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NAMIBIA: Have wheels, will travel

16 Apr 2008 18:30:39 GMT
Source: IRIN

Background

• AIDS in Africa

• AIDS pandemic

• Health and diseases

KEHEMU, 16 April 2008 (IRIN) - Home-based caregiver Salome Vendura knows firsthand that in Namibia's far-flung rural areas, one of the biggest determinants of HIV/AIDS treatment adherence is access to affordable and reliable transportation.

In Vendura's community of Kehemu, in northern Namibia, the nearest hospital is 5 km away - too far for many of her weakest patients to walk.

"We used to take patients in private taxis, and would tell the drivers that we didn't have money," said Vendura, 27. "Often the drivers refused to take us because of stigma and discrimination against people with HIV."

Namibia is a vast country where an estimated 19.9 percent of the adult population is estimated to live with HIV. But a lack of affordable transportation leaves many communities isolated from healthcare, as well as jobs and AIDS prevention campaigns.

Enter Bicycling Empowerment Network Namibia - an upstart nongovernmental organisation based in the capital, Windhoek. Since 2005, BEN Namibia has distributed more than 4,000 bicycles to disadvantaged Namibians, including community-based organisations (CBOs) that provide home-based care for people living with HIV/AIDS, and those that support orphans and vulnerable children.

Though Namibia's sand, wind and thorns make it difficult bike terrain, the organisation believes bicycles are the best solution for the country's poor.

"People are dying in Namibia because they don't have transport," Michael Linke, managing director of BEN Namibia, told IRIN/PlusNews. The idea is to empower those infected and affected by HIV with their own means of inexpensive and reliable transportation.

"It's about access to healthcare, education, and economic opportunities," Linke explained. "In Namibia there is an apartheid-era transportation system that is manifestly unjust. Yet the public transportation system is ineffective, while private taxis are expensive."

Caregivers can go the extra mile

People living with HIV/AIDS, particularly women, spend between N$20 and N$40 (US$2.50 and US$5.00) every month to collect medications, according to a study conducted by BEN Namibia in partnership with the International Community of Women Living with HIV/AIDS and the AIDS Law Unit from the Legal Assistance Centre in Windhoek.

But because nearly 35 percent of Namibia's population lives on less than $1 a day, many forego collecting their medications, or adhere to treatment only sporadically. And home-based caregivers can only do so much traveling on foot.

So far, BEN Namibia has distributed a total of eight steel shipping containers to CBOs, each packed with about 300 donated bicycles - often used bikes rescued from dusty garages and second-hand shops in the developed world. In turn, these organisations donate some of these bikes to caregivers, in order to help them see more patients every day.

"Caregivers generally walk long distances to visit their clients," Linke said. "By giving them bikes, they can see more clients and get further out into the bush, and spend longer amounts of time with their clients."

The bicycle ambulance

Soon after home-based caregivers received their new bikes, BEN Namibia noticed they were awkwardly transporting extremely sick clients to the hospital or clinic on their bike racks.

"If you're nearly comatose, very sick, or very weak from malnutrition, the last thing you want to do is sit on the back of a bicycle. So we developed the bicycle ambulance," Linke said.

Their "ambulance" is a stretcher on wheels that can be towed behind a bicycle. BEN Namibia's model includes different reclining options and a canopy to protect patients from Namibia's sun or rain. To date, the NGO has made and distributed 54 bicycle ambulances to community groups, and expects to deliver another 33 by June 2008.

BEN Namibia has found that if a hospital or clinic is within 10 km from a patient, home-based caregivers will use the ambulance. "This ambulance is helping a lot of people, especially those who don't have the money to take a taxi for treatment," said Vendura, who told IRIN she uses the bicycle ambulance to transport about 10 people a day, Monday to Saturday, to either the local clinic (3 km) or state hospital (5 km).

Bike shops and employment

Not all of the bikes BEN Namibia donates to the CBOs are handed out to caregivers. Instead, most are sold to locals through revenue-generating Bicycle Empowerment Centres (BECs), makeshift bike shops that also create jobs for local residents.

How it works is that BEN Namibia sources its bikes from overseas donors, particularly from partner organisations, such as Canada-based Bicycles for Humanity. The partner organisations typically collect about 300 new and used bikes, plus related parts, tools and accessories. These are packed into a second-hand steel shipping container and sent to the port of Walvis Bay.

BEN Namibia brings the container to Windhoek, where it refurbishes the bikes and outfits the container to serve as a portable workshop. It then distributes them to a CBO working with PLWHA or orphans and vulnerable children. The NGO trains locals in bicycle mechanics and project management. Proceeds from the bike sales and bike repairs from the bike shop support the operations of the CBO.

That made sense to Abigail Bachopi, head of Family Hope Services (FHS) in Hakahana, which provides meals and after-school support to orphans and vulnerable children.

"We sponsor 450 children in this community, and we reached a point where we needed to fundraise. The bike shop was how we decided to raise funds," Bachopi said from the group's warehouse facility outside Windhoek. "For us it's a sign of sustainability of the program, because donor funds are just for a moment, but this bike shop involves the community and will stay here for a long time."

Since its BEC launched two months ago, FHS has sold 11 of its 300 bikes and has raised about N$3,500 (US$450) for FHS staff and its food programme. Each of the Bicycle Employment Centres provides up to five full-time jobs for the newly trained mechanics and administrators. So far, BEN Namibia has launched eight of these centres, and plans to open at least 12 more in the next year.

gw/oa

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