bicycles are for global health

In many cities across the US, cycling is growing in popularity and local governments are working to implement bike-friendly urban planning initiatives, but is it growing fast enough? The US ranks first in the world for percentage of population that is obese (34% for adults age 20 and older). Not surprisingly, the US also ranks near the low end for bicycle usage with 1% or less of its population using a bicycle.
Graph (above, Figure 2) from: Bassett, Jr., et al.,

Walking, cycling, and obesity rates in Europe, North America, and Australia, Journal of Physical Activity and Health, 5, 795-814

Bicycles have been around for a long time. There is a sketch for an early bicycle design in one of Leonardo da Vinci’s pupils’ notebooks from 1493. Over the years bicycles have been upgraded and modified, moving from being a luxury of the wealthy to the transportation of the masses. The advent of cars slowed bicycle usage in industrialized countries, but in less economically developed countries bicycles are still a primary mode of transporting people and goods. Likewise the production of bicycles has remained nearly double that of cars.

For many countries bicycles are at the front lines of public health, they just may not realize it. The US has been watching a steady rise in obesity rates as a result of inactivity and unhealthy diet choices. Many states and cities are working to implement programs to increase bike usage including: Rails to Trails projects, Bike sharing in Washington DC and Nashville, as well as increased bike lanes linking residential areas to commercial zones. These programs will all have a big impact of the health of the US population. The CDC states that the number on strategy for increasing physical activity is shifting from car trips to walking or biking. Bicycling Magazine notes that new bicycle commuters can expect to lose up to 13 pounds their first year of biking to work.

Graph (above, Figure 4) from: Pucher, J., et al., 2010

Walking and cycling to health: A comparative analysis of city, state, and international data, American Journal of Public Health, published online ahead of print

The benefits are huge, but that doesn’t always make it easy for people to jump right on a bike. A recent study led by Dr. John Pucher of Rutgers University found a direct correlation between percentages of adults with diabetes and percentages of commuters biking or walking to work in 47 of the 50 largest US cities (Walking and Cycling for Health, August 2010). To state the obvious, the increase in programs that promote bike usage and the increase in people biking will have a very positive effect on the health of populations

However, the US isn’t the only country working to get its citizens moving. Copenhagen (Denmark), known for being a biking city, launched “You won’t believe it… You’re safer on the bicycle than on the sofa!” A campaign run by the city’s Public Health office, their goal was to get more people biking to work instead of taking their car for a short trip. The campaign told Copenhagen residents, “Lack of movement in everyday life is harmful to health, while physical activity keeps the body healthy. Daily exercise for at least 30 minutes prolongs life by up to 5 years, and cycling can thus help to prolong life.” Even as a strong biking city even Copenhagen felt the need to better educate and mobilize its population. As can easily be guessed Denmark has a low rate of obesity at 9.5%.

In “developing” countries of the world obesity rates aren’t the greatest health risk, nor is low physical activity often a common unhealthy lifestyle. The health risks in “developing” countries are often related to access to health services and emergency transportation. Surely this isn’t an area where bicycles can have an impact!

In many low resource setting around the world, Community Health Workers (CHWs) travel from village to village, home to home to deliver health education and services. In many places CHWs rely on bicycles as their only means of getting from one place to another. Bikes Without Borders highlights the work of CHWs in Malawi utilizing bikes to increase their effectiveness and to help more people. Bicycles for Humanity collects almost 50,000 bikes a year and sends them to organizations that distribute them most often to healthcare workers and women. Since women do a majority of traveling in “developing” countries, a bike can help them to transport themselves, water containers, and goods to market.

Bicycles have even been modified to serve as ambulances in areas where there is no emergency transportation. The Bicycle Empowerment Network (BEN) in Namibia has implemented a very effective model for faster transportation where there is none. Drivers of the bicycle ambulances come from local organization and they receive training on use and maintenance.

Whether it is in the post-industrial cities of the US, modern cities of Europe, or in some of the world’s poorest regions, the simplest transportation technology can have huge impacts on the future health of our population.

Featured on the Americans for Informed Democracy Blog, where I’m blogging as a Global Health Analyst.

ambulances run in the family

Lights and sirens, high speeds down the expressway, ER doctor drama on top of insane accidents, not to mention Grey’s Anatomy – behind all the loud noises, dramatic depictions, and hit television shows there is a lot to learn before entering the world of emergency medicine.

On September 1st (the same day Nichole started her MPH classes!), I began an Emergency Medical Technician (EMT) course with Huron Valley Ambulance in Ann Arbor. I have longed to have more advanced medical knowledge and skills and this seemed like the perfect avenue. The story of my medical interests begins with my grandpa.

During World War II my grandpa, Myron Schlott, served as a Navy Medic serving in the Aleutian Islands, visiting Hawaii and Australia, and finally on a submarine. In the above picture he is standing on the right with his arms crossed. Behind him is the ambulance that he drove. My grandpa was an important figure in my childhood, Scouting, and in the development of who I am today.

My grandpa was also a strong supporter of my project to fund an ambulance for a rural health center in Uganda. From that project and my trip to Uganda I gained a serious understanding of the need for emergency transportation and medicine in Uganda and at home.

Since the 5th grade I’ve been first aid and CPR trained through the Red Cross and the Boy Scouts, which included: wilderness survival, back country first aid, and cold weather survival training. Last year I completed a Wilderness First Responder (WFR) course with the Wilderness Medical Associates (WMA) and thoroughly enjoyed it.

