Keep It Simple.

Riders for Health is a charity that ensures healthcare workers can reach African villages on a regular basis by supplying them with motorcycles and pick-ups and, crucially, ensuring that they work. According to the article I read, they do this by operating,

a system of preventive maintenance that would shame any British rail operator. Spark plugs are changed before they stop sparking. Cylinders are re-bored before they seize up. Money permitting, vehicles are replaced before they break down unexpectedly, and no health worker climbs onto his or her motorbike without giving it a once-over worthy of an airline pilot. This means ambulances work, travelling clinics travel, and every community health nurse with “outreach” responsibilities for rural villages has a sturdy Japanese motorbike to take them there.

In other words, they focus on the true customer needs (in Gambia, for example, 60% of healthcare is delivered to patients rather than vice versa), anticipate problems rather than react to them and see flashy gestures as the waste of time and resources they really are.

Back in Bansang, the health ministry’s Toyota Hilux pick-up operates from a vehicle depot strewn with the rusting, overgrown legacy of a decade of costly and ultimately doomed initiatives: 21 Land Rovers and Land Cruisers emblazoned with grand aims and proud sponsors’ logos (the “BUPA Kadang Heath Services Rapid Response Vehicle”; a six-vehicle fleet for the “Elimination of Neonatal Tetanus in Africa by the Year 1995”), all kneeling in the dirt on tyreless rims, all useless. One Land Rover has a pumpkin growing from its bonnet. The Hilux, by contrast, has 222,183km on its clock and every prospect of accumulating more.

By doing so, they make themselves appear all the more impressive.