During the week of September 20th I had the distinct honor of being a part of the BikeTown Africa project in Orange Farm, Soweto, South Africa. This project was originated by Bicycling Magazine editor Steve Madden in 2006, extending the BikeTown project he started in the U.S. in 2003. The project is a partnership with the Bristol-Myers Squibb Foundation’s Secure the Future program and Kona Bicycles. The mission of the program is to provide purpose-built, durable bicycles to health workers in countries most affected by HIV and AIDS, so those heath workers can expand the quality of care to patients by minimizing the transit time between care visits. Kona designed and manufactures the bikes to account for the specific conditions in sub-Saharan Africa, and Secure the Future coordinates with local relief organizations to determine how best to distribute the bicycles to the point of need.
Below is from my journal entry for Day 3. To me this experience sums up the value of this program.
In the last two days we’ve built 260 Kona AfricaBikes, largely due to the direct support of 30 local health workers from the community. These are the very health workers who will be receiving these bikes to use as transport to administer to their patients in their area. The formal handover ceremony is tomorrow.
To celebrate the completion of the build, we all went to a local shebeen (pub) and had some social time. For context, these workers live in some of the poorest sections in the township. None that I have been working with the last two days has been wearing clothing that’s been recently washed. They administer to people who they describe as being significantly worse off than themselves. While we were at the shebeen I had the opportunity to get a head start on my interviews with a couple of them, and learned something I think rather important.
Today, a health worker has 10-14 patients assigned. Each patient is infected with HIV, and many others with TB as well. The role of the health worker is to deliver medications, perform critical hygiene functions if necessary (depending on the stage of the illness), and track the administration of HIV and TB drugs.
In a typical day, they can see up to 5 patients, which means that even for the sickest patients they can at best visit them every 2-3 days. This is due to the extended travel distances on foot, which sometimes have to be extended due to the risk of traveling through some more dangerous areas on foot.
With a bicycle, however, they were confident they would be able to visit each patient at least once per day, and twice per day for the sickest patients. Obviously for a patient on a triple cocktail as well as an antibioitics course for TB, this is a critical enabling development because it allows them to personally administer the drugs at the proper times of day to their critical patients, something they can very rarely do today due to the basic logistics.
Each of these workers was thrilled to have access to the bike, not for the bike but because they were clearly and genuinly passionate about caring better for their patients. It was really an inspiring day.
Doing some simple math, conservatively these 260 bikes could add more than 10,000 years of life expectancy to patients in South Africa:
[260 bikes to workers] x
[12 patients per worker] x
[4 years of additional life expectancy per patient (due to daily care and medication oversight)] =
Each of these bicycles has a landed cost of about $120 or so. That comes out to an investment of $2.50 per year in additional expectancy. Quite a worthwhile investment for any local economy.
The summary quote, however, came from Meshack, a health worker we worked with throughout the week:
“Our patients thank you. They may die, but thanks to you, they will die with dignity.”
Some videos of the program:
Day 1 Summary
Day 2 Summary
Gum Boot Dance
Day 3 Summary
Visit to Inkanyezi Community Center
Day 4, in 4 Parts
To get involved: