Let’s start with a simple thought experiment – imagine a young girl (27) delivers a baby in a typical off-grid rural village in Kenya. One day, she’s highly excited about her new baby girl. The next day she’s highly anxious because she can’t find a place to vaccinate her baby. Kiu, the nearest health center, is 10 kms away. Worse yet, there is no guarantee of finding ready vaccines at Kiu, the local clinic. “You will be very lucky to find vaccination at Kiu on the first visit. Vaccination is booked in advance,” comes cautionary advice from the older, more seasoned mothers in her village who have experienced similar ordeal in the past.
For you and I – the ordinary people – this would be a story with an obvious ending – despair, hopelessness, possibly even death. Yet, as this report will demonstrate, this story has a very positive and inspiring outcome, thanks to Norah Magero, the young lady who, against major odds, decided to turn her despair into hope for every mother not just at her Kiu village, but across Africa!
With an inquisitive mind and sharp eyes, Norah is not just extra-ordinary in her energy and passion, but also in her creativity and problem-solving skills. As a talented young engineer, Norah quickly discovered that the primary reason her village lacked access to vaccines was because there was no electricity. No electricity meant no cold storage or refrigeration to store not just the vaccines but also other live-saving medicines.
Thankfully, the more desperate she got, the more inspired and innovative she got! After several iterative rounds of fabrications and testing, a solar powered vaccination box (aptly dubbed Vaccibox) had taken shape. That was over 5-6 years ago.
Several years later, tremendous progress and improvements have been made on the prototype. The 50-liter Vaccibox is now not just solar powered. Its remotely-monitored, thanks to the integration of the latest internet-of-things (IOT) technology. It’s slick yet robust. Adding roller wheels and hooking it on a bike has made it more versatile and highly user-friendly. One can easily pull it a long the muddy roads in rural Kenya as easily as dragging a carrier bag in an airport!
Norah and her colleague James, a medical practitioner, founded Drop Access Ltd – the business entity with a bold mission: equipping every rural clinic in Kenya and Africa with a Vaccibox. This, they claim, will deliver hope to mothers and save the lives of millions of children. And the statistics are alarming! Every year, approximately 30 million African children fall sick from vaccine-preventable diseases, and half a million of them die as a result. This is according to the World Health Organization (WHO).
Sooner than later, however, Norah and her team realized that the mechanical fabrication of the Vaccibox in their workshop in Nairobi was a piece of (engineering) cake. “Give my engineers all the materials they need and they will assemble tens of units per week without a sweat,” Norah reckons with pride. However, realizing the dream of delivering a Vaccibox in every clinic, takes more than fabricating nice-looking metal boxes in a workshop. It requires what entrepreneurs call a “viable business model.” And if there is one critical lesson that Norah and James have painfully learned, it is this: creating a viable business model for Vaccibox, including building efficient supply chains for locally-sourced and imported components while delivering cost-effective last-mile distribution and after-sale service, is a very hard nut to crack!
To help them crack this hard nut, Drop Access Ltd turned to the Startup|Energy, an initiative of the Stiftung Solarenergie, Germany (StS DE), with an ambitious mission – transforming African Startups in Energy into viable and scalable enterprises through hands-on business coaching, mentorship and pilot projects for field operations execution and validation. Drop Access Ltd is one of the over 20 current fellows of the Startup|Energy. With support from StS DE, Drop Access Ltd installed Vacciboxes into four rural health centers in the Homa Bay County, roughly 400Kms west of Nairobi.
With this background and context in mind, our field visit in Homa Bay started-off with a lot of doubts and skepticism – how can a small solar-powered box “deliver hope and safe lives” – as boldly advertised by Norah and her team? What’s so innovative and transformative about a metal box with roller wheels? The answers to these questions are articulated in the two case-studies presented below. The case studies succeeded in converting our initial skepticism into evidence-based, rock-solid conviction that, indeed, Vaccibox delivers hope and saves lives. Another key finding is that the nurses love the Vaccibox. It’s has become one of their most critical tools of trade, without which, their effectiveness as front-line health workers, would be highly compromised.
Case Study One: Randhore dispensary, Ndhiwa Sub-County, Homa Bay County
Similar to designing a Vaccibox, finding one’s way to the Randhore dispensary is not for the faint-hearted. Located in the lower edge of the Ruma National Park and separated from Lake Victoria by the world-famous Lambwe Valley, the geography and green scenery to Randhore dispensary is beautiful and breath taking. But there is a problem – if the cattle-track like roads are impossible during the windy and dusty dry periods; they are impassable during the rainy seasons.
Luckily the journey fatigue melts away the moment you walk into the Randhore dispensary and meet a man clad in a white dust-coat, wearing a big smile. His name is Mr. Anthony Otieno, the only nurse running the clinic for the past two years. “The common diseases we treat here include malaria and upper respiratory infections like pneumonia,” explains Anthony as he welcomes us to the clinic and points at his data chart neatly displayed on the wall.
