Boat Clinic

Surviving the tides to treat on the ocean

By Kinya Kaunjuga

SAFARI Doctors boat captain, Fahmi, gets ready to anchor one of their boat clinics called 'Mama Daktari' (Doctor Mom) for the next stop in the Lamu archipelago. Photo courtesy Jim Koenigsaecker©

Legend has it that there was a lucrative and inimitable trade route from the Eastern Mediterranean to the African East coast. It was called the Indian Ocean trade. Sailors and merchants in dhows and proas would barter their wares for spices and exotic flora and fauna from the islands that dotted the world’s body of eastern waters even before reaching the mainland shores.

The trading resulted in a language called Swahili which is a mixture of Bantu and Arabic and is still used as the official national language of Kenya today.

A woman from the indigenous Aweer community weaves a mat. Traditionally hunter-gatherers, their way of life has been disrupted by ongoing insecurity near the border with Somalia. SAFARI Doctors works to ensure they have access to basic health services each month. Photo courtesy SAFARI Doctors©

As ocean trading stopped and boundaries crept in with colonization, the islands became obscure and forlorn. After all, their cowrie shells could not be compared to silver coins engraved with a crown, cytokinins hadn’t been discovered in coconut juice yet, and their untamed white sandy beaches didn’t stand a chance against the rich red soils found in central Kenya, which could grow “cash crops” for export.

Alas, and just like that, the islands were engulfed by a wave with a label that read, “poor and undeveloped.”

A little girl walks on one of the island villages that SAFARI Doctors visits to care for patients. Photo courtesy eilthomasphotography©

Despite not being a native to the coast, Jackson Mugambi, a clinical officer who has worked with SAFARI Doctors for the last two years, can now easily identify the perfect vessel to use at sea. This is a crucial part of his work in ensuring they reach the communities who live on the remotest islands.

On each trip, he must take into account how far he will need to carry medical equipment, medical drugs and his team. He has learned that on long trips deep into the ocean, selecting boats without engines is best. Engines rattle everything and have hard landings on choppy waters.

“Due to the heat combined with the sea, the waves have become taller and felt stronger than in the past decade.” Mugambi explains. He describes how wind blown sails on an old weathered dhow are perfect for their floating medical clinics. “A dhow is wide, slow moving and can even carry patients gently while they receive treatment.”

For 6 days, a local sailor, Ali Skanda and his crew transform this traditional dhow into SAFARI Doctors medical clinic, office and home as they sail to remote villages on the East African coast. Photo courtesy Cyril Villemain©
Sometimes the islanders have a dinghy to help the SAFARI Doctors team get from the dhow to shore. The clinical officers and nurses can reach 15 remote villages over 6 days at sea and provide primary health services for over 1,000 patients. Photo courtesy Cyril Villemain©
Other times like here, the islanders help carry medicines from the dhow into the village. Photo courtesy SAFARI Doctors©
Seen here, the SAFARI Doctors team treks far into the island villages to ensure noone is left without medical care. Photo courtesy shangaphotos©

Of course the dhow is not as fast as a boat with an engine. But for centuries the Swahili coastal communities have used its indigenous Arab design to sail on the Indian Ocean just like when it was used for long-distance trading across two continents. And now the SAFARI Doctors are using it to treat those very communities.

A little girl waits patiently at a SAFARI Doctors mobile clinic for her parent to finish speaking to the doctor. Photo courtesy Cyril Villemain©

Grab our next newsletter for the next chapter in this story on the SAFARI Doctors: “The wave that almost sunk us.”

We briefly leave the SAFARI Doctors surviving the tides on their boat clinic to mention some very exciting news!

Medical clinics using BandaGo have now treated half a million patients!

Let's go further.

A SAFARI Doctors clinical officer hangs a bag of IV fluids on a mud wall in the home of an elderly man who was in need of urgent medical help. Photo courtesy of Jim Koenigsaecker©
SAFARI Doctors have been using BandaGo since 2021 as their choice of a Health Management Information System. Photo courtesy SAFARI Doctors©

Our technology is supporting medical clinics to provide good healthcare to people living on distant islands that dot the sea, in villages surrounded by wildlife, and in slums that no faint heart dares to visit.

