Outgoing Médecins Sans Frontières Chief Writes To Us From The Road.
We wrote last month about Unni Karunakara, who until September this year was International Head of the humanitarian medical aid organization Médecins Sans Frontières. Mr. Karunakara is enjoying all his recently gained free time by making a fundraising bike tour through India and attempting to raise public awareness of MSF along the way.
Putting down hard daily centuries like nobody’s business since early October, he kindly managed to get back to us this week with answers to a few questions we had for him as he set off.
Unni, why are you using a bicycle for this trip?
A bicycle is the most accessible of all modes of transportation in India. It allows you to travel through villages as well as navigate India’s crowded urban streets. Using a bicycle for this trip will allow for more interactions and will hopefully foster the kinds of discussions I would like to have with people along the way.
What kind of physical preparations have you made? We’ve read elsewhere that you cycle recreationally, have you done much long distance cycle touring before?
A team of sports medicine professionals from “Sporting Ethos” have helped me prepare for this trip as well as providing physical therapy support during the tour. The focus has been mostly on core conditioning and endurance training. I have also been advised on nutrition and diet while on the road, aimed at maintaining fitness and facilitating recovery.
This 5,000 km trip is by far the longest cycle tour I have attempted. In 1988, I was part of a Himalayan Cycle Expedition that cycled 2600 km and reached an elevation of 5694 m.
Can you tell us a little about the equipment you’re using? Are you on a new bike, i.e. a different bike from the one you usually ride? If so, what kind of bike do you usually ride?
I will be using a Schindelhauer “Unnicycles Tourer”, a customised version of their Ludwig XIV model. It has a triple butted aluminium aero frame and is equipped with a Gates Carbon Drive centre track belt and a 14-speed Rohloff Speedhub. The tourer has been fitted with Tubus high-strength stainless steel tube carriers, and a SON dynamo from Wilfried Schmidt Maschinenbau powering head and rear lights as well an USB port. The tyres (Cycle X-King 32x700C) and tubes are from Continental. It goes with out saying that these bikes have the best saddles (B17 & Team Pro Titanium), waterproof panniers (Land’s End and John O’Groats) and other gear (Challenge large tool bag, Cornwall handlebar bag, Oxford roll-up cape, and slender grips) from Brooks.
The folks at Schindelhauer have been very supportive and have spared no effort in putting together a bike just for this trip that is durable, reliable, and easy to maintain. My other bike is a Schindelhauer Siegfried single speed/fixed gear which I love for its minimalist look and for its no-nonsense functionality.
The MSF awareness raising group ride which Unni organized on his way through Delhi.
Is there any area of sports cycling that interests you (more than another)? Just from a spectator’s viewpoint.
I have to admit I am not a big sports cycling enthusiast. Cycling for me is more of way-of-life that builds in physical activity and energy efficiency into every day life.
When you were a child, was there a particular bike you wished to have? And do you remember much about your first bike?
A Raleigh “Sports” three-speed bicycle.
I do not remember much about my first bike. If I am not mistaken it was a BSA single speed.
Will you be camping much? Or at all?
I am not planning to camp at all. I hope to find lodges or other accommodation along the way. MSF has been generous enough to support the “Unnicycles” tour and I am being accompanied by a logistics team and a film crew, in a caravan with a spare bunker that I can use.
You’ll be riding through rather extreme changes of altitude and weather over the course of your trip. What kind of stopovers will you be making, and what will you be doing? For example, will you be riding for a couple of days consecutively and then staying at, say, a field clinic for a day or two, then hitting the road solo for another couple of days before another stop?
Yes, I will be cycling and occasionally staying over for a day or two for rest or for meetings and discussions I have planned with medical students and others. For example, the first stage from Srinagar to Gurgaon lasted 19 days during which I took two rest days in Jammu and Delhi, spoke to medical students in Srinagar and Ludhiana, and took part in film screenings and discussions at the Alliance Française in Chandigarh and Delhi.
Unni’s short-hop Schindelhauer Siegfried also has Brooks leather at the points of contact.
You may find yourself pretty far from a bike shop at some point, how useful are you with a spanner and a set of allen keys?
I can attend to some of the basic repairs that need to be done. In September, I spent a day at the Schindelhauer studio in Berlin getting to know the bike and being schooled in the art of bicycle maintenance.
Tell us about some of the chief challenges that face an organization like MSF. Funding? Personnel? Big Pharma?
There are two main challenges faced by MSF when carrying out medical humanitarian work. Firstly, we face incredible challenges in reaching and providing assistance to people most in need around the world. For instance, in countries such as Syria, Somalia, the Congo, and Myanmar, governments and community leaders stand in the way of people receiving the health care they need.
Secondly, in places where we do reach vulnerable people, the challenge is to ensure that patients have access to affordable good quality care. Global trade interests and practices often prevent life saving medicines from reaching the poor in many parts of the world. For instance, big pharma companies have failed to develop new therapies for poor patients suffering from parasitic diseases such as chagas or sleeping sickness and for paediatric HIV/AIDS.
Our ability to reach disaster-affected areas within days or to deliver health care to those affected by conflict is largely down to our financial independence. Today we have 4.6 million individual donors around the world who support us financially. During this tour, I am looking to raise awareness of medical humanitarian action and to raise funds for MSF.
In your time as head of MSF, is there one particular positive change (in the general area of humanitarian medical work) you’ve managed to help bring about that you are more proud of than anything else?
It is not easy to think about positive changes in the area of medical humanitarian work. We constantly try to improve the quality of care that we provide in our programmes. In many instances, models of care developed by MSF in various parts of the world have been replicated and scaled up by governments and other organisations. The past years have however been challenging for medical humanitarians. Health workers are increasingly being targeted for the care they provide from Syria to Myanmar. Undoubtedly the worst moment of my tenure was the decision to leave Somalia, after 22 years, leaving many parts of the country with no health care.
The start of your trip coincides with the finish of your tenure as International President of MSF. If this extended tour of India goes well, what would be the next country or region you’d like to cycle through as an MSF ambassador?
I have not much time to think of it. I have received enquiries from Greece and from Japan though, for me to do similar tours to raise awareness about medical humanitarian action.
And where would you like to ride if your MSF capacities weren’t a part of the equation?
I have been thinking about cycling around Iceland for a while now. The terrain and the extreme weather conditions however are daunting.