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It was his teeth

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There are many kinds of wealth, just as there are many kinds of poverty

By Kinya Kaunjuga

Some say it’s not how you start, its how you finish. When I finally met “Mzae” (Peter Kabira), I had more than an inkling from a video I had seen that he was a remarkable human. In the video he scoffs at the $90 relocation donation from the government because it meant jostling crowds of people younger and stronger than him. Instead he had chosen to move into the highest drypoint, a toilet, and live there until the floods subsided. It was enough for me to want to meet him and find out more.

On September 10th, 2024, I had the opportunity to speak with Peter Kabira, fondly known as '"Mzae", outside a medical clinic in Mathare, Nairobi. He wore his signature flip-flops—his favorite choice of footwear—this time in a different color than those he wore in the video that first introduced me to him.

I was completely engrossed with observing every detail about him. I felt as though he was a rare specimen that encompassed an intricate combination of characteristics which had to be unearthed and carefully examined to discover how one could live past 18 into their seventies in a slum. And not just any slum, but one of the most dangerous slums in the city. Then there was the video I had seen where he spoke about surviving on a mere 10-shilling meal each day—just 7 cents in US dollars—after losing his home to Nairobi’s most devastating flood in a hundred years. His voice held the weight of someone who’d lost everything, yet was struggling to hold on.

But nothing had prepared me for his perfunctory enunciation of the Queen’s English as he delivered his words in syllables arranged in an array of skillful diction.

Two children playing on Saturday September 14, 2024 on the exact ground where Mzae's house and others were swept away by the floods when the Nairobi river burst its banks in April 2024. The ruins of their homes which were demolished have not been rebuilt as of the date we published this story.

I was shocked to find out that he does not drink unlike all his other age mates in the slum, has always cooked his own meals, and was in his high-school debate club and led them to win national championships. He was born and raised in Mathare shanty (slum) in Nairobi, the capital city of Kenya, to a mother who worked for the British colonialists and they had lived with his grandmother who had done the same.

Mzae attended a nationally renowned high school which was called The Duke of Gloucester School, named after Prince Henry, Duke of Gloucester by the British in 1955. It’s now called Jamhuri School after Kenya’s Independence.

He followed suit like everyone else who lived in the shanties and, right after high school, got a line job at a factory that made cooking fat, where he worked for the next 30 years of his life.

Mzae sitting on the Nairobi river bank beside the grounds where his and other homes were before the floods. The bamboo trees behind him were planted by reformed gang members who live in that slum. The trees helped save many people from being swept away by the river when it broke its banks in April 2024.

Where we work

Medical clinics that use Banda Health's clinic management system (BandaGo) are located in many of the Nairobi shanties (slums). Diagram by Gernheim.

Transforming a debate club champion

Hearing how Mzae, before the floods claimed his home, would brew coffee (which he loved drinking), and sell it to market vendors, his gentle smile lighting up the streets until every cup was gone, moved me deeply. Inspired by his resilience and beloved presence in the community, I wanted to help him smile confidently again. On October 5, 2024, thanks to a local clinic, Mzae’s new set of teeth was ready—restoring not just his smile, but a piece of hope to everyone who had missed it.
Peter Kabira "Mzae" before getting dentures. This was made possible by partnership with Karen Vineyard Church in Nairobi, Kenya in response to helping the residents of Mathare slum who were displaced by floods in April 2024.
Mzae wearing his new teeth.

Mzae’s life with teeth:

  • Children in the neighborhood: trooping after him to have conversations about how his teeth re-grew.
  • Walking style: now has a pep in step.
  • Long-forgotten favorite food: munching beans and soft corn almost daily.
  • Sadness from losing everything at his age: overwhelming ticking time clock thrown out of the window.
  • Learning complete strangers made this happen: filled with renewed hope.
  • Message to donors from Mzae, “Mwenyezi Mungu Akubakiri (Almighty God bless you), you are my saving grace.”
  • Financial stability: with part of donation, purchased a wheelbarrow, fills it with his favorite fruit (avocado) and sells them daily in the streets. In one month he has earned enough to pay his monthly rent and subsistence. He plans to open a small kiosk to sell the avocados and other fruit.
  • Healthcare: can now afford to see a clinical officer in a small medical clinic regularly.

