Ginger Bread Eye Clinic | We’ve done it!


It started off like any other day, we packed the van and I hugged Madeleine and Lucas goodbye for the day, Lucas shouting “I love you Daddy, look for some tuk tuks” as I made my way down the stairwell, his little voice echoing of the concrete walls. We hoped this day would come and we’d imagined it time and time again in the hope that it might be a reality, there was however always the very real possibility that we wouldn’t make it. A single vital piece of equipment failing, a police officer impounding the vehicle, getting stuck but not getting unstuck, team members being sick. In fact they all happened but somehow this final day had come and it didn’t feel like it did on our imaginings.

The clinic ran as usual but as we looked around at the incredible people who have become our family, we knew this was the last time we would be doing this. The team however had been led to believe that this was the penultimate clinic (we had a little surprise up our sleeves for them which we will tell you about later) and so they were not experiencing the emotional roller coaster we were internalising.  We have learnt so much from the wonderful group of people we’ve been surrounded by and have at many times been humbled by their efforts and desire to serve the community.

Mid-morning a special delivery of the final bake was made. Two of the team were tasked to collect and deliver it, the look on their faces was very similar to the one on mine several years earlier when Madeleine’s mother asked me to carry out her only son’s wedding cake from the kitchen to the wedding marquee in the garden, an impressive cake she had slaved over for days. I knew that if I dropped it, the wedding would have been overshadowed by my blunder and the weight of the cake was nothing compared to the weight of pressure I felt.  Thankfully, both the wedding cake and the gingerbread eye clinic were safely delivered.

Four days of design and planning to build a replica gingerbread eye clinic that required us to take apart our cupboard (temporarily) to form a base, for the entire kitchen and dining room table to be inaccessible for the duration and Lucas adamant on eating the eye clinic nurses and equipment was a fitting end to the project and several thousands of photos were taken before it was broken apart and eaten, quite symbolic, apart from the eating bit…

The baking begins


Piecing the clinic together



Edible coconut grass


A shosho (grandmother) with cataracts being led to the clinic by her grandchild


A gingerbread and liquorice slit lamp!





Many of the team will be involved in either the Kitale projects or the bakery and hopefully all are more skilled for whatever they take on in the future. The eye equipment has now been packed and installed in Kitale Eye Hospital for the next projects;



Our flat has the feeling of transition. Pictures are coming off the wall, graffiti (or art work – depends on your perspective) is more noticeable than ever, our clothes and books in boxes and bags. The random temperature generator is being readied for its last encounters with us. We’ve just finalised the plans for the bakery renovations and this will start any day now. The bakery team have all met together and the initial training went really well.

All that remained was to find specialist equipment for the bakery. We had planned a trip to Kisumu on our way back from Kitale but the owner was out of the country. A few days later, our time coming to an end, the owner still out of Kenya we decided to send Andrew in with his bargaining skills and sparing Lucas eight hours on the road…

The email conversation between Andrew (in Kisumu) and Madeleine in Nakuru

Andrew/11.25: I’ve arrived, wish me luck

Mads/11.27: Use those Egyptian bargaining skills! Praying it works out

Mads/12.45: How’s it going? Are you out of signal? Xx

Andrew/13.03: I’ve seen all the equipment, it looks ideal, about to speak the boss on the phone

Andrew/13.21: Looks like it’s not going to happen, he wants to sell ALL or nothing 😦

Mads/13.23: What! It can’t be?

Andrew/13.51: All is not lost, having another conversation

Mads/14.04: Well? X

Andrew/14.09: Nope, not budging, we can’t afford to take all of it so we are stuck

Andrew/14.33: We might have a deal…

Andrew/14.44: He’s agreed to us taking the equipment we need but it is still 30% more then we can afford, I’ll keep trying

Mads/14.48: Keep going beautiful, p.s. I just cut Lucas’ hair while he was asleep

Mads/15.22: Any progress?

Andrew/15.31: We are getting close, just agreeing terms on delivery and installation

Mads/15.37: Keep going! x

Andrew/16.01: We have a deal!!! Ujima Bakery is actually going to happen xx

Andrew/16.03: Did you seriously cut Lucas’ hair?

Mads/16.04: Wahoooooooo!!!!!!!!

