Thousands of Years of Life Expectancy Added

6 10 2009

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)] =

12,480 years!

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:

BikeTown Africa

Secure the Future

Kona BikeTown


Millions of Countrymen Brought Democracy

13 08 2009

Aung San Suu Kyi is a scholar and pro-democracy activist from Burma, also known as Myanmar. She is the leader of the non-violent political opposition to the military government that has been widely condemned for human rights violations and isolationist policies. She has been a pro-democracy advocate since 1988, and has made significant personal sacrifices in her life to fight for democracy in Myanmar. In 1990, the party she represented won a general election decisively, entitling her to assume the position of Prime Minister. The military government in turn nullified the results of the election to remain in power, which has been the state since then.

She has been living in Myanmar under house arrest for 14 of the past 20 years, as she is currently. She has worked extensively with the UN, and among many international awards to date is the Nobel Peace Prize, in 1991. From the Nobel Committee’s release:

“In awarding the Nobel Peace Prize for 1991 to Aung San Suu Kyi, the Norwegian Nobel Committee wishes to honour this woman for her unflagging efforts and to show its support for the many people throughout the world who are striving to attain democracy, human rights and ethnic conciliation by peaceful means.”

In 1997, her husband of 25 years was diagnosed with prostate cancer, while they were living apart due to impedance from the Burmese government. The junta refused him a visa to enter the country, and instead encouraged Suu Kyi to leave. Knowing she would not be allowed to return to Burma, she refused to leave to join her husband. He died in 1999, having seen her only five times since her initial arrest ten years earlier.

The military government

The true nature of the regime Suu Kyi has been struggling against came into full sunlight in the wake of Cyclone Nargis in May of 2008. That storm, which reached Category 4 strength, was responsible for more than $10 billion in damage and more than 146,000 fatalities in Myanmar. There were widely-published reports of the junta keeping international aid workers out of affected areas by withholding or denying visas, and also reports of the regime keeping US and other foreign military vessels full of food aid off-shore for extended periods during the apex of the crisis. The generally-accepted rationale for keeping aid at bay and preventing foreign nationals from distributing that aid within Myanmar’s borders was that the junta insisted on distributing that aid to the afflicted only with their own resources, and without international assistance.

From the New York Times:

“French and U.S. naval ships carrying aid supplies waited just offshore for more than two weeks while the generals dithered. Finally, lacking permission to deliver the aid, the ships withdrew.”

Ultimately, 146,000 people died. People didn’t get food, water, medicine, or shelter in a timely manner because their government wasn’t able to take all the credit.

Further, Human Rights Watch noted in the aftermath that citizens were being forcibly evicted from public shelters, despite aid organizations such as UNICEF stating after on-the-ground inspections that even voluntary returns were premature.

“The forced evictions are part of government efforts to demonstrate that the emergency relief period is over and that the affected population is capable of rebuilding their lives without foreign assistance.”

In other words, the government was pushing their citizens into unstable conditions after a disaster to demonstrate that things were perfectly OK, despite expert indications to the contrary.

The military government’s resistance to criticism continued well after the disaster, just in other forms. Recently the New York Times noted that more than 150 dissidents in Myanmar had been given sentences of 2 to 65 years, including a local comedian who was sentenced to 45 years for speaking critically of the military government’s handling of the relief efforts after Nargis.

Recent developments

Earlier this year, while Suu Kyi remained under house arrest, an American chose to swim uninvited across the lake adjoining her home. When he arrived, he remained for two additional days under Suu Kyi’s care claiming he was exhausted and unable to return safely across the lake. He was arrested by government authorities when he did make the swim back.

Suu Kyi was charged with volating the terms of her house arrest, tried and sentenced after that to 3 years in prison. The trial was widely-criticized as being unjust and her sentence was quickly reduced to 18 month extended house arrest. The circumstances both under which she was charged and sentenced has been criticized by world leaders and thought leaders alike, including formal protest by Secretary of State Clinton, UN Secretary General Ban, French President Sarkozy, and others. That’s where the story is today.


Aung San Suu Kyi has endured in ways that many of us can only imagine in defense of democracy for her country. She has rightly earned the respect of the Burmese citizenship and the international community, which no doubt contributes to her being so threatening to the existing power structure. We can only hope that international pressure and insistence on human rights will ultimately clear the way for her efforts to be rewarded by a free and vibrant democracy in Myanmar.

To get involved…

Human Rights Watch