Thank you for your help!

Our dream of using technology innovations to bring hope to the world’s most vulnerable patients is ambitious, and we are so thankful for all of your support as donors and encouragers on this journey. 

As of today 110 frontline medical clinics (small clinics that run on extremely low resources located in slums and rural villages) using our HMIS BandaGo to make their clinics more sustainable and to improve care for over 650,000 patient visits per year!

We are excited about this progress but realize it’s the one-mile marker on a 1,000-mile journey. We aim to reach 150 clinics in 2025. Thank you for making this possible with us! Steve and Wes, (Banda Health Co-founders).

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Kinya Kaunjuga

Kinya, our corporate storyteller is a digital nomad. She has worked in Africa, Asia and North America. She's a Texas A&M alumni with a degree in Communications and Economics. She's met people from almost every part of the world and believes everybody has a story worth listening to.

The Recruitment Quartet: Four Men on a Mission to Modernize Clinics

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The Quest to Digitize Healthcare in Small Clinics Across Africa

By Kinya Kaunjuga

His voice steady and determined, David Miner explains BANDA's next recruitment phase with excitement in his eyes, "We've covered so much ground, but there are still clinics out there that haven't heard of BandaGo. We’ve saturated our current regions. It’s time to expand." David is the client engagement lead at Banda Health. Photo courtesy Tdh, Ollivier Girard.

What would normally be a 30 minute drive had turned into a four hour adventure. The four men who recruit clinics for BANDA’s clinic management software had spent days mapping out their route. They were hopeful that recent protests in the country would not take place on the day they had meticulously selected to launch into a new territory in the city.

As fate would have it, or as Africa chooses what to blow your way after the rooster crows, unexpected rowdy mobs were gathering randomly wherever the police presence was scanty and blocking roads and highways, looting shops and destroying property. That’s what our implementation team at BANDA drove straight into.

Weaving through market stalls connected with makeshift timber bridges that were really just footpaths, they drove through a crowd of angry demonstrators battling it out with the police. It was too late to turn back. They had made it all the way with just less than a mile left to reach their first planned stop. Each of them knew it was time to gun it through the last cluster of market stalls and they braced themselves.

No one expected what happened next. As they descended towards the edge of the last alleyway with a clear road straight ahead in sight, a vendor began to lift his mukokoteni (homemade cart) and move it forward into the alley. Everyone in the car began to shout at the vendor to move. Paul, the skinniest of the team, had almost half his body hanging outside the back window screaming and waving at the man to get his attention. In a scene that mimicked something from an Indiana Jones movie, a space suddenly appeared right beside the car and David swerved, missing the vendor by a whisker. As he slammed on the brakes, they all turned back to look at what had just transpired. A mama mboga (veggie mama) was holding a rope and waving them on with a big smile. Some of the vendors were not new to the alleyway being used as an escape route by drivers trying to avoid traffic on the main road. They secure the roofs of the makeshift stalls with ropes, which they can easily loosen or pull back to create space for cars.

Mama mbogas (veggie mamas) in an African market.

Early Adopters in the Slums: The Journey

When the Banda recruitment quartet (Mike, David, Lawrence and Paul) are out in new areas, they are looking for what Simon Sinek describes well as “early adopters.” These are low-resource clinics ready to try an innovation like BandaGo before everyone else. The implementers know from experience what characteristics they are looking for in these clinics. Here are a few of them:

  • The clinic has clearly defined problems they want a solution for, and BandaGo already has a simple solution for those problems.
  • The clinic owner works full-time in the facility.
  • The clinic has a highly motivated champion to begin making the switch from paper.

