Kinya Kaunjuga

Resilience in darkness

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Every vital machine stopped working

By Kinya Kaunjuga

The power blackout was going into its fifth day. It had been a nightmare trying to treat patients.

This was how the clinical officer in-charge, Leonard Loontaye described the effect of El Niño rains on his clinic, Naikarra Medical Center. When he called me, he was staring at the fallen transformer he pictured below.

The power outage resulted from this transformer falling due to intense rainfall.

He narrated what he and the communities around his clinic experienced in the last weeks of December 2023.

Our solar backup power couldn’t keep up with the length of the blackout and every battery had been exhausted. We couldn’t work. I needed tests done to confirm diagnoses and we couldn’t do any lab tests. The laboratory refrigerator went off so samples, specimens, vaccines and medications were compromised.

The maternity sterilizer and oxygen concentrator had stopped working. Sunlight takes a long time to fully re-charge a completely depleted battery.

Fortunately, we rely on BandaGo for our clinic management. As it operates online, we didn’t have any concerns about patient visit records, medicine and supplies inventory data, or accounting information being jeopardized by power fluctuations caused by an unstable grid.

A Maasai boy adjusts a solar light outside his family's manyatta (the name of a Maasai traditional home made with cow dung).

We had to keep one particular patient outside the clinic. It was the only way to isolate her from the other patients before we confirmed whether she had tuberculosis (TB). It could easily spread throughout the entire clinic.

A community health volunteer visiting a Maasai family in their manyatta. The patient who we had to isolate outside the clinic had been sent to our clinic by a community health volunteer from one of the 30 villages that we provide medical care to.

She had been sick for some time but needed to complete her exams which took 3 weeks in her high-school. If found positive for TB it meant everyone around her had been exposed to the bacteria.

We only hoped the community health volunteer had intercepted in time to prevent the student from exposing too many people to the deadly disease.

Since the TB hood was also not working, we had to modify a way to process the patient’s specimen slides manually. It was a great risk to the lab technician but the patient had been waiting for almost 4 hours for the batteries to charge using the solar panels and she was completely fatigued.

The test revealed that the patient had pulmonary TB, and the community health volunteer was quickly notified so that she could visit the patient’s family and school and implement critical public health measures carried out when tuberculosis has been confirmed in a patient.

A biosafety cabinet or "TB hood."

The test results also meant that Leonard Loontaye, the clinical officer in-charge at the Naikarra Medical Center, along with the lab technician, had been directly exposed to the bacteria.

They were keenly aware of the importance of swift and comprehensive actions in the face of a possible TB diagnosis and had put themselves at risk by deciding not to keep waiting for electricity to return to power up their protective lab equipment.

A disease dating back to 8000 BCE

“TB is one of the world’s leading infectious disease killers. Until the emergence of COVID-19, the bacterium that causes TB was described as, “the most destructive pathogen on the planet,” killing more than 4,300 people each day. Despite being preventable, treatable, and curable, this ancient disease continues to kill more people each year than HIV and malaria combined. While a wide range of evidence-based and scientific interventions have been developed to combat TB, due to continued underinvestment and low global prioritization (compared to other diseases), TB persists, resulting in close to 11 million TB cases and 1.6 million deaths annually.” Source: USAID’s Global Tuberculosis (TB) Strategy 2023–2030.

Energy poverty

“Energy poverty can be explained by the lack of infrastructure, well-functioning energy services markets, and sufficient income to afford modern energy sources. Energy poverty in developing countries affects the entire territorial units. The rural and remote areas remain particularly disadvantaged, with no or little access to modern energy sources.” Source: Energy poverty in developing countries: A review of the concept and its measurements, Energy Research & Social Science, Volume 89, 2022.

$5000 helps us improve BandaGo and get it into another clinic

Medical clinics that use our clinic management system BandaGo have one less critical thing to worry about when treating patients in extreme hardship areas.

Thanks to your giving, Banda Health continues to focus on building technology solutions that improve the healthcare provided in medical clinics run by some of the most brave and selfless people on the globe.

Photo credits: Power for All; Solar Aid; Reachout Consortium ‘Implications of community health policy change in Kenya in light of world health worker week’ by Rosalind McCollum; Banda Health.

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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!"

Delivering the chief’s heir in my clinic

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37 Births in 30 Days

By Kinya Kaunjuga

Maasai Mothers. Photo ©Job Mukuria.

She was the chief’s 14th wife. The child she was carrying was betrothed to a distant village to unite two clans and make them a powerful force in land and cattle possession. The stakes were high. This delivery needed to be perfect.

