Making a Difference on the Global Stage

The head of the NPO AfriMedico believes that a unique, traditional Japanese distribution system can help solve some of the healthcare-related problems facing contemporary Africa.


by Julian Ryall


Eri Machii has always wanted to help people in need. She studied pharmacy at university in order to provide people with better healthcare and volunteered at a hospital set up by Mother Teresa in the Indian city of Kolkata. She later volunteered at a hospice in her native Osaka for people with cancer before working for two years in the west African country of Niger, where she instructed local people about the dangers of mosquito-borne diseases and the importance of preventive measures.


“I was working in six villages close to the town of Gaya, which is a six-hour bus ride from the capital of Niamey,” she says. “They had lots of questions for me about malaria and how they could protect themselves.”


Then a member of the Japan Overseas Cooperation Volunteers, Machii said that when she arrived in the country, only 20 percent of the people in the area understood that mosquitos could infect them with malaria. By the time she left, 80 percent of the villagers were aware of the link.


Yet while they understood that the insects were a danger, other problems, both economic (the nets were too expensive) and logistic (nets were unavailable) arose at times. “It was frustrating that I could not get them to change their behavior entirely, but my experiences in Africa made me more determined to gain new skills so that I could do something to help,” Machii says.


Back in Japan, Machii decided to make a difference on the organizational and management side of the equation. She entered graduate school where, as part of a six-month business planning course, she devised a scheme that would help the people of Africa obtain medicines when they most needed them.


Her plan was based on a very old and respected Japanese method of marketing medicine. “Okigusuri is a traditional system that was first used in Japan in the Edo period (1603–1868) more than 300 years ago,” Machii says. “I changed it slightly to meet the specific needs of people in Africa.”


The system began in Japan as a way to gain customers’ trust at a time when most people could not afford to buy medicines to keep around. Salesmen would leave the medicines with them and collect payment for whatever was used on a subsequent visit.


To introduce the system to countries where it was most urgently needed, Machii founded the non-profit organization AfriMedico in 2014 and presently serves as its chairperson. In the year of its launch, AfriMedico won first prize in the inaugural Tokyo Metropolitan Government’s Tokyo Startup Gateway award, with the one million yen prize money immediately used to buy medicine and fuel in Africa, among other expenses.


Many people in the most inaccessible parts of Africa have very limited access to medicines, in part because of their remoteness but also because of the relatively high costs. As a result, people who should have been treated early and would have recovered swiftly do not receive adequate care until their health has already deteriorated significantly.


In AfriMedico’s model, boxes containing 10 of the most frequently used medicines are left with each community for dispensation in a timely manner to anyone who needs them. These include drugs such as analgesic and gastrointestinal medicines, eye drops, insect repellant and kits to test for malaria. Among changes Machii made to the original Japanese system was the introduction of a smartphone application for money collection.


Having immediate access to the basic remedies, Machii says, makes a very big difference. “We started the system in Tanzania, where we now have 10 people working for the organization and we are working hard to teach the local people about okigusuri,” she says. “I think we are slowly getting there.”


Based in Tokyo, where she oversees AfriMedico’s 26 staff, Machii today spends most of her time promoting the work of the organization and speaking with private companies and individuals to raise funds. She says that Tokyo is an ideal place to build an organization, thanks to the ease of information access and the large, highly qualified work force. She is also the mother of one-year-old daughter Yuika, and insists that the solution to balancing her work and personal life is to integrate the two rather than to deal with each component individually.


“Having my own child, I have come to understand how mothers in Africa think,” she says, “and their universal desire for good health, education and food. Because I can relate to them better, I believe I can provide them with the things that are relevant to their lives.”


Nevertheless, Machii says she intends to return to Africa in the future to help the project expand. “The first step has been to establish ourselves in Tanzania, but I am hoping that we will soon be able to go into other countries in the region—perhaps Uganda, Kenya or Ethiopia—to meet the needs of the people there,” she says.


Photo Captions
-Eri Machii manages a life filled with family matters and operating an NPO that is breaking new ground in African health services (top).
-Eri Machii in Shakanwa village, Niger, when she was with the Japan Overseas Cooperation Volunteers program (bottom).


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