The implementers know that once a few early adopter clinics with the right characteristics are onboard, the implementers understand that referrals will quickly become the primary driver of new clinic clients. This network effect—where one clinic refers the next—accelerates growth. They also know that BandaGo is far from fully developed. As Banda Health Co-Founder and President Dr. Steve Letchford says, “The exciting thing is that BandaGo is being built in Africa for Africa – adding value, creating impact. As we keep investing in making BandaGo more powerful, we are able to both help a wider range of frontline clinics use technology to transform healthcare, and help them do more with that technology!”

Some of the BANDA team responsible for the success of our innovation are pictured here standing outside the BANDA office in Nairobi, Kenya in July 2024. From right to left: Mike (Business & Product Development), David (Lead Client Engagement), Gideon (Implementer), Lawrence (Implementer), Andrew (Lead Developer), Peter (Data Analyst), Paul (Implementer), Jeremy (Systems Administrator).

Thank you for making this possible!

A clinic in Kenya that uses BandaGo as their clinic management system.

The Banda team is deeply committed to bringing hope for the world’s most vulnerable patients using technology innovations and partnerships. We cannot thank each of you enough for joining our team as donors and encouragers to make this possible.

Our dreams are ambitious, and every bit of support is helping as we raise the remaining $139,000 for this year’s budgeted development work. Julie, our volunteer operations lead, makes sure that we stay transparent and accountable with our finances and our Financial Statements and Independent Accountants’ Review Reports. We are so thankful for you!

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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!"

Uniting for Better Health

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The Thrilling Changes Brought by Partnerships

By Kinya Kaunjuga

Uzima spent at least one day of the week’s lunch hour at a restaurant where he could escape the poverty he saw every day. He ate his meal in the upper dining room which they let him do even when it wasn’t open to the public. He was a consistent customer and he never failed to leave a tip. After his meal he always savored the soulful singing of a local dramatist as it floated above the melee of diners.

He had spent the previous week away from the clinic attending a training workshop facilitated by a BANDA partner learning how to use the Butterfly IQ3™ ultrasound and he was pleasantly surprised that the clinic had managed without him.

That morning, an injured man had been rushed into the clinic by his friends. They were scavenging for metals in a demolished building when it caved in on them. A common thing in slums. Upon examining the injury Uzima decided to use the Butterfly.

He showed the patient the image of his hand on the tiny tablet and explained that there was no breakage and it was a soft tissue injury. The patient was ecstatic. As he walked to the nursing station for bandaging, he told his friends, “Hii clinic ya mtaa iko na kila kitu maze! Wasee kujeni ni washow. Yaani sihitaji kuomba doh za kwenda hosi.” (This clinic in the slum has everything man! Guys, come I show you. I don’t need to borrow money to go to a hospital).

By then Uzima had started his walk to hail a cab for his weekly lunch reprieve.

‘There’s nothing like a good meal settling down into a gentleman’s stomach,’ he mused. ‘A clinician is like a dramatist of a high-stakes theater. The clinic transforms into a grand stage, where the actors, seasoned in their roles, must flawlessly deliver their lines the instant the curtain rises. The audience—comprised of patients and their companions—watches with keen eyes, ready to unleash their judgment should the performance falter. The drama must be nothing short of extraordinary.’

The noise from the cutlery as the waiter collected his plate jostled him out of his daydream. He sipped the last bit of his drink and sprung up.

On his way back to the clinic, he chatted jovially with the cab driver as they navigated the densely packed streets that transformed into bustling markets during the day. It was only when the driver asked, “What’s going on at your clinic Uzima?” that he noticed the line of people stretching all the way around the back.

Entering the clinic, he caught a patient saying to the receptionist, “We heard this place can even scan the sick and you see it on a screen. We no longer need to struggle with a two-hour journey to the hospital!”