We’ve both been daydreamers most of our lives, dreaming of adventure, new worlds, challenges and excitement. Every so often the dreams fill our consciousness to the point that we can no longer only dream about it. The reality it turns out is rarely as it is in the dreams. Yes, there is adventure, challenge and excitement, but there is also, in equal measure: pain, fear, doubt and struggle.

The unlikely combination of day dreaming eye surgeon, passionate doctor/baker and blond afro toddler have not only been accepted in to this wonderful country but also have been given the opportunity to make dreams happen.

As this wonderful time comes to an end, we look back over the months filled with highs and lows. The single, overwhelming emotion above all others, is still gratitude. Gratitude for the opportunities we were born in to, gratitude for the incredible people who have become our family, who trusted us as strangers and dedicated their time, energy and passion to make the project a success, gratitude to our families and friends who have loved and supported us throughout (and read our blogs).

This is one of the very hardest goodbyes we have had to do.



Orange, Lemon and Pumpkin Kenya Cake | So nearly there | 1 to go…


As we get ever closer to completing the study, mixed emotions surface: gratitude, sadness that amazing people who have been part of our day to day life won’t be for much longer, exhaustion, excitement to be close to family and friends again, apprehension at the difficult good byes to our beautiful Kenyan family and friends. Change is inevitable but it is rarely easy.

Here are some statistics from our time in Kenya:

Disclaimer – all statistics are best approximations and subject to change (one village to go) 😉

4,381 study patients were attempted to be retraced from six years ago

Almost 2,200 were re-examined (many had moved or died)

Over 7,000 people (many non-study) have been examined and treated as needed

Approximately 400 hours have been spent travelling to and from clinics by the examination team

At least 300 of those 400 hours have not been on tarmac (the equivalent of more than 12 days continuously)

Stuck trying to reach the eye clinic: 17 times (5 minutes to three hours)

Over 1,000 hours have been spent on foot by the advance team retracing patients and using Peek in their homes

100 different recipes have been baked and delivered to the eye clinics

Around 8 bakes never made the field or the blog…

Approximately 50kg of flour have been used

Approximately 350 hours spent baking in the kitchen with the random temperature generator

Seven baking related burns, four requiring bed time ice

Cockroaches in the kitchen: too many to count

Power cuts: too many to count

220 hours spent blog writing 😉

Bakeries established: 1

400 dusty runs

1,300 cups of coffee (at least) consumed between us

Lucas has spotted and described in detail over one million tuk tuk’s and tractors

Lucas has lived most of his life in Kenya

We arrived as a family of three

We leave as a family of four in the making: Madeleine, Andrew, Lucas and bump (15 weeks)…


Recipe – Orange, Lemon and Pumpkin Kenya Cake


Cake mixture (This make one cake but I multiplied it by three for a large cake)

3 medium eggs

160g caster sugar

200g peeled and grated pumpkin

Finely grated zest of two oranges and two unwaxed lemons

150g white flour

50g ground cashews (almonds can be used as an alternative)

2tsp baking powder

1/4 tsp salt

Icing (Enough for the large cake)

100g butter

400g icing sugar

Zest of three lemons

50g ground almonds

Two large spoons of plain yoghurt


1. Preheat the oven to 180°C

2. Beat the eggs and sugar for five minute till pale and fluffy . Whisk in the grated pumpkin, orange and lemon zests, followed by the flour and and ground cashews, baking powder and salt and mix for another minute

3. Ladle the mixture in to a baking tin. I had to make this twice in the oven tray (only thing big enough) to layer it for sufficient height. Cook for around half an hour

4. Remove and cool on a wire rack

5. To make the icing beat the butter and gradually add in the icing sugar and other ingredients until soft.

6. Once cool, layer the two cake sponges and using a stencil of Kenya cut out the sponge (off-cuts would make a great trifle if your son and husband didn’t eat them all) in to the desired shape.

7. Smoothly cover in the icing and decorate.


Ooooh, tuk tuks



An amazing crescent moon with a small planet next to it.


