Updates

Renovations have finally begun at Kwanda's newest clinic in Onosa, Lagos, Nigeria! The community has also given the clinic its name: TOP Community Health Centre, or TOP clinic for short. They chose it carefully, and it stands for both the name of our community partner and the clinic's ambition to be the top destination for accessible healthcare in Onosa. We absolutely love it.

This month we inspected the donated site, which used to be a restroom, with our local engineer and mapped out the clinic with our architects. The plan has a reception and waiting area, a nursing station, a consulting room, an observation ward with its own restroom, a pharmacy and a general restroom, all sized to approved government standards. We then removed the old toilets and sinks to get the space ready for renovation.

Quotes for the first block work came in three to five times above our planned budget, because of inflation in Nigeria and variation between communities. We took extra time to understand what was driving the prices, widened our search and reviewed quotes from the artisans who helped build Safe City. They won the bid, which kept us closest to our budget, and in September our local construction workers broke ground and laid the blocks.

We have spent around $1,500 (about £1,180) on blocks and materials, paying the construction workers and removing the old plumbing. We will keep you posted on whether prices keep rising as the renovation moves along.

It was a big month for the Oworoshoki community in Lagos. Safe City saw 532 patient visits in August, one of our highest this year, and has now cared for 9,594 people since launch, so our 10,000th patient is coming soon! Across both Kwanda-funded clinics we have now served 13,076 people.

246 of August's patients had never visited Safe City before, 46% of all visits, a strong wave of new families still finding their way to us. We saw patients from Oworoshoki, Bariga, Sawmill and Mushin, 12.1km away and our farthest patient this month. 367 of our patients (69%) were women and girls, many supporting families on an average of $11.66 (about £9) per person each month, still well below the poverty line and still without affordable alternatives, and 37% were aged 18 and under, 15% aged 61 and over. As in previous months, malaria was the illness we treated most at 30% of cases, followed by acute upper respiratory infections at 14% and hypertension at 11%.

We spent $516 (about £405) running the clinic this month, and recycled 6lb of waste to help support clinic operations.

Mr Oluwaseyi came to Safe City for a blood pressure check and a consultation with our team. In his own words: "Whenever I come here, whatever I explain to them concerning my health, they give me medications." He is one of more than 500 patients who visited this month, and people feeling heard and leaving with the care they came for, at no cost to them, is exactly the impact we hope for. Nothing went wrong this month, and at this pace our 10,000th patient should come through the doors in the next month or two.

We welcomed 429 people through Care Circle's doors in Itire-Surulere, Lagos, in August, each receiving a free consultation, diagnosis and treatment. The clinic keeps ramping up month on month as it settles in after launch, and has now cared for 3,482 people. Together with Safe City, the two Kwanda-funded clinics have served 13,076 people.

162 of August's patients had never been to Care Circle before, 38% of all visits, as word keeps spreading in Surulere, and we saw people from Itire, Kilo, Aguda, Lawanson and Ijesha. 305 of our patients (71%) were women and girls, who typically manage healthcare for the whole family, and we saw every age, with 25% aged 18 and under and 22% aged 61 and over. Malaria was again the illness we treated most, followed by hypertension at 14%. The families we reach live on an average of $4.64 (about £3.60) per person each month, so a household of four gets by on ₦26,000 (about £14), well below the global poverty line of $2.15 a day.

We spent $498 (about £390) running the clinic in August, mostly on medications and medical supplies, with the rest on clinic operations and materials. Our community plastic waste recycling programme brought in another $27 from selling the plastic we collect, which helps fund the clinic and cuts down mosquito breeding sites around the neighbourhood. Nurses Benedeth and Sylvia delivered care throughout the month, and we are so proud of the team.

Nothing went wrong this month, and with 38% of visits still coming from new patients, we should pass 3,500 people cared for at Care Circle in September.

This month we ran menstrual health and hygiene training at Mutendeu Comprehensive School in rural Kenya and gave Wings Poa reusable sanitary pad kits to 75 girls. Beforehand we ran a pre-survey there to learn what the girls already knew about their periods and how they manage them, and we went back to Makila Comprehensive School for a post-survey to see what has changed since our visit.

That takes us to 955 girls holding a kit and 15 training sessions completed, with 1,277 girls reached through our menstrual health surveys across 20 schools.

The kits are sewn by 12 LitMoms, local women who make the Wings Poa. They have now finished the liners and drawstring bags and have cut the outer cotton fabric for the shields and purses, but those parts cannot be made until the delayed shipment of waterproof PUL fabric arrives. We spent Ksh 129,790 (about £750) this month: Ksh 111,290 to the LitMoms for production, Ksh 10,000 on staff time, Ksh 4,000 on transport for the surveys and distribution, Ksh 2,000 on stationery and printing, Ksh 2,000 on monitoring and Ksh 500 on phone calls.

One girl at Mutendeu told us she had not known much about tracking her cycle, and that getting her period at school could be uncomfortable when she was not prepared. "I am happy because I now know how to count and track my periods. The Wings Poa will also help me when I am in school and I have my period." Once the PUL arrives, the LitMoms will move on to making the shields and purses.

Since receiving the funds from Kwanda in September, we have found the suppliers for the sewing machines for our new workshop in Luanda, Angola, and reviewed our financial plan. No funds have been spent yet.

We have focused mainly on planning and internal organisation, so we are ready to kick off the project and start building the workshop, and not many problems have come up so far. We expect to buy the sewing machines and start setting up the workshop within the next two weeks, once the funds are reimbursed locally, and we will share more as the work begins.