Uzima swung into the needed role, for now a business leader, after all the clinic was his drama, they were all actors and the Butterfly would be center stage! In full regalia awaiting the curtain call to debut her prowess as she spewed out every image on her tiny screen! Like the patients, she was daring their neighborhood clinic to go from just okay to good and even maybe great! He donned his white coat, fired up the Butterfly IQ3™ ultrasound on his desk just for added effect and then like a director on opening night, determined to enthrall the audience, he announced, “Next patient!”

A group of BANDA users and clinic owners with Dr. Rob and Nancy Congdon. They are holding the Butterfly tablet ultrasound, demonstrating its compact size. Uzima is second from the left in the back row.
In June 2024, Dr. Rob Congdon conducted a training session in Nairobi, Kenya, for clinical officers using BANDA, introducing them to the Butterfly IQ3™ ultrasound technology. Rob and Nancy Congdon donated these ultrasounds to BANDA users. Their goal is to enhance diagnostics and provide quality healthcare to some of the world's poorest patients. Rob has also committed to ongoing training and mentoring of the clinical officers, supporting their growth as both professionals and business leaders throughout the years of using the Butterfly technology.
The records room in Uzima's medical clinic located in Mathare slum in Nairobi, Kenya. They've used BANDA as their clinic management system since 2019.
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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 man who lives in a toilet

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No Pillow No Sheet Just Cardboard

By Kinya Kaunjuga

A family searches for anything they can salvage from their house which was destroyed by the recent floods in Mathare slum in Nairobi, Kenya.

After almost everybody has left the streets, he looks around to make sure no one sees him dig out a bag hidden in a space between the walls of two tin houses. So much had been going on with the flooding. Chaos raged. Everywhere was littered with everything the river had vehemently pushed into land.

Paths that wove through densely packed houses had turned into dark lakes of filthy water. Tin roofs, walls and doors that had withstood months of scorching heat were suddenly reduced to piles of rubble that resembled muddy garbage.

So it wasn’t hard to use a random crack to keep his cardboard box hidden until he retrieved it at night. After a few tries, he had managed to cut it into a shape that fit around the hole of the pit latrine and he could set it up with just one flip to lay on. The smell no longer bothered him because few people still dared to use the toilet that had survived the floods and was teetering precariously on a hill.

Streets in Mathare slum turned into rivers of mud.

When Daniel, a fellow journalist, told me about this man who they called “mzae” (meaning “father” or “elder” in Swahili as a sign of respect to an old man even with no biological relation), I asked him how come he was still living in that place and alone at his age. Where were his children or family? He explained that he had two daughters who were married and he did not want to ask them for help because they were poor too. He had raised them in poverty and it wasn’t fair to ask them for help. He wanted them to go on with their lives. Daniel also explained something I am still trying to understand. He said for men such suffering is endured as “kimwanaume” – it’s hard to translate accurately into English. The closest I can think of to explain it is that being a man means taking on your lot in life and living with it, bravely. 

 

Mzae outside the toilet he lives in.

But that must be a different generation. In my conversation with community volunteers who were attending to the needs of flood victims in their slum villages, I was shocked to hear that a significant number of pregnant women had been abandoned by their boyfriends and husbands when the floods washed away their homes. It was a stark contrast to the old man who lived in the toilet. He had raised his two children in abject poverty and because of his persevering nature, was not willing to encroach on their resources but would rather face each daunting challenge of survival daily until further notice.

It becomes increasingly clear that the three years spent writing about the lives of those in the slum ghetto is only a tiny drop in discovering and understanding how living in poverty shapes a person’s ideology. There is no obvious creed to unlock, and what seems so outlandish to an outsider is simply a way to hack life where all the odds are against you.

When Gitathuru river burst its banks on April 24th, 2024, it flooded most of Mathare slum and left the majority of its residents, like this woman and child, homeless.

