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I'm Anne Greenhall deputy director of
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the Wharton leadership program and it's
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my pleasure to interview Andrea Coleman
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the 2015 Litman family Prize winner
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Andrea it's really a pleasure to have
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you here today and you represent writers
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for health and are our 2015 Litman
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family Prize winner could you begin and
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tell us a little bit about your
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organization and the kind of social
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impact you've had yeah thank you and
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it's a great honor to be here thank you
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um riders for health is an organization
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we started 25 years ago um and we
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started it because we were we became
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aware and that's another slightly longer
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story uh that Vehicles were being sent
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to Africa ambulances motorcycles and
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other um uh vehicles but nobody was
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training local people to maintain them
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or run and manage all the very basic
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things that have to be done to keep a
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vehicle going and we realized that what
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that meant was that Vehicles were break
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very expensive Vehicles were breaking
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quickly and easily which meant a waste
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of the money the waste of the vehicle
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and the waste of the of lives because
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people weren't being reached with the
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health care that those Vehicles Were
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Meant to take to them and of course
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Africa is 86% rural it's a it's a rural
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continent so once those hard roads
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finish there's no infrastructure but
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actually there are no roads but the
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vehicles aren't working either so even
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if you had all the roads in the world
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that you still wouldn't be getting to
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those people who desperately need the
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health care so we decided that that was
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something we could address and really
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make a change
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to you know if you can spend a lot of
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money on developing drugs or training
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health workers but if they can't get to
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the people who really need
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it it's you're wasting time and lives
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all right so let me start from the top
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what would you say what's the vision of
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your organization just in a nutshell the
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vision of the organization is that no
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one should die of easily preventable and
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curable disease simply because they
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can't be reached with the health care
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that's available all right and the
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values underpinning the organization
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we are very uh certain that that that
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this must be local this must be local
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people that have trained with the skills
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that they need to work with the Ministry
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of Health and to make sure that it's the
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country's strategy not our strategy and
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that it's local people who are building
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the skills and delivering the impact
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okay and then how how do you do that
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through Partnerships I'm sure but tell
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us a little bit about those Partnerships
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well the the the primary partnership is
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with the Ministry of Health okay and up
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until this point which is actually
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critical point in Ryder's uh history uh
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which I'm sure we'll come back to later
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um that that partnership with the
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ministry to explain to them if if you
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can adopt this if you can Outsource the
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Vehicle Management to us that takes the
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burden away from you but it also means
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that um
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you don't have to worry about those
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issues you can think about what the
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health workers are going to do and what
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your health strategy is and what your
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budget is and so that partnership is the
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primary one and the and the critical one
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okay and then from there onwards it's
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building the the skills of the staff and
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and
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and bringing in new other partners other
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NOS also need their vehicles maintained
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but obviously um the the primary one is
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with the is with the ministry but then
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of course we've got our external
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stakeholders people who support us and
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that those are very important uh
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Partnerships all right now the
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partnership then runs both at the
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national level but also locally isn't
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that true yes the the the the the the
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partnership in terms of permission if
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you like is with the ministry but then
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at the next level you're really working
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very closely with uh the the provincial
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and the district um Ministries but then
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you have your technicians your mechanics
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working very closely with the health
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workers so it's the health workers who
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are needing the mobility to reach their
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rural communities and it's the the
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mechanic if you like that has the
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relationship with the health workers to
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enable them to be predictable and
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reliable when in in reaching their rural
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communities so really there are two
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critical aspects to what you do one is
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the management of the vehicles but also
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the M maintenance of those Vehicles as
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well and when we talk about Vehicles say
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a little more about what vehicles we
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have in mind well you know the the most
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there are three kinds of vehicles that
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are very important in in rural access
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motorcycles is one and that's for
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outreach that's for health workers to be
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able to reach their communities with
