliable motorcycles can provide a critical tool in preventing and halting the outbreak of disease. A prime example of this is the development of a unique motorcycle courier service to tackle one of the unseen challenges in health care delivery: the transportation of patient samples from health centres to laboratories, and the timely return of results. 

It might sound obvious, but without this link patients cannot get the diagnosis they need to start life-saving treatment. But Riders’ Sample Transport service is turning this situation around. Building on the success of programmes in Lesotho, Zambia and Zimbabwe, in 2012 we expanded this system into seven districts of rural Malawi. Today we now operate across nine districts, with plans for moving into another two by the end of 2014, and a further three in the first half of 2015. Thanks to Riders’ Sample Transport service, for 4.2 million women, men and children in rural Malawi, actually getting that diagnosis is now much easier. And the results are impressive. In 2013, Riders’ team of motorcycle couriers transported a total of 38,779 samples and results, and this means that:

-        Patient waiting times for CD4 count test (cell count treatment that identifies presence of HIV) results have reduced from an average of 10 days to three, with some health centres previously reporting delays of up to 60 days. This means that our Sample Transport service is now delivering test results in advance of the national seven day target.

-        The turnaround time for a TB diagnosis has been cut in half (10 days to five). This means that if a patient tests positive they can start treatment immediately, which will prevent spread of infection.

-        An infant in need of a diagnosis for HIV/AIDS will get one in 30 days, which is nine days faster than averages before Riders’ Sample Transport service began (NB: EID (Early Infant Diagnosis) samples are referred on to a higher level of testing laboratory, which is why turnaround times are longer).

And if people can trust in the health system to deliver, then they will be more likely to go for testing. It is perhaps no surprise then, that 83% of health centres reported a greater number of patients accepting the opportunity to get tested.

Managing 230 vehicles in The Gambia for years to come…

At Riders for Health our technicians are central to everything we do. It is their high level of ability and competency that enhances Riders for Health’s superb reputation across the countries we work in and across the world.

In order to maintain a workforce capable of providing this essential service, it is imperative to train technicians for the future and not just today. These technicians of the future will be the legacy of the outstanding workers who currently uphold the 230 vehicles in operation in The Gambia.

This is why in the latter stages of 2014, Riders launched a scheme that sought to provide training for seven female apprentices for three years, with the eventual aim that all seven women will gain a professional qualification as a ‘class one’ mechanic.

We hope that all the women will join Riders’ national fleet management at the end of their three years of training, serving rural communities and ensuring that health care continues to be mobilised effectively. This project is also aiding the national initiative to enhance the status of women in The Gambia. Through our work, Riders is able to provide women with an opportunity to succeed and embark on a career without the restriction of gender.

Riders moving in to Liberia

Liberia is home to over 4 million people, of which roughly 85% live below the international poverty line. Diseases such as tuberculosis and malaria are widespread, and since March 2014, around 4,800 people have died in Liberia from the Ebola virus.

The Ebola outbreak highlighted how a lack of reliable transport makes health systems weak, with devastating consequence. During the outbreak, there was a vital need of reliable transport for delivering blood samples for diagnosing patients, referring patients to health centres and the monitoring and education of communities. For 25 years, Riders for Health has shown that reliable transport is vital in strengthening public health systems.

After discussions with the Liberian Ministry of Health and Social Welfare, Riders for Health will now operate on a national scale in the country. We have already trained 329 and 70 motorcycle riders as well as training 10 technicians. The next step: Although the ST system has been a great success in Liberia, there are four counties where the implementation of this programme is yet to be completed. After completion the transport of samples will be entirely handed over to Riders by our partners Global Communities and the system will continue to be monitored.

Set up of the fleet management programme continues and will require us to train more drivers. We are also planning to conduct further motorcycle rider training in September once the motorcycles are refurbished. Finally, we are in the process of procuring protective clothing for our riders and further replacement parts for vehicle repair and maintenance.

Another reminder of the importance of our work

It is always encouraging when the effectiveness of Riders for Health’s work is recognised. A new study by Stanford University has found that health workers who have well managed and maintained motorcycles can travel further, visiting more people, more frequently, delivering lifesaving health care.

The two and a half year randomised control trial, which focused on the work of Riders in Zambia’s Southern province, found that health workers can travel an average of 10km further on every trip and can make longer trips more frequently. It is also discovered that the motorcycles managed by Riders were available 50% more often than ones run by the ministry of health.

This study really reaffirms the importance of the work of Riders and the recent outbreak of Ebola has explicitly demonstrated the devastating effect that a lack of transport can have on weak health systems in Africa.

Riders for Health co-founder and CEO, Andrea Coleman has said: ‘This is a landmark study. The Ebola outbreak has made the world aware of the disastrous effects on people when weak health systems in Africa have a lack of transport. This study shows that when health workers have access to properly managed motorcycles, they are able to deliver more health care, and visit communities that would otherwise be out of reach.’ 

On behalf of everyone at Riders for Health, I would like to take this opportunity to once again say ‘Thank you’ for your support of Riders for Health. Your generous support is vital to us, and greatly appreciated. We look forward to keeping you updated on our work as we continue into 2015.

• Riders for Health Feedback Report (PDF)