And this far it’s made a difference in 500,000 patients’ lives from 3 countries in over 70 clinics because of your support!

Let’s go even further and with your help, reach our goal of treating 1 million patients in 150 clinics by the end of 2023!

Thank you for doing this with us. We simply couldn’t do it without each of you.

Did you know

The English words gumbo, goober, banana, yam, zombie, gorilla, canary, oasis and bark were borrowed from various African languages.

The Swahili Coast, an 1,800-mile stretch of Kenyan and Tanzanian coastline, has been the site of cultural and commercial exchanges between East Africa and the outside world – particularly the Middle East, Asia, and Europe – since at least the 2nd century A.D.

You can speak Swahili instantly! Jambo (Hello), Hakuna Matata (No problem or no ‘worries’) and Asante (Thank you).

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

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!"

A phone, a laptop and an old land rover

We're off-grid and BandaGo is on the internet. So we use it to care for our patients from anywhere.

By Kinya Kaunjuga

"Everything in this medical facility runs on solar power. Our phones are charged by solar and we even scare wild animals with solar," explains Leonard Lemontoi, Clinical Officer at Naikarra Health Center.

Since 1977 Naikarra Health Center has used paper to record the treatment of patients from 30 villages in a 200 km radius near the Kenya – Tanzania border.

Some of the patient records Naikarra used before they chose BandaGo as their electronic health information management system in December 2021.

“I asked a friend of mine how I could get rid of paper health records. I explained that I wanted very simple clear records. I wanted to capture data that would help me understand my patients – how they’ve been and how they are feeling.

“As a clinician, you need a patient’s entire story; not just the patient as they are today, but the patient holistically.

“Paper records would delay my staff and I from instantly reviewing a patient’s history as soon as they presented themselves in the clinic and during our treatment rounds in the villages. They were getting lost and taking up a lot of storage space,” explains Leonard.

Leonard and the team at Naikarra Health Center during a BandaGo remote training session.

“My friend told me about BandaGo and I watched the demo on Banda’s website.

“Since BandaGo is online, it did not require us to purchase any software, a server or network cables. This made it affordable and accessible to us. BandaGo also works for us because we run the facility using an off-grid solar power system and go out into the field with just our laptops and phones.”

Seen here, Leonard uses this old Land Rover converted into an ambulance, to reach the communities surrounding Naikarra and carries his phone and laptop to connect to BandaGo.
Leonard using BandaGo to record a consultation with a patient.

“During a Banda implementer’s visit to Naikarra for additional training, the entire district experienced a major power outage.

“However, because we use solar power to charge phones, the implementer would move with my phone and his alternatively from the examination room, nursing desk, laboratory and finally the pharmacy

“In two days, the Banda implementer managed to train the whole Naikarra Medical team – lab, reception, accountant, cashier, nurses, nutritionist, triage, and pharmacy. He would move with the laptop and the phones and train him or her!” remarks Leonard.

Leonard (fourth from the left) with the Naikarra Health Center clinical and administrative team.

From a chat with Leonard

Q: If you had one message to the world what would it be?

A: Digital records in healthcare are essential. We can now reach so many people in distant rural villages. They are efficient and sustainable and we should embrace technology.

Q.What else have you accomplished by using BandaGo?

A: It’s now our core patient records system. We have stabilized our pharmacy inventory and what to dispense. We get a financial trend of the week, complete month-end summaries, and cash collections have improved. We now review revenues and records each morning at our team meetings.

Q: Are wild animals the only ones you scare away with solar and spears?

A: Yes, there are no bandits here; the majority of the communities around us are Christians. Naikarra started as a church and extended into Naikarra Health Center. This is now a place known as ‘where churches are more than schools.’ Here people love God and God loves us so much.

An arial photo of Naikarra Medical Health Center in Narok County, Kenya.