An old Mzee (old man/grandfather) having his vision tested



LogMAR Tumbling E vision test for those of you who get excited by this kind of thing…



A mzee inviting us in to his home to be examined with Peek



Croquembouche/Choc-embouche… | It’s about the journey | 2 to go…


Andrew could be kindly described as directionally impaired (that would probably be the politically correct term for it), to be frank, he has no sense of direction. Thankfully we are living in an era of technology and the invention of satellite navigation made it possible for us to see each when we lived in different cities for four years before we were married. He was well known for day dreaming and getting lost on routes he’d done a hundred times before and with out someone directing him at every turn he could quite easily end up miles away, ironic given the project has required the team to find 5,000 people spread over 100 locations, many of which are not even on the map. He has however always been someone who places more importance on the “journey than the destination”, which is all well and good except for when I asked him how far this village was and he gave me a typical Kenyan response of, “it’s not so far”.  To have reached 97 locations before today can only be described as a miracle. In fact, it has been down to an incredibly hard working team who have travelled to each and every location twice or three times before hand both preparing the clinic sites, meeting the village chiefs or elders, determining if the roads would be possible, whether we could get access to stable electricity and going to each and every home of the study patients to meet them in person, explain what we are doing and examine them with Peek.

Andrew’s “It’s not far” turned out to be four hours away, three hours of which were spent off road on what can only be described as roads with a very generous amount of artistic license. Not an ideal trip for delicate structure of the Croquembouche that is hard enough to keep in one piece when stationary. This French masterpiece, often used for weddings had 100 (representing the 100 villages) choux pastry balls delicately pieced together with chocolate (it was meant to be caramel but we ran out of sugar on my second failed attempt to make a suitably sticky caramel)


After packing up the Croq into the laundry basket and sticking material all the way round to keep dust out, I was pretty amazed it was 80% intact on arrival…







There are many things about our lives in Kenya which have become normal, but when we write or reflect on them we realise they are probably not. This week for example, not to mention transporting the delicate choux pastry tower baked late in to the night in to the middle of nowhere in laundry basket. Other slightly abnormal happenings included: buying our usual stock of UHT Milk when the bill came to almost £700?! They had managed to key in 888 Litres of milk rather than eight and it took several people to come and correct the error. It was even suggested that we pay it and be reimbursed, not an option we went for. We’ve had no electricity for the last 24 hours but are grateful that we still have water (for now), Lucas has spent a few hours Tuk Tuk spotting and we are working out the purchase of a load of bakery equipment this Friday if all goes well…

Recipe – Chocembouche

The Choux pastry balls were made as in this recipe

We fashioned a cone out of cardboard and Sellotape which we then covered in a layer of foil and baking paper.

For the chocolate sauce melt dark chocolate in a metal bowl over boiling hot water and when a fluid consistency apply to edges of the choux pastry balls to stick to one another. Finish by flicking chocolate all over it and be prepared to make a mess!

 A Peek inside the eye clinic



Courgette and Lemon Honey Cake with Chocolate Avocado Icing | Sight for Sore Eyes | 3 to go.


‘Let me think about it”

She had been almost blind without knowing it. In her sixties and seemingly losing her love of life with her family losing hope that she would ever be herself again. She no longer wanted to leave the home, had stopped cooking and socialising and her children were worried that she was going down hill fast.

The news that she was almost blind seem to come as a surprise to the lady and her family.
I explained that this was a condition that could be treated and we could put her on our list. A wave of anxiety spread over her and she agreed to think about it and get back to us. Usually when people say this we don’t hear from them again. The fear of the unknown grips them and myths of what happens in eye surgery are often shared.

One week later she called and said she would like to go for surgery… now! In an attempt to not let her anxiety prevent her having treatment she made a last minute decision and commitment to go for it.
At the hospital her stress levels remained high and she was very teary. When her turn came she almost refused but somehow summoned the will power to go ahead and lay on the operating theatre bed.
In just over five minutes her dense cataract had been replaced with a clear artificial lens and before the surgery was over she started shouting that she could see!

At home her family exclaimed that their Mum was back. Despite advise to rest, she was up and about, cooking and cleaning. She came to the clinic with her grandchild, feeding her and playing with a broad smile not leaving her face. She took a leap of faith and now not only was her vision restored but also her sense of self.



Stuck again….


With the health conscious bakery in mind and the high cost of soft cheeses here I was determined to find a way of making icing without using icing sugar….I was reading somewhere about the soft creamy smoothness of avocado ….that is when the idea came, avocados and honey are in abundant supply here so I had to try it, amazingly it worked.

