Greasy, Oily Hands Needed

If health systems in Africa are to become effective we need people with dirty hands.

Not just dirty hands but greasy, oily hands.

Health systems in Africa are derelict. I heard Sir Richard Feachem say this some years ago and, despite great efforts from many organizations since, things have not moved on. Millions of people, men, women and children, die of easily preventable and curable disease because they lack access to public health services and curative treatments.

This is not because knowledge of curative and preventive treatments does not exist. We know that treatments do. Most of us take this for granted in the developed world. But, to bring together the knowledge and the treatment with the people who so desperately need it there must be transport – well managed, cost effective, predictable, reliable transport. And, that means people must be prepared to get their hands dirty and oily – and most importantly it means people must be prepared to deal with the dirt and oil in a highly systematic way.

So it is not an issue just about dirt. It is about the practical. How are we going to ensure things actually work?

Social enterprises build infrastructure – not just systems but that other infrastructure within individuals – otherwise known as empowerment or capacity building.

Riders for Health is a social enterprise that focuses on managing vehicles in harsh conditions in Africa so that healthcare reaches people in rural communities. It embraces the principles of building appropriate, practical infrastructure – where there currently is none. And, for the infrastructure to take root there needs to be training in practical skills, systematic behaviours and in, our case, the management of the valuable assets in our care – the vehicles. And, of course, we know about the money – we know where it is and what it is doing. It is visible and it matters.

Perhaps, this is a fork in the road created by social enterprise. Perhaps it is here that social enterprise makes the long-awaited difference. Not in just being able to show where the money is and what it is doing, but in the building of infrastructure.6 dirty hands. They are all looking at the practical: How to make it work – forever – with local people for local people, and how to make the money visible and work to the maximum effect. Neither health systems nor anything else in development will work without practical, skilled and, yes, dirty hands – because these are the hands that link up the systems and the money.

Andrea Coleman

 

Editors Note
Andrea Coleman, Founder and Chief Executive Officer, Riders for Health, United Kingdom
Social Entrepreneur; Schwab Fellow of the World Economic Forum

Riders for Health ensures health workers in Africa have access to reliable transportation so they can reach the most isolated people with regular healthcare services.

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