From City to Country and Back


Nairobi TrafficMud

As we head north out of Nairobi on Thika Road, shopping malls and rush hour traffic gradually fade into small kiosks and open countryside. It is pouring rain as we arrive in Makuyu Province and when we turn off the main road, Charles (SHF’s driver) turns to me and says: “Are you ready? It’s going to be a bumpy ride!” Charles has become a hero of mine in my short time here – for his ability to navigate Nairobi traffic and now endless puddles, as well as his warmth and welcoming. In between getting stuck in ditches, he points out fields of pineapples, hippos peering out of the water, and monkeys on the side of the road.

I’ve been accompanying Charles on his regular delivery of drugs and hygiene products to SHF outlets, and taking advantage to see operations firsthand and learn from the franchisees. Today I meet Ann, Miriam, Philomena, and Veronica. I sit with them as they count up the items that we deliver, and listen to their successes and challenges as small business owners and health care providers. I am struck by the differences from Dorah and Millicent’s shops in Kibera. Here the challenge is to get enough people in the door, in rural settings with government/missionary clinics providing free services nearby. Each of the franchisees we meet today sees only about 15 patients a day, compared with Dorah’s 65. At the same time, a greater percentage of their patients are paying clients.

I find myself coming up with more questions than answers after these first few visits: Can franchises operate in the same way in these very different settings? How can we improve marketing/outreach efforts to bring more people in the door in rural areas? And what is the ideal design of a payment system for patients who cannot afford treatment/drugs? I also reflect on a conversation the fellows had in New York: Is everyone an entrepreneur? Some of the franchisees are as entrepreneurial as anyone I’ve ever met, others are not at all… but that is not necessarily a bad thing. I am interested to learn what John is finding at Scojo with Vision Entrepreneurs, Jon at Jamii Bora, and Wangari at Kashf.

Traffic back into the city was a nightmare, as always, but I made it back for a late Thanksgiving dinner. No turkey for me this year, but Edwin made ugali & greens and Lisa a sweet potato pie. Lots to say “asante” for.

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