Recipe: Courgette and Lemon Honey cake:

Ingredients cake:

4 eggs at room temperature

150g honey (runny)

350g grated courgette with skins removed

Finely grated rind of 3 lemons

140g ground almonds

220g plain flour

3 tsp baking powder

pinch salt

Ingredients – icing:

1 ripe medium avocado, needs to be soft

5 dessert spoons of honey

2 generous dessert spoons of cocoa powder

1 tsp vanilla extract


1. Prepare two 15cm circular baking tins with baking parchment.

2. Peel and grate courgette.

3. Wash and grate the lemons.

4. Whisk the honey and eggs for 6minutes until soft and airy, beat in the grated courgette and lemon.

5. Weight out the dry ingredients and gently beat into the mixture until well combined.

6. Divide equally into the two baking tins.

7. Place into a pre-heated oven at 180°C for 15-20mins until slightly golden and beautifully risen.  Listen before taking out if you cant hear any slight whistling it is ready.  Test with a clean knife, if it comes out clean it is ready.

8. Let cool in tins.

9.Whilst baking make the icing, mash the avocado and whisk with the remaining ingredients to a smooth consistency and place in the fridge.

10. When the cakes are cool select the best shaped cake and use this for the top of the sandwiched cakes, take the other cake and using a sharp serrated knife gently but firmly level the top of the cake.  Spread icing over this cake and place the other cake on top, then ice the top cake.  when finished store in an air tight container in the fridge.

Cheese and Rosemary Focaccia | Finishing or Beginning? | 4 to go…


I am rummaging through the cupboards and I find the backing to the sticky Cath Kidston ducks we had stuck all over the tiles in our bathroom when we first arrived.  They had seemed such an important touch of making an alien environment feel like home (and they were light to carry), now I am peeling them off one by one thinking of all the giggles, bubbles and splashes they had become part of as we bathed Lucas in a laundry bucket for the past year and a half.

The rain outside pours down, the thunder booms around the flats, it is dark but cosy for mid afternoon. We are in the wet season, the much awaited rains have finally come and the dust has settled, its home.  As the rain draws in its like winter approaches in a single afternoon, the concept of seasons is distant, its either wet or dry.  When this village was completed the road was tough and very long and thankfully we just avoided the rains, what a blessing! Lucas happily plays in what to him is the home he knows and remembers, he is in a world of tractors, play dough mud, bales of hay and a tele-handler (we so have to live near a farm!). We have less than three weeks during which we are also due to travel to Kitale, Western Kenya to take the equipment for the further eye projects, as I write, two engineers are on their ay to Kisumu to check out the bakery equipment for sale, things are getting busy and so we take what opportunities we can to sort through whats getting packed into cases.  As one chapter begins to close others are opening, we are not sure if we are finishing or beginning….

Recipe – Cheese and Rocket Focaccia

Adapted from The River Cottage Handbook: No. 3 – Bread


  • 500g strong white bread flour
  • 5g dried yeast
  • 10g fine salt
  • 325ml warm water
  • About 1 tbsp olive oil, plus extra for coating

To finish:

  • A generous drizzle of olive oil
  • A sprinkle of flaky sea salt
  • 150g of cheese, cheddar, blue cheese, parmesan what ever you feel like.  I used mozzarella and a strong almost cheddar like cheese.


To knead by hand: mix the flour, yeast, salt and water in a bowl to form a sticky dough. Add the oil, mix it in, then turn the dough out on to a clean work surface. Knead until smooth and silky, about 10 minutes.
Or, to use a food mixer: fit the dough hook and add the flour, yeast, salt and water to the mixer bowl. Mix on low speed until evenly combined, then add the oil and leave to knead for about 10 minutes, until smooth and silky.

Shape the dough into a round and coat with a little extra oil. Leave to rise in a clean bowl, covered with a plastic bag. When it has doubled in size, tip it on to the work surface and press into a rough rectangle. Place in a lightly oiled shallow baking tray, measuring about 26 x 36cm. Press the dough in with your fingers, right into the corners.  Sprinkle the grated cheese over half of the dough and fold over the other half to sandwich the cheese. Now leave to rise, covered, for about half an hour, it helps of slightly oil cling film to cover.

