Kigezi Community Project
In late
January 2010, Dr. John Baptist Niwagaba rode a Bicycle for Humanity
deep into a rural African village to launch the “Cycle for Health”.
This is the first in a series of updates on his work to create a
sustainable home based health care delivery service. We thank every
person who helped to make this moment possible and look forward to
updating supporters on the progress.
What
if I could bring health care to the home?” was the question that drove
Dr Niwagaba down a path to realize the bicycle could be used in a
social venture for primary diagnosis, counseling and treatment of
disease in rural African villages. The idea for Cycle for Health
developed while during Dr. Niwagaba worked from Mulago Hospital, the
national referral hospital of Uganda.
Dr. Niwagaba was troubled
to find the hospital hallways overwhelmed and crowded with families
which had traveled long distances from a rural village for care.
Without knowledge of how much the care would cost or how long they
would be there, the families were sleeping at the hospital.
Having grown up in a rural village himself, Dr Niwagaba realized that there might be a way for him to help families
avoid the up to seven hour or more journeys to Mulago Hospital in
Kampala and create a sustainable income generating venture in the
process.
The starting point was that many rural village homes do
not have access to motorized vehicles or public transport. Households
are linked by footpaths like the one seen in the pictured right,
inaccessible to cars. Even when reaching the main road, for many to
hire a car or motorcycle for part of the journey is just too expensive.
The lack of transportation limits options for families in the rural
villages. Many rely on the land for sustenance and income, and trip to
even the local health clinic is a major process.
Walking
the distance to the clinic and receiving care takes up to a day or
more. To fall a day or more behind work on the farm can be a major
economic setback, and so many who feel ill rely on local herbal
remedies to treat sickness. It is only when the case becomes an
emergency that the family will visit the local health center, and at
that point, often the treatment requires specialized attention. Dr.
Niwagaba returned to his question of the possibility of home based care.
“A
dog barks only at its home”, goes an African proverb. People are most
comfortable at their home, can ask many questions that they are afraid
to ask in the setting of a clinic or hospital. Home health visits
provide a chance to see the 4 “P” –predisposing, precipitating,
perpetuating and protective factors of disease causation. In a country
with a poor health worker to patient ratio means many go without vital
care because of long trips, lines and waiting. Trained community
members can be re oriented to provide some of the basic home care and
education for needed health care services
Families could avoid
so much trouble if they could receive primary treatment and information
earlier in the development of the disease. Dr. Niwagaba moved to
develop a model that could use the bicycle as a cheap and efficient
form of transportation, to bring community health care worker to
people’s homes and offer services for a small fee.
He
connected with Bicycles-for-Humanity, a group which collects unused
bicycles from North America and sends them to Africa to find new life.
In the final days of 2009 the container of bicycles and spare parts
arrived in Kabale, sent from a Bicycles-for-Humanity chapter in
Calgary, Canada led by Mr. Walter Rudolph. It was secured at the local
Red Cross compound as Dr. Niwagaba prepares the infrastructure needed
for a sustainable future program.
The
entry point for Cycle for Health will be HIV/AIDS counseling and
testing. He cites a recent Ugandan Ministry of Health report that 99%
of Ugandan’s know about HIV/AIDS but only a little over 20% have been
tested. He believes part of this is associated with stigma towards the
disease, but he says many do want the test, but it’s the transportation
problem that restricts their access.When a community health
worker offers this service at someone’s home, it improve access and
reduce the stigma associated with being seen entering the clinic for a
test. He Is certain people will pay for these tests, which will allow
for the home based health care model to grow and scale to other
services. To become involved in the Cycle for Health, please contact
Dr. John Baptist Niwagaba at jbniwgaba@yahoo.com