Sniffing

As some of you may already know, I (David) won't be starting full-time at Banda Health until the end of October. In the meantime, we're focusing on language training (Kiswahili), but we only have classes four times a week, so I can already get a little taste of the work.

I would like to tell you about such a day because it is representative of what my work will look like in the future.

Early in the morning, Steve, the head of BANDA Health, picked me up. Our destination was a clinic near Kariobangi, a slum on the other side of Nairobi. For the first time, we drove around the outside of Nairobi to avoid traffic, and once again I was amazed by the contrasts in this city. Right next to the highway built by the Chinese, stretches a sea of rusty corrugated iron roofs (the Kibera slum), the alleyways between the dwellings barely discernible. Behind this extreme poverty rise the high-rises of the CBD (Central Business District) – the financial capital of East Africa.

As we drove at walking pace through the unpaved streets with open drainage ditches (we couldn't go any faster because of the handcarts delivering yellow oil canisters full of drinking water), I thought, yes, it is precisely because of these people that we came here.

The Mundika Clinic has 25 beds, birthing and examination rooms, as well as a laboratory and pharmacy, all within a space smaller than an average three-room apartment in Austria. It's open 24 hours a day, and the nurse who founded the clinic in 2007 is the best-trained staff member on site—no midwives, no doctors. Over 901,000 of the surrounding population's medical needs are met at this clinic for less than €1 per patient per month. I have no idea how this business can operate.

We hoped that our conversation with the owner would allow us to explore an ethical issue. Many clinics need BANDA Health's services, but currently it's not possible to serve everyone who is interested. Therefore, we need a process or set of guidelines to determine the order of service. So far, BANDA Health has focused on clinics run by churches or Christians. However, we are now considering serving clinics that act as gateways to a specific area or population group. This would allow us at BANDA Health—and colleagues and brothers and sisters from other ministries—to reach people who would otherwise be inaccessible. In this conversation, we wanted to get to know this man and his clinic, understand his motivations, and determine whether we could collaborate on an ethical basis. What does he hope to achieve with his clinic? How does he treat his staff? How reputable are his medical treatments? Are his prices reasonable? Does he collaborate with other groups with whom we would also consider working? Some clinics unofficially offer procedures that are prohibited or dangerous. Abortion is illegal in Kenya, for example, yet it is frequently attempted using unconventional methods – often with fatal consequences for mother and child. It was fascinating to have such a conversation and to gain insight into this sector in this country for the first time. It was also exciting to discuss such strategically important issues for the organization and to be able to contribute my perspective.

After we had received answers to many of our questions, we discovered that our vehicle had been hit by a car outside on the street. This gave me another hour to question the receptionist about the public funding of such clinics. It was very enlightening and also sad, because I saw how inefficiently the limited resources for the population are used.

In the afternoon, we visited the BANDA Health office, where the leadership of a local church network had been invited for a meeting. These churches run two clinics, one in the Kibera slum and the other in a poor coastal area (Kwale). Until then, they had no idea how effective their work was. What had their hard-earned donations truly achieved? Who had been helped? What could be improved? After just a few weeks of working with BANDA Health, they finally had answers to these questions. Data was visualized, processes were clearly defined, plans were developed, and steps were established to better serve the patients and their families. It was so refreshing to see that—despite corruption and overwhelming poverty—brothers and sisters in Jesus were helping their fellow human beings and offering love and hope.

On the drive home, I unexpectedly had a lot of time in the car with Steve because the sunny day turned into a thunderstorm. In Nairobi, that means flooding with raging currents and even more traffic than usual. It took us almost two hours to cover four kilometers, but it was valuable time during which we could discuss BANDA Health's strategy and my role in its implementation. There is so much urgent and important work to be done, and the possibilities are almost limitless, so it's crucial to think carefully and plan what you do, and above all, to pray a lot for wisdom and guidance. Once you get started, completely unexpected challenges arise, requiring a flexible response. I felt even more excitement about and joy for the new tasks ahead.

Arriving home, I was greeted by three cheerful blondes and a grinning dog. The girls had invited friends over – which in itself is an answer to prayer – and it warmed my fatherly heart. Lisa had good news about her own area of responsibility, and we chatted and discussed it like excited teenagers until late into the night.

Oh, I simply love it here. We thank God daily that we are allowed to walk this path with Him and with you.