Blood, sweat, and gears: how a charity bike ride ended in a hospital visit (in a good way) But what if signing up for a charity challenge was both fundraising and fundspending? What if you finished the physical trial and followed it immediately with a psychological one? Some might say it is philanthropy tourism; that when a group troops into a hospital ward to photograph malnourished babies and post them on Instagram, it can never be a good thing. I wasn't sure myself what I thought until I went to India with Action Against Hunger Hunger (its slightly confusing acryonym is ACF - Action Contra la Faim being the name of its first headquarters). This international NGO works towards ending child hunger, worldwide. It has head offices in Britain, France, Spain, the US and Canada, and thousands of field workers in 45 countries, and has been operational for 30 years. To my shame, I only learnt of their work through my side job as this supplement's restaurant critic - AAH does a lot of work with chefs, restaurateurs and the food industry and the London team invited me to take part in "Too Many Critics," a fundraising dinner at which the writers cook for the chefs... But if I thought that was pressure, it was nothing as to what I experienced looking at the itinerary for the Rajasthan Cycle Challenge. This endeavour was a first for AAH - they would take a group to India on a 450km sponsored bike ride over five days, followed by a field visit to where the region's most malnourished children struggle to survive. Like I said, a physical and psychological trial in one. 1 September The first meeting of the group taking part, at the delightful north London pub The Drapers Arms; its proprietor Nick Gibson has signed up for the ride and is already well on the way to his £10,000 sponsorship target. There are 19 of us, and three Action Against Hunger staff, going to India - and those who know each other swap stories about training, the benefits of gel saddles and who's had which innoculations. It appears that male chefs, of whom there are several, are the most likely to have gone tearing into training. Duck and Waffle's Daniel Doherty is regularly clocking 100km rides, Tom Hunt of Poco restaurant in Bristol has yoga-honed muscles and Jose Pizarro (whose eponymous Bermondsey restaurants are long-term AAH supporter) is a recent but very enthusiastic convert to the two-wheeled life. I, meanwhile, am hotly debating with chef and food writer Gizzi Erskine what we do if we need a pee by the roadside. We decide to fashion modesty skirts for over our padded shorts. And Tina Dimelow, who works at Ed's Easy Diner is here because she won her place by raising the most money in her organisation for the charity. Talk about in at the deep end ("the longest I've ever cycled is three hours," she later confides). We are swiftly silenced by a briefing from Charity Challenge, the organisation which will facilitate the trip, and AAH's Christine Kahmann. Details of the terrain are left deliberately vague, I feel, but on everything else, there is no room for doubt. We must adhere to the charter of principles, and go into this understanding what we are here to do. That means no political showboating, no giving to beggars and no disrespectful behaviour. To foodies whose contact with the charity has most often been at raucous wine auctions and gargantuan feasts, this is, literally, sobering. And let's not lose sight of the facts. India, despite being a country that's rapidly growing its economy, has more malnourished children than anywhere else in the world. It is the underlying cause of death for 54 per cent of its children under five; one dies every eight seconds. There are eight million children suffering from Severe Acute Malnutrition (SAM) there. If those figures are mind bogglingly huge, here are some smaller ones. Just £15 will give a seasons" worth of seeds and agricultural training for a family; £42 is enough to save the life of a SAM child with nutritional treatment and get them healthy. Our personal pledges to raise £5,000 will mean each of us saving 120 children. We are galvanized. 5 October Been invited to cycle the infamous Box Hill to help with my training. The snag, it's with Sir Chris Hoy. Well, not snag exactly, but I am by no means up to such an undertaking. I volunteer Dan who's the only person I know capable of keeping pace with an Olympic champion. He comes back buzzing and with tons of advice about training and nutrition (and some Science in Sport gels, tablets and a water bottle, all of which will save my life later on). Read more: Sir Chris Hoy's nutrition tips for cyclists Meanwhile I have been training by tooling to and from work on a most elegant Electra Cruiser, which with its wicker basket and retro-groovy styling is about as far from what I'll be on in India as its possible to get, but frankly if I can propel this hefty two-wheeler uphill after a long day at the office, that's got to help... 11 October Six weeks and varying degrees of preparation later, the trip commences. This being the age of Twitter updates and Instagram oversharing, I've seen who's been bruised and who's got buff; also the tally of who has got the most donations. Because I'm along as a reporter and not for the entire 450km (blame the day job, from which I can't take off two weekends), I haven't trained as much or raised as much as the others, but I'm determined to do my bit. Day one sees Team #indiacycle - which includes two couples not in the food industry but who are supporters of AAH - clamber into their shorts and logo-ed lycra cycling tops and set off, from the Taj Mahal, no less. I'm pining back in London. 