In our first blog post, we described our mission of “philanthropos” (love of humankind) and how this has drawn us into an incredible web of inspiring people and organizations working around the world to restore wholeness to our world. One such partner is Lwala Community Alliance in Kenya, a rural health clinic started by two Kenyan brothers who came to the US for college (Dartmouth) and medical school (Vanderbilt).
While they were at Dartmouth, both their parents died of AIDS. In their grief, an idea surfaced to honor their parents lives and do something for their community. The story of how their dream became a reality is what Craig Parker shares in this post and is a great inspiration as we start a new year. It’s a story of how friendship, faith, and “philanthropos” can make incredible things happen in our world!
In Western Kenya, about five miles from a paved road, there is a rural village called Lwala. It is named for the red soil found throughout the region, which turns the area to mud during the rainy season.
In January 2005, I sat across from my two friends from Lwala in a café in Hanover, New Hampshire. A large blueprint covered the table between us, as they presented their appeal to me for financial help. I listened politely, but couldn’t imagine being able to do anything to help.
My friends, Milton and Fred Ochieng’ asked me to assist them with a clinic they proposed to build in their village.
As a Christian campus minister with the Navigators at Dartmouth College, I was a friend of Fred who had been a member of our student fellowship for four years. We had traveled together on several spring break service trips, he had been to my home countless times, and he began to call me, “Paps”. We grieved with him when he lost his mother and his father to AIDS during his junior and senior years, and helped to cover his airfares to return to their funerals.
Although I didn’t know Milton as well, he and Fred played soccer with my son, Garrett.
Milton and Fred have improbable stories of how they came to Dartmouth College from a rural village in Western Kenya. They had done well on their 8th grade national school exams and were admitted to one of the most prestigious schools in Kenya. From there they both won scholarships to Dartmouth. It was like winning the lottery. Their success was so celebrated that, in 2000, when the people of Lwala heard that Milton was going to go to college in the US, they sold chickens and cows to purchase a one-way airfare for him and said, “Don’t forget us.”
The clinic Milton and Fred proposed to me on that winter day in 2005 was to be a tribute to their parents, who were teachers, passionate about education. Their father, Erastus Ochieng’ challenged them to do something about the non-existent health care in their village. Erastus had even begun plans for a clinic, including putting in place a local committee to organize it. After he died, Milton and Fred wanted to honor their father’s dream by fulfilling his plan.
The challenges they described to me were daunting. Lwala had no running water or electricity and limited transportation. There were only a few vehicles among a wider population of 30,000 scattered within a three-hour walking radius. The closest medical facilities were accessible by foot, bicycle, or motorcycle. It could take several hours to get to a clinic or hospital.
When Milton and Fred were boys, a good friend of their family was in the throes of childbirth, having a complicated delivery. Needing medical attention in her duress, her family placed her in a wheelbarrow and tried to transport her up the long dirt road. She died en route. Milton and Fred vividly remember the grief around her body the next morning. Experiences like this one drove their desire to see change.
As we finished our coffee, I asked them the cost.
“$30,000—$35,000,” was Milton’s reply.
A first-year medical student at Vanderbilt in Nashville, Milton had worked out the plans for the clinic as part of a medical emphasis project required for one of his classes.
“Who is going to build it and who is going to channel the money?” I asked.
Those details were still a little fuzzy.
We wrapped up our conversation and I wished them well. Milton returned to Nashville and Fred to his Dartmouth classes. I moved on to other things.
A month or so later, in early 2005, I was helping to lead an annual Navigators conference where we decided to take an offering for an AIDS peer education program for university students in Nairobi.
Shortly before the conference, I emailed my friend. “Fred, I need a real, live Kenyan to speak at the conference.” His AIDS story would dramatically portray the need and work of ICL.
Fred was in the midst of preparing for medical school exams. Time was tight, but he emailed back, “Hee, hee, a real live Kenyan – OK, I will come.”
I was delighted.