The chief was one of those who had ordered Lemontoi Leonard Loontaye’s return so that mothers and children in the 30 Maasai villages around Naikarra could be treated by one of their own.

"I knew the call would come one day after completing my medical diploma so I didn’t hesitate when they sent the Moran to fetch me from another hospital," said Leonard. Photo ©Bradford Zak.
Leonard Loontaye, the clinic officer in-charge at Naikarra Medical Clinic, seen here using BandaGo on his laptop during a patient visit.

News that a chief had entrusted the birth of his child to scientific medicine was spreading like wildfire and would confirm the flourishing health of Maasai mothers and children being treated at Naikarra Medical Clinic.

A Maasai man is trailed by his daughter as he leaves home to take their cattle out to pasture. This is an example of the traffic Leonard encounters when he travels on his motorbike to treat patients in 30 villages around Naikarra.

“I treat and monitor expectant mothers in Maasai villages spread over more than 100km. Some are so deep in the hills that I’ve shown a few of the villagers how to take a pulse, listen to a fetus heartbeat, count contractions then give me the information by phone so I can tell them if it’s time to begin their journey to the clinic to give birth.

Lemontoi Leonard Loontaye, the clinical officer in-charge at Naikarra Medical Clinic, holding a baby he delivered at 3am on Friday December 1st, 2023. He said it was "a long wait" but was he able to dash home to shower and return to deliver another baby at 8am on the same day.

“From last month, we stopped counting at 37 births after 30 days because they just kept coming! We just entered the records in BandaGo and kept going! Each birth was a perfect delivery. We have not lost a single child or mother. We are so happy. The staff and all the villagers are so happy.

“Even when we feel exhausted by a few who are born after hours of labor and their counterparts then follow right on their heels, we’ve learnt to rush home to shower and change, then return to the clinic to help bring these little gifts into the world.”

Epilogue

While gathering this story, I suddenly lost all communication with Leonard. It was the day after he had spent an entire night in the clinic with a particularly difficult delivery. We had been texting back and forth throughout the night as he gave me updates and I cheered him on.

When he finally resurfaced I gobbled up his words like a thirsty antelope, and decided to share them with you.

“I got a really bad flu over the weekend after that night in maternity. I was in so much pain for 48 hours. It was pneumonia. The weather has been cold. But this is part of our job. I took medication and funny enough I was up in a very short time. I thank the Lord for healing. I was so happy to be back at work to help people again.”

In case you missed previous stories about Leonard, you can find them on our website: “A hero cannot exist in a vacuum,” “Spear guarded patients,” and “A Phone, a laptop and an old land rover.”

Glimpses into Maasai Life...

A Clinical Officer teaches Maasai Morans how to take a selfie

Lemontoi Leonard Loonyate, the clinical officer in-charge at Naikarra Medical Clinic, showing two former patients, Maasai Morans how to take a selfie. They visited him after their passing out ceremony to thank him for carrying out their circumcision operation. He has convinced some of the villages to send their Morans for circumcision at the clinic instead of using the traditional method which at times leads to death from bleeding.

A Maasai Boma

An aerial view of a Maasai boma. It is basically a combination homestead and barn. The buildings around the edges are mostly houses for each of the patriarch's wives, children, and in some cases younger siblings. The buildings are constructed out of cow manure and grass. The center is a pen where the livestock are kept at night to protect them from predators and theft. During the day the cattle will be taken out to graze, as is shown in this picture. The borders are living thorny hedges which they have cultivated into that shape. The entire boma is also surrounded by a hedge to keep out predators. Photo ©Reddit Pics.

Why Banda builds technology solutions for clinics without doctors

Only two of the 86 clinics that Banda Health works with have a medical doctor. The rest are staffed by clinical officers and nurses who make all of the diagnoses, prescribe and carry out all of the treatments, and balance all of the books.

Kenya has a total of 189,932 health workers for its 55 million people. 25,000 of these are clinical officers and their clinics are a lifeline to 38.6% of some of the poorest people in the world. (Sources: Kenya Clinical Officers Association (KECOA) & World Bank using IHBS/SSAPOV/GMD).

They cannot afford medical doctors fees including the cost of travel to reach doctors found in hospitals in large towns. The small medical clinics owned and run by clinical officers like Lemontoi Leonard Loontaye provide life saving primary healthcare where nothing else exists.

We have designed BandaGo specifically as a clinical management system for small medical clinics to use 21st century technology to address barriers to accessing good healthcare for those who live in remote distant rural villages and in slums.

