Commute by bike to stay healthy - the Zambian way

The British Medical Journal published the findings of a huge research project last week comparing health outcomes for people in the UK who travel to work in different ways. They found that the 2% of people who regularly commuted by bike had a 40% lower death rate, a similar reduction in cancer deaths, and less than half the risk of dying of heart disease.  Regular walking commuters also had reduced risks of dying from heart disease.

Obviously some of this difference may be because the cyclists are healthier in the first place, but the differences are huge, and very statistically significant (i.e. very very unlikely to be a chance finding). So the potential benefit to the health of the UK from a large increase in ‘active’ commuting is massive. But how can this be done.

In rural Zambia, almost all journeys to work are on foot or by bike. The mass of cycling and walking commuters on the roads in the morning and evening would gladden the heart of any public health doctor.  If only the UK population would do the same. The difference is also very obvious when one looks at the muscles on display. The glutes, the six packs and particularly the back muscles of most Zambians would be the envy of many a pilates instructor.

So how have they managed to achieve this situation? And can we copy from them?

First of all they have very little alternative! There are a few cars that operate as taxis but they are unaffordable for the majority. Secondly, they have really taken on the bicycle in the last ten to fifteen years. They can buy cheap new bikes from china for $70 or so, and recycled bikes from the US and Europe for even less. They are used as much for transporting goods (especially huge bundles of firewood) as people.  The bicycle is ideal here as the terrain is pretty flat and paths between the tiny villages on the clay earth make an excellent flat surface.  There are also few people who live more than 10 km from their work.

So many of us cannot really follow their example.

Unfortunately it seems more likely that they are beginning to follow ours!

If you do have an office job in Zambia, or work for example as a safari guide, you will be sitting down most of the time, and there are very few opportunities to take recreational exercise unless you are young and fit enough to play for one of the many football teams. So economic development seems certain to worsen the outlook here for the ‘Diseases of affluence’, and we do often see slightly overweight office workers or housewives with pot bellies and diabetes and high BP.  And the toll from these diseases in terms of Strokes and Heart failure is bad now and certain to increase.

We have just finished “National Health Week” in Zambia. One of the daily messages sent out to everyone with a mobile phone last week was ‘Exercise 3-4 times a week to reduce your risk of Heart Disease and Diabetes.’  Pretty hard to understand if you are subsistence farmer! And hard to understand in a society where for most people physical exercise is work, and rest is physical rest.

So the image of happy cycle commuters is great, but we cannot learn from Zambia how to get there. They may learn from us about the dangers of a sedentary society, but it will be a hard lesson.

The positive images we can try to follow, are those of Amsterdam and Copenhagen, where bikes exceed cars for commuter journeys.  To get there we just need to invest massively in cycle infrastructure,  regulate or tax car commuting, and get employers onside in terms of secure bike parking etc.