Update! - Jill Marie Stokes is visiting Uganda and is selling her fantastic paintings here to raise funds.

Kigezi Community Project - Bicycle Empowerment Program Update

The Kigezi Community Project proudly announces the pilot project location for the Bicycle Empowerment Program: The Kabale Red Cross Society headquarters.

Location for Bicycle Empowerment Center – Kabale

A needs assessment of the District revealed many health related organizations operating in the Kabale area, with over 200 HIV/AIDS related groups registered. The above pictured compound is located on the outskirts of the town center, alongside a main paved road. There is space for outdoor and indoor activities.

Charles, a member of the Kigezi Community Project & Kabale Red Cross Society

Management of the BEC will be lead by the Kigezi Community Project (KCP), Executive Director, John Baptist Niwagaba. John Baptist is familiar with the district as he was born and raised there. KCP community promoter Charles Bikorowmuhengi sits on the board of the Red Cross and work towards a collaboration between the two groups.

Executive Director, John Baptist Niwagaba overlooking Kabale District

The management strategy for the BEC is to first secure the safety of the bicycles and then distribute the bicycles with a tracking mechanism. Distribution duties will be shared with KCP, which will simultaneously work on a project to network HIV/AIDS services in the Kabale District. The initial target area for the BEC will be the Kabale Municipality, which includes the village center and its outskirts. Organizations and individuals will only be able to obtain a BEC cycle after completing a basic maintenance care course and will be obligated to submit reports on the use of their bicycles at quarterly meetings. Once a working model for bicycle distribution and tracking is in place, the BEC can expand its services to districts further from the central hub.

If interested in supporting Kigezi Community Project, please contact Executive Director John Baptist Niwagaba at jbniwagaba@yahoo.com

A Bicycle Pineapple Stand in Kabale

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The Bicycle as an Instrument of Social Change:
Using Bicycles to Save Lives & Transport the Social Vaccine

Introduction

In the electronically driven modern world, it's easy to become infatuated with the newest gadget or gizmo. Many embrace new technologies as the end all and savior, but something more grounded is needed to fight infectious diseases in impoverished rural communities. This article tasks the stance that no amount of money or science will cure the HIV/AIDS epidemic that now ravages the most vulnerable parts of our world. Instead, the article explores the idea of the social vaccine: a global idea to fight preventable disease at the grassroots level by putting an end to unhealthy cultural practices and traditions while increasing access to primary medical care.

The Kigezi Community Project (KCP) is a new non-governmental organization in pursuit of the social vaccine. It was established in 2006 to improve the quality of HIV/AIDS care and education to underserved rural African communities. The guiding principal of KCP is to work at the community leader level to produce organic solutions and come closer to realizing the social vaccine.

Specifically, KCP works with local community leaders to achieve three main objectives:

• Empower community leaders with the skills and resources needed to administer primary medical care, home based care, and health education
• Enlighten community leaders with the idea of the social vaccine, and provide them with the knowledge and tools to instill new healthy practices
• Create an environment where community leaders may operate in a timely, cost effective manner

It is the steadfast belief of the KCP administrators that the bicycle is the ideal vehicle to "transport" the social vaccine.

A Case History of Cultural Change

Before diving into the details of the pilot project of KCP, let us take a step back in time and look how the bicycle affected American Society when it was first mass distributed in the 1890's. The greatly accelerated locomotion of the individual had a profound effect on the imagination and mindset of the American people.

The 1890's saw a bicycle craze sweep across the United States. Magazines, clubs and riding schools dedicated to cycling appeared around the country. Law enforcement took to the bicycle to fight crime and doctors and ministers utilized the bicycle to increase the number of home visits they could make in the day. City cyclists took to the countryside on weekends, and business boomed for country inns and restaurants. For the most part, Americans praised the cycle for helping create saner mind and stronger hearts.

Over the decade, the bicycle also became an agent of cultural change. A considerable part of American Society was forced to revaluate its old ideas. Most significantly, the bicycle eroded barriers of etiquette that separated the sexes and led to greater emancipation for women. The following excerpt is taken from an 1895 book, How I Learned to Ride the Bike: Reflections of an Influential 19th Century Woman. The book was written by noted female author Frances E. Willard and illustrates the way women used the bicycle as an emancipation theme.