As I drove to the conference, I thought about Milton and Fred’s proposal. It occurred to me that this could be a great opportunity to help fund their clinic. On the spur of the moment, I called my supervisor. “Doug, how about we divide the Kenya portion of the offering project between ICL and Milton and Fred’s clinic idea.” Although it was risky, Doug agreed to my suggestion.
After we took the offering we were stunned to discover that, from a group of mostly college students, a donor had enclosed a check for $20,000.
Nearly $10,000 would go to Milton and Fred.
When I returned to Hanover and mentioned this to my friend, Dave, a professor at the Dartmouth business school, he said, “What a great story, my wife, Sue, and I will give you $5000.”
In just a few days we had gone from 0 to nearly $15,000 – halfway toward our goal. I, who knew nothing about global health, had suddenly become Milton and Fred’s chief development officer.
We had to see this project through to completion.
Building the Team and Facing the Challenges
Bill and Sarah Young joined the effort. Bill is a retired obstetrician who lives in Hanover. He and his wife, Sarah had become sponsors to Milton in the way that my wife, Nancy and I had been to Fred.
Bill, Sarah and I first met together at their home in the spring of 2005. With Fred and a few others, we began to think through how to make this dream a reality.
We had some major questions that had to be addressed:
- How do we legally channel funds?
- Who would lead this from both the US side and the Kenyan side?
- Should we align with an existing non-governmental organization (NGO) or should we form our own non-profit?
- Who could partner with us to get us launched?
- What are the best practices in building a clinic in rural Africa? What are the pitfalls?
- What was the scope of the work to be done? A medication dispensary? A primary care facility? AIDS treatment? Public health? Education? Economic?
- How would we develop a long range plan for sustainability?
- How should we approach this from a faith perspective? (Many of us were Christians, but some were not, including potential benefactors.)
- What are the operating costs and how do we create an appropriate revenue stream?
- Who could help us locally, nationally or internationally to answer our questions?
As I review these, I am struck at how naively optimistic we were. We had no idea of how impossible it is to “build a clinic” in the middle of a sugar cane field in Kenya, at the end of a long muddy road, in a village with no electricity or running water.
We invited people to join us:
Dave Pyke, an operations professor, agreed to help us come up with a plan.
Sue Pyke investigated the feasibility of starting a non-profit 501(c)(3) in New Hampshire.
Bill Young brought his obstetrics expertise as medical advisor, and I helped to bring leadership and many connections I had made over the years.
A number of Navigators students also got involved.
Meanwhile, construction began in April 2005, employing local workers.
In late July, I took a trip with Fred to see the progress of the work and to investigate if there were NGO’s in Kenya who could take this on.
The challenges I discovered were even greater than I imagined:
- 29% of the 408 children in the Lwala Primary School had one or both parents deceased.
- The prevalence of HIV was estimated to be between 15% and 20% of the adult population. HIV was highly stigmatized and hidden.
- Cultural practices of polygamy, wife inheritance, and sexual assault accelerated the spread of HIV.
- Unwanted teenage pregnancies spiked during the three annual school breaks.
- There was a high drop-out rate in the area primary schools, especially among 7th & 8th grade girls as they began menstruation, couldn’t afford school fees, or became pregnant.
- People survived by subsistence farming. The local sugar cane economy was unsustainable leading to a high rate of poverty.
- Basic awareness of preventable health care practices was nearly non-existent.
- Only 27% of expectant mothers had their babies delivered with a clinically trained professional. Too many mothers and infants died at childbirth.
I contacted several global health providers in Nairobi to see who could help us. It became increasingly obvious that no one was working in the area we needed. We would have to push forward by ourselves.
I returned to Hanover to report to our little dining room table team. I presented a summary of all the organizations with which I had or hadn’t spoken. Reluctantly, we concluded that we needed to form a non-profit in New Hampshire. Thus launched the Lwala Community Alliance (LCA).
