Delivering free primary healthcare in Nigeria with microclinics

This August, Safe City treated its highest number of patients yet—786 in a single month—bringing the total number of people reached with free primary healthcare to 4,768 in just nine months. Over half of this month’s visits were returning patients, while 44% were new, showing that even as the clinic matures, word continues to spread among neighbours in Oworoshoki.

Safe City continues to serve those who would otherwise go without care: 97% of patients were uninsured and living on an average monthly income of $29 while supporting a household of four. While this figure is slightly higher than in previous months, it remains far below the poverty line. The clinic has become a true medical home and safe haven for mothers, children, and fathers alike, people whose lives have been improved or even saved thanks to your support through Kwanda. On behalf of our Oworoshoki friends, thank you for the real, tangible change you’ve made possible.

Developments:

• In August, 786 people received care, bringing the total number of patients treated from 3,982 to 4,768.

• Patients also recycled approximately 3 pounds of waste this month. The clinic will receive funds generated from the past four months of recycling through WeCyclers by the end of September.

Activities:This month, Safe City's medical team treated:

• 193 malaria patients, many of them children under 10 at high risk of severe illness or death

• 94 hypertensive patients

• 134 respiratory infections

• Over 300 patients with other illnesses, including rashes, insomnia, and peptic ulcers

Hear from Mrs Kehinde, one of Safe City’s patients, this month:

Challenges:Young adults aged 19–25 remain underrepresented among clinic visitors. We suspect this is due to work hours conflicting with the clinic’s weekday schedule (Monday–Friday, 8 am–4 pm). We’re exploring possible solutions, including telemedicine, and would welcome any thought partnership on identifying and addressing the root cause.

Financials:

About 54% of Safe City’s six-month budget has helped provide free care to 2,044 patients.

Over the past two weeks, we completed all renovations at Care Circle Surulere, including painting, branding, blind installation, and final equipment purchases. We also welcomed two incredible nurses, Benedeth and Sylvia. We also finalized plans for the clinic’s official launch: a large community outreach event on September 14, followed by a medical outreach and ribbon-cutting on September 20. Full-time operations will begin shortly after.

Activities:

• Completed painting and added branding to the reception area

• Purchased and installed blinds throughout the clinic

• Acquired and organized remaining equipment (BP machines, weighing scales, mattresses, laptop, phone)

• Hired and confirmed two nurses: Lead Nurse Benedeth (25+ years experience) and Nurse Sylvia (10+ years)

• Conducted deep cleaning and fumigation of the clinic

• Finalized launch plans: Sept 14 community parade, Sept 20 medical outreach and ribbon cutting, followed by weekday clinic operations

Challenges:

Operations ran smoothly overall. The only delay was finalizing staff interviews and ensuring full buy-in from Surulere stakeholders. To support community ownership, our partners and local residents were deeply involved in hiring decisions. With a high volume of applications and coordination across groups, the process took longer than expected but we’re now fully staffed with two excellent registered nurses.

For future hiring, we’re exploring affordable applicant tracking systems and calendar tools to streamline the process.

Meet Nurse Benedeth, our lead at Care Circle. She brings 25+ years of experience, including 16 years as a matron in a Lagos government hospital. She’s kind, highly skilled, and a passionate advocate for health equity. She’ll be working alongside Nurse Sylvia, who has over 9 years of experience. Both nurses were selected from a pool of over 50 candidates and vetted by the AHA, community partners, and the Surulere clinic committee.

Care Circle’s services will be supported by our network of volunteer physicians.

Next steps:

Staff orientation begins next week. Nurses Benedeth and Sylvia will undergo a five-day immersion at our Safe City and Gbagada clinics to train in operations, EMR tools, and best practices, ensuring they’re fully prepared for day one.

Finances (last 3 weeks):

We’ve now used about 94% of Phase 1 funding. The remaining 6% will go toward clinic decor and initial medication procurement in the coming week.

This month, we’re excited to highlight the story of Mrs. Emako and her son, who recently shared their experience at Oworoshoki Clinic. In their video testimony, they speak about the impact the clinic has had on their lives and how the care they’ve received has helped them feel healthier and more hopeful.

We’re thrilled to share that the Oworoshoki clinic has now provided care to 3,982 people since launch! This means we’re close to reaching our annual target of 4,000 patients in just eight months, showing the incredible need for healthcare in and around Oworoshoki.

In July alone, 716 patients walked through the clinic’s doors, the highest monthly number yet, to receive free, high-quality care.

A particularly significant milestone this month was the diagnosis of the clinic’s first two HIV patients in Oworoshoki, made possible by our introduction of rapid HIV test kits. Without this intervention, these individuals could have gone months or even years without knowing their status, risking progression to AIDS or unknowingly transmitting the virus. This is exactly why the Oworoshoki clinic exists.

Our medical team referred these patients, along with others in need of specialized care, to tertiary institutions for further treatment and continues to follow up with them. Through our partnership with Health Emergency Initiative, referred patients can have bills covered up to N20,000. In this case, because of their HIV diagnosis, their ongoing treatment at government institutions is fully covered.