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health education with uh vaccines with
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uh all the things of bed nets all the
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things that prevent people from becoming
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sick monitoring nutrition levels of
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nutrition is a malnutrition in this
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community are how many women are
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pregnant at what stage are they making
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sure the pre- and postnatal Care is
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taken taken very very seriously and then
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the the next uh level level is trkking
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Vehicles if you like a vehicle that can
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take goods and and larger numbers of
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people for say a a mass uh clinic for
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immunization or pre-imposed natal care
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and then the next level of course is
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ambulances to to move people in
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emergencies and you know women in
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obstructed labor um can't walk of course
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and and they often die in the village
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and when they you know there just aren't
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ambulances available and sometimes
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there's no fuel or there's no driver so
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the logistical part of it is something
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that we take very seriously we think
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about um The Journey planning the how
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you make sure th those Journeys are
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efficient and that they are actually
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addressing the health needs of the
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communities in terms of just percentages
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what would you say of the of the fleet
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motorcycle versus ambulance and so
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on the are many more motorcycles because
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that that Health uh prevention is is so
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critical rather than leaving it till it
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turns into a a disease or even an
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outbreak and so uh there are many more
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motorcycles because if you if you
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picture um uh the the the uh the
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geography that you're really looking at
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um large numbers of people in a city
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down at provincial level in the larger
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towns the logistics aren't so difficult
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but once you get past provincial down to
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district there are Villages that people
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don't even know where they are and so
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you have to and there are millions of
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people living in rural communities so
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and there are no roads to them so there
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are animal tracks and and and you know
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human tracks but actually navigating
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that to those large communities is is
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pretty tricky now when you say managing
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the fleet are you um
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owning or do you own any of the vehicles
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or do you just simply manage the
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infrastructure there are two models two
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Financial models with that uh we can
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either manage the vehicles that the
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ministry already owns and uh we call
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that transport asset uh transport
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resource management and and that's
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making sure that they are viable
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vehicles and they're fit for purpose
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we've also done a model where we buy the
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vehicles we've borrowed money which has
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been underpinned by uh very
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philanthropic organizations to to
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guarantee it but nevertheless then the
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ministry has to pay us to for the
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running of the vehicles and pay back the
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capital cost and of course it's up to us
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to nego a very negotiate a very low
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interest rate in that case but it's it's
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a it it what your question really hits
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home at is that having the vehicles that
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are already there run well and manage
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properly is one thing but having enough
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vehicles to reach all the areas that
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need to be reached is another issue so
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having some control about enabling the
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ministry to have control about the
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number of vehicles whether they've got
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enough and also manage their budget and
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that's the beauty of knowing exactly
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what the running cost is because the the
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ministry can spend as much on having
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vehicles that are not running as having
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vehicles that are running simply because
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they're wasting away the capital cost is
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wasting away in a car park somewhere
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right and in terms of proportion I'm
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imagining that most of the vehicles are
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uh owned by the ministry is that right
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yes most most of the vehicles we run are
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owned by Ministries but at least a third
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of them are owned by riders for health
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and but least on a full service lease
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basis to the ministry very good and just
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in terms of numbers how many vehicles
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are we talking about we're running 1,600
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vehicles at the moment so it's pretty
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big in in in8 countries our newest is
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Liberia as a result of the Ebola crisis
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and so um at least two thirds of those
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are motorcycles and then for for the
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Outreach and then there are ambulances
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and what we call trekking vehicles tring
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and I've read that the reach is 12
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million people 13 14 million is that
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right people we reaching enabling
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Healthcare to reach 14 million people at
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this stage that's really quite quite
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remarkable so part of the equation is
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the fleet the other side of the equation
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is the maintenance of that Fleet could
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you talk a little bit about how you do
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that yes and and I'm I'm delighted you
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asked the question about the maintenance
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because I think people talk too often
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about fixing a vehicle they think of
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maintenance is something that's broken
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let's fix it we don't allow the vehicles