The Lwala Community Alliance (LCA)
Some of the answers to our initial list of questions unfolded as we began, others took longer.
- Vanderbilt University agreed to steward the funds initially to get things started until we could receive funds ourselves.
- A Navigators foundation in Colorado Springs agreed to help with our education initiative.
- Milton and Fred’s older brother Omondi would serve as our Kenya clinic manager to oversee construction and to hire staff.
- Blood:Water Mission became one of our partners to help us with issues regarding water and AIDS.
- We would raise funds in New Hampshire; Milton would do what he could in Nashville (Fred eventually joined him at Vanderbilt Medical School in the fall of 2006).
- We hired Joel Wickre as our first executive director.
We spent the next 20 months getting organized and incorporating as a non-profit. Joel worked out of coffee shops in New Hampshire and Maine and made trips to Kenya to coordinate construction and staffing with Omondi.
We adopted a mission statement:
To build the capacity of the people of Lwala, Kenya to advance their own comprehensive
We decided to be a multidimensional (holistic) provider with a phased roll-out plan including:
- Basic primary care (malaria, water-borne diseases, minor wounds, pharmaceuticals)
- Education development (scholarships for merit and need based secondary students)
- Public health (water and sanitation training)
- Economic development (agriculture and micro-enterprise).
In time, we planned to provide HIV education and treatment, family planning, prenatal care, labor and delivery, and clean water for 15 area schools. We also planned to train local farmers with nutritional gardening practices.
We sought to create an asset-based-community-development (ABCD) model in that our organization would be led by Kenyans. We would work with the local village development committee organized by Milton and Fred’s father, Erastus Ochieng’, to establish goals and priorities. We would only hire nationals. We wanted to avoid a “top down” leadership culture where outsiders served in key roles.
Although we chose not to become a faith-based organization, we adopted a non-sectarian faith-friendly mindset, and welcomed all to get involved regardless of their faith perspective.
One immediate problem that emerged is that in addition to the construction costs, hiring Joel Wickre and a few Kenyans caused our $35,000 startup budget to mushroom.
We reached out to people in and around Hanover. School children at the Hanover middle school ran a “penny war” coin drive and raised nearly $2000.
Blood:Water Mission helped us in Tennessee. Milton began to tell his story to everyone he could at Vanderbilt. Money trickled in.
After two years of planning, construction and delays, the clinic opened in April 2007.
We began with a clinic manager, a small medical staff, and support staff, eventually adding other positions as we were able.
We were soon overwhelmed with patients. Within a year we were seeing 2000 patients per month, stretching our staff and resources.
A Nashville television reporter named Barry Simmons met Milton over coffee in December 2005. He immediately decided to leave his job to tell Milton’s story. After two years of unemployment and hundreds of video tapes Barry directed and produced the full length documentary SONS OF LWALA. The film premiered to an audience of over 1800. This helped to increase the visibility of the LCA and led to the screening of the film in locations around the US. It also helped to generate significant revenue.
Milton and Fred told their story to thousands of physicians through a series of medical conferences hosted by Pri-Med. This led to more visibility and revenue.
For Milton and Fred, A defining moment came when they were visiting Lwala to observe the progress of the clinic. A woman came in to deliver a baby that was in a breech presentation, and the mother was in duress. Via cell phone, Milton, then only a fourth year medical student, called an OB/GYN doctor in Tampa, Florida who was connected with our team. Together, over the phone, they were able to deliver the baby safely. Milton and Fred soon discovered that the infant delivered that day was the granddaughter of the woman who had died in the wheelbarrow during their childhood. They knew their vision for changing the lives of the people of Lwala was finally being fulfilled.
Changes and Growth
In 2008 both our executive director, and our clinic manager, needed to step down from their roles. It was critical that we find the right people to replace them.
Bill Young and I knew a family practice physician who had worked for four years at Kijabe hospital outside of Nairobi named Kevin Shannon. Kevin said, “If you could get Robert Kasambala, it would be like getting Michael Jordan on your basketball team.” Robert had been overseeing hundreds of medical staff at Kijabe, and was hoping to relocate to western Kenya where his wife would be teaching nursing.