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

Through improving BandaGo, technology is actively helping frontline medical clinics continue to provide good healthcare for those living in slums, informal settlements and distant rural villages like Naikarra.

In case you missed the first two stories in the Naikarra series, you can find them on our website here.

Thank you for being a part of this journey with us, we couldn’t do it without you!

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!"

A hero cannot exist in a vacuum

The 30 villages fenced by hills

By Kinya Kaunjuga

The heat was brutal and unforgiving as I herded our cattle. At times the dust would prevent me from knowing where they were. When I couldn’t see each one, I would call out their names, so they wouldn’t stray too far.

And yet there’s nothing I was more proud of as a boy. In fact no matter how far I walked, sustaining myself on the milk my mother had packed in my gourd, I was motivated to search for pasture deep in the harsh terrain, knowing that our fattened cattle would be the admiration of the entire village.

A Maasai boy herding cattle. (Photo by Roya-Ann Miller).

Over time, I developed a keen sense of where to find succulent patches of vegetation and hidden pools of water southwest of the Ewaso Ngiro landscape. Usually, they were too far away for me to return home on the same day so I spent many days and nights alone without the security of our kraal and this created a bond between myself and nature.

This bond led me to study Agricultural Engineering at Baraton University in Kenya.

Naikarra means fence in the Maasai language. It describes the hills that surround 30 villages in Narok County like a fence. (The first photo in this story shows those actual hills from the middle of Naikarra town).

When we had a break from the university, I would visit my village and witness the difficult plight families faced when a loved one got sick or had birthing complications and they couldn’t reach the nearest hospital because it meant walking for many days.

As I spoke to a friend about the struggle our villagers experienced to get medical care, he suggested that I study nursing. A nurse himself, he was convincing and so I applied to nursing school. When I didn’t get in, I applied to the school of pharmacy. When I didn’t get in to that either, I applied to medical school and got accepted. Since I couldn’t afford the entire medical degree, I got a medical diploma which is why I’m a Clinical Officer.

Seen here, Leonard Lemontoi, the Clinical Officer In-Charge at Naikarra Medical Centre, travels to the villages to treat and dispense medication to patients because reaching the facility on foot can take many hours or days.

When the elders asked for my return, I was perfectly positioned as a Maasai with medical training to address the unique challenges presented by our deeply cultural people. Especially the fear of medical treatment that they did not understand.

For example, I discovered the maternity uptake was very low at the health center because the Maasai mothers believed that healthcare workers were not friendly towards them and were not kind.

Leonard weighs one of Naikarra's patients during his medical rounds in the villages.

I decided to go out into all the villages and reach them. I started making sure the staff were kind to our mothers. For example, by showing them how to use and deposit pads and how to use the indoor toilet when they came to Naikarra to give birth. We got good beds with good mattresses, cleaned and brought in a heater for cold nights, and a small gas cooker to make tea and a meal for the patients.

Our deliveries at the clinic increased from 10 to 30 per month.

Sounds bites, odds & ends

A Maasai gourd on display in a gallery.

“This work is more than just work. There are things you have to do that are extraordinary. For example, forgoing a salary due to patients who cannot afford to pay. My wife Josephine does not complain and she adjusted to the life we have. She is currently running a small shop in town and sometimes it’s what feeds us and our three children,” says Leonard.

Leonard and Josephine have 3 children, Sanaiyan, Naserian and Neitanei. They always know where to get a sip of milk that's nestled in their gourds.

“I carry out many procedures to save patients’ lives because the alternative is to send them to a bigger hospital in Narok town, which is 3 hours away by car and they would die on the way without my intervention,” Leornard Lemontoi, CO at Naikarra Health Centre.

In the next and final chapter of this story, Leonard talks about, “How Naikarra found Banda.” In case you missed the first chapter, check it out here: Spear guarded patients.

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

Thank you for giving to Banda Health. Your donations make it possible to consistently improve our technology solutions which medical clinics in distant villages like Naikarra are using.

We couldn’t do it without you.

Author picture

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!"

