Black Belt Nurse

"I was multi-tasking, asking the lady to push, and trying to stop the bleeding on the gentleman."

By Kinya Kaunjuga

He couldn’t decide which experience had been more difficult. Trying to stop the bleeding from a man’s head in the clinic while delivering a baby beside him, or holding Ondieki’s abdomen together in the street because he had been stabbed 17 times and no ambulance could get past the ambush set up by gangs.

He was shocked to witness the gruesome acts on human life. After all, he was right out of nursing school. He and Uzima had been dealing with non-stop emergencies in the days following a presidential election that had brought a tribal war to the slum. 

He was not afraid, he was terrified. He knew being a second-Dan black belt made him impervious, but he was also keenly aware the ghetto was a fierce place. Persistent hunger made angry and fearless contenders out of its residents.

Balala, the black belt nurse (left), facing an opponent in a tournament.

Over the past five years, 26-year-old Balala has gained the respect of the community where he was born and raised. In a Taekwondo class of 70 students which he joined when he was seven, he is one of the eleven students still living. The rest have died from gang-related violence.

The second day we sat down to talk, he was pensive but accommodating, which seemed to be his nature. To get him relaxed for our interview, I gently prodded him about his day. Like a tired hero arriving home from battle, his drooping shoulders began to straighten as he spoke and his weary eyes slowly regained their glow.

Balala outside of his home.

“Say for you, Kinya, your place of work is known. And your line of work is known. Same for the people in the ghetto, we know their line of work. We know who is involved in theft and other activities. And the wages of sin is death. So we know that at the end of the day, death is coming. Just a few minutes ago, I was at the Mama Lucy Hospital morgue, where I went to identify a 16-year old friend. He underwent mob justice in the night. And that is the trend in this ghetto.”

As if that morning’s task had transported him four years back in time, he continued, “During the 2017 general elections, myself and Uzima worked tirelessly. Mathare is divided in a way that when war erupts, zones are divided by tribe, like a Luo zone and a Kikuyu zone. I was the only person who could walk from this place to a Kikuyu zone, bring a sick person to our clinic and then call an ambulance. In fact, those Kikuyu boys, most of them had my phone number. I don’t know where they got it, but they would call me Daktari, or call me by name, and ask me to go rescue people who were injured. I would go there terrified, but because I had already resolved to serve, I would just go.”

Balala shows the way to his home. He remarks, “I love working here, it has really taught me a lot.”

A prophet is without honor in his hometown, and it took time for the community to trust Balala as a nurse rather than as the boy who did Taekwondo. They found it hard to believe that someone who grew up in circumstances similar to theirs could work in a clinic and help treat them. However, there was one person who never doubted the slum child could help his community – “Uzima” White Indimuli, the owner and founder of Uzima White Clinic.

When Balala asked White to teach him first aid, Uzima asked him to learn nursing instead. The two struck a deal, and Balala agreed on condition that Uzima would find him a job as far away from the slum as possible. Uzima took care of everything Balala required for college, including travel to a nursing school under the tutelage of a consultant surgeon, Dr. Mleche.

By the time Balala completed nursing school, Uzima’s clinic – running in the makeshift structure – had become tantamount to a lighthouse for many suffering in the dark sea of poverty. Balala could not turn his back on his community.

“It was hard at first before the people got used to me being their nurse, but thank God, I and the community managed to adjust.”

sound bites

Nurses are drawn to those in need of rescue. When Balala found Tyson, he was a young boy being beaten by a crowd for stealing. He begged them to let him take the injured boy to a hospital. Years later, Ty (as Balala fondly calls him) found his rescuer on Facebook and thanked him for stopping the angry mob from cutting his hand off that day. He had returned to the countryside where he now lives peacefully.

“All that we’ve done with Uzima for the community has been a calling.”

“I come to the clinic even outside my shifts when there are calamities. For instance flooding of the houses built near the river, or fires that catch the mabati (tin) houses.”

“I’m part of the community with my everything, beyond treating people, being a child of this slum.”

“Every so often Ondieki comes to the clinic to greet me. When he was stabbed just a few meters from here, I was called to go help.”

“It weighed heavily on me that the ambulance could not come, so we tried to treat his wounds while people scrambled to find a car. When the hospital where Ondieki was later treated asked if we had an operating room to care for patients, I told them no, all we do is save lives with what we have.”

"Banda's clinic management software has helped us a lot with record keeping," explains Balala seated at work in the Uzima White Clinic.

You can empower frontline teams with technology

“Uzima” White Indimuli runs what we call a frontline clinic because it is the first or second place a patient in a slum, informal settlement or remote village goes to for medical care. His clinic is open 24 hours a day with 15 beds and 22 staff and he uses Banda’s clinic management software.