Captured moments as the floods unfolded

The toilet Mzae lives in. He eats a meal when he can get one for 10 shillings ($0.076) from a lady who cooks what she finds. It's usually cabbage and "ugali" (traditional maize meal resembling corn bread). The price Mzae pays is for a serving that fits in the palm of his hand. The fact is that living on a dollar a day is actually not completely true anymore. It's become worse as time has gone by.
Mzae's flooded house where everything he had was washed away and what remained was caked in mud.

In this video, a nurse called Balala who works at Uzima White Medical Clinic located inside Mathare slum, less than 50 meters from the Gitathuru river, is the one holding the young boy crossing two rooftops on a sheet of metal.

While rescuing flood victims in his neighborhood, Balala also went in search of the men and women who attend a Bible study on Tuesdays for those addicted to drugs and alcohol in the slum because almost all of them are homeless. (They’re pictured above seated and listening to Balala – in a yellow t-shirt – standing before them). Sadly, he informed me that one of the men was found dead, drowned by the floods.

Where Banda comes in:

Using technology to break barriers to access good healthcare in slums and rural villages

In the heart of slums and the farthest reaches of rural villages, small medical clinics stand as beacons of hope, treating individuals who endure unimaginable poverty. We’ve built our clinic management system precisely customized to run in clinics with extremely limited operational budgets so they can afford to remain open and use 21st century technology to deliver good healthcare.

It’s our job to consistently build innovative features in our software that, for example, allows the clinic “Mzae” visits to record payments of as little as 10 cents when he goes there for treatment. This ensures uninterrupted medical care in a little clinic right there in his neighborhood and eases the tracking and collection of random cash payments for the clinic.

Thank you for supporting Banda Health as we develop technology solutions for clinics that care for people in some of life’s most vulnerable situations.

Before publishing this story, this update came through: Mzae is shown here in his new house with a new mattress. He recounted how he watched his previous mattress get washed away by the flood. This turnaround was made possible by some fellow residents in the community who discovered him living in the toilet.

Milestone Achieved!

Five years ago we set an audacious goal that was slowed down by the COVID pandemic. On our website we announced that goal: “We plan on putting BandaGo in 100 clinics by the end of 2024. That’s 2 million patients that will have access to good healthcare over 5 years, and we won’t stop there.”

As of today, 101 medical clinics are using our technology solution BandaGo to manage their clinics and they have recorded 1.2 million patient visits!

We simply can’t do it without you! Thank you.

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Photos and videos in this article are courtesy of Theano Ratcliff, a Mr. Irungu and Sheikh Balala and should not be used without permission from 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!"

Will we eat hope

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The chicken thief

By Kinya Kaunjuga

Things were turning out better than expected. The small group of miscreants had grown in number after the successful capture of the rooster. What now consumed them was getting a hold of the propane gas lighter.

The rooster belonged to the high school farming club and had been raised on a special nourishment formula, a closely guarded recipe passed down from one club leader to the next. Its size boasted an ability to provide a feast.

A few teenagers hanging out in their neighborhood in Mathare slum. Balala, a black belt nurse employed at Uzima Medical Clinic which is located in that slum, is pictured here engaging in conversation with them.

The group leader was Fidel Castro and no one was surprised. He was already facing possible expulsion after racking up multiple demerits from breaking almost every rule in the school. His antics had only fallen short of appearing in the school newspaper because that would fuel the rumors and myths about him which always seemed to make the school principal the villain and Fidel Castro more popular whichever turn they took.

A school in Mathare slum.

It had taken time to plan their heist. Everyone knew the night guard left his post just twice very briefly and that was when everything had to take place. The chemistry whiz in the group couldn’t guarantee that his sleep inducing concoction wouldn’t poison the bird or the guard. Only the bravest and most daring students were entrusted with core functions because there was no plan B with a live chicken.

