The Need
'All the donated drugs in the world won’t do any good without an infrastructure for their delivery.' -- Dr Margaret Chan, Director-General of the World Health Organisation
Statistics for health problems
Currently, 30,000 children under the age of five die every day across the developing world from preventable or treatable diseases including measles, diarrhoea and malaria. Immunization programmes still do not reach 30 million children each year. Birth-related injuries contribute to nearly one-third of all newborn deaths. Access to skilled attendants could reduce these deaths but more than half of women in sub-Saharan Africa give birth alone or with untrained assistance.
The tyranny of distance
Developing new vaccines, donating mosquito nets, producing condoms or providing food supplies, and the billions of dollars spent on them, will have no effect unless they reach their destination. Millions of people across Africa remain deprived and isolated from health care resources due to distance, terrain, poverty and lack of transport. Not one of the Millennium Goals mentions transport, yet the achievement of each is dependent on reliable access to rural communities.
One African health worker can be responsible for up to 20,000 people, scattered across miles of treacherous terrain. There is little or no public transportation and even the best roads are little better than dirt tracks. Delivering health care on foot or even by bicycle is an exhausting and near-impossible task, but even when vehicles are available they quickly break down if no-one has the expertise or resources to maintain them.
Sulayman Suso, from the Gambia, knows the anguish that poorly-managed transport can cause. His wife Karo was about to give birth, but the ambulance which should have taken her to hospital broke down. Karo and her unborn child both died. Now Sulayman Suso is left to care for their two-year old daughter, Ooli.
'I know that if my wife had been taken to hospital she would still be alive today. She's dead because there was no transport. It should never have happened. I feel such a terrible sense of loss and my little girl will never know her mother.'
Lack of infrastructure, skills and expertise
When development organisations plan programmes in Africa, they often completely underestimate the costs of maintaining vehicles. They will regularly spend tens of thousands of pounds on new vehicles, but put them into an environment where there is no support network to keep them running. Without routine maintenance, these vehicles will almost certainly break down, and without proper budgeting, it is unlikely that there will be the money available to replace the broken parts. The health care programme will fail, and those targeted will remain out of reach and isolated.
Most of Africa has no infrastructure for managing vehicles to ensure that they can provide lasting and cost-efficient transportation. There is little understanding of preventive maintenance, with trained technicians few and far between.
To the founders of Riders for Health – people who had worked with engines all their lives – this situation was unacceptable, and they were determined to find a solution. Over the last 17 years, they have created a system for managing vehicles in the harsh conditions of Africa, which can be applied across the developing world.
Find out about Riders' solution.