They began using BandaGo this year. “We usually treat over 200 people per week. Before we got BandaGo, we didn’t even know how much money we were getting, how many drugs we were using and for what, or how much we had spent. But now BandaGo keeps records for us. It has really helped us to realize how much we make and spend. Now we are happy!”

Read more about White “Uzima” Indimuli in this story: We dance

Picture of Kinya Kaunjuga

Kinya Kaunjuga

Kinya brings passion, an infectious laugh and her 15 years of experience in the corporate and non-profit world to Banda Health’s operations.

A Texas A&M alumni with a degree in Journalism and Economics, she says, "I love doing things that matter!"

Protected by gangs

Protected by gangs to care for the poor

By Kinya Kaunjuga

The gangs protected me and kept me safe so that I could treat the sick without being attacked.

Morning and night, gang members coordinated escorting me in groups of three, switching their cover to keep from being identified by the community.

Crude weapons and machetes clumsily constructed from metal pieces found in garbage dumps, were tied closely to their midriffs making it impossible to detect beneath clothing.

Never taken off even to bathe, never brandished openly, these blunt, rough pieces caused gushing wounds and ruptured bones, including their own which I treated. I didn’t know if the next maimed victim would be my own sister. 

I came to live in Mathare 18 years ago because it was where I could afford housing. Within 6 months I opened a clinic. I could not live among them and watch them suffer from a lack of medical care when I had the ability to treat them. 

I decided to open our home to emergency cases. That led the gangs to protect my family and neighbors. Eventually, I rented a small space in the neighborhood and began to take in all types of patients. 

A landlady, herself a resident of the slum, showed me a half roofed structure she had given up trying to complete. She told me I could have it, complete it and pay the rent whenever I found it because she saw the need for my work and that I was one of the slum dwellers and hardly making ends meet.

People with problems rushed to my makeshift medical facility in the slum. There were hundreds of them every week. They kept coming day and night. They called me their savior. 

I also found out that the gang members called me Uzima, which means full of life in Swahili. As they guarded me, I counted 20 of them but never knew their names. My name is White Indimuli, the founder and owner of Uzima White Medical Clinic. 

In a desperate search for an income, boys aged 10 to 17 leave the countryside to look for jobs. They find shelter in slums for a cost close to nothing; but they also find others who were there before them, and with that, the higher cost of a life strung with violence. Gangs roam the 18 slums in Mathare which is half a square mile of land where 600,000 people live. (By comparison, Denver is 155 square miles with a population of 556,835). The gang members are lucky to live past 35.

With you we can empower frontline medical clinics with technology

White Indimuli runs what we call a frontline medical clinic because it is the first or second place a patient in a slum or remote village goes to for medical care. His clinic is open 24 hours a day with 15 beds and 22 staff. 

They began using BandaGo this year and he says, “Before we got BandaGo, we didn’t even know how much we were getting, the number of patients we were serving or how much we spent. But now BandaGo keeps records for us so it is very important because it has really assisted us to realize that we make this, we spend this and now we are happy about this.”

What White and his team do daily is a sacrifice, but what they do not do is despair or give up, so they can provide care and hope for those who just can’t afford it.

We think you’ll enjoy getting to know them better in upcoming newsletters. They will inspire you to never give up!

The stories that followed this about Uzima Medical Clinic include: We dance and The Black Belt Nurse.

Picture of Kinya Kaunjuga

Kinya Kaunjuga

Kinya brings passion, an infectious laugh and her 15 years of experience in the corporate and non-profit world to Banda Health’s operations.

A Texas A&M alumni with a degree in Journalism and Economics, she says, "I love doing things that matter!"

Surviving a mugging to make an impact

Surviving a mugging to make an impact

By Kinya Kaunjuga

A patient is served by a pharmacist (behind bars for security). He is using BandaGo on his laptop computer, a paperless clinic management system.

When he was attacked by muggers in broad daylight during a clinic visit in Mathare – known as one of the roughest, most dangerous parts of Nairobi – it dawned on Mike that being a college athlete was actually an asset for his work at Banda Health.

Mike is Banda Health’s “implementer.” He’s the guy that makes sure clinics in communities like Mathare have what they need to get up and running when they make the jump from paper to digital with BandaGo.

That day, it was a good thing he is also a six-foot-tall, broad-shouldered, former high school and college soccer player.

Mike (far right) with a healthcare team at a clinic.

As he made the trek up the hill from the clinic towards the only spot a taxi cab would pick up passengers, Mike noticed a motorbike descending the road much faster than all the others milling around.

