Andrea Coleman: “You cannot deliver a medicine by virtual technology”
Andrea Coleman is co-founder and CEO of Riders for Health, a non-profit organization that manages and maintains vehicles for health-focused partners in Africa. Together with co-founder and husband, Barry Coleman, they saw that healthcare wasn’t reaching the people who needed it in remote communities. Well-maintained fleets of motorcycles and vehicles could be a game-changer to deliver healthcare in areas without any health infrastructure.
Moreover, their employees learn skills that equip them to work in qualified jobs for the future. For more than 20 years, Andrea has been raising the profile of the need for managed transport systems in development, and lobbies for the investment and funding needed in order to put these systems in place.
Her understanding of “Riders” differs from the traditional donor-financed NGO. She sees her organisation as a service provider, and is involved in what she sees as a “long process for change that is only recognised once the change is visible – and not during the long road to get there.”
What are “Riders for Health”?
You can provide healthcare worth billions – but for one reason or another, people in Africa are not able to access it. People who live in remote communities are cut off, because industrial revolution missed Africa: no one is trained in fleet management and the infrastructure was never developed. Once you provide training and infrastructure – healthcare can arrive predictably and reliably, where it is needed. That’s our business, and this business is built out of our passion.
My husband Barry and I both come from the motorcycle world – he was a journalist, I have raced motorcycles, and come from a family that was completely involved in racing and developing motorcycles. I love engines. I think they are perfect things and, importantly, in the context of the development world they are vital. For example, medicines have to travel by truck to reach the patients who need them – you cannot deliver a medicine by virtual technology. Of course, there will always be new developments: we will get electric vehicles, or better equipped machines. But delivering services will still depend on some mode of transport.
Everybody is excited about mobile phones and the role they can play in development. It is true that you can order anything by mobile phone, but the delivery needs the physical infrastructure. And this infrastructure starts with maintenance issues. Without maintenance all vehicles break down eventually, in rural, harsh conditions they break down much sooner.
Maintenance makes vehicles reliable and it makes them safer. But it needs a supply chain of replacement parts. That, in turn, requires stores management, a team to manage an inventory of parts replacement and so on. It is a complicated system, but it is essential for an effective health system. This is the expertise that Riders brings, and it means our partners can reach all the people they need to.
Who are your clients and how does your relationship work?
Our clients are health care organisations. This is usually the ministry of health, although it might be another NGO or agency. These organisations don’t have the expertise to manage vehicles, and there is no reason why they should. By taking care of this aspect of their work we are allowing them to focus on their own area of expertise, delivering healthcare.
Riders for Health are a social enterprise, our partners pay for our services but on a not-for-profit basis. By ensuring partners put transport and vehicles into their budget, it ensures their sustainability. We run our programmes with the discipline of business, but we have a social goal: to make sure that health care reaches everyone, everywhere.
You provide a lot of training – how do you make sure, your trained staff will not leave you shortly after: with the knowledge they get from you they could open their own garage?
It is part of our business plan to make sure that we are attractive enough so that they stay with us. There is one major thing that everybody likes: being with us means they are part of the health system – they play a role in helping to stop people dying in rural communities. That is something our teams are proud of.. Also, we make sure that everybody wears a uniform; our drivers are not called drivers, but “asset managers” – because they do manage a lot of expensive assets, the vehicles, the medicine, and of course the patients they transport.
We are building a set of blue-collar skills – and we hope that what we do in health will translate into many other sectors, too. Because the questions of transport and logistics are of course not restricted to health: transport is a cross-cutting issue.
Currently, we employ 420 people in seven countries in Africa, 25% are trained as trainers. We have our own academy of vehicle management in which we train people on riding and driving skills as well as financial or management skills. We own a pool of around 1700 vehicles in total, and about two-third of these are motorcycles. This allows our clients’ health workers to see nearly six times more people than without Riders’ support.
It seems you tackle problems that are at the very heart of automotive or logistics companies wanting to open markets in developing countries. Are you talking with them?
Yes, we have just started discussions with a number of potential corporate partners, initially through their CSR-programs. Managing vehicles in remote, rural places is incredibly challenging and we have expertise in overcoming the logistical challenges on the “last mile”, so I do think we bring something to the table.
You set up highly complex operations for maintenance/training and logistics. To be successful, you need to have access to local knowledge, and work with local authorities. Could you maybe give an example?
It is a key element of our sustainability that from the start our programmes are staffed by local people. This includes all of the technicians and drivers, and also the senior management teams in all of the programmes. They know and understand the environment in each country. We also have strong local networks in all of our programmes. For example, in Lesotho, our programme director Mahali Hlasa was formally a health worker, and worked for the ministry of health. In the Gambia, some of our senior management team have worked in government or the civil service. Having this local knowledge and cultural understanding is vital to creating strong programmes.
How do you work with cost that cannot be allocated to a certain project or client – such as the overheads for your US/UK offices?
Achieving financial sustainability is the goal for all of our programmes. We charge our partners a not-for-profit fee that covers the complete cost of running their vehicle. This includes replacement parts, technicians, fuel, and administration. We do not have a fixed fee for our services, our offer is based on the needs of the client. We work closely with them to make sure they have the system that meets their requirements.
All of our programmes are run on this not-for-profit basis. However, covering overheads is always a challenge, which is why we still depend on donations from individuals and foundations, but our goal is to make all of our programmes financially self-sustaining. Several have already reached this goal and others are making strong progress.
You don’t have competitors, but you create what could potentially be a thriving market. Did you come across some garages in Africa that might do what you do?
In the larger cities there are some organisations who operate fleets of vehicles, but Riders are the only organisation that is able to run entire fleets of vehicles in remote and rural areas and perform maintenance on them on an outreach basis.
And, obviously, there are many garages and skilled mechanics that repair vehicles. However, for a ministry of health, it is not enough to know that you can repair or even service a vehicle: you have to know that you can service hundreds of vehicles so that they are reliable and do not break down. This does not just require skilled technicians, it requires access to genuine parts, logistics systems, accounts and book keeping staff and so on.
This is why one key elements of our work is training. Apprentice technicians often say how their goal is to open a garage. By increasing the numbers of technical staff who have worked in Riders system, this will be building a system for managing vehicles in the whole country. In turn, this will help to improve the infrastructure of garages even outside larger cities.
You see the future in creating a “for-profit” way of your transport and logistics model – not only in health, but in other areas, too. How could that work?
Riders is operating in an area of market failure. There is no reason why this model could not be run in a ‘for profit’ way in the future, but if this were possible at the moment, people would be doing it already. We are developing and proving the concept, so other organisations might seem to realise the opportunities in this.
Currently, we are doing a study in Zambia that will show how health care for rural communities can be transformed by managing transport properly. What we see happening now is: “we see your model working, can you come to work with us”. The future for us is about creating a way so that other people can earn a living and save lives at the same time.
Photos Courtesy of Subject.