12 October Up at 5.30am to get to Heathrow for flight to Abu Dhabi, then onto Jaipur to catch up with the rest of the team. I struggle to put my hand luggage in the overhead locker - with a saddle, pedals, helmet, SPD shoes, padded shorts and Vaseline, it's heavier than my main suitcase. Thanks go to Etihad for an upgrade when they heard about the charity's endeavour. Time alone to think about what's ahead and read up more on AAH. We are closer than ever to ending child hunger - there is enough food in the world for everyone and malnutrition is treatable and preventable. But malnutrition, so rife in India, is not the same as hunger. It's a disease - the stomach cannot tolerate or digest food. It can only be treated with medically formulated nutritional feed. My knowledge gap needs bridging before I get to the villages and see SAM first hand. 13 October Arrive in Jaipur at about 5.30am... As I get through customs, an official calls me back. Why have I put "various" as my address in India? I try to explain that I don't actually know where I am going, this is a cycle ride and the stops are very small areas and towns. Fear of the unknown strikes me, not for the first time. Drive to Ranthambore National Park to meet the others, who are cycling there from Karauli. Sometimes the roads are really bad and I imagine what it's going to be like tackling them on two wheels, while avoiding the oncoming juggernauts and meandering sacred cows. I try not to feel nervous about meeting everyone. I'm all fresh and showered and they've already tackled about 250km in three days. They arrive, hot and sweaty but buzzing after a huge ride. Wow, so much energy. I listen to the stories long into the night: there have been tears and elation to manage, potholes and cows to swerve. "Everyone's been in pain but they're doing it," notes Dana Elemara, the food entrepreneur who back home doesn't own a bike. Being in a group pushes you further. I wake up in the middle of the night in the tent I'm sharing with Gizzi, disoriented and jetlagged. Did we really have Indian shepherds pie for dinner? 14 October The weather has "cooled" to 36 degrees and the Charity Challenge team, led by the indefatigable Sian Everingham, has sensibly built in a mid-trip treat of a mini safari. This pain and pleasure motif is crucial to the success of an undertaking like this. Whether you've been to India many times (or, like Alfred Prasad of Tamarind, Indian food expert Anjali Pathak and designer Jamsheed Todiwala, have family connections) or a complete newbie, it's still an assault on the senses. We don't see any of the famous tigers on our jeep ride, but we do see plenty of monkeys... and a 7ft python. A pre-ride lunch at a truckers" café - tandoor-fresh rotis, dhal and a spicy cauliflower dish. They just keep bringing it till we say stop (my kind of carb-loading). We get onto bikes and almost immediately the road is blocked by a fallen tree - resourceful locals arrive with saws and drag off precious firewood. Just a few miles further on, there's a burst water main to navigate. In a country where clean water is at a premium, this might be inconvenient for us, but it's disastrous for the community. The riding is brutal. A combination of heat, dust, dangerous roads and long distances takes its toll. Sometimes I find myself without a team member in sight; just road and road and road. I ask Laura Hazel, who is here with her husband Graham being adventurous and making a hefty financial contribution, what her high point is so far. "Every day, when I get off the bike" is her rueful answer. Only about 20km left, but we go through a town that's all heat and dust and mud and gravel: there are tuk tuks, cows, vans, motorbikes everywhere - we must keep our wits about us. While crossing a dual carriageway I have to stop suddenly and can't unclick my shoes in time. SLAM, a smashed-up knee. I get back up and keep going, trying to rub hand sanitizer into the wounds as I go... Late that night, I sit on the terrace with food writer and long-time AAH partner Bill Knott, and chef Tania Steytler. We talk about some of the terrible things Bill has seen on previous field trips. His passion for fundraising is infectious and I go to bed more exhilarated than exhausted. Nitesh with his mother in Baran District Hospital 15 October Wake at 4am with churning stomach. Gizzi looks after me wonderfully, fetching water so I can take Immodium and start on Dioralyte. Sian arrives with a huge medical bag. She feels my head and looks concerned - we are supposed to be on the road at 7.30am latest. The drugs kick in and I get dressed in my cycling gear and pack my bags; drag myself downstairs. OK, let's roll. But before long I have to flag down the support vehicle and photographer Tanzeel Ur Rehman and Jamsheed (out of cycling action for medical reasons) leap out. The bike's wheels are speedily detached and we are back on the road, me curled up and grey in the back. At one point I'm dimly aware of rain. A few kms from the finish line I get off the bus to join back in - everyone cheers and claps which makes me cry. We race off and up a fairly steep incline. My muscles kick in instinctively; I can hear Indian music and suddenly there's a banner and Sian and the cameramen and we turn into a beautiful garden to be greeted with cold beers, a traditional Rajasthani picnic and a medal ceremony. Our mountain bikes are stripped of any kit we customized them with, and are whisked away. From here on in, it's all engine-powered travel. Our weary legs, tender skin and numb hands (an ailment I wouldn't have predicted, inevitable from gripping the handlebars along pitted surfaces) can have a chance to recover. Ben Maschler, a major force in linking the charity with the food industry (and all-round forcefield of positivity and wit on this trip) stretches out to doze on the grass. He's done the entire 450km in Birkenstocks. We've had some wonderful dosas and thalis, dhals and parathas (which doesn't stop us all falling on a huge bowl of chips that arrived at one guesthouse), and at each stop on each day's grueling ride, a team had gone ahead to set up fresh water supplies, bananas, chocolate, nut brittle and assorted other fun fuel to keep us going. We are lucky to be so well looked after. Transfer by coach to Jaipur city centre and to the Diggi Palace. Dinner is a Rajasthani feast on the lawn. Or was supposed to be... torrential rain and thunder arrive. Everything moves indoors, and a small band and women dancing with water containers on their heads entertain us. 16 October Gather up all the sneakers left to dry in the morning sun after last night's deluge. It's goodbye to the cycling support team, led by the helpfully charismatic Matt, and onto the coach we go. It's going to be a long one, six hours, to Kota, the nearest town of any size to the projects in Baran district. Once there, any grumbles about sharing beds, never mind rooms, are put into perspective by the presentation by Thomas Gonnet and his team that work on the ground here for ACF. By the end of the short film, Gizzi and I are both crying and several others look very distressed. My group will see a malnutrition treatment centre in action. We ask Thomas what happens if we burst into tears while seeing a desperately malnourished child? That impotent reaction is of no use to anyone. He is reassuring: the family themselves will have been upset but have to go on with their lives. Thomas may just be AAH's best weapon: persuasive, determined and with many years in the field (he has run 23 AAH programmes around the world). When he talks, you listen because his knowledge is undeniable - as a less-than-helpful doctor at a local hospital later discovers. 17 October We thought we'd like to get involved and see where the money ends up. So says Peter Nagle, a perennially cheerful man who with wife Sharon is a keen benefactor of AAH. He's with our group as we set off for the Malnutrition Treatment Centre in Baran District Hospital. It's certainly been a huge shift, from geeing each other up along the roads to sitting in quiet contemplation as our car approaches the hospital. I'm nervous but energy is high - this is what we're here for. We're met by the hospital director who steers us through dark corridors and to a new ward, open for just two months. It's light and airy, at least, but nevertheless quite heartstoppingly sad. From the 20 beds women gaze out impassively, each with a tiny shape motionless on the bed - some have an older sibling there too. I'm surprised to see two dads here - we'd been warned that the men are often against their wives "leaving" their families and work to bring a sick child to the hospital. One little girl is very unsure but when I say "I love your earrings" and touch my ears, she beams. I have goosebumps writing this. Any anxiety I had of losing control and crying is gone. It's hard to put in words what I feel... utter hopelessness at the filthy dressings, the flies, the listlessness of a very, very sick baby. The first boy we meet is 18 months old but looks half that. A doctor demonstrates the upper arm measure of malnutrition and his little arm looks like it might snap; it is covered in downy hair. We've been told not to take pictures but one family, watching me move around the room, signal their agreement when I gesture. I wouldn't have forgotten them anyway, but the picture of little Nitesh in his mother's arms is a powerful reminder. Outside, Sharon Nagle is silent. I felt quite angry, actually. I've worked in the health service and when I saw the level of hygiene ..." She shakes her head. Doctors should know better. Later Peter tells me what he'll take away from this trip. What the charity needs to do is to figure out a way to maximise the impact, because what's needed here is the ammunition to make a difference; a call to action. In the car on the way to a remote village where six weeks ago Thomas Gonnet identified a child as having SAM, he lays out the challenge in stark terms, repeating the exchange he had in front of us on the ward with the doctor who wanted fewer visitors and more money. "I've seen a boy three times admitted to the centre and three times discharged after getting the "necessary" 15 per cent weight gain. Now he's dead. He must have seen so much over the years, but his eyes blaze. Yes the families do wrong, and need educating, but the healthcare professionals