I was married to a 32-year old wife once too

I was married to a 32-year old wife once too

By Dr. Steve Letchford

Steve and Sherri Letchford

My best friend turned 39 (again) this past month. She’s a suburban girl who has held my hand for so long now that it’s hard to imagine not having done life with her.  The older I get (and no one has thought I was 39 for a long time now), the less I take for granted how long we have walked through life side by side.

Njoroge’s wife died one night when I was on call a few years ago, leaving him with their 8-year-old daughter. The Kijabe team did what few places in Kenya could have done for Njoroge’s wife.  But it was too late. And she was 32.

She had been healthy, and now she was dead, and once upon a time, I was married to a 32-year-old woman too.

I’ve been doing this job so long that nights like this shouldn’t make me tear up. But they do.

Wes and I started Banda a few years ago because God let me do just a little bit of life with Njoroge. If his wife had gotten a bit better care a few weeks before she came to us she would still be alive, taking some inexpensive medicines to treat her illness, and watching her daughter grow up.  But she isn’t. And now Njoroge and his daughter wake up every morning without her.

Because it’s what happens when sweethearts live on the edge of absolute poverty.

Today Banda is working with 77 “no-doctor” clinics in the slums and villages where the poorest families live, helping these clinics improve the care they give to 300,000 patients per year. There is so much more that needs to be done, though, and so many more places that we need to do it.

Empower others. Use technology. Do it together.

Thanks for being a part of this journey with us, using technology to empower the frontline medical clinics and medical health centers taking care of some of the world’s most vulnerable patients.

We couldn’t do it without you!

Author picture

Dr. Steve Letchford is a specialist in internal medicine and in pediatrics. After running a US suburban private practice for 7 years, he and his family moved to Africa in 1998 where he has worked since at rural hospitals in Zambia and Kenya in patient care, medical training, and leadership development.

In 2016, Steve and Wes Brown co-founded Banda Health with a vision of transforming lives by using technology solutions to empower the clinics caring for the world's poorest patients.

Steve and Sherri's four children and their families keep them young :).

When grit meets tech

Medical Clinics are Nailing it with Technology

By Kinya Kaunjuga

Patients in slums, informal settlements and remote villages are flocking to clinics that use BandaGo. The clinics are owned and run by clinical officers and nurses bent on fixing access to good healthcare in those communities.

Without much else besides their grit, they’ve saved up, bought a computer and purchased internet access then logged into BandaGo determined to use digital technology like never before.

A medical clinic with BandaGo on their computer.

In the past few months, we’ve acquired two new partnerships which join us in empowering healthcare heroes using our technology solution in their clinics, to avail the best treatment to their patients.

The first partner, LifeNet International, has teamed up with Banda Health to train clinics that use BandaGo in their business operations and clinical management.

The second partner is Mission for Essential Drugs & Supplies (MEDS) which is now supplying BandaGo client clinics with bona fide medical drugs and supplies at best-in-market prices, keeping their supply costs down and eliminating the risk of counterfeit drugs at the same time.

As soon as LifeNet began training a BandaGo client clinic in best business and clinical practices, the clinic’s use of BandaGo to track their patient visits, income, expense, and inventory increased from 25% to 100%!

We hope the video at the end of this newsletter will inspire and excite you about the impact our partnerships are already making!

Little Genius Update

In the story One Way to Inject Hope we told you about a heroin addict who decided to quit to save her unborn child. She persevered through painful withdrawals for close to a month.

On a cold July night in her house, she gave birth on the floor where she and her neighbor had spread paper. They used a razor blade to cut the umbilical cord and a rope to tie it. She visited a medical clinic the following morning and the baby boy was declared in perfect health. He is pictured below at 4 weeks old during a visit with the Black Belt Nurse.

Little genius his sweatshirt proclaims!

In the video below, Diana, a clinical officer and owner of a clinic, describes the impact of getting technology to manage her business and clinical operations.

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!"

Spear guarded patients

Send Us Back Our Son

By Kinya Kaunjuga

Leonard Lemontoi Loontaye with two moran patients at Naikarra Medical Centre located at the border of Kenya and Tanzania. He is the Clinical Officer In-Charge.

