I am an entrepreneur in my professional life and personal pursuits, so it’s natural that this approach will also guide the philanthropic efforts of Madiro. In the tech start-up community, there is a widely accepted methodology for taking a business from idea to reality: the Lean Start-Up Methodology. When we rebooted Madiro two years ago and brought James Fraser on board as CEO to lead the effort, we were determined to not only incorporate what we’d learned through the first decade of running Madiro and the lessons James picked up over an illustrious career with MSF, as the founder of Dignitas, and then as the CEO of ChipCare, but also to apply first principles thinking and the power of rapid iteration as prescribed by the Lean Start-Up Methodology.

We had a few re-founding principles:

1. We wanted to contribute to removing health as a barrier to human thriving in sub-Saharan Africa,
2. We wanted to invest in initiatives that would have a sustainable impact, and
3. We believed that innovation and entrepreneurship, not hand-outs, paved the path to prosperity and held the keys to a productive life accessible to all.

These principles led us to connect with amazing entrepreneurial initiatives like Healthy Entrepreneurs, Signalytic, and Aviro. Open conversations with founders like Joost van Engen from Healthy Entrepreneurs led us to reframe many of our contributions from grants to investments.

The vision for Madiro is crystalizing. We are primarily a social impact investor. We provide patient capital and value creation services for our portfolio of innovators. We are connectors and catalyzers.

Following my last visit to Kenya and Uganda, we got interested in making investments more precisely targeted at the level of development of the host country(ies). Sophisticated hardware/software solutions built on the blockchain for digitizing medical supply chains are sometimes the best interventions to drive impact, but other times the best impact is lower-tech and can be achieved with a loan to build or modernize a factory. It was in this context that Madiro agreed to a 6 figure loan to CeraMaji, a ceramic water filter that eliminates water-born pathogens of the type that lead to a massive disease burden, particularly in informal settlements where access to clean water is limited and/or prohibitively expensive.

We visited Ceramaji on the outskirts of Nairobi and saw the finishing touches being put onto the new factory. This initiative will deliver employment for the factory workers, economic empowerment for the network of female entrepreneurs that resell the filters, and affordable clean water for the millions of Kenyans and displaced persons living in informal settlements around Nairobi and beyond. After visiting the factory, we went to visit a nearby settlement to observe the current water supply chain. Water is trucked in to central distribution points where it’s sold one gerry can at a time to families, who then need to spend money on fuel to boil the water to make it potable. There are chlorine tablet solutions to make the water safe to drink, but the cost and impact on taste make these less preferable. Relative to the cost of fuel to boil the water, these $12 filters that last 4-5 years create a lot of health and social good for the community.

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We then headed back to Nairobi and met with the Dot Glasses team, Adam and Bradley. Their good enough vision approach has the potential to be one of the most impactful health interventions by removing the vision barrier to human thriving. There is innovation in the design of the adjustable glasses and the accessible optometry approach, but fundamentally this is a business model innovation. It’s about getting $2 glasses to those traditionally excluded from access to corrective lenses. These types of businesses need great entrepreneurs to succeed, and we’re pleased to be in talks to back Adam and Bradley because we think they’ve got what it takes to scale the business while staying true to the double bottom line.

One of the most exciting realisations for me on our whirlwind tour of Nairobi (which included drinks with Jesse Moore -Madiro board member and founder of the regions most successful tech scale-up: M-Kopa) is the extent to which the ecosystem is evolving and the ladders to opportunity that are being laid. One of the ecosystem players we met with was Wilfred from Villgro Africa. We knew many of the same people and were tracking or supporting many of the same innovators. It felt like two Seed/Series A investors inToronto comparing pipeline and portfolio.

One outcome of this comparing of notes, was the introduction to Naomi Monari, Founder and CEO of Bena Care. Bena Care is a tech-enabled homecare agency operating in Nairobi and expanding rapidly. Given my role as AlayaCare’s Founder and CEO, I know my way around the homecare industry and was immediately attracted to the proposition of supporting a homecare entrepreneur in East Africa. We’re starting due diligence on this investment opportunity.

This wrapped our time in Nairobi and off we headed to Burundi where we were planning to spend 3 days before finishing up our trip in Kigali, Rwanda.

Permit me a small detour from the travel log to describe the lovely discussion we had with Robert, the founder and Chairman of Amazi Water. Robert is a Texan entrepreneur and a man of faith. After monetizing several entrepreneurial ventures, he set out to use his accumulated resources to affect maximum positive social impact. Some smart utilitarian calculations led him to the mission of providing clean water to all of Burundi’s 13M+ inhabitants. Given the relative neglect of that country by the many scaled water charities that have dug wells across sub-Saharan Africa and the relatively high child mortality rate in the country, Robert had calculated that in deploying $80M+ of his capital, he’d be able to save lives for an average cost of $200/child. He set out to run this charitable endeavour with the efficiency of a for profit business and had already covered one third of the country. It’s another model of a North American tech entrepreneur looking to have a sustainable impact in East Africa, and one that has many advantages.

