Health Care and the Art of Motorcycle Maintenance

From The New York Times:

For nearly all of human history, lives were short and miserable because there was little anyone could do about disease. Now we know what to do. The science is there. The technology is there. But we have a different problem ─ a happier one, but no less challenging: how do we get these interventions to people everywhere? And this problem doesn’t just apply to health care, it applies to almost every modern good or service, whether it’s education, energy, clean water or job opportunities. As the science fiction writer William Gibson has said, “The future is here ─ it’s just not evenly distributed.”

That’s why we’re beginning Fixes with the story of a health assistant named Tsepo Kotelo, whose job is to take care of people in remote mountain villages in the Maseru district of Lesotho. Kotelo’s story shows the critical need for something not usually on the global to-do list for Third World health: motorcycle maintenance. Lesotho has some of the world’s highest rates of AIDS and tuberculosis, and much of Kotelo’s time is spent counseling and testing people for these diseases, giving talks about AIDS prevention, and helping people stick to their treatment plans and deal with side effects. He also checks the water supply, helps villagers improve sanitation, weighs and immunizes babies, examines pregnant women and treats basic diseases.

Until 2008 Kotelo could visit only three villages a week, because he had to reach them on foot, walking for miles and miles. But in February of that year, Kotelo got a motorcycle ─ the best vehicle for reaching rural villages in Africa, most of which are nowhere near a real road. Just as crucial, he was given the tools to keep the bike on the road: he received a helmet and protective clothing, he was taught to ride and trained to start each day with a quick check of the bike. His motorcycle is also tuned up monthly by a technician who comes to him. Now, instead of spending his days walking to his job, he can do his job. Instead of visiting three villages each week, he visits 20. Where else can you find a low-tech investment in health care that increases patient coverage by nearly 600 percent?

More here.