The Last Mile Is The Toughest — Delivering Help On Two Wheels

The Last Mile Is The Toughest — Delivering Help On Two Wheels

PSFK interviews the CEO and Co-Founder of the international initiative, Riders For Health, that deliver medication and health services to remote areas.

Jeff Weiner
  • 23 august 2011

PSFK recently sat down with Andrea Coleman, co-founder and CEO of Riders for Health, to learn more about the organization, their goals, and the key behind their staying power as a force for good. Riders for Health is an organization devoted to the delivery of healthcare and other vital services to those who have traditionally been isolated by distance or terrain.

Many organizations donate drugs and equipment to improve health systems in developing countries, but Riders for Health’s focus is on getting these things to the people that need them most. Currently, the organization manages over 1,300 motorcycles and ambulances in seven countries. The local health workers who use these vehicles are able to reach over 10 million people in isolated communities.

Riders for Health has been around since the 1980s.  What compelled you to build the organization and what is the secret behind your staying power?

Riders for Health was established to address the vital but neglected issue of transport for the delivery of health care across Africa. Africa is a rural continent and communities live remote from health centres and clinics. The services they need are public health as well as curative and palliative. The developed world has the information and pharmaceuticals that are needed but they do not reach the people who so desperately need them in Africa. So men, women and children die of easily preventable and curable disease.

Riders’ founders recognised that well maintained motorcycles and appropriate four wheel vehicles is the answer to creating a reliable, cost effective health delivery infrastructure. We devised a model that enabled local people to be highly trained in maintenance skills as well as skills in procurement, stores management and rider and driver training.

Everyone assumes that people who deal with vehicles just have greasy hands. Not so, they also have the intellectual horsepower to devise and maintain transport and logistics systems to transform health care in Africa. But we always knew this was going to be a long haul. We found the job to be more about behaviour change at every level health care than straightforward marketing to ministries of health and health focused ‘charities’.

I think our staying power comes from the fact that we find the situation that women and children find themselves in to be unreasonable in the 21st century. A woman in childbirth being taken in a wheelbarrow to a hospital that may be ten miles from her village is unacceptable. A child dying of a disease that became extinct in the developed world because no one could reach the child to vaccinate her is unacceptable. Especially when millions of dollars have to spent to create the vaccine to prevent that disease. And we find it all no more acceptable today that when we started 20 years ago.

There are a lot of organizations that donate wares to third-world and developing countries.  Often times, these gifts come in the form of ‘information-flow’ goods, versus ‘physical-flow.’  Can you explain the difference between the two and give us your take on the relative importance of each?

Mobile and internet technology have the potential to be helpful for health care on the continent of Africa. Particularly in urban and peri-urban settings. However, in rural settings power and reception are most often not available (if they were things would be much improved in many ways for those communities). Furthermore, information flow is important but physical movement of goods and services is vital. If you want to move 10 tons of potatoes to Florida from California you have to have a truck – you can’t do it by mobile phone. And it is no different with health care. You have to get people (women in labour, people who need surgery to professionals and immunisations for children, ARVs and TB drugs, bed nets etc. to the population.

Try to imagine your world if you had a mobile phone but no car, motorcycle, bus service, train system or ambulance service.

You have said that ‘the last mile’ is the toughest.  Can you describe the reality of that last mile?  What are the major impediments to transporting goods to the most affected rural villages.

The last mile (even for professional logistics companies in the US) is the most difficult. It is the point at which at which a consignment of goods is broken down into items that are needed by individuals.  In the developed world that consignment will be broken down and sent to stores, hospitals etc. But access to those ‘point of sale or point of care’ facilities is tragically difficult for individuals in Africa. They have to walk. Sometimes as far as 10 miles over very rough terrain in extreme weather conditions.

For Riders that last mile means riding or driving over very rough terrain but our work means the vehicles used will not break down. The motorcycles we maintain are used by health workers to reach the communities they serve. A health worker with a motorcycle can reach up to five times more people than before. They will visit communities more frequently, however remote they communities are. This prevents the inequity created because of distance from centres of health.

What are the greatest successes that Riders for Health has achieved to date and what do you need to fuel future success?

I think one of Riders’ greatest successes is getting the issue of transport for the delivery of health care onto the global health agenda. But, undoubtedly it’s greatest achievement is creating a cost effective and sustainable system for delivering health care across the continent of Africa.

How can people assist Riders for Health with their cause?

Riders has come a long way but it still has a long way to go. So many people have no access to health care simply because they cannot be reached. But Riders’ solution is very cost effective. One health worker on one motorcycle can reach as many as 10,000 people in one year – five times more than she will on foot. It means that she will be arrive predictably in a community – meaning that women will walk to the clinic on a specified day. The health worker can do more work in the community because she has more time and energy that would have been spent walking.

People can help by simply sharing information.  Introducing Riders for Health to friends, family, teammates, colleagues, and other networks is important to our growth.  Additionally, Riders for Health volunteers across the United States and the United Kingdom have been successful in raising support through fundraising. It is with the help of our generous donors that we can strengthen health systems in Africa.  Every gift Riders for Health receives brings us an important step closer to our vision of a world in which people do not suffer or die simply because the health care they need does not reach them.

Riders for Health has tight ties to the motorcycling community around the world.  The organization was jointly founded with Randy Mamola, one of the most recognizable motorcycling stars of the past thirty years.  Those that attend the Red Bull Indianapolis GP practice on Friday August 26th will have the opportunity to meet some of the MotoGP riders and participate in a fundraising auction. Check out the video below for additional insights into the initiative:

For more information about Riders for Health, you can help visit their website at or contact Lisa in their Chicago office at or 312-373-1447, or their office in the UK at or +44 (0)1604 889 570.

Thanks Andrea!

Riders for Health on Facebook

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