Rural Africa is difficult terrain for health care workers. Villages are separated by many miles. Roads are often washed out or potholed -- if there are any roads at all.

In these isolated villages, the sick and injured cannot be seen by health care workers. In some cases, parents must walk hours to the nearest clinic, carrying sick children on their backs.

And when vehicles are made available, maintenance is often overlooked. Replacement parts and skilled mechanics are in short supply, and many vehicles end up as rusted hulks after only a few months of service.

When British reporter Barry Coleman visited Somalia in 1988, he saw motorcycles intended for use by the Ministry of Health standing useless, idled by a lack of simple maintenance.

"It's simply not reasonable," said Coleman. "People were dying because nobody knew how to manage vehicles with internal combustion engines."

Investigation Sparks a Passion

Coleman -- who as a journalist covered motorcycle races -- began to examine motorcycle maintenance programs in Africa. Joined by his wife, Andrea, a former professional motorcycle racer, their investigation turned into a cause. "All of a sudden we all became very passionate," Coleman said.

What the couple started eventually grew into Riders for Health, an organization devoted to providing motorcycles and mechanical training programs for African health care workers.

"I'm not just passionate about children dying of stupid things -- I'm angry, I'm furious," said Coleman. "But I focus my passion on air filters."

Operating in several African countries, Riders for Health is bringing health care workers to remote areas where such care was virtually unknown. "When our staff turn up in our Riders for Health T-shirts, they're treated like royalty," Coleman said. "People are reporting, 'We've never seen a health worker before we saw one on motorcycle.'"

Simple Measures Saving Lives

Not only are Riders for Health staff health care professionals, they also receive training in basic motorcycle maintenance and repair. Vehicles also undergo regular maintenance by trained mechanics.

"It must be the only intervention that actually saves money," said Andrea. "One health care worker with a motorcycle can have a profound effect on 20,000 people."

The proof of Riders for Health's success came recently when the group provided motorcycles for every health care worker in an impoverished district of Zimbabwe. Workers distributed mosquito netting and trained village volunteers in other simple prevention measures like insecticide spraying.

Within a year, malaria deaths in the district declined by 20 percent, even while malaria cases in a neighboring district continued to rise.

Riders for Health emphasizes health care intervention that is designed specifically for Africa. In addition to training women as well as men, the Colemans insist that each of their programs throughout the continent be staffed and managed by Africans.

"It has to be African-owned and African-maintained," said Andrea. "What we need is appropriate mobility for Africa."