March 02, 2006

Going Global: Biketown Africa

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Christophe Tshego will get an AfricaBike. It won’t be as fancy as the Kona Smoke I gave him last November on my trip to Botswana, but it will be better suited to the dusty roads he’ll ride around his home in Bobonong. Tshego, a slim, soft-spoken man in his mid-30s, got the Smoke as a reward for his courage: He is the rare HIV-positive African who is willing to stand in front of a group of strangers and admit to his ailment.

“I want to let people know that being HIV-_positive isn’t a death sentence,” he says.  “Life goes on if you take the right drugs. But you have to get tested in order to know, and you must practice the right behaviors to avoid the virus. That’s what I will ride all over and tell people.”

His message, and the bike on which he delivers it, will help save lives. Sub-Saharan Africa is a part of the world where a bicycle can make the difference between life and death. Literally. Not in a “the doctor told me to lose some weight or I’m gonna have a heart attack” kind of way.

But by allowing health-care workers to deliver medicines-or even something as simple as crucial information that can arrest a disease in its tracks.  Or by allowing a laborer to commute to a job that pays a wage that allows him to support his family and break a generations-old cycle of poverty and despair that allows HIV to spread like a wildfire.

If the United States were enduring an HIV epidemic on the same scale as the one currently plaguing sub-Saharan Africa, it would be the subject of congressional hearings, a medical Manhattan project and daily front-page news.

But in much of Africa, it’s a grim fact of everyday life that one of every three people you meet is HIV-positive. Go to a soccer match and the picture is clear: There’s a guy sitting on your left and a woman sitting on your right. One of you won’t be alive a year from now. It’s a fact made harder to accept by the crushing poverty and the rampant crime.

That’s why BikeTown is going to Botswana, a country so devastated by HIV/AIDS that nearly four out of every 10 of its citizens has been infected by the disease, and almost two-thirds of the deaths of children five and under are caused by AIDS.

This spring, bicycling and Kona Bikes will distribute 200 AfricaBikes to groups fighting HIV/AIDS in Botswana’s capital, Gaborone, and in rural Bobonong. The bikes are for use primarily by home-health-care workers, all of whom are employed by programs funded by the Bristol-Myers Squibb Foundation’s Secure the Future project (securethefuture.com).

They will use the bikes to distribute anti-retroviral drugs and provide home care to people infected with HIV, and to disseminate information about how people can protect themselves from HIV and on the importance of being tested for the virus.

In Bobonong, most of the STF-funded health-care workers visit their patients on foot. This means that those heading into the remote areas outside the town can sometimes see only one or two people each day. STF workers estimate a bike will allow them to increase that number to as many as five visits per day. As a South African STF worker told me, “Giving an African a bike is like giving an American a helicopter.”

Spreading the word is particularly important. Part of the reason HIV/AIDS has reached epidemic proportions in sub-Saharan Africa is the potent stigma attached to those who carry the disease, and the denial that accompanies the stigma.

It’s not unusual to hear someone tell you that there’s no such thing as HIV. Manto Tshabalala-Msimang, South Africa’s minister of health, has repeatedly said that AIDS can be cured with a rigorous diet of garlic and potatoes.

Of the three patients I met at a clinic in Gaborone, two hadn’t told their families they were infected, even though both had been taking anti-HIV medicines for more than two years. It’s a common story.

Sam Lister, health correspondent for the Times of London, whom I met in Gaborone, told me that he had visited the home of a woman in a South African shantytown in Soweto. “She told me her husband thinks she’s got some sort of mystery illness,” he said. “I don’t know if it’s denial or shame, but the problem needs to be brought out into the open.”

Taking BikeTown to Botswana is a huge step for bicycling, and a logical and very necessary one. We live in a world where physical location is no longer the sole hallmark of a neighbor, and where the need for help has never been greater. I know BikeTown Africa will help, and I intend to keep it growing. My great hope is that by the end of this decade, we can have a BikeTown on every continent.

Why am I so hopeful? For one thing, we have a good idea that fills a dire need using the simple yet highly effective tool of a bicycle, and we have great partners with whom we can get the job done.

For another, I believe in omens. On the day we handed out three Kona Smokes in Gaborone last November, rain fell on the parched capital, the first real rain in months. The last I saw of Christophe Tshego, he was riding off into the rain. To spread the word, no doubt.

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