You often speak of the importance of the “last mile” in healthcare access. What do you mean by that?
A. C. : On one side, there are the inhabitants of certain isolated zones. Most of the time, they have to travel over thirty kilometers to get care for their children. So they do without care, which puts them in danger. On the other side, public health organizations do not have the means to come to them. Twenty-eight years ago, we decided to create Riders for Health,1 an NGO entirely dedicated to transport. It wasn’t the most passionate part of development aid, nor the most selling. But it is absolutely essential, without transport, nothing is possible!
How can these problems of conveyance be resolved in the field?
A. C. : The objective is to use existing vehicles in an optimal way and to ensure their maintenance. This means managing everything: lubricants, fuel or even replacement parts. So we train in mechanics and spare parts management to optimize transport and maintenance. We also train riders, thanks to celebrities from the motorcycling world. These “ambassadors” participate in our program by contributing to qualification. But the people we train are more than just mechanics and riders: they are full-fledged technicians who work with the care provider on arrival. We also try to promote parity, by working with both men and women. Thanks to all this, medical centers come to isolated populations and not the other way around.
Beyond healthcare access, what impact does your action have on distant communities?
A. C. : At the moment, we have a fleet of 2,500 vehicles present in seven African countries: Lesotho, Zimbabwe, Malawi, Kenya, Liberia, Nigeria and Gambia. We have reached 24 million people who otherwise would not have been able to receive care. But training people in mechanical maintenance and delivery also creates economic opportunities! Individuals who were unemployed before are now earning money. They are proud to be part of an innovative project and to contribute to the improvement of the healthcare system. Finally, ensuring a predictable and trustworthy service means showing that, for the first time, the state is doing something for them.
Transport logistics are expensive. How do you find the needed funding?
A. C. : Most of our revenue comes from collecting funds during the MotoGP races. We organize events around the courses and auction off memorabilia donated by the riders. The Health Ministries also contribute. We charge them a per kilometer fee that includes fuel, spare parts and the training of personnel. We chose this strategy from the beginning: we are an NGO and cannot pay for all the vehicles across Africa. However, it is not-for-profit, the funds for the race events and our internal functioning are covered by other revenue sources.
Are the authorities conscious of the impact of your work?
A. C. : It depends on the value they attach to their “distant” communities. The healthcare budgets are often feeble, and it is easier to reach people in urban zones than in far-off regions. Happily, other organizations use our services. for example, the Centers for Disease Control and Prevention (CDC). We were able to put this collaboration to the test during the Ebola epidemic in Liberia. Usually, we are faced with rather slow pandemics such as AIDS or tuberculosis. With Ebola, we had to detect the virus in a hurry. So we set up a dedicated sample transport program. By using relays and motorcycle delivery, we were able to run our diagnostics in far-off communities and send them to laboratories. Reaching these zones permitted a complete and effective action. In the end, the CDC was quite clear: without our work, they wouldn’t have been able to bring the crisis under control like they did.
By Timothée Vinchon
1. The organization is today separated in two entities: Riders for Health (operational) and Two Wheels for life (fundraising).