“I think they are asking for my return,” I told my wife, Josephine as we sat down to eat dinner.

It had been a usual day at the hospital but the stares and flurry of activity my colleagues would engage in every time I walked by seemed exaggerated.

In fact, as I picked up a patient file from the nursing station, I was surprised to find the receptionist huddled in conversation with the nurses. Being the oldest employee at the hospital, the entire village knew she never left her desk which was in perfect view of the tv where her eyes remained glued even as she stamped patients’ cards and belted out their names.

A typical reception area in a small-sized medical clinic that uses BandaGo.

As I reached for the file, their voices reduced to hushed tones. My suspicion that they were keeping something from me was confirmed when I walked outside during one of my breaks. Unaware of my presence, our pot-bellied hospital superintendent was staring at a fly on the wall as if wishing he could get that close to the ceiling fan to cool off in the midday heat.

Since arriving in Narok county, he had taken a fancy to the local goat meat. No one blamed him, the goat meat here was renowned country-wide. Its naturally tender pink hue and irresistible salty flavor was caused by the thorny acacia bushes and alkaline water the goats fed on. The Maasai did not eat meat daily. They drank milk and cow blood, which sustained them during the long distances they walked their livestock in search of pasture.

Maasai shepherds returning home.

I cleared my throat loudly and in an attempt at a cursory glance towards the noise, the superintendent swiveled and faced me. Over the past few years, his neck had gradually disappeared, seeming to leave his head planted immediately atop his stout body. His crestfallen expression at finding me there was quickly disguised with the jolly smile he always wore.

Yet looking closely it was unaccompanied by the hope-filled childlike twinkle in his eye that patients and staff had grown fond of. My instinct told me that the odd behavior I had witnessed all day was connected to whatever was weighing on his mind. As a medic in this cultural region, I had learnt to look at my patient’s eyes as I examined them. In spite of their brave smiles or positive greeting, a patient’s eyes could not hide how bad they were feeling. Our eyes are a window to our souls.

Leonard, a Maasai himself, understands his patient's needs uniquely. Seen here, he travels to villages around Naikarra treating the sick in their homes, churches and schools like the one above. With BandaGo, he can now record their treatment digitally to enable continuity of care as far as he goes.

“If they want you to go back, you must. They gave you their blessing and sacrificed one of their morans to leave the village and go study. They need you now. I will prepare the children and items for the journey,” said Josephine.

That is how I came to Naikarra Medical Centre.

My colleagues had seen the moran clad in beads and our distinctive tribal red cloth draped over his shoulder obscuring a sheathed knife. By the time he was leaving the superintendent’s office, word had spread fast throughout the hospital.

Besides being covered entirely in caked dust that indicated he had walked during sunny and rainy days, his upright, tensed and focused physical stature sent fear down anyone’s spine that would try to stand in his way. Managing such energy and emotion under strain is taught to Maasai boys from as early as 8 years old when the rite of passage from childhood to moran takes place. They must be tough enough to protect their cattle, women, children and the elderly from rustlers, wild animals and tribal warfare.

A moran is a member of the warrior group of the Maasai people of East Africa, which comprises the younger unmarried males. To prove their strength and maturity, they jump in the air as a part of traditional dance. The higher the jump is, stronger is the man, and the more respect, admiration and desire from women. The jumping also acts as a way for morans to attract brides. The higher he jumps, the more of an eligible bachelor he is.
"Everybody is using BandaGo at Naikarra - even our cleaner is putting in soap needs in the system; soon we will put in Maasai spears for the guard," says Leonard Loontaye. Pictured here is the guard who uses his spear to watch over Naikarra's patients and staff throughout the night.

Your commitment is making this happen!
With your help BandaGo is now used in 71 clinics which have treated 410,860 patients in 3 countries.

Through BandaGo – our Health Management Information System, technology is actively helping medical clinics continue to provide good healthcare for those living in slums, informal settlements and remote villages like Naikarra. Thank you for being part of this journey with us, we couldn’t do it without you!

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!"