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to break because if a small part in an
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engine breaks it could destroy right the
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roast of the engine I'm not saying it
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always does but needless to say that's a
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risk we don't want to take so in terms
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of keeping the economics of the service
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at the right level we make sure that if
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a manufacturer's part if they recommend
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changing it at 8,000 kilometers we'll
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change it at six and the health worker
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is trained to do his or her daily
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maintenance
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they she will do her making sure the
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chain on the motorcycles the right
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tension checking up for not air and
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tires and no stones in the tires that
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will cause um punctures making sure that
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all the nuts and bolts are On Tight cuz
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if you're out in the rural area and a
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nut bolt falls off nowhere to get
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another one and you could be eaten by a
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line or anything could happen to you and
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and those things are real risks in in in
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rural areas but worse than that of
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course worse than anything is that
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you're not getting to the communities to
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to deal with th that healthare so the
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the the way in which we do this is um in
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the capital city in the country in which
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we work the parts will come in for the
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for the for the vehicles and so stores
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management is a very critical part of
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what we do we make sure the stores are
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kept very well and then the workshops
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are very clean and very well
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systematized and also uh we our
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technician uh so the the the the health
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worker will do his or her daily
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maintenance and on a monthly basis our
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technician will ride out to that those
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motorcycles out in the rural communities
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and do the next module whatever it is
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changing the tires or or making sure
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that all the brake cables have change or
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whatever it is whatever's the next part
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of the plan and that means that a health
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worker doesn't have to ride in to a
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major town maybe 500 miles away to get
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the vehicle service we're taking the
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service station to them however Rural
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and however remote those those vehicles
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are so it's a it's a very systematized
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infrastructure issue and then we have to
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think about the fuel because also in
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those remote areas there's no fuel so we
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have to make sure that we have fuel
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stores in strategic places to enable
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them to have constant fuel supplies
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which of course in crisis moments is
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very difficult because uh fuel is always
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uh under pressure at at crisis times how
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do you go about tra training the healthc
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care professional worker to do the kind
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of Maintenance that's required yeah so
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it it's wonderful to see I'm always
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thrilled when I watch this process um in
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the very first instance we had a highly
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trained person to train two or three
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people in our first country that was
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lutu and the same people training two or
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three people in The Gambia our second
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country and now those people are the
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training professionals those initial
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people trained in West Africa and
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southern Africa are the specialists in
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training and the levels of training are
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riding and driving that's you know
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critical to preserving an engine and a
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vehicle um how you ride and drive and to
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to make sure that the uh the yes that
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the vehicle well preserved but also that
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they're not uh careless driving
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carelessly because as you probably know
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Road accidents in in on the African
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continent are very high so we make sure
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that that's done that everybody is uh
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who's on a motorcycle wears gloves and
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proper protective clothing and a helmet
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there's no you know riding around with
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on a pair of sandals and no helmet um so
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we take that very seriously and then we
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train the health workers to do their
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daily maintenance and it we've got I
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know this sounds unlikely but it's true
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we've actually found a way to ensure
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that somebody who uh has never ridden a
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motorcycle can can
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ride without any fear of falling and be
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able to break and stop within 10 minutes
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and once you've got that down
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the rest is easy because you there there
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are a lot more complications about
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riding in very remote um tough
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Countryside but just getting that
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initial confidence is so important and
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the same with cars it's you know and
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ambulances and so on but they have to be
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highly trained and then their daily
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maintenance they're trained in that
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routine and that's a very important
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piece of their work um and we believe
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you know people think of um
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you know this sort of as it were the
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greasy hands part of of of of healthc
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care as not really being relevant it's
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sort of something else but actually it
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is critical that boring kind of
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Maintenance and um greasy hands thing is
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actually critical to the health system
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where would we be without Logistics in
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the developed world so we really think
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this is Health Care oh very good so in
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so now you have a sort of a train the
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trainers model would that be fair to say