Picture: Anthony Otieno Nurse-in charge at Randhore Dispensary
“And what has been the experience with Vaccibox?” I go straight to the point of our visit here. “Oh, you take away this thing and am out of here!” he responds without hesitation. “You simply can’t run this clinic effectively without the Vaccibox,” Anthony continues as he stands up to demonstrate what he stores inside. “Vaccibox is the only source of power in this clinic,” Anthony explains as he excitedly points to the 260W solar panel mounted on the roof.
Started in 2016, Randhore clinic is not yet connected to the national grid. There was a glimmer of hope 3 years ago when a nearby primary school was connected to grid power. Unfortunately, the grid power lines were damaged soon after by a heavy rainstorm typical of this region. Since then – three years ago – the grid power lines have never been repaired, plugging the village back into darkness and dashing any hopes of access to grid electricity. Across rural Kenya in particular and rural Africa in general, this on-off grid supply is the rule rather than the exception.
“At this clinic, we attend to 7- 10 maternal deliveries per month,” Anthony takes us back to his well-maintained records. “And the 7-10 are only the minority because fewer deliveries happen during the day than at night. For night deliveries, which are the majority, we refer them to the nearest grid-powered health center 20 kms away,” clarifies Anthony wearing a sad look on his face. “I hate sending expectant mothers away at night. But what can I do? I can’t help them deliver at night in darkness!”
“Anthony, if you were given an opportunity to request for one single thing for this clinic, what would it be” I pose the question to Anthony as we sign-off his visitor’s book. “A bigger solar system to power this entire clinic. That would empower me to serve my community 24/7!” Anthony’s need and dream for a fully solar powered health center is compelling. We can only wish that his dream will be realized one day. Sooner rather than later!
Aged 33, Anthony is still young in his medical career. But why is he so passionate about serving his community? We discover the answer to this question when we meet Millicent, a short distance away (2 kms) from the clinic on our return journey. Married off at below 20, Millicent is now barely 30, with 3 kids. The last one hardly 2 years and a expecting a 4th one. Its noon and the kids are munching on some sugar cane for lunch as they take cover from the scotching mid-day sun typical in the Africa tropics. A mud-walled, grass-thatched single room is their only cover from the elements. It’s self-evident poverty has taken deep roots in this village. And, as is often the case across rural Africa, women are bearing the heaviest burden of the deprivation.
“This family represents my typical client at the clinic. Serving them well feels like serving God to me,” concludes Anthony making it clear the source of his inspiration and passion. With a local population of nearly 4,000 depending on the Randhore dispensary for a wide range of health services, Anthony’s work is clear cut out.
Case Study Two: Rapedhi dispensary, Ndhiwa Sub-County, Homa Bay County
Having started off with lots of doubts and skepticisms on the Vaccibox, it was very tempting to dismiss the powerful testimony of Anthony as an isolated case. That was until we entered Rapedhi, our second Health Center, and met Cynthia Morin Otieno, the nurse in-charge since June 2022.
Started in 2021, Rapedhi serves a much larger population of nearly 6,000. “My immunization target for children below 5 years is 2.465 for 2024. And as you can see on this chart, I already immunized 142 kids in the month of January,” proudly explains Cynthia as she effortlessly and cheerfully switches from injecting a vaccine jab on a kid to helping us understand the health data and graphs on the wall.
Picture: Nurse Cynthia at Rapedhi Health Center
“And how did the Vaccibox helped you achieved your immunization target?, I inquire wanting to learn more. “Before we got the Vaccibox, we only managed to deliver vaccination at a rate of only once or twice a month. This is because I had to hop onto a motor bike to go and collect vaccines from the nearest hospital. Carry the vaccines for the day in an ice-box. Deliver the vaccinations and return any surplus back to the hospital for refrigeration. Working out these logistics, back-and-forth, on a single day would leave me completely exhausted barely able to work the following day yet am the only nurse here!” Cynthia articulates her challenges in the past.
“But since the Vaccibox was installed last month, vaccination has become an easy “walk-in-work-out” experience for the mothers. You no longer see long queues of mothers waiting for their turn as was the case before. Indeed, a mother can rush here, get served and rush back to the market or back to the farm. I expect the immunization rate to increase significantly once every one in the village learns of our new efficient service,” explains Cynthia as she shows us how she uses the Vaccibox.
How about her personal productivity? “Personally, I can say my productivity has improved because vaccination is no-longer the nightmare experience it used to be. Vaccination has become easy. It’s not part of my daily work which I highly enjoy,” Cynthia concludes her testimony.
My visit to the two health centers showed me two impressive things: on the one hand, the immense benefits of the solar-powered vaccibox for the healthcare of our rural population in Kenya. And on the other hand, the value of local startups and their innovations: They develop new products based on their own life experiences: made from Kenyan experiences by Kenyan engineers for Kenyan people.
If you would like to support the installation of more vaccine boxes in health centers or the installation of a 24/7 solar energy supply for the Randhore dispensary, then donate to the work of the Solar Energy Foundation!
