In The Gambia, Riders for Health manages the Ministry of Health and Social Welfare’s (MoHSW) national fleet of health care vehicles using our innovative full-service leasing model.
This means that The Gambia is the first country in Africa to be equipped with complete transportation coverage for its health service. For the first time, health workers are able to reach every village ensuring basic health care is delivered to even the most rural communities.
Ambulance and trekking vehicles
Each of The Gambia’s public health centres now has an ambulance or trekking vehicle. The MoHSW uses Riders’ ambulances to conduct emergency referrals while trekking vehicles support the delivery of outreach clinics and regional activities like immunisation campaigns.
Mobilising outreach health workers
Outreach health care is further supported by a nationwide fleet of motorcycles. Such infrastructure enables the delivery of key health interventions to any location, no matter how remote.
Riders has vehicle maintenance units spread across The Gambia. The main workshop is in Kanifing and we have smaller outlets in Mansakonko, Bansang and Kerewan.
Thanks to support from the MoHSW, Skoll Foundation and the Guaranty Trust (GT) Bank, The Gambia is the first country in Africa to have complete transportation coverage for its entire population.
- The Ministry of Health and Social Welfare (MoHSW)
- GT Bank
- The Skoll Foundation
As with most of sub-Saharan Africa, health care access is challenging in The Gambia. A small narrow country with a river running through the country, ground transportation extremely difficult. According to the World Health Organization (WHO), life-expectancy is 59 years, with major health risks including: malaria, diarrhoea and pneumonia – all preventable and treatable conditions.
Almost half of the country’s 1.7 million inhabitants live in rural areas, but just 19% of the road networks are paved. Here, ‘weak technical support services’ mean that essential health care - ambulance referrals, drugs and vaccines – does not reach those in need.
Riders for Health’s first presence in The Gambia was in 1989 when Barry Coleman, our co-founder, acting as a consultant to Save the Children Fund and the World Health Organization, examined motorcycle uses in the Gambia and the basis of a new training/management system was established.
In 2002, we entered into a historic agreement with the World Bank and the Ministry of Health and Social Welfare (MoHSW) that saw them fully outsource their fleet management to our team.
Seven years later, Riders pioneered a new vehicle-leasing model that would overcome the MoHSW’s budget restraints by spreading fleet purchase and running costs out over a number of years.
With capital finance from the Nigeria-based GT Bank and Skoll Foundation, Riders purchased a new fleet of four-wheeled vehicles and motorcycles and leased them back to the Government, who pay a not-for-profit, cost recovery rate for Riders’ fleet management service.
63% of outreach health workers are now able to provide follow-up care to patients at least every fortnight. Before, just 10% did. This consistency of service is critical as it helps to build public trust in the health system - which in turn encourages positive health-seeking behaviour.
Country director: Therese Drammeh
Therese – or Auntie T as she is affectionately known at Riders – joined us in 2001 after retiring from the civil service. As country director for The Gambia, she has guided the development of an award-winning nationwide programme there.
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We have been maintaining high coverage for the past three years and one of the main reasons is the good transport system in place. It means we can reach all the villages in The Gambia. Babourcarr Boye, Expanded Programme on Immunisation (EPI) unit, Ministry of Health and Social Welfare