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