A day in the life of Kameko Nichols

IAS Member and Partnership Director (Africa) of Riders for Health
Riders for Health is an international not-for-profit social enterprise that builds, manages and maintains transport systems for health care delivery in Africa. We train vehicle users in safe riding and driving, and we carry out preventive maintenance and ongoing management of motorcycles and four-wheeled vehicles. I support the leaders of our seven country programs by advocating for transport to be considered as a vital piece of the health system, and by advocating at regional and global levels.

This transport that we manage and maintain is not necessarily disease’s specific, but it is specifically used in the fight against HIV in many ways. Motorcycles and four-wheeled vehicles are used for community outreach activities, including health education and HIV prevention, voluntary counselling and testing, follow-up care, surveillance, defaulter tracing, patient support services, etc. We also run a specialized motorcycle courier system called Sample Transport (ST) that couriers patient samples from primary health care facilities to laboratories, and results back, to enable regular disease monitoring, timely treatment initiation, and treatment recommendations. These tests include HIV-related diagnostics such as CD4, chemistry, haematology, and dry blood spot samples for early infant diagnosis of HIV. Our ST system essentially increases access at the primary health care level to diagnostics that are often only available at higher levels of the health care system.

There is no such thing as a ‘typical’ day for me at Riders, but the closest I get usually falls into one of three categories.

In the first, I visit one of our programs and attend meetings with various health partners so I can support our country program management to hold discussions about Riders’ work. All of our country programs are staffed by nationals of the countries where we work. They provide invaluable on-the-ground knowledge, but I can bring experiences and solutions from other countries and I can share these learnings.

In the second scenario speak to organisations at a regional and global level, to elevate the issue of transport within the health system. This can include going to meetings or speaking at conferences.

In July 2013 I attended the 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention held in Kuala Lumpur, where I presented two posters on our work in Kenya and Malawi:

  1. Increasing health system efficiency: Use of motorcycles for patient outreach in Kisumu, Nyanza Province. It was a poster on our partnership with KEMRI-FACES and the work that they are able to do with reliable motorcycles to trace defaulter patients and return them into care.  
  2. Understanding health center testing practices in Malawi: baseline assessment for implementation of Sample Transport (ST) programme. We looked at the baseline situation for diagnostic practices at primary health facilities and laboratories prior to Riders’ ST intervention, which is currently being implemented (we are now in seven districts).

Finally, when I am not traveling, I spend my time working from home in South Africa and trying to read as much as possible about different key topics on the current health agenda, especially in Africa, so I understand who we should approach and what we should talk to them about.

I also lead a small team of two, one who is based in Kenya and the other in the UK. Besides the support that we give to our country programmes, we also work with the other departments in the UK (where our head office is based) to help move the process of partnership development and ongoing relationship management forward.