In August we ran three GEAR Lab sessions in Haiti: the first for 20 students, the second for 14 and the third for 13. Together with the 14 who completed our first session in July, 61 students have now been through the programme.

We are behind our projected student count for one main reason. Gang activity severely disrupted the school year. The ministry closed schools later than expected, in July, and then opened the new school year earlier than expected, on 7 September rather than in the first week of October. That shortened the summer, so we could not run nearly as many sessions as we could have, and it made it harder to generate interest among students who had so little time off.

Budget-wise we are doing well. Our spend so far stands at $5,139.68 (about £3,830): $2,346.62 on mentor stipends, $866 on student food, $785.54 on robot kits, $520.53 on marketing, $335.99 on mentor onboarding, $156 on fuel and transport, $75.16 on transfer fees and $53.84 on miscellaneous costs. That is just about two fifths of the budget.

We still have a couple of months in the year to organise more sessions and reach our target of 120 students. With the school year already under way, those sessions will likely run at weekends rather than during the week.

July was Safe City’s biggest month of the year. Our nurses saw 502 people in Oworoshoki, Lagos, well past the 300 patients a month we aim for, taking the clinic’s total since it opened to 9,062. Safe City accounts for three quarters of the 12,115 people the two Kwanda-funded clinics have cared for between them, all in under two years.

228 of July’s patients were visiting for the first time, 45% of all visits, a strong wave of new families finding us more than a year into running the clinic. We treated patients from Oworoshoki, Bariga, Ketu and Ebute Metta, and from Mushin, 12.1km away and the furthest anyone travelled to reach us this month. 71% were women, most supporting families on an average of $10.14 (about £8) per person each month, still well below the poverty line and still with no affordable alternative closer to home. Malaria was the condition we saw most, alongside respiratory infections and a wide range of everyday health needs.

We spent $497 (about £390) on medications, medical supplies, clinic operations and materials, and our community recycling collection brought in 7lbs of plastic waste, which keeps the neighbourhood cleaner and offsets some of the clinic’s running costs.

Nothing went wrong this month and the team kept pace with the extra demand. At this rate we should pass 10,000 people cared for at Safe City before the end of the year.

In July, 418 people received free consultations, diagnosis and treatment at Care Circle in Itire-Surulere, Lagos, the clinic’s busiest month since it opened and enough to take its total past 3,000. Care Circle has now cared for 3,053 people, and between the two Kwanda-funded clinics that makes 12,115 in under two years.

136 of July’s patients were finding us for the first time, a third of all visits, and we saw people from Itire, Ikotun, Kilo, Aguda and Ilasamaja as word about the clinic keeps spreading across the area. 71% were women, who usually manage healthcare for the whole family. Malaria was again the most common condition we treated at 34% of visits, with unspecified malaria adding another 14%. The average patient lives on $5.10 (about £4) per person each month, so a household of four gets by on ₦29,317 (about £16), well below the global poverty line of $2.15 a day. Nurses Benedeth and Sylvia ran the clinic right through the month and we are proud of them.

We spent $491 (about £390) on medications, medical supplies, clinic operations and materials, helped along by our community plastic-waste recycling programme, which turned 6lbs of neighbourhood waste into cash for the clinic and cut down nearby mosquito breeding sites.

Nothing went wrong this month, and with a third of visits still coming from people who have never been before, we should pass 3,500 people cared for at Care Circle within the next two months.

This month we ran menstrual health and hygiene training at five partner schools in rural Kenya and gave Wings Poa reusable kits to 240 girls: 82 at Mbaani Comprehensive, 57 at Kiuanzukini Senior, 53 at Kithiiani Comprehensive, 37 at Kyeengai Comprehensive and 11 at King’atuani Comprehensive. The sessions covered managing periods, tracking a cycle and reproductive health, and the kits mean the girls have a supply that lasts rather than something to buy again every month.

That takes us to 880 girls holding a kit and 14 training sessions completed, with 1,195 girls reached through our menstrual health surveys across 19 schools.

The kits are sewn by 12 LitMoms, local women who earn from every batch. With schools on holiday they carried on making the drawstring bags and liners, but the waterproof PUL fabric we shipped in is running later than we have ever seen, and since it is an important part of the kit the rest cannot be finished without it. We spent Ksh 194,300 (about £1,130) this month: Ksh 158,800 to the LitMoms for production, Ksh 30,000 on staff time, Ksh 5,000 on transport to the schools and Ksh 500 on phone calls to coordinate with them.

At King’atuani we also spoke with parents about the reusable pads. One mother told us the kit would take a monthly cost off her hands: “I am so happy because I can now focus on getting money for food and paying my child’s school fees. I will not have to worry about buying sanitary pads for my daughter every month.” As soon as the PUL arrives the LitMoms will finish the remaining kits, ready to distribute when schools reopen.

We held our first GEAR Lab session in Haiti in July, for 14 students. Seven teams completed the curriculum and built Segway robots to compete. We'd hoped for more students to apply, but the Minister of Education pushed back the school calendar this year, so many of the students we'd expected were still sitting national exams when the session ran.

This past month we focused on creating marketing material to build interest in the coming sessions, and worked with our mentors on their feedback from July. We spent $2,135.50 in total (about £1,590): $785.54 on robot kits, $530.62 on mentor stipends, $288.99 on mentor onboarding, $250.53 on marketing, $208 on student food, $54 on miscellaneous costs and $18 on transfer fees.

We're pushing the sessions we postponed from July into August and September, running them back-to-back so we don't lose more time. We already have interest from new applications, so we still expect to reach our goal of impacting 120 to 140 people by the end of the summer, 14 so far. Our next session starts on 16 August, and we'll run through to 21 September without a break.