Thanks to you, we can keep building health technology solutions that medics like Leonard and others use. We treasure your continued support because your giving is intrinsically woven into the fiber of every mother, child and patient treated in a small medical clinic that uses BandaGo software and proves that the poor don't have to live without good healthcare. Thank you for another year with Banda Health! Photo ©Tdh/Sandro Mahler.

$5000 helps us improve BandaGo and get it into one more clinic!

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Photo credits: Maasai warrior ©Ferdinand Reus, Maasai mothers ©Job Mukuria, Maasai woman ties shuka by ©Bradford Zak, Baby on scale ©Tdh/Sandro Mahler, Farm in Africa ©Reddit Pics, all other photos ©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!"

Slum night

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Share Everything or Risk Losing It

By Kinya Kaunjuga

“If they rob you, tell them you know me and they might return your phone.” This instruction was part of the preparation for a visit to one of the clinics that uses BandaGo. It wasn’t obvious that the entrance to the road leading to the clinic was manned in shifts by gangs. In fact, everyone was busy.

Children walking back from school dodged garbage to avoid smudging their uniforms, veggie bandas (kiosks) selling chopped kale were now crowded by customers who preferred to skip that step in their cooking prep, and the queue outside the communal bathing stall was growing. I learnt that you can wash your entire body with one 350ml cup of water, the size of a can of coke.

A main street in Mathare slum.
A communal bathing stall in Mathare slum.

What we call a slum, those born there call a ghetto. This means it’s a place where every day is tough to live through and every night is rough. That it’s only different from other places because their homes have no windows and are made out of mud, cardboard and metal sheets pieced together with sticks and stuff. That all their water is fetched from an outside faucet shared by slightly more than 200,000 people, and that indoor plumbing doesn’t exist but one can pay to use a communal bathing stall and toilet that’s emptied now and then.

All this sharing of the most basic things seems to indicate that patience is a critical survival characteristic for a poor person, followed closely by settling on never having space, privacy, or ownership. Adults and children begin to line up for everything from as early as 4 am. As a result, some of the residents make some money by charging to hold a spot in queues to use a toilet, a bathing stall and a water faucet.

Houses in slums have a cloth draped over their "doorways." Since there are no windows, pulling back the cloth allows for light and air. To visit, you announce your knock with "Hodi Hodi?" (Knock, Knock?). Here, these neighbors with white and blue doorways live in a common plot.

As darkness fell in Nairobi, the October night felt utterly still. There was no wind and the air was so hot, it made being indoors feel unbearable.

The cab guy was nervous. I assured him that we would be safe because I had some people waiting for us at a clinic that uses our software. This did not seem to reassure him at all, especially when he recognized the road we would be turning onto since it had featured on the news for months during recent political demonstrations in the country.

An alley in Mathare slum.

For countless days during the demonstrations, Uzima White and his staff had faced complete mayhem. Because his little clinic is in the middle of the slum, there was a non-stop flow of injured people and he had turned parts of it into a medical emergency refuge while continuing to care for regular patients in his small ward.

“At one point I realized we would have to lock the main door to prevent the crowd who were carrying the injured from pushing into the clinic. I was shouting at the top of my voice pleading with them to stop crushing each other but they couldn’t stop in the chaos. So my staff and I would shut the doors, treat those inside and re-open the doors to take the next ones.

A few ambulances bother to get to small clinics in slums. Photo courtesy MSF Nairobi.

“Ambulances were having a hard time reaching the clinic because of the exchange of stones and gunfire, and barricades like burning tires on the road. A 17-year-old’s last words to me when an ambulance finally arrived to pick him up were, “My mother told me not to join the demonstrations.” I had treated him for a gunshot wound that had severed his groin. He died before the ambulance reached the hospital.

“That memory stays with me because I have a freshman and a sophomore in college now. In fact, it affected me more than the gunshots being fired outside the clinic.

“When we would open the door to let the injured in and out, the soldiers would yell, “Doctor, shut your door!” I remember a patient I was examining who kept screaming each time a gunshot went off. She asked me, “Doctor, aren’t you afraid of the gunshots?” And I responded, “What shots?”  She and the others around her looked at me incredulously. I didn’t realize that I had become so used to hearing the gunshots that I didn’t flinch when they went off anymore. It made me wonder if I would have been a better soldier than a medic.”

“Why do you keep doing this Uzima?” I asked. “It’s a call I answered. That the people who live here will at least have some medical care near them.”