We contacted Robert immediately and he agreed to take the LCA position as Kenya Program Director. Still with us today, Robert’s leadership, wisdom, integrity and patience are the reason why our Kenyan staff grew from just a handful to over 180 today.
We also needed to find a US Executive Director. James Nardella had recently married Jena Lee, founder of Blood:Water Mission, and was familiar with the Lwala story through her work. He agreed to become our second executive director. His vision, leadership, and gifts as a communicator are the reason why the LCA has become globally recognized as a model for transformational development. James continued with us until late 2015. Ash Rogers took over as executive director in 2016.
Within four years we added staff housing and a sewing and soap-making cooperative. We built a second wing to provide a labor and delivery facility, HIV care, and a larger laboratory for blood work.
We provided rain catchment tanks for 5,100 children at 15 area schools, and began to distribute new uniforms and reusable menstrual pads to over 2,000 adolescent girls each year as an incentive to stay in school.
Through Robert and James’ leadership, the LCA did what it set out to do, namely to increase the local capacity. We recruited and trained women as community health workers in maternal/child health, water, sanitation and hygiene, and HIV care. These women visit all 4800 households in our catchment area of nearly 30,000 people.
- We now have 1,000 HIV patients receiving antiretroviral therapy (ART).
- The percentage of women who deliver their babies with a clinically trained professional has increased from 26% to 97%.
- We have over 45,000 patient visits each year, and we deliver over 550 babies annually.
- 1,000 farmers are trained annually with best agricultural practices.
- 40 students receive merit/need based scholarships to continue on to secondary school.
- A third wing was completed in early 2016 to expand our capacity.
It Takes a Child
I have been to Lwala three times, have made many friends, and have the photographs of many individuals to remind me of the place I have grown to love. One girl embodies Lwala for me perhaps more than any other. Her name is Caitlin Otieno. She is named after Caitlin (Reiner) Glover, one of the Navigators students who has spent a lot of time in Lwala.
When little Caitlin Otieno was three years old, she tripped and her hands plunged into a vat of burning sugar cane sap. She suffered 3rd degree burns and was at risk of serious infection.
Although our facility was still in its infancy at the time, we cared for Caitlin and saved her hands.
I visited her parents, Monica and Isaiah in their home in 2005, and I visited again with Caitlin and her mom in 2014. The scars on her hands reminded me of her injury, but the smile on her face reminded me of the hope that we had been able to offer her and her family.
Our vision statement says simply Wholeness of Life in Lwala and beyond.
As I think about Caitlin Otieno, my prayer for her is that she would experience wholeness of life. My hope for her is that she would complete her education, that she would be free from HIV and unwanted pregnancy, and that she would emerge as a leader among her peers for their well-being.
We have all heard the African proverb, it takes a village to raise a child. The main lesson I have learned over the past nine years from my friends, Milton and Fred is that the reverse is also true.
It takes a child to raise a village.
It has been my great privilege to be a part of the story.
We had the chance to visit Lwala two years ago and got to see its holistic approach to promoting health and human rights in action. We were so impressed with the spirit of the place and and how they begin with the physical needs of the community but reach out to work with families like this one here to use more healthy cook stoves, keep their girls in school, and work to transform cultural taboos which keep women with already large families, like this woman below, from accessing reproductive care to plan their families. A few months ago, I had the privilege of meeting Craig, who I knew from my own days at Dartmouth, and loved hearing this incredible “faith back story” to Lwala’s founding. Thank you Craig for your friendship to so many “Freds and Miltons” in your ministry to college students, and your example of how faith can inspire little and big acts of philanthropos to work together to restore wholeness and health to our broken, hurting world.
Craig Parker works with the Navigators in Boston and serves as a campus minister at Boston University.
He can be reached at email@example.com.