By Ashley Morris
Alvin's Guide To Good Business, BBC World News, Zambia
Africa's health systems are in crisis. Could motorbikes be the answer?
Zambia is the latest country to benefit from Riders For Health's operations
Social entrepreneurs Riders for Health think they are. They are striving to transform health delivery in Africa, using business principles and motorbikes.
Founded by two motorcycling fans, Riders For Health now works in partnership with health ministries in seven African countries.
And Chadiza district in rural Zambia is the latest place to be transformed by their initiative - providing speedier healthcare for sick people for whom transport can be the difference between life and death.
The district has very few motorised vehicles. The red dirt road carves its way through scrub and over steep hills.
Cyclists veer left and right, struggling through a maze of potholes and ruts.
Alongside a small village of grass-roofed huts is the remote Bwanunkha rural health centre.
This tiny cluster of bright blue concrete buildings sits 30km away from the nearest town.
It may not seem far, but it's a journey that takes an hour-and-a-half by car, let alone by bicycle or on foot.
Perhaps a hundred people sit on the floor outside, waiting to see the nurse.
For television presenter, author and financial expert Alvin Hall, this is his first experience of an African clinic.
"It's hard to see things that you've read about actually confirmed. Realising how difficult it is for them to get healthcare. It's just hard to take in as reality."
Inside, nurse Joseph Sakala pricks the finger of another child and drops a spot of blood onto the malaria rapid-test that sits on his desk.
As the chemicals react, two lines appear that signal the start of yet another tiny child's fight for survival.
But at least Joseph has a clear diagnosis with which to begin treatment. For other illnesses, test results can be much harder to get.
For many patients, he has to send blood and sputum samples to the district laboratory in town. What Joseph lacks is reliable transport to get him there.
"It means that the specimen will stay for a month or two months without getting to a laboratory and they will always go to waste," he says.
"It's a long time to wait. Especially for TB patients, because a TB patient is a threat to the community."
ZAMBIA'S HEALTH WOES
More than 60% of Zambia's population live in rural areas
One in six Zambians is HIV-positive
Life expectancy at birth has fallen to just 43 years
Quick results are also vital for those who are HIV-positive, especially pregnant mothers. If the right treatment is given early enough, the chance of the mother passing HIV to her baby can drop from 40% to just 2%.
But Joseph cannot treat them until he knows exactly how compromised their immune system is, and test results can take months to come back, if they come back at all.
He's in no doubt what the problem is: "It's all about transportation."
Outside the district laboratory, 30km away, the broken carcasses of vehicles are everywhere.
Behind one building, motorbikes lie rotting, gradually disappearing under the plants that wrap themselves around their wheels.
Motor vehicles easily fall prey to Africa's harsh terrain
An ambulance sits in the centre of the yard like a makeshift roundabout, its wheels missing and cobwebs decorating the interior. All are apparently casualties of Africa's unforgiving conditions.
It was a similar sight that first motivated motorcycle-racing enthusiasts Andrea and Barry Coleman to set up Riders For Health.
Barry explains: "I saw a motorcycle that was new and gleaming and it was completely dead that had done 800km, and we know you could have 150,000km of health care delivery out of that and there it was dead at 800."
With their knowledge of engines and motorbikes in particular, they knew it wasn't Africa's harsh conditions that were the problem, but poor maintenance.
They decided that if they could persuade African governments to let them, they could manage vehicles efficiently and keep them on the road.
The secret of their success is that they train local riders and drivers to carry out simple checks and preventative maintenance.
The result - hardly any breakdowns, no matter how rough the roads.
Barry and Andrea have now brought their model to Chadiza district. Their plan is to start with a motorcycle courier system for medical samples.
Zambia's health services are heavily dependent on nurses
If it is successful, patients in remote areas will get a diagnosis to life-threatening diseases fast.
Although the pilot project will be paid for by fundraising, Riders For Health strive for all their schemes to be self-funding in the long run.
They charge governments a small fee to cover their costs, fixed for five years, so it is easily budgeted for.
It's this business-like approach that sets Riders apart from conventional charities.
As Andrea says, it means they have to think carefully about the constant compromise between keeping the money coming in and maintaining the social benefit.
"I think that social enterprise really has to think about the double bottom line. The money and the humanitarian impact and between those two lines there has to be a tension."
RIDERS FOR HEALTH
Employs 298 people across seven African countries
Manages more than 1,300 vehicles
Reaches 10.8 million people
On launch day for Riders For Health's first Zambian programme, a few local dignitaries and medical staff sit under trees at Chadiza District health centre.
The ribbon is cut and the first motorbike courier roars through. From here, the bikes will leave each day for the 15 remote health centres they will serve, some as far as 135km away.
They will return the same day with the samples packed in special backpacks to protect them from heat and vibration. Patients that might have waited months for results, will now get them in just a couple of days.
The sense of excitement at the launch is palpable. Everyone is acutely aware of the transformation this scheme will bring.
But nowhere is the excitement more apparent than on the face of Bwanunkha health centre nurse Joseph Sakala, as he waves off the first Rider For Health with their precious cargo.
"With their coming, I'm so very happy that the whole programme, the whole chain of health service won't be interrupted, it will be quick. Oh, I'm happy."
Riders For Health are the subject of the first programme in a new eight-part series made by Rockhopper TV on BBC World News, featuring presenter Alvin Hall and entitled Alvin's Guide To Good Business, to be transmitted on 13 and 14 February.