Skip to main content

Riders for Health – Making Things Very Boring

Jun 6, 2013

Gradian is pleased to publish our first guest blog post below from Riders for Health CEO, Andrea Coleman. Riders is a social enterprise working to ensure that health workers in Africa have access to reliable transportation in order to reach isolated people with regular, predictable health care. We are thrilled to feature this organization that is doing such wonderful work to make healthcare more accessible around the world. Read more about Andrea Coleman and Riders here.

Guest Post by Andrea Coleman (co-founder and CEO of Riders for Health –

The truly transformative developments are the ones that are so fundamental that they go from being revolutionary to routine and boring before our very eyes.

This is a huge challenge for organisations like Riders for Health whose job it is to make sure health care vehicles work reliably in Africa. Really, who wants to talk about infrastructure and maintenance? And yet, without those things nothing can really happen. It’s a fact of life.

Currently transport in Africa is too exciting. Without regular maintenance dramatic things happen to vehicles. They break down suddenly, or they run out of fuel in the middle of nowhere. This creates great anecdotes, and the sight of ingenious solutions for fixing vehicles with bits of wire. But for a country where vehicles are the only way to deliver health care to people in isolated communities, excitement is a disaster for a Ministry of Health. They need complete predictability. Absolute boredom.

The first challenge is to show that this predictability is even possible in Africa. One of the great barriers is that, for some reason, people wrongly assume that it isn’t.

Riders for Health is showing that by training technicians, having a supply of replacement parts and a logistics system for making sure they are in the places where they are needed, you can maintain vehicles as well in Africa as you can in the USA. It needs trained accountants and book keepers, as well as fuel supply experts. It is a complicated system, and Riders for Health is putting it in place.

Riders for Health's Kenya Programme (Photo by Tom Oldham, lit by Tom Andrew -October 2011)
Riders for Health’s Kenya Programme (Photo by Tom Oldham, lit by Tom Andrew – October 2011)
Women Mechanics
Some of Riders for Health’s female apprentice mechanics training in Kanifing,The Gambia – photo taken in December 2012

With this reliability comes infrastructure. Ministries of Health can create systems for complete vaccinations coverage, emergency transfers to hospital, and the reliable testing of samples. They can guarantee that drugs reach pharmacies and that doctors reach patients.

And this infrastructure means advances that make medicine safer and more effective become possible. For example, a machine has been invented for safe and reliable anaesthesia in remote parts of Africa. This is something we take for granted, yet, modern medicine would be unthinkable without it.

But, for me, the real revolution comes not with the eureka moment of developing the first car – or the first anaesthesia machine – it is when you can do the boring thing of making a million cars run perfectly. It’s when you can make the replacement parts you need to maintain them, and when every town has a garage with trained mechanics who can service your vehicle and keep it running reliably. That is what transforms societies.

In the developed world, for both transport and anaesthesia, we have had these revolutions. In Africa they are still waiting.

But where Riders for Health is working, we have shown what being predictable can actually achieve: health workers can see six times as many people, and spend twice as long in communities. Clinics no longer get cancel and ambulances are available for emergencies. Patients can finally get the care they need.

In The Gambia and Lesotho, two of the eight countries where Riders operates, they understand their health systems have been transformed. But in time, they will view what Riders does as completely routine. They will not think twice about putting transport into their budget, because they cannot imagine health care without it. And that is as it should be. And Riders will not stop until the whole world thinks transport is as boring as this.

Riders for Health (Photo shot in Zambia and Zimbabwe - May 2010)
Riders for Health (Photo shot in Zambia and Zimbabwe – May 2010)