"A woman with bands hanging on her hips, and dress snug about the waist and chokingly tight at the throat, with heavy trimmed skirts dragging down the back and numerous folds heating the lower part of the spine, and with tight shoes, ought to be in agony...If women ride they must, when riding, dress more rationally than they have been wont to do. If they do this many prejudices will melt away. Reason will gain upon precedent and ere long the comfortable, sensible, and artistic wardrobe of the rider will make the conventional style of women's dress absurd to the eye and undurable to the understanding."

Soon after the implementation of the cycle, unhealthy traditional clothing, like the corset, a fashionable undergarment which was used to squeeze women's bodies into tight hourglass figure, came under scrutiny. Women who took to bicycling immediately did away with their corsets, and began to call clothing an unhealthy, sexist tradition. By the 1920's, the corset had faded from closets of American women.

This final quotation from The Social History of the Bicycle (Robert Smith 1972) cements the idea of the bicycle as a tool of emancipation.

"More and more women came to regard the cycle as a freedom machine. Until the 1890's they had confined themselves to demanding the right to vote and timidly advocating some dress reform. But on a bicycle the American woman was another being, free and her own mistress. She wore the kind of clothes she wanted, men's opinions notwithstanding, and she began to reach for even more freedom."

Using the Bicycle to Save Lives

Over a hundred years after the American Bicycle craze, the bicycle is being rediscovered as asset for rural health care systems. With the cost of medication dropping rapidly, access to health care is the largest hurdle facing the rural African population. Approximately 2% of Africans living with HIV have access to ART, with 25 million people still in need. Poor transportation infrastructure makes visits to local hospitals or home-based care difficult and time consuming.

In the wake of these problems, health care organizations have turned to the bicycle and seen impressive benefits, especially with community based health care workers. Health care organizations that introduced the bicycle saw large time savings for their workers, and costs of transportation were reduced. Retrofitted "ambulance bicycles" greatly improved emergency response time in areas where motor vehicles were either unavailable or the terrain was not passable.

The Kigezi Community Project will utilize the cycle's benefits in its mobile, community based approach to health care.

The Kabale District Project

See the proposal here (Adobe .pdf format)

The pilot project for KCP will be in the Kabale District, located in the southwestern corner of Uganda. Kabale has a large rural population, a poor transportation infrastructure, high illiteracy levels, low doctor patient ratio (1:20,000), and high poverty levels. With most health centers located in the crowded village center, availability and accessibility to health care is extremely difficult for the large rural population. Many AIDS cases go undetected in the region, and this increases the potential for transmission.

KCP will use a mobilization strategy for the Kabale District. Education and health care will be provided at "Hubs", created at selected sites in Kabale. Each hub will be run by a team of local community leaders, consisting of clinicians, counselors, mobilizers and selected volunteers. The selected individuals will be taught the basics of healthy living and empower them with the knowledge to provide primary medical care and give proper counseling. Graduating from a training session, community leaders will receive bicycles from a Bicycle Empowerment Center. In addition to decreased transportation costs and travel time, he bicycles will increase their visibility in the community and enable more home based care.

Once a hub is established, and a community team is trained, preparations will be made for a visit from a mobile health care unit, run by doctors, clinicians nurses and laboratory technicians. The mobile health care unit will schedule visits to hubs at regular intervals and provide advanced health care services to those most in need.

These services include:

• HIV testing using rapid methods and giving results
• Follow-up enrollment of new patients
• Provision of basic health care package (i.e. insecticide treated mosquito nets, drinking water jerry can with water treatment chemicals and latex condoms)
• Opportunistic infection and co-infection treatment
• Prophylactic medication to all HIV positive patients using Septrin
• Provision of Antiretroviral Therapy (ARV) to eligible patients
• Gathering of baseline information about community members who come for care at the mobile unit, to be used in follow-up visits, project assessment and for observational research.

Conclusion

Bicycles-for-Humanity has realized the potential of bicycles for a rural health care system, and they have already begun to make impact and exceed expectations. The situation in many rural villages is dire, but with the social vaccine in mind, there is reason for hope, but even more so, the time for action is now.

Questions, inquires comments on the social vaccine, KCP, or the Kabale district project can be directed to John Baptist Niwagaba Executive Director of KCP at KCP@yahoo.com.