With $26, a personal sacrifice, and a fierce commitment to serving her community, Tabitha Atieno Festo laid the foundation for Carolina for Kibera (CFK) in 2000.
A widowed nurse and mother of four, Tabitha struggled to find work in Kibera after her employer decided to downsize in 1998. Desperate to continue supporting her family, Tabitha moved into an abandoned vegetable stand in Toi Market. Two years later, Tabitha met Rye Barcott, then a student at the University of North Carolina at Chapel Hill, who was researching youth empowerment and ethnic violence in Kibera. Though Rye had made a point to not distribute money while in Kibera, partly because he did not want to create a cycle of dependency and partly because of safety advice he had received from locals, Tabitha approached him with conviction and a plan. She asked him for an investment of 2,000 Kenya shillings, about $26 U.S. dollars, and told him that she planned to use the money to buy vegetables and sell them in the Eastleigh District of Nairobi to make a small profit. Tabitha’s pointedness and confidence struck Rye; he gave her the $26 investment she asked for and flew back to the United States the next day.
After selling vegetables, Tabitha accumulated money and joined a local women’s micro-finance group. Six months later, she had $130 in savings and used the money to achieve her lifelong dream of opening a clinic. One of the few clinics in Kibera operated by a registered nurse, Tabitha’s facility was attached to her home and operated 24 hours per day because, in her words, “people do not stop getting sick at night.”
Nurse-to-Nurse: Sustaining Tabitha Medical Clinic
Though Tabitha worked hard to establish Tabitha Medical Clinic, she dreamed of providing high-quality maternal care and would not rest until the clinic became self-sustaining. To do that, she needed support. She needed microscopes to differentiate between infectious diseases such as malaria, yellow fever, and cholera, essential medicines to treat patients with severe illnesses, and recognition from national bodies to operate with authority.
Donna Schwartz-Barcott, an American nurse and anthropologist, helped Tabitha with each of these steps during a tireless two–week visit in 2002. Donna’s son, CFK co-founder Rye Barcott, arranged a room inside Tabitha Medical Clinic for her to stay, and she arrived in Nairobi with three suitcases full of equipment, including a microscope, for the facility.
She first met Tabitha on the way to the clinic and remembered Tabitha taking one of the suitcases and steadying it on her head as she navigated the steep, narrow paths.
“When we arrived at the clinic, Tabitha greeted me warmly with a hug, and we instantly made a connection mother-to-mother,” Donna said.
After setting up the equipment and bonding over their families and the practice of nursing, Donna and Tabitha began attending meetings together, drawing on one another for encouragement and support. First, they visited the Nurses Association for Kenya in Nairobi to ensure that Tabitha and the clinic had proper certification and the authority to operate. Though a bit anxious at first, Tabitha told her story and gained acceptance from the organization. Next, the two women met with a contact of Rye’s at the Ford Foundation and connected with her instantly. Tabitha talked about her adopted son Ronnie and shared her dream of helping women become healthy and financially stable to support their children. The meeting lasted over two hours, and the Ford Foundation became one of CFK’s first major supporters.
Tabitha and Donna also attended CFK’s first board meeting in Kenya, and Rye asked them to present about Tabitha Medical Clinic. At first, Tabitha was hesitant to speak in front of the crowd, but Donna encouraged her to share her story just as she had with the Nurses Association and the Ford Foundation.
“She understood the struggles that women were facing in Kibera, and she would often leave her home in the middle of the night to support women as they gave birth,” Donna said. “Her presentation was powerful and showed the board members that they were dealing with an intelligent professional who knew exactly what her needs were.”
While Donna witnessed Tabitha’s confidence throughout the different meetings, she also appreciated how compassionately she treated patients and noted how well-respected she was in the Kibera community.
“It was common for Tabitha to stop and help someone clearly battling health issues on the street,” Donna said. “An average woman in Kibera couldn’t approach a stranger and do that, but the community seemed to agree that Tabitha could.”
Before Donna left Kibera, she and Tabitha discussed how to make the clinic self-sustaining. Tabitha had already developed a sliding scale payment model, only charging people what they could afford, but that was not enough to cover the cost of essential medicines. The two women talked about expanding the clinic’s services, and Tabitha dreamed of providing high-quality maternal care to women in the community.