$5000 helps us improve BandaGo and get it into another little clinic

Social determinants of health (SDOH) are non-medical factors that influence health outcomes. They are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Thanks to your giving, Banda Health continues to focus on building technology that improves the healthcare provided by small clinics in neighborhoods and environments like Mathare slum.

We can't do it without your help!

So far 86 clinics are using our software in slums, informal settlements and remote rural villages and have recorded 852,000 patient visits to date!

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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!"

Clinics Without Doctors

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Can a medical clinic in a slum or in a remote village really provide good healthcare?

By Kinya Kaunjuga

A nurse completing a government booklet at one of the clinics that uses BandaGo.

In reality, medical doctors are often absent from clinics within slums, remote rural villages, and informal settlements. This absence stems from the inability of residents in these areas to afford the normal fees charged by doctors for their services. Consequently, this void is filled by clinical officers, nurses, and pharmacists who establish and manage modest makeshift setups to offer fundamental primary healthcare.

A nurse immunizing infants in one of the medical clinics that uses BandaGo.

Our software is meticulously tailored to cater to these types of clinics and their patients. Notably, our approach encompasses an all-around feedback mechanism, guiding the creation and design of every improved facet of BandaGo. The intention behind this approach is that one day we will help to ensure that these doctor-less clinics are equipped to provide treatment at par with a doctor’s presence. And that every feature of the system is a useful tool to them.

A nurse using BandaGo on a laptop in a medical clinic.

As our software becomes an integral part of these clinics, it takes on the role of a partner, aiding in inventory management, financial accounting, and, as of a year ago, the capture of diagnosis codes to use in public health government reporting. Anticipating its further utility, we envision it aiding in more precise diagnosis, more accurate prescriptions, and devising follow-up care regimens encompassing areas such as HIV and tuberculosis management, chronic illness management, prenatal and antenatal care, and child immunization tracking and reporting.

The capability to swiftly display a patient’s complete medical history on a laptop, as opposed to rifling through paper records, has a profound impact on enhancing healthcare in resource-poor clinics situated in underserved areas.

A patient leaving a medical clinic that uses BandaGo as their clinic management system. Reporting showed one clinic that 64% of their revenue was from product sales, 36% from services and 4.5% of visits were solely for the purchase of medications. This data enabled the clinic to know where to focus staff time and training.

In November 2021, we set a goal to reach 100 low-resource clinics by the end of 2023.

As of September 2023, there are now 82 clinics successfully using BandaGo as their choice of a clinic management system.

You can empower more low-resource medical clinics with technology.

$5000 helps us improve BandaGo and get it into one more clinic!

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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!"

Rock, Paper, Banda!

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"Even though these interlopers consumed our time meant for our regular patients, we stood strong."

Kinya Kaunjuga

Picture grand seafaring maidens, crafted to brave the relentless surges of high tides. They sail fearlessly through the deepest waters, riding daunting waves with unyielding might. And just like such formidable vessels – medical clinics adorned with the prowess of BandaGo stand tall amidst the crushing waves of adversity – despite their small size and makeshift composition.

Their voyages echo the visions and dreams of the clinic owners, undeterred by the tempestuous poverty that surrounds them. They forge ahead, navigating through uncharted waters of desperation akin to dark storms, yet never succumbing to the challenges they face.

Recently, in some of the places where BandaGo-equipped clinics exist in Nairobi, Kenya, waves of chaos and turmoil surged with violent protests and demonstrations. For their protection, the names of those specific clinics have been left out of this article.

When the protestors and demonstrators found themselves injured, they flocked to these resilient clinics, demanding free care. Forced by circumstances to attend to these agitators, the clinic owners and staff selflessly treated them, knowing that to refuse would bring destruction upon their haven.

With BandaGo serving as a clinic management system, like a sturdy ship they navigated through the unpredictable tides of unprecedented “patients” flooding in. Their well-maintained inventory of medical drugs and supplies handled the surge, leaving no genuine patients stranded.

One brave clinic owner shared their experience, acknowledging the challenge of treating the unruly visitors while maintaining care for their regular patients. Yet, with BandaGo having replaced antiquated paper systems, their survival, sustainability and success was secured, and their ship sailed forward undeterred.

In the face of the rocks hurled during demonstrations, their gratitude lay in the technology solution’s protection. For it is this modern marvel that enables their triumph over adversity, steering them towards a future where the storms may rage, but they will continue to thrive, never to be tethered again by the constraints of paper, theft and medical inventory stockouts, but instead, sailing victoriously with Banda’s robust technology solution as their guiding star.

We simply couldn't do it without you.

