Cycle Care

Dusty roads wind through the dry grasslands of northern Zimbabwe, connecting scattered villages. Biking along these roads are people whose love for their neighbors has inspired them to travel long distances to bring hope and healing.

There are many medical needs in Zimbabwe. The country has one of the lowest life expectancies in the world at just 55 years. It has the 5th highest prevalence of HIV/AIDS, with 15 percent of the population — approximately 1.4 million people — affected by the disease. Zimbabwe today has nearly 1 million orphans because of HIV/AIDS.

Zimbabweans are at high risk for a variety of infectious diseases, and a recent outbreak of cholera killed thousands of people. Tuberculosis also occurs frequently, and it is the most common cause of death for people with HIV.

Recent political instability and economic decline have worsened Zimbabwe’s health situation. In 2000, longtime president Robert Mugabe began seizing almost all of the country’s white-owned commercial farms. This threw the country’s economy into chaos, nearly destroyed its once-thriving agricultural sector, and lost the country billions of dollars. Years of high inflation followed, along with food and fuel shortages. High levels of poverty and unemployment have resulted in hundreds of thousands of Zimbabweans emigrating. Consequently, the public health system is failing. Government hospitals do not have sufficient staff, medicine, or equipment, and they are often too expensive for most people. The vast majority of people in Zimbabwe do not have adequate access to healthcare.

There are some places where Zimbabweans can go for help, however. Karanda Mission Hospital was established in 1961 in a rural area of northern Zimbabwe. Though it is primarily a surgical hospital, it also treats patients with HIV/AIDS and other infectious diseases, as well as pregnant women. The hospital runs a program to support orphans and vulnerable children, and it has a home-based care program.

The home care program began in the late 1980s, when Karanda became overwhelmed with HIV patients. In order to handle large numbers of people staying in the hospital for long periods of time, Karanda discharged some of the patients and monitored their treatment in their homes. Chaplains were sent to encourage and pray with the patients, and nurses would dress wounds or administer medicine.

The program quickly became and remains extremely popular among local people. Today, dozens of volunteers help Karanda run the home care program, though the number of patients, combined with long travel distances, makes work difficult.

Dorothy Chirindo is coordinator of the HIV/AIDS program, the orphan program, and the home care program for Karanda.

“It has been very difficult to be a volunteer, as we have up to 100 volunteers out there in the community; they are helping people; they’re doing a good job, and we have nothing to pay them,” Chirindo says. “I got to a point where I was feeling it’s very unfair to take from these people’s time to do all this work, to walk all this kilometers for nothing, and they leave their families and they can’t do anything for them. So I wanted to reduce the amount of work and reporting that they could do. Sometimes, I’ll just say we lay them off and say, ‘you don’t have to,’ although we needed their services. They were getting discouraged themselves.”

Then last year, Karanda discovered a way to re-energize the home care program. Dr. Paul Thistle, a TEAM missionary and obstetrician-gynecologist, who has practiced medicine in Zimbabwe for 20 years, joined Karanda Mission Hospital in late 2012. He quickly realized the need for better transportation for the hospital’s volunteers.

“Soon after I arrived and started duties, started work here at the mission, I recognized that this is a huge district. Its rugged land and roads are rough, and people are scattered across a large area, with villages and poor people that don’t have transportation,” Thistle says. “I brought in the idea of [giving] added value to our village health workers … trying to have them be our eyes and our ears and our hearts out there in the villages scattered across the Mount Darwin district of a quarter-million people. And you need transport for that.”

In summer 2013, Karanda Hospital, with the help of Rotary International, bought 100 bicycles and two bicycle ambulances from a development-oriented bike manufacturer called Buffalo Bicycles. Every hospital volunteer was given a bike.

“It gives them a sense that we’ve added value to their work,” Thistle says. “In the eyes of the community, it’s like a badge. It’s a Sheriff now who has the badge on, saying, ‘Yes, we’re a link to Karanda’ ... And it’s not there just to be sitting in a showcase in their village, their huts. It’s there to be used, and it’s used for a purpose. So it’s an excellent way to give them a sense of purpose and let them do their work better. It’s … a way for them to reach out to their own neighbors and make a difference.”

Karanda volunteers perform a variety of jobs. They assist palliative patients, such as the elderly or those living with HIV. Trained by the Red Cross, volunteers help in the home doing chores like laundry and cleaning, or dressing wounds and ensuring patients continue to take their medicine. They work with HIV/AIDS support groups to provide encouragement to those living with the disease. Volunteers can inform patients of lab results or even help take them back to the hospital, if necessary. Volunteers also help identify new illnesses and have greatly improved the hospital’s communication with surrounding communities.

“They are our eyes and our ears out there to identify need,” Thistle says. “Patients who are coughing and need to be screened and treated for tuberculosis, for example, or orphans who need support, whatever we can provide: nutrition or clothing, or whatever we can offer. And most importantly, to link them holistically to our network of churches to provide psychosocial and spiritual support. There are only so many things we can do for each and every individual, but we do what we can with what we have where we are.”

The bicycle program has allowed Karanda to expand its services to more people. Health volunteers can now identify the needs of people who could never afford to visit the hospital because their village is too far away. The furthest village is about 150 miles away.

Willard Kapuyanyika is a volunteer with Karanda Mission Hospital and was trained as a behavior change facilitator. He began volunteering because, being HIV-positive, his life was saved and his heart encouraged by a hospital chaplain. Now, he wants to tell others that they, too, can live a healthy life. Having a bicycle has broadened Kapuyanyika’s work.

“Some time ago, I was working with only one village. A village is like a hundred homes. But now I’m covering the whole world (sic), which is about 59 villages,” Kapuyanyika says. “Walking was difficult. I was just doing it because I really had to help others, because I’ve been helped. But it was difficult, I tell you. Now, with the bicycle, it has become very easy.”

The bicycles have encouraged Karanda’s volunteers and boosted their work with the home care and other programs.

“They’re feeling supported,” Thistle says. “They’ve been given a new wind of energy. Because HIV and AIDS has been around for 30 years, home-based care programs have been in Zimbabwe for 20 years and there’s a bit of a donor’s fatigue with HIV and AIDS. We’ve given them a new fresh sort of energy to do the work.”

Karanda plans to eventually redesign and improve the program, but for now the hospital wants to maintain its operation and expand its reach. Though the program has grown and become more effective with the bicycles, there is still great need in the area. Hundreds of villages are spread around the Mount Darwin district and 100 volunteers can’t reach them all.

“My vision,” Thistle says, “is that every individual — adult to child, sick or healthy — that comes into contact with Karanda … would be linked somehow to a Karanda volunteer.”

Dedicated volunteers at Karanda, like Kapuyanyika, will continue to travel down long, dusty roads to make that vision a reality.

“As long as God keeps me alive, I will continue being a community volunteer,” Kapuyanyika says. “I want Zimbabwe to move forward.”

-Written by Megan Darreth
-Photographs by Robert Johnson

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