Preheat your oven to 220°C, or as high as it will go. When the bread looks puffed up and airy, use your fingertips to poke deep holes across the whole surface, almost to the bottom. Drizzle the top generously (but not swimmingly) with olive oil and sprinkle with salt, black pepper and even chopped rosemary if you feel like. Bake for about 10minutes, then turn the oven down to about 200°C and bake for a further 10 minutes.

Focaccia is best eaten warm, but not hot; leave to cool on a wire rack for about 10 minutes before serving, or leave to cool completely.



Pecan Pie | The Bakery has the Green Light! | 6 to go


It was over a year ago that we decided this was something that could work. The team had been complimenting the baking with comments such as “you could sell this” and “you should open a bakery”. The idea grew in to a vision of a social enterprise supporting the community through employment, healthy food and providing sustainable eye care. You never really know how things will pan out when you commit to an idea or a dream and there is always the possibility that it may never happen. Maybe that is why the term “dare to dream” is used?

When the director of the Ujima Foundation met us last week he gave us the green light to proceed with opening the bakery. We were delighted to have found such an amazing organisation and location to get this started. Maili Saba Camp where the bakery will be set up was actually the first place outside of our apartment that we stayed after being in Kenya five months. We’d had a pretty rough start to life here and our really close friends, Lydia and Chris had visited us just before our first Christmas. They gave us a generous gift and insisted we have a night away somewhere (probably sensing our high stress levels). That somewhere, was Maili Saba Camp and it has become our second home ever since. There is something just lovely about the place. It overlooks the menengai crater and has an aura of peace and tranquility about it. It is simple, rural and beautiful.

Ujima Bakery

We have also found some potentially very good bakery equipment and if it up to standard could purchase it in the coming weeks. Renovations will start to turn the existing building in to a bakery and before long, we hope, the bakery will be open. Although this will be when we are back in England we have found the right people to lead it and it should run at its own pace to ensure every part of it is done throughly and with consistent high quality.

Dare to dream…

Recipe – Pecan Pie


Pastry: See previous bake for Tarte au citron – make: 

  • 245g pastry


  • 110g unsalted butter
  • 110g golden syrup
  • 1 tsp vanilla extract
  • 225g brown sugar
  • 3 eggs, beaten
  • 285g pecan nuts, halved (bought in England)


  1. Preheat the oven to 180ºC
  2. Place the butter, golden syrup, vanilla extract and sugar into a heavy-based saucepan over a low heat.
  3. When the butter has melted, remove the pan from the heat and leave to cool for 5-10 minutes.
  4. Add the beaten eggs to the mixture and stir well.
  5. Set aside a small handful of the pecan nuts. Arrange the remaining pecan halves evenly in the pastry case and carefully pour over the syrup mixture.
  6. Place into the preheated oven and bake for 40-50 minutes – the pie will be golden-brown, but the filling should still be slightly soft.
  7. Leave the pie to cool on a wire tray. As the pie begins to set, decorate the top with the reserved pecan halves. Serve in slices.

Goat and Ugali Pie | Two long lost friends | 7 to go…


The two ladies used to be the best of friends. Around ten years ago one of them went blind in her second eye and could no longer walk safely to meet up with her friend. Her friend also suffered complete loss of vision in one eye and partially in her other. They sat next to each at the clinic without being aware they were next to one another. The clinic was busy; around two hundred and fifty patients came throughout the day. As the afternoon moved to early evening we had identified eighteen patients who were blind from cataract and all were willing to come to make the three-hour journey (largely off road) to town for treatment.



The two friends of old were in the group of eighteen and as their names were read out they simultaneously realised that the person sat next to them was an old friend. Although we couldn’t follow exactly what they were saying to one another it was clear they were both in disbelief and excitement. From that point on the old friends sat next to each other, the lady with partial sight becoming a guide to the lady with no sight.

The hospital van arrived a few hours later and took the patients to St Mary’s hospital in preparation for surgery the next morning.

The surgical team worked tirelessly till 6pm operating and restoring sight with incredible levels of skill and stamina.