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yes we do how many trainers do you have
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we have some specialist trainers who
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will go from country to Country to do
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training but we also have in-country
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trainers who are who do refresher
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courses and making sure that everybody's
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up to standard and they will go around
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and um supervise and make sure that
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there is no carelessness kind of uh
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creeping in oh very good well Andrea I
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would be remiss if I didn't ask you a
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little bit about your personal Journey
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to writers for health so would you speak
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speak to that how did you get into this
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business well um my husband Barry
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Coleman and and are we are co-founders
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and um we we have different backgrounds
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but that where we are the same is that
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we're both motorcyclists and that that's
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our background my background in
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motorcycling comes from the fact that
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all my family right from the early part
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of the last century were were motor mot
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cyclists and uh racing motorcyclists in
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fact and my father was a development
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engineer so was my brother so it it and
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on my mother's side too is is the same
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is the same background and I used to
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race motorcycles myself um my husband
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Barry uh has a much more dignified
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background he's a he's trained as a
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lawyer and a journalist uh wrote for the
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Guardian newspaper in in the UK and um
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but also a motorcyclist so when we saw
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this issue Barry looked at that and said
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that's got to be solved and I said
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that's got to be solved so from a
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different standpoints we both um focused
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on that and we
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wonder how we risked at that time our
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three children were young really young
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at that time and uh I was 42 I think and
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Barry was 43 and we kind of um took the
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risk of starting this organization
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giving up everything we were doing in
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terms of income and just focused on this
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because we thought if we're not going to
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do it nobody's going to do this and so
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that's how we started and uh fortunately
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we were able to keep the roof over our
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children's head and not not starve
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everyone to death but it was a big risk
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but nevertheless worth every second oh
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very good and now am I right in uh
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remembering that part of the discussion
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came over a kitchen table and in fact
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with uh at the time a rather famous
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motorcycle racer as well that's right am
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I right yeah absolutely and who who was
00:19:03
that um Randy mamola has been a person
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I've worked very closely with over the
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over many years I used to do his um
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public relations and other management
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and so uh he and another famous
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motorcyclist also from California they
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both come from California one from
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Modesto one from Santa claraa we said
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how are we going to raise the money to
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do this and we decided decided that we
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had to make all these famous stars in
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motorcycle racing do what we need them
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to do just for one day a year they're
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all you know amazing people they got
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this you know competition Focus but for
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one day a year and so they helped us
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with the the core funding that enabled
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us to prove the concept so without those
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two guys from California we wouldn't be
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sitting here today very good now
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speaking of funding the Lipman family
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prize comes with with an unrestricted
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cash Award of
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$125,000 how do you see that award
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helping you further your vision of the
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organization well this is a very
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important award to us and uh the the the
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the the prestige of it of course is is
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is immense but the money is is really
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critical at this time because as I said
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earlier we're at a really um important
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transition uh point at this moment and
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and really what's happened uh is that
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now is the time to really build um the
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the the leadership in the Africa
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programs and to make sure that in the
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future riders for health is an African
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organization and not one that's that has
00:20:51
to be generated from the UK the
00:20:53
leadership and this
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expertise is outstanding but we have to
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make sure that it's transitioned
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properly and this is going to be what's
00:21:04
going to help us to do that transition
00:21:07
to take it from an entity that's driven
00:21:10
if you like from the UK to one that is
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solely driven uh by our amazing staff in
00:21:17
Africa do you have thoughts about how to
00:21:19
do that you're really talking about
00:21:21
succession I think yes this is
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definitely about succession and uh I
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think that um Barry and I both have came
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to realize some time ago that we we're
00:21:31
not going to live forever so we you know
00:21:34
it was a bad moment but nevertheless one
00:21:36
that we all have to face so um we we
00:21:40
think that not only should we be
00:21:41
thinking about how to hand over to
00:21:46
leadership in in the in the way that the
00:21:48
organization looks now but how to make
00:21:51
sure we're handing over that leadership
00:21:53
to the Africa continent and to think
00:21:56
about our outstanding staff there how
00:21:58
they think about succession as well in
00:22:01
their own
00:22:02
countries our new work in Liberia has
00:22:06
really shown us what what skills and
00:22:08
expertise we have in those programs
00:22:11
building teams from The Gambia Zambia
00:22:14
and and and Zimbabwe have really put in
00:22:17
place the new Liberia program in a
00:22:19
country that isn't their own and that
00:22:21
shows the the the the capacity that
00:22:24
there already is but we've there are a
00:22:26
lot of functions that we still do in the
00:22:28
UK that really need to be built in and
00:22:31
that's our next step and that's where
00:22:33
the the the money from the Litman prize
00:22:36
is so critical and so welcome oh well
00:22:39
Andrea it has been such a pleasure
00:22:40
having the opportunity to speak with you
00:22:42
and congratulations again thank you so
00:22:45
much I'm very proud
00:22:49
[Music]
