A note from Riders for Health, a charitable organisation ensuring that healthcare workers can reach their patients throughout The Gambia.
Everyone at The Gambia Experience were delighted to make a donation to this fantastic organisation ’Riders for Health’ as part of our 25 years’ celebration. We think they are doing an amazing job, especially when you consider the challenges faced when providing health care in rural Gambia. Over to Riders...
Mobilising maternal health services with outreach clinic teams.
"We should give credit to Riders for Health because of this transport system. We’ve not been having any problems with transport since Riders – it is our greatest strength." Babourcarr Boye, with the Expanded Programme on Immunisations (EPI) unit, The Gambia
With thanks to the team at The Gambia Experience
Riders’ vision is of a world in which health care reaches everyone, everywhere. As part of this, in The Gambia we provide a nationwide fleet management service that is helping to transform health care access for the country’s 1.8 million people. In January 2013 the team at The Gambia Experience demonstrated their belief in the role of transport in development by donating £1,000 towards this programme. This grant has been used to procure an injector test pump and two adaptors (plus shipping) for use in our vehicle maintenance unit in Kanifig – which helps us to make sure that all our vehicles are regularly maintained and that public health services in The Gambia are on the road, day in, day out.
10,000,000 kilometres and counting...
In 2009 Riders launched a historic partnership with The Ministry of Health in The Gambia that saw us purchase a national fleet of 140 vehicles, which are managed by Riders – but leased back to the Ministry at a non-profit rate. This agreement makes The Gambia the first country in Africa with the resources needed to bring universal health care access to its entire population. What’s more, it’s financially self-sustaining - which means that life-saving health services are set to be ‘on the road’ for generations to come.
Building the new driving school
Four years after our programme launched, and this landmark fleet has now travelled 10,000,000 kilometres to deliver critical public health services, which include: national vaccination campaigns, outreach health clinics for pre/post natal care, and home-based support. This is an incredible achievement, one that is furthered by the fact that in this time, our fleet has experienced just two preventable breakdowns. And it doesn’t stop there. In January 2013 The Gambian Ministry signed a second five year contract with Riders which will see us add another 100 vehicles to the programme. This means that for the first time in its history, the men, women and children living across The Gambia can be sure that if they need medical support, it will be there to meet them. And it is this assurance, this consistency, that is key – because if people can rely on public systems then they are more likely to trust the services on offer and seek medical care. And that saves lives.
Training in vehicle maintenance
The vast distances covered by Riders’ fleet in The Gambia is made possible because we take a unique approach to transport and logistics. We don’t simply provide vehicles, we provide a full fleet management service. This happens on two levels: firstly, each and every vehicle user is required to give their vehicle a daily ‘health check’, so that any potential problems can be identified early, and minor adjustments made. Building on this, every vehicle will also receive a full service once a month from one of our own professional technicians. This means that parts are changed before they cause a vehicle breakdown – and as you can see, it works!
Changing oil – preventative maintenance keeps health care moving.
To make sure our systems are adhered to, we invest heavily in training. We make sure that each and every mobilised health worker completes a full course in basic vehicle maintenance – as well as standard training in road safety and off-road driving skills. To meet this need, we run three dedicated training centres located in the heart of our programmes in Kenya, Zimbabwe – and now, The Gambia. By the end of a 10-day course, vehicle users will be able to:
- Perform daily and weekly maintenance checks on their vehicles.
- Operate vehicles with consideration and confidence.
- Safely drive vehicles in traffic constantly aware of other road users and reducing the risk of accidents.
- Competently negotiate off road terrain taking care of their vehicle and goods for safe delivery.
- Understand the importance of fuel efficiency and be confident in low-impact driving skills.
- Be aware of road safety and the need to stay alert at all times.
Riders also runs a ‘train the trainer’ programme, as well as professional apprenticeship training courses training in preventative fleet maintenance – together they give us a solid foundation for regular and reliable health care delivery.
Maintaining child heath – meet Musa
Bubacarr Jallow is a community health nurse in the Marakissa district of The Gambia – and is just one of those mobilised by Riders in The Gambia. He covers an area that includes 14 villages and sometimes travels up to 100 kilometres a day, because he makes sure he visits every village, every week. And this wouldn’t be possible without his Riders-managed motorcycle.
"I do nutritional surveillance, which means I look at nutritional health of children up to five years old. I do this by running ongoing tests. Every six months I assess their health on a weight to height test and every quarter I measure their upper arm circumference, a MUAC test. I use the results to assess whether any children are malnourished, need any supplementary nutrition." Bubacarr Jallow, Community Health Nurse
As part of his regular visits, Bubacarr met Musa, a four year old boy suffering from malnutrition. Musa is one of four children, and his mother, Mam Touray, tells us of Bubacarr’s care and support:
"Bubacarr measured and weighed the children. He noticed that Musa was small and didn’t weigh enough. He gave us extra food called Plumpy Nut. He showed me how to give it to him and came here the next week to check. He then came every two weeks. We noticed Musa’s weight change, it went up quite quickly and he was healthier. After a month Bubacarr weighed him again and measured his arm, and things had improved. Now he checks up on us every month, I know that he is coming on the first Thursday of every month." Mam Touray, mother of Musa
Bubacarr measures the arm of four-year old Musa to check his health
These regular visits to ‘at risk’ people are an essential – if not the most important - part of Bubacarr’s job, because it means that people can trust him to turn up on time, and that he can provide regular care and support to those that need him.
As Musa’s father describes, "What was important for us is that in the early stages of having the supplementary food Bubacarr came every week to check up on Musa. It helps us to now that he’s coming, to see that we’re doing the right thing – we know when he’ll be here, and he always is."
And the result? Musa is now a healthy four year old, running round and playing with his brother and sisters. Now he is visited by Bubacarr just once a month, and both he and his family know that if they need medical care, Bubacarr will be there to meet them.
"Having a motorcycle that works means that I am reliable. I tell the communities when I’m coming and now they know that I will be there.. It can mean saving a life." Bubbacar Jallow
One of the true strengths of Riders’ work is that it doesn’t just focus on disease areas by silo. We provide a solution that is designed to strengthen the very core of public health systems, and so its impact is felt across a range of high-agenda issues, from malnutrition, as we have seen, to maternal health. You will be delighted to hear that in May 2013 Riders’ programme in The Gambia – and critically, our partnership with the government Ministry – was recognised by the Aspen Institute of Global Health and Development, part of the World Health Assembly in Geneva. This high level recognition comes with the naming of The Gambian Ministry of Health as a winner of a 2013 Resolve Award, which honours their commitment to achieving universal access to maternal health. I’m sure you can imagine just how delighted we are to be a recognised part of this prestigious award – which is testimony to the dedication and commitment of the Gambian Ministry, our in-country team and – most importantly – of the need for managed transportation in health care development. Spark plugs, it seems, really do have the power to save lives.
On behalf of everyone at Riders for Health, we would like to say a massive ‘THANK YOU’ to The Gambia Experience for choosing to support our work. If it weren’t for the support of organisations such as yourselves, Riders simply wouldn’t be where we are today. Thank you for being a part of our work.