January 31, 2010

Social Entrepreneurship on Two Wheels

Posted in Advance Trip tagged , , , , , at 2:59 pm by kampala2capetown

“What if I could bring health care to the home?” was the question that drove Dr. John Baptist Niwagba to realize the bicycle as an appropriate technology which could be used in a social venture for primary diagnosis, counseling and treatment of disease in rural African villages.  The Road Show crew took a brief detour to meet with the Ugandan doctor and social innovator to learn more about his venture “Cycle for Health”. The opportunity to visit his project meant the road show organizers could better understand what it exactly means to be a young social entrepreneur in Africa. It is part of the objective of the road show to inspire hundreds of them during the World Cup.

Cycle for Health developed during the doctor’s studies at the Makerere University School of Medicine in the capital city, Kampala. At that time he did a lot of work from Mulago Hospital, the national referral hospital. 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 journey to Mulago Hospital in Kampala and perhaps create a venture in the process.

The starting point for Dr. Niwagaba 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 picture above, 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 options for families in the rural villages, many who rely on the land for sustenance and income, mean a 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 the long trip to Mulago.

Dr. Niwagaba realized that the families could avoid so much trouble if they could receive diagnosis and primary treatment earlier in the development of the disease. He developed 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. A few months ago a container of bicycles and spare parts arrived in Kabale, from a group in Calgary, Canada and was secured at the local Red Cross compound.

The entry point for Dr. Niwgaba’s 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 believes people will pay for these tests, which will allow for the home based health care model to grow and scale to other services.

Dr. Niwagaba explains that being a social entrepreneur means being part of a network of individuals who are putting their community before themselves. It is being part of a group that support each other to create projects that are sustainable and do not rely on charity to operate. With the Kampala 2 Cape Town Tech Road Show, we hope to add new young people to his network of young social innovators in Africa, and continue to build the foundation for a new generation of high impact change makers.

Like any good entrepreneur, Dr. Niwagaba is continuing to innovate. He is developing another venture to take on the access problem, The Medical Call Centre, which would offer Ugandan’s 24 hour health care advice through a low-cost service via the mobile phone. The Medical Call Centre idea is finalist for the Unreasonable Institute, which we suggest you check out and support.


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