Peekaboo & melting plastic

By Kinya Kaunjuga

The drunk patient’s wife was yelling at the top of her voice. She was clearly fed up with her beloved husband who seemed to have taken a considerable liking to the bottle. He had been found asleep by his oldest child who had ran to find his mother in the market after his father didn’t respond to a thorough shaking.

It turns out the patient’s father is a renowned businessman in the slum and word quickly spread that his son had been found dead drunk this time round. He stood despondently by his son’s side, cringing whenever his son’s wife spoke loudly enough for everyone in the small clinic to hear. Everybody knew the unfolding scene would be the highlight of conversation in local bars and around dinner tables that evening.

Bars and restaurants in slums are where food and drink are cheap and the only thing that's rich are the stories.

The receptionist kept playing a game of peekaboo with 2 year old Julie while greeting patients. It was obvious she was distracting Julie because her mother was visibly in discomfort and pain. They looked like they had walked to the clinic. Their clothes, hair and shoes were covered in brown dirt. Julie was holding onto a piece of bread that looked hard and dry.

Her mother seemed too worn out to mind her so Julie would nibble her piece of bread and wrap it back in her little green blouse as if storing it for as long as it could last.

Winter, who was playing with Julie, has been the receptionist for 3 years at Space Care Health Services in Mtego slum, Nairobi. She's pictured here using BandaGo, our online Health Management Information System (HMIS) customized for small low-resource clinics located in slums, informal settlements and distant rural villages.

Despite the haphazard appearance of the clinic, the staff carried out tasks with poise and calm, coordinating their movements throughout the tiny reception, triage and consultation spaces that made up 20 feet. Their obvious time-honed rhythm of task execution and their friendliness reassured waiting patients that care was happening and treatment was taking place.

The dust blew in through the windows coating everything in its path while the sewage-laced breeze flew in right behind it. Those who were seated repeatedly lifted their legs to cool their thighs from the scorching plastic chairs that appeared to be on the verge of melting.

The fenced perimeter and street outside Space Care Health Services in Mtego slum in Nairobi, Kenya. They've used BandaGo to manage their clinic since October 2019.

It’s good that Julie had something to keep her occupied while her mother waited for her turn to be treated because Diana had been diverted from the regular patients to resuscitate the emergency case of alcohol poisoning. The clinic was awash with excitement. Those visiting Space Care that day were preparing to tell their versions of the case of the slum landlord’s drunk son and his belligerent wife which was destined to be irresistible gossip.

Prologue

For two weeks, Space Care Health Services, tucked away in the Mtego slum of Nairobi, Kenya, unexpectedly found itself without their clinical officer (CO), Diana Ayabei.

Led by the unyielding dedication of Winter, the ever-vigilant receptionist, Peter, the jack-of-all-trades: cook, cleaner, security guard, and Daisy the compassionate nurse, they ensured that patient care remained uninterrupted, embodying the clinic’s commitment to serving the community.

Daisy the nurse and Winter the receptionist at Space Care Health Services located in Mtego slum in Nairobi, Kenya.
Peter preparing meals for both patients and staff in the kitchen at Space Care Health Services, situated within the Mtego slum in Nairobi, Kenya. Over the span of 8 years, he continues to fulfill multiple roles, including cooking, cleaning, maintaining the grounds, and serving as a security guard.

Diana’s lethargic movements were visible to everyone, and one patient jokingly remarked, “Daktari (doctor), are you pretending to be sick to avoid treating us all? The crowd seems overwhelming today.” Amidst the banter, she realizing the concern behind the joke and discreetly informed her staff that she was going to take a quick nap in the maternity recovery room.

The maternity recovery room and maternity ward at Space Care Health Services in Mtego slum, Nairobi, Kenya. This is where Diana, the owner and clinical officer (CO) tried to take a short nap while she was feeling unwell at work.

It felt like she had just put her head down when a knock informed her she was needed back. She continued attending to each patient well into the late hours of the night, a routine that had become the norm for her as the owner and only clinical officer at Space Care. However, upon returning home, exhaustion overcame her, and she collapsed.
 
Witnessing her deteriorating condition, her husband rushed her to the ER, where she was admitted to the intensive care unit for a grueling 14-day stay. Three days prior to her discharge, she reached out to me and expressed her conviction that she had felt her life slipping away, her breaths growing increasingly labored, pleading with the hospital staff for oxygen. When she regained consciousness hours later, she was tethered to a ventilator, a stark reminder of the fragility of life and why she does what she does to care for some of the poorest patients in the world in her little 20 foot clinic.

Diana is pictured here back at work in her consultation room which doubles as Space Care's pharmacy. In this photo, she's telling me about a recent feature she likes that's been added to BandaGo. After a near death experience from a severe asthma attack on January 23, 2024 which led to 14 days in hospital, she now wears a heavy coat on her boda boda (motorbike taxi) commute to and from work.

With your help, innovation is transforming healthcare access in slums, rural distant villages and informal settlements in sub-saharan Africa.

A glimpse at the number of people Diana and her team treat in a single month:

Total patients treated: 1,083
Regular treatment: 435
Child & infant wellness treatment: 346
Family planning treatment: 180
AIDS & HIV treatment: 122

By using BandaGo clinic management system, Space Care Health Services can keep track of the specific type of care that people living in Mtego slum require. (Stats: November 2023).

Thank you for doing this with us.

Photos: Copyright Banda Health.

Picture of Kinya Kaunjuga

Kinya Kaunjuga

Kinya brings passion, an infectious laugh and 15 years of experience in the corporate and non-profit world to Banda Health. A Texas A&M alumni with a degree in Journalism and Economics, she says, "I love doing things that matter!"