We are profoundly grateful for your support. Your contributions play a vital role in helping Banda Health continue to build technology solutions used by frontline medical clinics to care for over 300,000 patients per year. Read more about the amazing clinics and people across Africa that we work with!

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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!"

The Black Belt Nurse Series: Trailer

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Dead siblings, gangs and drugs, sewage and the hope from sports

By Kinya Kaunjuga

Balala "the black belt nurse" works at Uzima White Medical Clinic in Mathare slum where he lives.

In the initial installment of the Black Belt Nurse series, we were introduced to Sheikh Balala, a nurse who works at the Uzima White Medical Clinic where our software, BandaGo, is utilized. Since then, I have maintained contact with Balala and gained further insights about his experiences.

Having listened to his vivid account of his daily activities, I felt compelled to provide you with a preview of what you can expect in the forthcoming episodes of the Black Belt Nurse series.

Alley gym

Balala teaches taekwondo to 100 boys and girls in an alley in the slum. He has chosen this spot because of the availability of a large security light that the school activates once darkness falls.

He utilizes the alleyway for an hour and has structured this initiative as an “after-school” program, aiming to keep the children engaged and occupied, away from the influence of gangs and crime. Balala draws from his personal experience of successfully escaping a life of gang involvement, applying the same principles to potentially save these children from gang influence.

Under the guidance of the black belt nurse, the children take part in tournaments. Ngugi (who is the youngest qualifier from the slum to compete at the national level), can be seen on the far left of the third row, looking visibly exhausted!

As word spreads, parents have become increasingly interested, resulting in a surge in enrollment. Due to his background as both a nurse and a black belt, parents find solace in the fact that Balala can effectively ensure the safety and well-being of their children, even in the event of an injury.

In addition to the prerequisite of finishing their homework before departing for training, he conscientiously invests time in providing comprehensive explanations to parents. Balala ensures that they fully understand the program’s specifics and secures their consent prior to enrolling their children.

Sharing fight gear

Balala buys uniforms which the children share among themselves in a rotating manner. This arrangement is necessary due to his limited financial resources, which only allow him to acquire a certain number of uniforms.

The uniforms have gained widespread admiration within the community and among the children’s families, as they appreciate the sense of discipline and belonging associated with them.

Wearing these uniforms represents discipline and being part of something constructive, counteracting the associations of poverty and hopelessness experienced in the slum.

Occasionally, the rotation schedule for the uniforms is subject to negotiation. Clever children engage in bargaining with the next person in line, striking deals to retain specific items. For instance, they may convince the next wearer to take only the pants, while keeping the shirt and belt for themselves to be worn for a few more days to prance around in the neighborhood! This resourceful approach ensures that the uniforms are utilized effectively and enjoyed by all.

Wizeck and Ngugi

I refer to them as Balala’s protegees, as they have made the conscious decision to steer clear of gangs and pursue a path of personal growth and improvement through the practice of taekwondo. In a place where trust and loyalty is everything, they have trusted Balala and he has aided them in participating in tournaments where they have astounded many by emerging victorious.

When I asked about this immense responsibility, Balala said, “Because I live by His will and not mine, I pray that God would raise the standard of my life just a little bit. I pray that He doesn’t give me too much or too little, but just as much I can manage.”

From left to right: Balala, a new friend, and Wizeck in an agility and balance test during a taekwondo conference.

During a conversation with Wizeck, Ngugi and Balala, they recounted a remarkable journey – they endured a 4 hour and 48 minute ride in the back of a truck – traveling from their slum in the city to a distant town. Their determination was unwavering as they sought to attend a training camp conducted by a renowned Kenyan taekwondo grand master from Japan.

Although they knew they could not afford the seminar fee, once they arrived their plan was to request permission to sit near the wall and observe the maneuvers they aspired to learn. How this and other stories unfolded will be in our upcoming newsletters.

You can empower frontline teams with technology

“We are all human beings of the same race. We have the same blood. And if you ever have the chance to help wherever you can, please do. Help is by one’s capability. Because we cannot all be equal, equilibrium can be found if we treat each other equally. This would be the way to handle the widening gap between the rich and the poor.” Sheikh Balala – Nurse at Uzima White Medical Clinic in Mathare slum, Nairobi, Kenya.

Uzima White Medical Clinic is open 24 hours a day with 15 beds and 22 staff and they have used Banda’s clinic management software, BandaGo since 2021. They treat over 200 people per week.

Our work wouldn’t be possible without your support. Thanks to you, there are now over 80 frontline medical clinics using BandaGo in 3 countries across Africa.

$5000 helps us improve BandaGo and get it into another clinic

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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!"