An afternoon in Kibera

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“Welcome to Kibera!” announces a cheery voice.

My mind is racing; I hadn’t even noticed our arrival at Senye Clinic, one of SHF’s Child and Family Wellness Shops in the Kibera Slum of Nairobi, where nurse Dorah Nyanja greets us. Her brightly painted white shop stands in stark contrast to the surroundings – run-down homes with rusted tin rooves, chaotic storefronts, and trash… trash everywhere.

Kibera, East Africa’s largest slum, is home to nearly 1 million people in a 630-acre area on the outskirts of Nairobi. I have read, heard, and seen video footage of Kibera, but I am still overwhelmed when we arrive. My Dad described Soweto to me as “cities within cities” and I am struck that this is a fitting description here. As I stand on a crowded stretch of road in front of Dorah’s shop my senses are overloaded: the smell of stale trash mixed with stewing meat, music playing through the open windows of a ‘café’ nearby, and kids running uphill in faded school uniforms. It’s hard to imagine that the same intensity extends for miles.

It is in this context that Dorah tries to provide quality health care and drugs to Kibera’s residents. She travels 1.5 hours each way on public transport, leaving her own three children with family, to keep her clinic open from 7am-10pm, 7 days a week. She sees more than 65 patients a day, with problems ranging from malaria, to diarrheal diseases, respiratory infections, and secondary complications from HIV/AIDS. At times, she also serves as counselor, midwife, and mediator. “When you really work in the community, you end up doing everything,” she says with a laugh. Even as we talk, Dorah remains focused on running a tight ship, organizing her files and the new supplies we’ve delivered.

After finishing nursing school, Dorah had the option to work in larger hospitals, but she chose to join the SHF network and open a clinic in Kibera. “I wanted to be with the community,” she describes. But it was not the easy option — it took almost one year to secure the facility and business in Kibera is tough. Most patients cannot afford to pay, and Dorah often provide free consultations against franchise regulations. “I cannot turn someone away who needs help,” she says.

I talk to Dorah for as long as I can before we need to make our next delivery; I hope to come back to spend a full day with her next week. As we drive to SHF’s other clinic in Kibera, I reflect that the 2 main challenges that Dorah describes – 1) Collecting accurate and timely data without access to any technology, and 2) Sustaining her business when more than 70% of her patients cannot pay – are perfectly aligned with my Terms of Reference for the year. The realities of Kibera make the challenges ahead even more apparent, but meeting Dorah provides an enormous sense of possibility and urgency. As Dorah asserts: “When people are suffering, you have to do something.”

Dorah

Pictures from the day:
http://picasaweb.google.com/catherine.m.casey/SHFChildFamilyWellnessShopsKiberaThika 

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4 Responses to “An afternoon in Kibera”

  1. More News from Nairobi « Immersion Says:

    […] members have been impacted, many losing their homes and businesses. But even in Kibera (where I met Dorah just a few weeks ago), which was devastated by riots and violence, things are starting to return to […]

  2. Commitment « Immersion Says:

    […] The last time I saw Dorah, at her Senye clinic in Kibera, we discussed the challenges of providing health care in an urban […]

  3. Another happy customer « Immersion Says:

    […] happy customer Today I had the chance to see the latest addition to Dorah’s Senye clinic: A small refrigerator that allows her to store immunizations for kids in […]

  4. Acumen Fund Blog Says:

    […] Dorah’s Senye Clinic in Kibera has a new addition today: A small refrigerator that allows her to add immunizations to her list of services. […]

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