Thanks to having the TED/Mazda film crew with us we had a rare opportunity to witness the day after surgery, not something we’ve seen very often as we are usually preparing the next clinics.  The patients from the remote village all sat anxiously anticipating having their patches off. The two friends, hand in hand had not left each others side. Dr George, the amazing surgeon, took the patches off one at a time. The old men and women slowly opening their eyes and taking in their surroundings. One grandfather jumped to his feet, clapping his hands and excitedly shouting that he could see. For those still waiting the anticipation was growing. The lady before the two old friends seemed, in a single moment, to become ten years younger. She dropped her stick, jumped to her feet and pulled off some dance moves that school kids of today would have been proud of.

post op waiting

It was eventually the turn of the two friends. The lady blind in two eyes spent several long seconds staring out at us and taking in everything around her, she then turned to her friend absorbing the image of an old friend who was several years older then she remembered. Soon her friend too was looking back at her and their half toothless smiles were shared as they embraced, old friends reunited.

Moments like this are humbling; I found my own eyes fill with tears as it became impossible to hide the overwhelming feeling of gratitude to be involved in such work.

Recipe – Goat and Ugali Pie

Adapted from a combo Paul Hollywood’s  Goat Herd Pie and Chilli Beef Cornbread Pie


For the filling
  • 1 tbsp olive oil
  • 2 medium onions, finely chopped
  • 2 celery sticks, de-stringed and chopped
  • 125g butternut squash, peeled and chopped
  • 2 garlic cloves, peeled
  • ½ tsp coarse sea salt
  • 500g  goat mince
  • 1 tbsp roughly chopped green olives
  • 1 tbsp tomato puree
  • 2 tbsp plain flour
  • 150ml red wine
  • 150ml beef stock
  • 1 tbsp chopped rosemary
  • ½ tsp ground cinnamon
  • freshly ground black pepper
For the topping
  • 125g plain flour
  • 125g cornmeal/ugali
  • ½ tsp salt
  • 115g unsalted butter melted and slightly cooled
  • 2 eggs, beaten
  • 125ml butter milk
  • 125ml Goat’s Yoghurt
  • ½ tsp baking powder
  • 75g cheddar cheese, grated


  1. Preheat the oven to 190ºC
  2. To make the filling, heat one tablespoon of the oil in a wide frying pan over a medium-low heat. Add the onions, celery and squash and cook gently for about 10 minutes, or until the onions begin to soften.
  3. Put the garlic in a pestle and mortar with the sea salt and crush to a paste. Add the anchovies and bash to form a rough paste. Add this mixture to the pan of vegetables. Cook gently for about five minutes, stirring, so the anchovies begin to ‘melt’. Remove the contents of the pan to a bowl, leaving any oil behind.
  4. Increase the heat under the pan. Add a little more oil if necessary, and half the mince. Cook, stirring, until it is browned, then add it to the vegetables. Repeat with the remaining mince then return all the meat and vegetables to the pan.
  5. Add the olives. Stir in the tomato purée and flour and cook gently for 2-3 minutes. Add the wine and stock, bring to the boil then simmer for 15 minutes.
  6. Add the rosemary and cinnamon and season with salt and pepper (if needed – the anchovies are already quite salty).
  7. Transfer the meat to an oven dish with around 1.2 litre/2 pints capacity.
  8. For the topping, put the potatoes in a pan, cover with water, add a little salt and bring to the boil. Simmer for 15-20 minutes, or until the potatoes are tender. Drain well, then mash them or push through a ricer back into the hot pan, and stir in the butter.
  9. Spread the mash over the meat in the dish. Combine the crumbled goat’s cheese and parmesan and sprinkle over the potato.
  10. Bake in the preheated oven for 25-30 minutes, or until the top is golden-brown and crusty and the filling is bubbling.
  11. Leave to stand for 10-15 minutes before serving.




Victoria Sponge (with potato) | Quite a day… | 8 to go


Andrew gets off the phone from Dr Rono, the eye surgeon in the west of Kenya who will be taking the lead on several Peek projects over the coming years. He excitedly tells me that Rono is meeting a group in his region working on non-communicable diseases/NCDs (diabetes, heart disease etc, diseases that are non-infectious), going door to door doing blood pressure and diabetes checks and trying to find people early before the disease have a serious effect on their health. As these diseases all have eye related problems they are keen to see if Peek could help. This area is my passion and the ethos of the bakery is to provide healthy choices to people who are surrounded by processed food (high in fats, sugars and salts that contribute to NCDs). I’d love to do research in greater depth looking at new ways of challenging unhealthy environments which encourage the increase in these diseases.

