Riders for Health Work in Liberia
Riders through its engagement with the MoH prior and during the EVD epidemic, the MoH recognised its weak transportation and logistics. Riders Liberia runs two related but independent projects to address the transport challenges , the two projects work directly with the Ministry of Health these are Sample Transport (ST) for Laboratory diagnostics and Fleet Management (FM) for vehicle maintenance, transport management for entire MOH fleet inclusive of Ambulances and trekking vehicles. The Ministry of health sees the Riders activities as an integral component of the health system. Riders’ activities reduces the strains on the Ministry by helping to keep the health workers motivated, by providing real time and effective health care service delivery.
On Sample Transport during the outbreak before Riders, there were individual organizations and projects that put in place ‘coping mechanisms’, oftentimes went outside of their primary goals, to ensure that EVD samples reach the laboratories and results are then shared as quickly as possible. However, there was still lack of coordination, standardization, set guidelines and understanding of timelines and responsibilities. There was no focal organization on sample transport management. Since its inception, Riders Liberia has been the focal organisation and set up necessary infrastructure. Now that Ebola has been controlled the ability to detect, test, diagnosis and respond to Ebola flare-ups and other infectious disease threats remains a key a priority for Liberia. As the country has now sustained a zero new case level, health activity efforts have now shifted from emergency response operations to programmed disease surveillance and continued health education. However, notwithstanding this transition, specimen referral from point of collection to laboratories, not only for EVD samples but for other infectious diseases such as such as measles, HIV, TB, Polio, Malaria, Lassa fever and Cholera that require higher-level laboratory-based diagnostics remains a critical need.
Access to timely diagnosis of EVD or other infectious disease allows the health care delivery system to detect, respond and control outbreaks quickly by ruling out new cases quickly and maintaining vigilance against potential EVD and other infectious disease flare-ups in Liberia. And even with Liberia declared Ebola-free, there is need to maintain vigilance to ensure there is no return of the outbreak. Monitoring safety, specimen cold chain, compliance and proper use of paperwork are also areas of priority. Without a reliable network for specimen referral, infected patients, contacts and health workers are at risk of the disease spreading
On Fleet Management prior to Riders there was no system for maintenance or management of transport, no support infrastructure for maintenance, no trained human resources to maintain and manage transport hence there was no capacity to manage the entire donated fleets using the same standard throughout the country. As a result most of the vehicles though new were already breaking down and some of the reasons for the break downs were the use of contaminated fuel from unregistered suppliers, largely not serviced on time and when serviced most parts fitted were non-genuine parts, general lack of know how to manage transport effectively. Most drivers were volunteer drivers with questionable driving competencies, which caused numerous accidents. Riders brought professionalism in their driving and also gave them reliable income. One of the drivers Daniel Myers said “working for Riders has made me a man in my house for I can now come with reliable income for my family”.