On our arrival in Burundi, James had fond memories of running in a palm forest on the outskirts of Bujumbura, the capital, and so we donned our running gear and headed there straight from the airport. Unfortunately, when we got there that side of the road was interspersed with Burundian soldiers who forbid us to run in the forest due to“the enemy” being a threat. We were dismissive of this threat, and would have found our way into the forest were it not for the big rains that had turned the paths to mud. It was not until we later got internet access that we read the news about incursions by militias from the DRC into this area the previous month. This detail will become important later.

Undeterred from our run, we set off along the road and soon had a group of kids running with us and tossing a ball fashioned out of plastic bags back and forth. As we passed some hippos frolicking in the palm forest we had intended to run in, we joked that these territorial mammals, not the Red Tabarra rebel group, would have been the real threats to our physical security!

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We then checked into our hotel on the edge of Lake Tanganyika. Due to the effects of climate change, the water level was up several meters and the restaurant and part of the property was nearly fully submerged. The terrace was refashioned on wooden stilts in the water, making this surely one of the least disruptive examples of climate adaptation in the region.

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Next on our agenda was meeting with the Healthy Entrepreneurs (HE) chapter in Burundi. Country Manager, Francis, and Clinical Director, Wilfred were kind enough to host us. We had a lovely and animated dinner on Tuesday night and then a great tour of the office and warehouse the following morning. Having spent a good amount of time with Healthy Entrepreneurs in Uganda, I was able to contrast some of the obstacles to reproducing the model in Burundi. At one quarter of the average annual income of Uganda, Burundi is one of the poorest countries in the world. The regulatory environment also threw up obstacles to the flourishing of the business. I won’t elaborate on those but I am certain that, despite these challenges, HE will continue to expand it’s important work here.

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We then met Dr. Alexis and drove 3 hours up the mountain to Mugamba Province to visit Ubuntu Village of Life (UVL). This was the main event of the trip. We met Dr. Alexis Nizigiyimana a year and a half ago in Montreal and were inspired by his story. I’ll keep this description brief since you can read about it here, but we rapidly went from a site visit to buying a motel for UVL to convert into a hospital, to giving financial and operational support to Alexis to expand UVLand ultimately scale the model to other communities across Burundi. UVL takes a holistic approach to health and wellness of the community, and so pairs healthcare services with food security and educational programming.

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Alexis and I also connected around our love for basketball and play on the same men’s league team in Montreal. It was a huge pleasure to visit the basketball court where Alexis grew up and get to play a game with the basketball program that Madiro and the US Embassy support. As a side note, the determination and resilience it took Alexis to put time into his beloved game growing up, when his parents would prefer he do chores around the house/farm after school contains a lesson I hope to pass on to my kids…though perhaps with fewer punishments. Pictured at the bottom right are Alexis’s mother and father. His mother is a force of nature, and meeting her provided me with some clues as to how her 8 kids produced 3 medical doctors including an exploratory hero, Alexis, who set out into the world to bring back knowledge and resources to his community.

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The following day was the Mega Event to inaugurate the donation of medical equipment from the US Embassy. America gets a lot of flack for its foreign policy, and sometimes for good reason, but stepping behind the headlines and meeting with Keith Gilges, the Chargé d’Affaires to Burundi, we are reminded why America is the indispensable nation and why of all of the unipolar moments we’ve had in the history of mankind, the Pax Americana has been one of the most peaceful and prosperous. Not only did they donate half a million dollars of medical equipment, but they also financed the creation of the American Corner attached to UVL clinic with computers, books, fiber-based internet service, and educational services.

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The event was attended by all levels of government, from the provincial governor to the local mayor to the permanent secretary of health. I learned a lot about how to get things done in Burundi, and also the importance of building support for an organisation at UVL. We even had the Bishop in attendance. We are working on getting UVL better integrated into the public health system and to promote the services at the facility in the broader region.

I was also honoured to be able to recognize the efforts of so many in the community to build UVL into what it is today, and then also to announce that Madiro - via the proceeds of the MadiroRoast coffee by Canal Coffee - will be paying for free under-five care for all members of the community.

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One of the expansion strategies of UVL to broaden the scale of its impact is to open satellite clinics in neighbouring villages which will provide some health services locally but then also refer to the main UVL clinic for tertiary care. We drove a few hours through muddy mountain roads to the first satellite clinic that we’re opening and got to appreciate the majesty of the terrain in the country.

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The last stop of our trip was meant to be Kigali, where Madiro has recently established a presence in a local tech incubator. We are looking to hire a local investment manager and are in active recruitment.

Unfortunately, only hours before we were meant to drive across the border, the Burundian President closed the border with Rwanda. This closes the loop on the story of why we couldn’t run in the palm forest. The proxy militia battles in DRC continue to boil. This is one of the most under-reported conflicts in Western media as nearly 5M people have been killed in the past years. Being a landlocked Central African country with natural resources has turned out to be one of the worst curses a nation can have, but I’ll save the political musings for another forum.

On the bright side, this interruption led me to fly home on Ethiopian Airlines through Addis Ababa, and so at least I got to eat some authentic injera in the capital.

I will be looking forward to returning to East Africa again soon to see the progress and impact of Madiro’s investments.