I knew this was the right next step for me when my fiancee, Nichole, told me that I was getting excited about taking vital signs and blood pressures. Thankfully I have only had rewarding experiences with ambulances thus far and I can only see it continuing to be positive.

A desire to help others was instilled in me at an early age and I can only imagine that is why I have a strong desire to get more involved in medicine.

How many of you reading this are currently involved in or studying health care, medicine, etc.? What are you doing and where?

hmm, what is this?

Here is the first of many stories:

It all started on a Sunday in July 2000. I was at Mass in the church I had attended all my life, Holy Family Catholic Church, when there was an announcement made that a visiting priest from Uganda would be living in our parish for the summer. He would be offering African drum lessons to anyone who wanted to learn. Since I drummed on everything—including the dinner table, my desk, and the church pew—my mother gave me a knowing look. After Mass, I introduced myself to Father Joseph Birungi and became his first student.

Fr. Joseph spoke with an accent native to Uganda and didn’t always understand my words. But we both understood a smile. We met several times over the summer and he taught me how to drum. But, Fr. Joseph taught me more than drumming. We talked about his home and his people and their great need for basic medical care. He told me of the many deaths of his people due to simple, preventable diseases. He told me of his dream to construct a health center in a remote area of his country. From those lessons, I was inspired to help the people of Fr. Joseph’s community—somehow. I asked him what I could do to help.

Of course, Fr. Joseph was pleased by my excitement and thoughtfulness, but he also knew I was only a 13 year-old boy. As he told me later, he didn’t expect that I would be able to accomplish much. Nonetheless, he decided to dream big. Fr. Joseph said the new health center would need an ambulance and asked if I could try to get one for him. At first, I thought it would be impossible, but eventually I convinced myself I could do it. The Toyota dealership in Uganda’s capital city of Kampala gave him an ordering price of $50,000! I knew that in order to raise that much money I would need a really great idea. I decided to make life-size foamboard cut-outs of Fr. Joe and ask people in my community to “host” him for a day at their home, business, classroom, meeting, or special event. He would come with a “suitcase” containing information about Uganda and the need for the ambulance, a video message from Fr. Joe, a camera to record a picture of the hosts with Fr. Joe for my scrapbook, and a yard sign to show their participation in my project – and, hopefully, inspire others to participate too. I asked each host for a donation to the ambulance fund and a small medical supply.

Many people helped me prepare the supplies and promote the project, although I initially had to overcome my fear of public speaking. I knew that the no one would know about the need of the Ugandan people if I couldn’t tell them. I spoke to service clubs, school groups, and church congregations—anyone who would listen. Thousands of people responded. I collected 20 boxes of medical supplies and raised over $67,000 in less than 4 months.

I actually traveled to Uganda and went with Fr. Joe to sign the order for the ambulance. During my one month stay I met and lived with the people who would benefit from my project. My trip to Uganda left an indelible mark on me and it is an experience I will never forget. All the people I met were so friendly and, even in their poverty, they wanted to share what little they had. I have seen that all people of the world share the same needs and wants. We are really all more alike than we are different. Everyone needs food, shelter, clean water, and necessary health care. We all want to know happiness, health and love. Parents everywhere want the best for their children and children want to learn and grow. But not everyone gets the same chance for success.

My project helped to provide quality healthcare and emergency transportation to those who would otherwise have no place to go and no way to get there. It brought the world a little closer together as my community realized—and met—the needs of a community across the ocean. Fr. Joseph’s dream became reality when the health center opened its doors in April 2003. His health center treats anyone who comes, regardless of who they are or whether or not they can pay. Hundreds of people have been treated and the ambulance has provided emergency transportation to other facilities when necessary. The ambulance also transports nurses to villages far from the health center to teach disease prevention and provide immunizations. Since the ambulance goal was achieved, I have continued to help by raising awareness and funds—largely at my high school—to help ship a 40-foot container of medical equipment from Michigan to Uganda.

I have been privileged to lead a project that has directly impacted many people living in Uganda. Additionally, the project itself greatly increased awareness in my community about the lack of healthcare and other basic needs. Although my original goal was accomplished, I realized that once I made a connection with the people of Uganda, I couldn’t just walk away. I couldn’t assume that my part was over and that someone else would pick up where I left off. I had seen their faces, held their hands, visited their homes, and eaten with them. I know that I saw the faces of people who are no longer there—and so I continue to tell their story and ask for help.

I have realized that working to help those who are in need in the global community is the best way to show that I care. When I traveled to Africa, I came to understand the many differences in culture that separated the Ugandan community and my community. And even though we were physically distanced, I saw how my project brought us together. I know that I need to continue to work to change the world for the better.

Through my project, I also learned a few important lessons about life. One, it is our deeds, not our words, that change and shape our communities and our world. Second, we must all believe that one person can make a difference. Everyone has the potential to make a difference, but who among us will choose to act on that potential – and what kind of difference will we choose to make? Third, we must first believe in ourselves before anyone will believe in us. And lastly, although one person can make a difference, one person cannot make a difference alone – we need one another to succeed. It takes a group of dedicated people to create change. From my own efforts to promote global understanding, I know that YOU, as one person, can make a difference in the world!