must do better. And they're not trained in how to treat malnutrition. And the government must review its policies. It's along very dusty, unmade roads for some time and then we go off-road completely, across rock-strewn fields. These terrible conditions lay bare how hard it is for these people, most from the Shariya tribe and in bonded labour, to get help. Under the watchful eye of her mother-in-law, Somi crosses her neatly swept mud yard. Behind a purple veil, she holds Ramdas to her and then, coaxed gently by an interpreter, she talks about what happened. And Gizzi uses her considerable warmth and charm to make her feel comfortable on camera (for a film to be shown a later fundraisers). Somi, who doesn't know her own age, knew Ramdas was ill with diahorrea and worried that he would die, but it was only after a health visitor (supported by AAH and its local partners) told her he must be taken to Baran to the centre, that things changed. And only because relatives taking a child to hospital will get money to replace lost wages, and food, during their stay. They will receive ongoing checks, and a food basket to make sure Ramdas - or his three siblings, or his mother herself - doesn't slip back into malnutrition. I'm horrified to hear, as we leave Somi, Ramdas and the 400 or so villagers behind, that a major cause of SAM is the traditional belief that colostrum milk (the first breastfeed a mother gives a newborn) is "dirty" and "old." This idea, coupled with a punishing workload for women, means the most natural and effective way to build up a baby is not used. To my relief, once Somi felt comfortable we had seen that she was breastfeeding the boy, who has just turned two. Dr Shivangi Kausik explains that even very young children are given unsuitable food, dirty water, even tobacco to quell hunger pangs. It's desperately sad but as our next stop shows me, this is not neglect, but ignorance. Mothers being able to bond with their children is the key: we troop into a village gathering to sit with the women (the men observe from the sidelines) and help them draw pictures of breastfeeding. For many, it's the first time they've ever picked up a pencil. This is not easy for either side: Dan, Jose, Ben, Tom all feel uncomfortable drawing breasts for this shy, cut-off audience. My lack of artistic skill can't be a barrier, and soon I'm churning out simplistic sketches, for the women to colour in with crayons, a source of excitement in themselves. It's with enormous reluctance we leave the village, and we don't have time to take part in baby massage, another initiative to help bonding. The long drive back to our hotel in Kota passes with uncharacteristic quiet. No one goes straight to bed. We need time to decompress from the day - and to share what we've seen. Nevertheless, a plan to visit the strange miniature versions of the world's greatest buildings, which we passed on the way into town, has been quietly dropped. I eventually go to bed thinking of little Nitesh. 18 October The long return to Delhi. By now our team has fully bonded, and we quickly fall into groups for chatting, playing Scrabble, charades, word games, listening to tunes with headphone splitters, and dozing. Just as well, the journey ends up taking 16 hours. I sit for a while with Pascal Aussignac, the quintessentially French chef of the Club Gascon group of restaurants. I find him in a reflective mood. On the first night I was in agony. I asked myself "what am I doing here?" After yesterday, I know what I'm doing here," he says. The field trip felt like time travel back 200 years, but we're jolted back to 2014 with Delhi's cacophony of hooting scooters, bellowing hawkers, and an endless throng of crowds. Battle through to Jyoti Mahal, our guesthouse and head straight to the roof for one last meal together. Our long table buzzes with anecdotes and applause; another loop on the emotional rollercoaster this trip has been. 19 October As I cram my cycling clobber, including a filthy ACF top I'm rather proud of, into a bag, I wonder when I'll use it again. I've been more vocal about this than almost anything I've ever done - tweeting and instagramming from the trip to drum up sponsors. It'll be odd to be neither training for or taking part in this adventure. This trip, we hear as we prepare to leave Delhi airport, has hit its £100,000 target. Not everyone can take the time or raise the money to take part in this kind of trip, but they can do something different, closer to home, and make a big difference here. But it's the combination of the physical and the psychological that has had the most impact, for us at least. We are now all ambassadors for the charity, which means long-term help for a long-term problem that needs long-term solutions. Philanthropy tourism? I duck out of the luggage-carousel goodbyes with the rest of the team and dash to my family, waiting at arrivals. My daughter pelts towards me in tears. I hold her tighter than I've ever done before. For more information, visit actionagainsthunger.org.uk If you're moved to donate, please visit rajasthancyclechallenge.everydayhero.com/uk/lisa-markwell Thank you to Etihad, who placed me in business class when they heard about the charity's endeavor, to Science in Sport for supplying energy bars and tablets and to Electra Bikes, who lent me a cycle to train on.