Finances:

~$535 total used in July on the following:

• $250: Staff salaries

• $285: Medications, supplies and maintenance (slightly above monthly average budget due to higher patient turnout)

Excited to share some updates from the Surulere clinic renovation this past week:

1. PVC ceilings are up:

We’ve completed ceiling installation in both the newly renovated indoor space and outdoor waiting areas! Thankfully, the donated basement already had a solid, intact ceiling and only needed a bit of repainting. As always, we sourced the PVC materials locally and hired a skilled local Surulere-based artisan to do the install.

Indoor space:

In the past week, we purchased tiles and tiled the entire clinic floor. Here’s a quick before-and-after:

Before: 

We purchased plumbing materials from local vendors and installed handwashing sinks in both the nursing station and consultation rooms (aligned with local Lagos state health regulations). We’ll be fixing the full toilet fixture in the restroom this week.

We’ve started buying our first pieces of medical furniture, including an exam couch, desk, ward screens, and more. More purchases are lined up this week as we inch closer to full setup.

This week, we’ll be partitioning the space into: Reception area, Nursing station, Consulting room, Pharmacy and Mini ward/observation room. 

Once that’s done, we move straight into painting.

We’re thrilled to share fresh updates from Surulere from the past week!

Roofing complete: The roofing for the clinic is now fully installed. Since the donated space already had a solid, fully constructed room, we only needed to roof a small section, which helped us save both time and resources.

Here’s the transformation:

Before clearing:

Tentative launch date set: We’ve put a tentative launch date for the clinic in the first or second week of September, and we’ll confirm the exact date very soon.

June was a huge month. We officially crossed the 3,000-patient mark! In just this month, we treated 542 people with completely free, high-quality primary care. Since launching in November 2024, we’ve now reached 3,266 lives, and the need keeps growing.

98% of our patients had no insurance, and the average household income was only ₦29,114 (~$19/month), showing the real gap we’re helping to close.

June Highlights:

• Patients came from 8 different communities, including one who traveled 23 km from Ajah (about an hour away). Word about the clinic is clearly spreading.

• Our sustainability program kept going strong. We recycled 3 lbs of plastic waste.

The clinic is delivering high-impact, respectful care to some of Nigeria’s most underserved communities.

I’ve attached the June report.

Renovations have officially started at our Surulere clinic!

We’re excited to share that construction is now underway. Over the past week, we worked with local builders to survey the site and begin renovations.

Through a careful bidding process, we chose the most cost-effective team from the Ikate Surulere area. In line with our mission, we’ve prioritized hiring local workers and sourcing materials locally. This helps improve healthcare access while also supporting the Surulere economy.

Here’s what’s been done so far:

1. The basement is being cleared and renovated into a consultation room and observation ward. Builders have sealed off old doors and added window openings.

2. Foundations and brickwork have begun for the new area, which will include the reception, waiting room, and likely the nursing station/pharmacy.

3. Bricks for a toilet and shower have been laid, meeting state standards.

4. A clinic committee made up of local residents and professionals has been formed. They’ve been involved since the start of renovations, offering valuable community insights. Their input is shaping a space that truly serves the neighborhood and builds local ownership.

Next up: Roofing

A local carpenter measured the space last Friday and will begin sourcing materials. Roofing is set to start on Monday

The micro-clinic in Oworoshoki provided free primary healthcare to 538 patients in May and reached an amazing milestone of 2,700+ patients treated since launch!

The youngest patient was a 1-year-old baby girl and our oldest was an 86-year-old grandma.

Malaria, hypertension, and respiratory infections remained the most common illnesses treated.

Nearly 98% of patients were uninsured.

You can read the full report here.

I am really excited to share the latest impact metrics from the clinic, Oworoshoki. In the month of April, the clinic treated almost 400 patients at no cost—95 % of whom were uninsured and earning an average of $20/month in a ~ five-person household.

One of those patients was Marvelous, a 17-year-old girl from Oworoshoki. During her post-visit survey, Marvelous said to the care team at the clinic:

I've been able to get free medication, which is something I was unable to afford before.

We observed a moderate overperformance to our initial monthly target of 200-300 patients, with 357 patients served in April! This month, we continue to see a strong shift towards repeat patients (42% repeat), anchoring the idea that Safe City is now becoming a true medical home for many patients.

The micro-clinic provided free primary healthcare to 357 patients in April, and also celebrated a major milestone—the 2000th patient!

The youngest patient was a 1-year-old baby boy, and the most common illnesses treated were malaria, respiratory infections, and unmanaged hypertension.

You can read the full report here.

Another month exceeding impact for the target with almost 500 patients helped at no cost in March!

Super excited to share the latest impact metrics from the Oworoshoki clinic.

In March, the clinic treated almost 500 patients at no cost, 100% of whom were uninsured and earning an average of $11/month in a ~ four-person household.

Similar to last month, the clinic continues exceeding its impact target! This month, we see a strong shift towards more repeat patients (24% repeat patients vs 5% last month). This shift signifies the clinic's gradual transition to becoming a true medical home for thousands of children, mothers, and fathers in Oworoshoki, who, before this clinic, had no other option for affordable primary health care in their community.

Hear from one of the patients here:

In March, the micro-clinic we funded in Nigeria treated 487 patients, including a one—year—old baby girl and an 88-year-old grandmother.

Plus, patients recycled 7 lbs of plastic to help sustain operations.

You can read the full impact report here.

We've just published the February report from the clinic in Oworoshoki. You can read the report here.

Also, here's a video of one of the best beneficiaries. It's in Yoruba, but English subtitles have been added.