Thinking outside the box

 “Thinking outside the box” is one of the articles collected in the book Advancing Change: inspirational stories from a decade of giving, created on the occasion of the Trafigura Foundation’s 10th anniversary. North Star Alliance is a non-profit organisation creating wide-scale social change through its network of roadside clinics offering health services to mobile workers and communities living along the main logistics roads.

Converted shipping containers painted the colour of the sky are proving to be places for sequestered communities in sub-Saharan Africa to weather taboo health issues. The Blue Boxes, as they are known, are located at ‘hotspots’ such as border posts, transit towns or ports, where large numbers of trucks stop and where sex work and informal trades flourish, existing not only as medical clinics but classroom-come-confessionals for those seeking support for deeply sensitive afflictions.

“There are several people who have found out they are HIVpositive, but don’t know how to deal with it,” says Ylse van der Schoot, the Executive Director of North Star Alliance, a nonprofit health-delivery organisation that has grown its network of roadside wellness centres from just one to more than 50 across 13 countries in the past decade.

People still think that HIV is a death sentence, but by coaching, by counselling, by listening, by asking questions and by informing, they get to understand that they can live with it and be put on medication. They can thrive at the same time as being HIV-positive,” she says. “There are people who say, ‘I’m 33 years old, and have never been to a medical facility in my life. Thank you for coming to my community because now I can get quality healthcare.’

Not only does North Star Alliance serve the trucking community – highly mobile workers who are potential vectors in the spread of infectious diseases – it also extends its reach to local communities with little or no access to medical services. Health services on offer include screening for HIV, health checks and counselling, as well as training for drivers to increase road safety, and medication for malaria, tuberculosis and sexually transmitted infections. Additionally, special communication sessions are organised to increase awareness and change behaviour.

I’m pleased to be working there,” says Van der Schoot. “I like how caring our staff are, people who want to make a difference and work in and around our clinics all day and do the best they can with the moderate means they have.” Financial assistance from the Trafigura Foundation facilitated a big step forward in 2016, with the official launch of six clinics along the Dar corridor in Tanzania. This was in partnership with the Trafigura Foundation’s sister philanthropic entity Puma Energy Foundation. In their debut year, the six clinics in Tanzania registered 26,787 visits, of which 56 per cent were made by truck drivers, and remaining visits made by community members.

In 2017, the number of visits increased by just over 10 per cent to 29,524, of which 58 per cent were made by truck drivers. The total number of services provided in 2016 was 33,458, with more than half being primary healthcare, followed by almost a third HIV testing and counselling. In 2017, the number of services increased to 36,775.

An inventive electronic health passport system enables patients to continue their treatment at any one of the clinics across the continent, enabling the exchange of patientspecific data between each Blue Box as well as the collection of site-specific data used for monitoring and evaluation.

In addition, the support of government and NGO partners allows patient referrals to other health facilities. Nevertheless, it is clear that such successful collaboration between the Foundation and the healthcare provider encompasses more than financial support.

The team at the Trafigura Foundation does not just fund a particular project, it really helps Blue Boxes and the organisation to develop,” says Van der Schoot. “That’s an important additional value from our relationship. I find the partnership with the Trafigura Foundation very special because it’s about the long-term vision; it’s not just about the current programme or the exact output, and what we’re trying to change in the project period. I like how they help us in looking at alternative income, to move away from dependency on grants. There’s a level of trust and understanding in the relationship. Not everything always goes according to plan, but we can easily discuss and adapt things and reason together on how to fix or change things.

There are five strategic objectives for the years ahead, she determines: increase access to healthcare; guarantee the quality of services; strengthen data management; optimise funding; and enhance governance, leadership, and engagement. However, Van der Schoot acknowledges that North Star Alliance is a niche player only known in certain circles, and so 2018 is not about superfluous growth but spreading the word that a series of stationary boxes can transport communities to better lives, by putting Blue Boxes – the brand – on the map.

We would like to get our name out there, so people come to us, instead of us looking for them.” Being born and raised in the Netherlands is a privilege, she says. “I’m lucky to be able to go to the doctor any day without worrying about cost, and quality is guaranteed. Healthcare is a human right. That’s not a reality for everyone in the world and changing that and making that as accessible as possible is essential.

Download the book and discover the other inspiring conversations with some of the Foundation’s most meaningful partnerships.

Pictures: © Gareth Bentley

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