In less than a few seconds, this particular motorbike seemed to be heading straight towards him, pelting down at full speed. Instinctively, he began to assess which part of the curbside he should jump onto to avoid the impending collision.

He heard a loud roar from the bike’s engine and felt the heat of its front tire beside his leg. He realized he no longer had time to avoid being crushed. He prepared to face the impact by doubling over. Suddenly, he felt someone grab the strap of the bag on his shoulder. Just as swiftly, the same hand began to pull the strap, jerking him violently, and bringing him close enough to feel the attacker’s hot breath on his ear.

He tightened his own grip on the bag which was tucked under him and spun in the opposite direction from the bike. His strength and quick full-body turn caught the attacker off guard and the bike veered sideways then sped off.

As he straightened up to look at the disappearing bike, he noticed there were two riders and the passenger was stuffing a blade back in his shirt. As he looked around him, the merchants were still arranging and dusting their wares alongside the road in readiness for the evening buyers.

Roadside vendors preparing to sell to the rush-hour crowd. They are fondly referred to as mama mbogas (“veggie mothers” in Swahili).

The incident had only taken a few seconds but Mike, who had just welcomed his firstborn baby a few weeks earlier, was deeply relieved to have survived the mugging attempt unscathed. He continued to the top of the hill and hailed a cab home.

Mike holding Gabe outside their home.

When Mike reflects on that day, he says he continues to learn why and how the staff who run the clinic in the “valley slum” put themselves at risk every day to care for patients.

The road where Mike walks to reach the clinic in Mathare.

If you’d like to read about how it feels to treat patients in dangerous places and how some of the bravest people do it, check out all the Banda Health stories at www.bandahealth.org. Also, look out for the upcoming interview with the owner and staff at Uzima White Medical Clinic where Mike was that day.

Empower Health Workers. Leverage Technology.

Thank you for being a part of this journey with Banda as we develop healthcare technology solutions for clinicians who treat patients in some of the poorest parts of the world.

We couldn’t do it without you!

Picture of Kinya Kaunjuga

Kinya Kaunjuga

Kinya brings passion, an infectious laugh and her 15 years of experience in the corporate and non-profit world to Banda Health’s operations.

A Texas A&M alumni with a degree in Journalism and Economics, she says, "I love doing things that matter!"

Who said slow down?

Who said slow down?

Banda Health’s vision is transforming lives by reaching and empowering healthcare providers in very-low-income communities. Technology and relationships are our tools.

Most of us do good in our spare time.

Some people do it for a living. Nobody told them that pandemics are a reasonable excuse to take your foot off the gas and slow down a bit. Even while they are trying to put food on their own table, they are still looking out for others. Eric is one of those guys.

Eric is a fast-mover, the former President of the 7000-member Kenya Clinical Officers Association. But his core business is not what I expected. He runs clinics that have a goal of providing quality and affordable healthcare for patients from very low-income areas in western Kenya.

Eric started using BandaGo in two of his facilities in the midst of the COVID outbreak but it was not until recently that I had the chance to meet him virtually on a video call. I was very interested to understand why someone with his ability –  and with a family – would set up his medical practices in some of the poorest parts of the world when he could have been somewhere else making a lot more money.

What drives him to do good for a living? What battles is he facing?

DOING GOOD FOR A LIVING: Our friend Beatrice Njoroge (left) is cut out of the same cloth as Eric. Beatrice spends every penny she has running the Children at Risk ministry helping children of all ages find their way home.

Exactly why did you move here?

When I ask Eric why he moved to work in a low-income community, he doesn’t hesitate to tell me the story. Early in his career, he worked in a clinic that served a wide range of socio-economic groups, from very-poor to high-middle income.

“I saw people discriminated against based upon their income every day. The lower-income people were treated poorly and I wondered, ‘How can you treat someone like this when they are a human being?’”

Two jobs later, however, he experienced a completely different model working in a clinic that provided quality, affordable service for the poor with dignity.

“When I later started my own businesses, my goal was to work in low-income communities and to find ways to support those communities. This included being sure my staff can earn a decent living while we focus on providing our patients with good quality care at an affordable price, focusing on prevention.”

Today, his pharmacy and two clinics serve his community well but he is not done yet. He is working hard to extend his impact further despite all of the challenges his patients face.

Good does not mean easy, doc.

"The lower-income people were treated poorly and I wondered, ‘How can you treat someone like this when they are a human being?’” - Eric Ondieki.

When I ask Eric to describe the biggest barriers his patients face when they want to get good care for their family, his answers are immediate.  

