Aid is useless if it doesn’t get there

HRH The Princess Royal (THE TIMES, 28/12/07):

The efforts made by the global community to help the continent of Africa to manage its way out of its difficulties have doubled and redoubled over the past 20 years.

The world has certainly not forgotten Africa. In the field of health alone, numerous bodies from the Global Fund to fight Aids, Tuberculosis and Malaria to the various United Nations agencies have committed many billions to Africa — so much so that the continent sometimes seems awash with well-heeled concern. Perhaps all this money and compassion have emerged so dramatically because of the unexpected horror of HIV-Aids, on top of all the traditional diseases. Perhaps it was because more big hitters began to understand the problems of Africa or that technology gave everyone a better chance of making a lasting impact.

Whatever the reason, things have changed. And yet, the facts on the ground remain obstinately horrifying. Aids rampages onwards, malaria is as yet largely unabated, and the old killers such as cholera, measles and above all diarrhoea sweep through helpless communities in all their medieval pomp. Nothing seems to stop them. And now, on top of all this comes the hellish scourge of multi-drug-resistant tuberculosis. Life expectancy continues to fall.

Not surprisingly, researchers and think-tanks are constantly looking for a solution. There is talk of magic bullets, of the glue that binds and, more dramatically, of the holy grail.

But there is a simple and practical factor that is overlooked time and again, and that is the question of transport for healthcare and for development. It may not be a thrilling subject to some people, but it is for me. But then, as well as being Patron of Riders for Health, something of which I am very proud, I am also President of Save the Children, which pioneered the Stop Polio Campaign with the help of Riders for Health. And as it happens, I have my own HGV licence.

But much more to the point, when I began to travel in Africa all those years ago, I couldn’t help but be struck by the alarmingly obvious: no one could get around. Transport for poor people was sporadic, unreliable, dangerous and expensive and transport for public services such as healthcare was almost at a standstill.

What this meant then, and still means now, is that doctors and nurses could not reach communities that needed their help. They could not bring the benefits of public health education (for example, important advice about only using clean water and washing your hands, which cost nothing but reduce the likelihood of catching cholera) or immunise people. We have an effective vaccine against measles, so why have we not eradicated the disease? The answer is transportation — or rather lack of it. In Africa there is a very, very limited capacity to distribute anything at all.

This was the single issue that Riders began to address, back in 1989. What they were up against was lethal isolation. What stood between rural communities and a healthy life was not information, not technology, not pharmaceuticals (we had all those) but distance. Well-trained public health professionals had to walk for anything up to 20 miles to reach communities they were supposed to serve. And for the people who remained isolated and unreached, the consequences were catastrophic.

The charity’s founders realised they could do something useful when they visited an aid project in Somalia. Seeing broken motorbikes intended for health workers lying in the dust, useless for the want of a missing part or for a lack of mechanical knowhow, they realised they could make a vital difference by training local people in the art of vehicle maintenance, of teaching them how to make their vehicles work — and stay working — in the most inhospitable of terrains

I have been Patron of Riders for ten years. During this time I have watched them slowly but surely build innovative and sustainable systems for managing vehicles from The Gambia to Kenya, from Nigeria to Lesotho in such a way that they can operate normally, without breaking down, in the most hostile of conditions. And what this means is that health workers using the motorcycles and other vehicles in their systems can reach farflung communities time and time again.

Riders is the bicycle chain — the link that allows the key components of aid to work. It is, and can be, the mechanism by which all the wonders of 21st-century medicine and technology reach the people who so desperately need them. Through this year’s Christmas appeal, The Times and its readers have the chance to accelerate rapidly the pace at which healthcare races across the continent of Africa. In years to come, looking back, we may even wonder if, in its modest way, it was a little bit like a holy grail.

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