Feature story

The power of two wheels

18 August 2008

Yvonne Awuor, a volunteer home-based
care provider with Women Fighting AIDS in
Kenya (WOFAK) takes a bicycle taxi to visit
her clients in remote villages.
Credit: WOFAK

Before she sets out to visit her client Ms. Heluda in Kisian, Yvonne prepares a bag with a towel, multivitamin tablets, over-the-counter painkiller tablets, a packet of porridge flour, liquid detergent, hand gloves and soap. Then, she takes a bicycle taxi to Kisian village, 12 km away.

On her arrival at Ms. Heluda’s home Yvonne is met by three young children who are not in school today because their mother was too sick to get up this morning and has been too weak to cook for them, she is HIV-positive.

Yvonne Awuor is a volunteer home-based care provider in Kenya with WOFAK (Women Fighting AIDS in Kenya) an organization founded by women to give support and reach out to other women experiencing discrimination as a result of being affected by or infected by HIV.

Yvonne talks with Ms. Heluda and makes the fire to prepare porridge for her and the children. She then helps her to take the cup of porridge, perhaps her only food intake that day and bathes her face, hands, feet and body. She applies massage oil and massages her feet, hands and shoulders. After chatting with her about the importance of taking care of herself and the need to take her HIV medications so that she will get stronger, Yvonne later returns to town by bicycle taxi, promising to visit again in three days time.

Home-based care ensures a continuum of care for people living with HIV who have left hospital and returned home. It offers a holistic approach often including palliative and spiritual care. However, in most areas, providing care for people living with HIV would be far more difficult and in many cases impossible without a bicycle.

“We use bicycles in Kisumu because it is the cheapest means of transport for our caregivers. We also use the bicycle as it offers a more convenient way of reaching remote places within our area”, says Dorothy Onyango, Director of WOFAK. “In many cases, our caregivers are one of the best sources of hope and inspiration for the sick person and the family members. Such visits are therefore received with joy,” she added.

Home-based care volunteers from Okathitu
Parish, part of the Anglican AIDS
programme in the country (2006).
Credit: BEN Namibia

In Namibia, the non-governmental organization Bicycling Empowerment Network (BEN) was set up to respond to the need for affordable transport by providing bicycles and maintenance training to home-based care volunteers. Through field research they found that in this vast country rural Namibians have extremely poor access to emergency medical transport and that the cost and non-availability of transport has a particularly negative impact on adherence to antiretroviral treatment for people living with HIV.

“Bicycles benefit the caregivers, clients and their families,” says Michael Linke, Director, BEN Namibia.

In urban settings with good roads, bicycles can increase the range and carrying capacity of people by four or five times compared with walking. Even on un-tarred rural tracks a bicycle carries up to four times the weight, goes twice as far and travels twice as fast as a person walking.

However according to Linke a bicycle is much more than a practical mode of transport.

“Both volunteers and clients have told us that their sense of pride in the home-based care service increases when the volunteer has a bicycle to make her visits. We didn’t expect that a bicycle would also affect the clients’ perception of the services.”

In addition to bikes for delivering home-based care, BEN Namibia has also purchased 93 bicycle ambulances to take people over what are often long distances to the nearest health clinics and so improving access to healthcare for people living with HIV.

In countries like Kenya and Namibia the volunteers who bring home-based care services to people living with HIV form the backbone of the response to AIDS. Bicycles are playing an important role enabling them to visit clients more often, spend longer with them, deliver more supplies including antiretroviral treatment, and reach more distant locations.