1. “Patients often don’t have the cash to see the clinician. If they pay $1 for the consultation, they don’t have enough left to get their lab test or medication.” Eric’s best-paid patients make $5 to $10 per day, so he has to figure out how to get them their basic evaluation, including laboratory and medications, as cheaply as possible. He keeps his total charges for everything <$3.50 per visit.

2. “Patients do not have reliable access to medications. This is a big problem. In public health facilities, medications are often out of stock.

3. “Patients do not have dependable access to credit. Clinics can sometimes offer credit, but their own finances are tight, and if credit is not managed well, it can completely crush their business.

All of this means that clinics need to run as efficiently as possible,” he says. But as the former President of the national Clinical Officer Association, he has noticed that most of his colleagues struggle to get the tools they need to run their business efficiently.  “You learn medicine in school, but not business. Knowing how to keep track of and manage your finances, be sure that supplies are not going missing and be able to convince investors that your records are well-maintained, all of these present hurdles that almost all small clinics struggle to clear successfully.

We have to keep getting better, even during COVID

Stephen Muthama outside his clinic. He referred Eric to Banda Health. Patients and their families in many communities rely on small clinics like this one for their healthcare services.

Eric reached out to Banda after hearing about us from a colleague, Stephen Muthama, a clinician who runs an urban clinic in Nairobi.

Transitioning his team to a new, digital way of running their clinic wasn’t difficult, even in the middle of COVID when no one from Banda could come by and help his team set it up.  Mike from Banda connected with Eric over Zoom and within a week he and his staff were up and running. 

Banda is making it easier for Eric to manage his business as efficiently as possible.  From his past work in Kenya’s big research institute, Eric knows the importance of data in improving care.  He has traveled a lot for his professional association, but even when he is on the road, he can quickly see how healthy his clinics are operating. He can check and monitor their inventories, and financial position records from any point as long he has access to the internet.

Thanks for helping those who are going to do well

Peter Drucker said, “The foundation for doing good is doing well.” Eric and healthcare teams like his provide low-cost care right when and where their patients need them. Providing good care in these settings means maximizing the use of every penny. Helping teams like Eric’s keep their clinics healthy and cost-effective means they can focus their time and resources on keeping their patients healthy.

At Banda Health, we use real-time input from Eric and others to create ever-improving solutions to the challenges these clinics face. With the beauty of the internet, every Banda Health improvement is immediately made available to all clinics, even during COVID-like seasons when our team can’t visit clinics personally.

Thanks for being a part of this journey with us. We couldn’t do this without you.

Steve and Wes, for all of the team.

What drives you?

What drives you?

By Steve Letchford, MD

My answer these days is pretty straightforward. Google Maps drives me.

That’s because my medical career in very-low-income communities has taught me that being one of the world’s poorest patients is a nightmare that you never really wake up from.

But Google Maps has taught me that we can change that. Google Maps saves me 10 minutes on a 30-minute drive across town simply by using vast quantities of real-time GPS traffic movement data to predict slow-downs on my route, redirect me. It isn’t all that complicated.

Google Maps just uses vast quantities of real-time GPS traffic movement data to predict slow-downs on my route, redirect me, and save me 10 minutes on a 30-minute drive across town.

As a doctor I know that good healthcare isn’t all that complicated either.

It just involves processing large amounts of real-time data to get the right diagnosis and the right treatment at the right time. 

But somehow we haven’t figured out how to do for the world’s poorest patients what Google Maps does for the world’s wealthy drivers.

A clinic with BandaGo showing on a laptop. Just like this clinic, all that is required is a laptop and an internet connection to use BandaGo to "...process large amounts of real-time data to get the right diagnosis and the right treatment at the right time."

After 22 years, I’m so tired of weeping with mothers in the middle of the night because their child just died – and died simply because they got the right healthcare when it was too late. I’m tired of knowing that it took them too long to get the right healthcare because they had so little money.

And so I roll out of bed every morning thinking, “Surely, if technology can transform something like my drive across town, we can figure out how to use it to transform healthcare for the world’s poorest patients.” Banda Health is the story of making that drive become a reality.

This is a hospital that uses BandaGo. "My medical career in very-low-income communities has taught me that being one of the world’s poorest patients is a nightmare that you never really wake up from." Dr. Stephen Letchford.

Inspire the next

Inspire the next clinic like those in these stories, by donating to Banda Health.

BandaGo software is continually adapted and driven by the value its users derive, those treating some of the poorest patients in the world by using digital ingenuity.

Our team of local developers and programmers listen to healthcare workers as we build and refine BandaGo so that patients get accurate diagnosis and treatment in any Kibanda (hut) in any part of the world with an internet connection. Thank you for being an inspiration to lives.