By 2004, under Tabitha’s guidance and management, the clinic moved to a permanent location and expanded to include a laboratory and home-based care program for people living with HIV/AIDS. Specializing in maternal health, the clinic also became one of the few in Kibera to offer in-patient and out-patient primary care services to patients 24 hours of the day, seven days a week.
Care Beyond Clinic Walls: A “Mother and a Half”
While Tabitha did achieve her dream of opening her own healthcare facility to serve the Kibera community, her patience and care as a nurse radiated beyond clinic walls. She often provided home-based care and advice for Kiberan residents. Once, she helped her close friend, Jane, deliver her child at home since she “did not have even one shilling” to help pay for a hospital delivery.
Fondly referred to as Mama Jane by many in the community, Jane met Tabitha while they were distant neighbors and both unemployed. The two would spend the days walking through Kibera looking for work and stay up late discussing issues in the community. Jane saw Tabitha as a mother figure, someone who supported her throughout her pregnancy, provided advice on raising a family, and offered emotional and financial support after Jane lost her first daughter in 2002.
“Tabitha was a mother and a half, and I don’t know how to appreciate her enough,” Jane said.
While Jane viewed Tabitha as family, the two also shared a close bond as neighbors and co-workers. Together, they led much of the clinic’s operations in its early days. Though she had no formal training as a nurse, Jane began learning under Tabitha as they worked together.
“If she were alive today, I know that I would be a nurse,” Jane said, recalling how Tabitha constantly guided her and encouraged her to learn more.
Though Tabitha passed away at an early age in 2004, Jane continues to work at Tabitha Medical Clinic and tries to include pieces of Tabitha in her everyday interactions with the people around her.
“Tabitha has helped make me somebody,” Jane said. “She taught me to do what I know to do with all the strength I have. She taught me to be patient, polite, and transparent, and she taught me to listen and make every patient confident.”
Serving the Community: The “Queen of Kibera”
Though Tabitha operated the clinic and saw it grow to serve thousands of patients every year, her dream was to live to see CFK expand its home-based care program and reach more women and children in the streets. Sadly, Tabitha’s health began declining in the early 2000s. Claire Weston, a volunteer with CFK from 2004 to 2005, developed an intimate relationship with Tabitha and her four children during that difficult time, transitioning from writing grants for CFK to assuming the role of one of Tabitha’s caretakers.
The first time they met, Tabitha asked Claire to accompany her to a doctor’s appointment, giving Claire no time to believe that they were strangers. When they arrived at the clinic, Claire hesitated by the door, but Tabitha beckoned her back to the exam room, an area normally reserved for private, intimate interactions between doctors and patients.
“I remember thinking that I had never even accompanied a close friend or family member to an exam room,” Claire said. “But there was no privacy there, and that established a great deal of trust.”
After the appointment, Claire helped Tabitha zip her skirt and bent down to tie her sandals. She had heard a great deal about Tabitha’s leadership and impact on so many lives in Kibera and felt honored to experience these personal moments, supporting Tabitha and her health.
“I thought of Tabitha as the Queen of Kibera,” Claire said. “And the community felt that way too. She was like a celebrity in Kibera, but people also welcomed her into their homes like a trusted friend.”
While Tabitha was sick during most of Claire’s time in Kibera, she continued to hold herself with poise and serve the community with purpose. Claire remembered visiting a postpartum ward with Tabitha during her stay. Most of the women there were struggling with health complications after childbirth; many were dying. Amid the agony, Tabitha approached each patient with a calmness and comfort that encouraged them to keep fighting.
“Like a pine bent and shaped by the wind, she is strong and serene,” Claire recalled writing about Tabitha. “She taught all of us around her how to lead with grace and with selflessness, even amidst great personal difficulties.”
When Tabitha’s health severely declined in late 2004, Claire spent most of her time with Tabitha’s children, Valerie, Kevin, Joy, and Ronnie, by her bedside. Sharing vulnerable moments and raw emotions created quick but deep-rooted bonds among the group.
After Tabitha passed away in December 2004, Claire continued to keep in touch with and provide support for her children. She helped finance Joy’s education, and Joy now works at the same clinic that her mother started nearly 20 years ago.