The conclusion had been that it all needed to happen almost at once. Stealing the chicken and breaking into the chemistry lab to get the propane torch. Fearless Fidel would apprehend the prized cockerel and silence him with a blindfold. No one else was venturesome enough to stand between the high school farming club and their win at the regional competition. The chemistry whiz was tasked with getting the gas lighter from the school lab and a deputized leader would commandeer the rest to find firewood and build a large fire.

Somewhere between gazing in anticipation at their meal which was roasting on a blazing flame and bragging about their success among themselves, the pack of go-getters never realized the air was filling with gas. The chemistry whiz described his dexterity at disconnecting the propane torch from a gas pipe in the school lab and crawling back out of a window undetected. There was a loud explosion as the fire ignited everything around it and lit up the night sky. The entire school was jolted out of sleep by the shrill whistle blowing of the night guard in between his frantic shouts of “Fire! Fire!”

Fidel Castro and his followers had fled in all directions, not daring to glance back at their meal as it sizzled into a pile of ashes.

The Slum Odyssey

A walkway between homes in Mathare slum.

Name: Fidel Castro O.
Age: 17
Father: unknown
Mother: currently a third wife
Siblings: three
Residence: tin structure in Mathare slum
Education: grade 11
Health status: addiction to drugs
Addiction substances: illicit brews of alcohol and the “slum cocktail” (a mix of cannabis, cocaine, diazepam, tobacco and petrol dried and rolled).

Adding to a rap sheet of four fights, the theft of the high school’s chicken which is considered a criminal offense, finally got 17-year-old Fidel Castro suspended from school. During the time out of school, he was caught stealing a bicycle, beaten by a mob and left for dead. Barely a couple of days later, he was arrested by undercover police while buying and using the slum cocktail.

Balala visited the badly bruised and despondent Fidel in his police cell. It had been a long and miserable two nights but no harm had come to him because Balala had called in a favor to a friend, a high-ranking officer at the police station, when Fidel’s mother had called for help.

Some young men who live in slums eke out a living by transporting garbage for market vendors to dumpsites using a "mukokoteni" like the one above. (Constructed from used wheels, wood and some metal).

A few of the slum residents were preparing to bury another victim of mob justice. In the week prior to March 1st, 2024, a local morgue had received 13 patients between 17 and 22 years of age who had been beaten by mobs when caught committing crimes. One of them was Fidel’s friend and as he wept during the burial, he asked Balala, “Will we eat hope?“

In the video below shared by Balala, we see him training children from the slum in taekwondo. He is a full time nurse and does this for free as an after school program to help steer them away from joining gangs and begging in the streets.

The medical clinic where Balala works is a fortress of safety and hope for everyone in the Mathare south slum. That includes gang members. You can read more about their impact in the stories, We dance, Black Belt Nurse and Protected by gangs.

Fidel Castro is back in school. He was willing to return on condition he was not made to repeat the tenth grade but go on with the eleventh. Balala pleaded with the school principal to take back Fidel because he was desperate to rescue him from idling in the slum, where within just three months of being out of school he had almost been murdered. Balala is also aiding Fidel in overcoming his addiction; although he has stopped consuming the slum cocktail, he remains addicted to the slum’s illicit alcohol brews.

“A lot of the teens here are so addicted they keep returning to the drug bases where they are recruited into gangs and a life of crime,” says Balala, black belt nurse at Uzima Medical Clinic, users of BandaGo software since 2019.

Balala and Uzima White (owner and clinical officer of Uzima Medical Clinic) continue to try and find out who is supplying the diazepam pills to the addicts in the slum. They have been unsuccessful so far.

The Secret of Life

Seen here, a wall in Mtego slum proclaiming "the secret of life": Think, Believe, Dream and Dare.

Thank you for your support that helps us as we think, believe, dream and dare to impact the lives of some of the poorest patients in the world by building technology solutions for the medical clinics that are treating them.

In slums, informal settlements and distant rural villages, small medical clinics are a lifeline to so many. We simply couldn’t do it without you.

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Photos by: 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!"

20 feet of care

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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).

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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!"