How One Dynamic Social Entrepreneur is Redefining Healthcare in the Slums of Kenya
Written by Nora Peters of StartSomeGood
Moving thousands of miles away from home to a foreign country all by yourself to start a social enterprise could be a little too intimidating for some.
Not so for brave soul Melissa Menke, Co-Founder of Access Afya and social entrepreneur extraordinaire. In early 2012, after studying social business at NYU, Melissa moved from her home in the U.S. to Nairobi, Kenya to start Access Afya’s first community-owned mini-clinic. By employing local staff, Access Afya was able to connect with the community immediately, establishing clinic staff as a trustworthy source for factual medical information – and a dignified healthcare experience.
Melissa’s goal is to build a second clinic in order to provide more comprehensive medical care to patients and to build relationships to make healthcare feel good and empower Kenyan people in their quest for good health. We sat down with Melissa over a Skype chat during a brief trip back in the U.S. and asked her about how she got started as a social entrepreneur and the kind of future she is trying to build.
Q: Can you tell me a little bit about your background and how you became interested in social enterprise and health care?
A: Well I began as an undergraduate studying political science and international development and actually was able to travel to Kenya for the first time in 2007 with the Foundation for Sustainable Development, working with womens’ groups on healthy lifestyle and nutrition. The experience taught me that I really wanted to study community development, but through an economic lens. I had the chance to work with the public housing authority in Virginia, where I began to see how many community partners came together to tackle an issue: from nonprofits to government and small businesses. This experience fueled my interest in looking at economic development holistically and systematically, and I began studying at NYU’s Wagner School because of their intentional focus on anti-poverty work and blurring lines across sectors. During my social business studies I also met my co-founder, so the ideas for Access Afya kept growing and growing. We conducted a feasibility analysis in January 2012 and built the first health kiosk shortly thereafter.
Q: How did it feel to move to Kenya on your own?
A: Exciting! It was a new adventure, but it wasn’t my first time there. I’ve done a lot of travelling in my time, and had been back to Kenya a few times to do the feasibility study and build up a community and team members, so it felt both familiar and unfamiliar at the same time. In the process of graduating from NYU I had job offers to work in the states, but I was invested in Access Afya and just had to go for it.
Q: What have you been able to accomplish with your first clinic?
A: One of the first things I did when I moved to Kenya was research the local landscape and build a team. My first hire was a bright woman named Domianah who grew up in Kenya and was already doing health work there. She helped with the clinic site selection and does a lot of our front-facing work, marketing, and staffs the pharmacy. I also hired qualified Kenyan medical staff and an MPH from the region, so the clinic was informed by their local knowledge.
As a result, one thing we were able to do really well was navigate trust-building with the wider community, because my staff knew the leaders and right people to talk to and communicate what we were trying to do: preventative health care like screenings and not waiting until things get bad to go see a doctor. The first clinic saw hundreds of patients and followed through on our commitment to treating every patient with respect and dignity, which was extremely well-received.
Q: What have been your biggest challenges so far and how will they inform the plans for the second clinic?
A: The fee-for-service model has been challenging, so with clinic #2 we will be testing a model of “membership” for one fee that will include a lot of services. Patients will still have to buy meds and labs, but at a low cost.
We also hope to offer comprehensive health services at the next clinic, including family planning and well baby immunizations. How we communicate our services is key, because from the outside, it doesn’t look like much (though this was intentional – too modern and it might turn people away), so we are revamping our marketing and outreach to get the message out.
Q: Is there a particularly inspiring story of how someone has been impacted by the respectful and dignified way that you approach the healthcare experience?
A: There are at least five stories a day! I think the most powerful stories are when patients gain new information on top of the health services. In March we went door to door and talked with 25 people who had been to the clinic, and all of the feedback was positive. We spoke to a woman who shared that she originally went to the clinic to purchase family planning medication, but explained that she didn’t like taking pills and often forgot to take them. She said the nurse at Access Afya took the time to listen to her concerns and offered alternatives but also explained the importance of taking the pills at the same time every day; something she had never been taught. So in this case it wasn’t even about just access to health care that was the issue, it was information that also empowered this woman.
Q: Have your clinic’s patients taught you anything? What have you learned from them?
A: Well I’m not a doctor, I’m not a nurse. I actually try to interact with patients as little as possible, because I want patients to connect with their Kenyan doctors. Also, our job is to give quality information about western medicine and there are some traditional treatments that we actually counsel against. My staff teach me a lot – they have taken it on as their own and are in it for the long term.
Q: If you could snap your fingers and create the change you want to see, what would it look like?
A: It would be a redefinition of the healthcare experience at the base of the pyramid, so that it feels respectful and feels good and empowers people. Care should always feel good, not scary.
If you want to help empower people living in poverty in Kenya through quality healthcare, consider supporting Melissa’s campaign on StartSomeGood.com.