A few hours later we have a conference call with a great guy in Peru who is leading several programs tackling issues around NCDs, who had heard about Peek and the possibilities it has for use in NCD diagnosis and monitoring, we too had been thinking how the same platform can be quite easily transferred for exactly these uses.  It’s been in the diary a while and given my love of Peru (I lived there for a year when I finished school) and I took Andrew there seven years ago to meet the family I had stayed with whilst on my medical school elective – Andrew was doing eye things. We spoke at length about the various projects in Peru and amazingly, it came to light that the team Rono was meeting in Kenya were partnered with the team in Peru – a small world! Both teams tackling similar issues we’ve written about previously.  Somewhat in shock at the possibilities this opens up the day was complete with a notification email from Oxford that I had been offered the job I really wanted and  had travelled back to the UK for! It is a fantastic post with a team that excel in primary care (general practice and health care in the community) and research in the areas I am passionate about.

The post in an incredible opportunity to continue work in this area for years to come so we are very thankful all that effort in travelling back with Lucas was well worth it!

EyeBakePeru? 😉


Recipe – Victoria Sponge

Taken from Harry Eastwood’s “Red Velvet Chocolate Heartache”


For the sponge:

3 medium eggs

150g caster sugar

200g peeled and finely grated potatoes

100g white rice flour

2 tsp baking soda

Pinch of salt

Tsp vanilla extract

For the filling:

150mls whipped cream (original recipe uses 40g margarine but I think it is tastier like this)

90g icing sugar, sieved

Tsp boiling water

Half tsp vanilla essence

Pinch of salt

150g blackcurrant jam (the original recipe uses strawberry)


  1. Preheat the oven to 180ºC.  Lightly oil the base and sides of two loose bottomed cake tins (18cm x 5cm).  Place a circle of baking parchment over each base and oil lightly.
  2. Whisk the eggs and sugar together until pale, fluffy and tripled in size.  Stir in the potato, flour, baking powder, salt and vanilla.  Stir well to ensure that everything is incorporated.
  3. Divide the mixture between the two tins and cook for 20 minutes.  Allow to cool slightly before removing from the tins and transferring to a wire rack.
  4. For the filling, whisk the margarine then add in the icing sugar one tbsp at a time.  Add the boiling water and whisk to combine.  Add the vanilla and salt and beat again.
  5. Ice the bottom of one of the cold cakes covering the other one with jam.  Sandwich the cakes together.
  6. Lick the bowl…


Onion and Bay leaf Loaf | Driving Blind… | 9 to go


“Are you able to work?” The well dressed man points to his left eye and tells me he doesn’t see so well from this eye but it does not stop him working.

I look at the measurements of his vision. His left eye is blind and his right is also very poor. He can make out the top line of the vision chart only, effectively ten times below “normal” vision.


He has cataracts (clouding of the natural lens) in both eyes, more so in the left.

This is not an uncommon finding in the older population in Kenya, what is surprising (and maybe not uncommon?) is that he works as a driver for a living and drove to the clinic!

In disbelief I asked him several times if he actually drives? He responds that he drives every day.

I ask if he’s ever been in a car accident? He responds that they are very few…

I explain at great length that he is a danger to himself and other road users and that we will urgently arrange surgery for him. Having seen the disasters on the road in Kenya I really beg him not to get behind the wheel until his surgery has been done. A friend has accompanied him to the clinic and so I also take the opportunity to press on his friend the dangers of driving with such poor vision and I ask that he ensure this man doesn’t drive until he has had treatment. They both smile and agree that they will stay off the road.

Half an hour later I see the almost blind man and his friend climbing in to an old Toyota and driving out of the car park…

Recipe – Onion and Bay Leaf Loaf

Taken from Dan Lepard’s “The Handmade Loaf”


For the onions:

140g white onions, diced into 1cm pieces

350g whole milk

3 bay leaves

For the dough:

100g strong wholewheat flour

475g strong white flour

1.5 tsp fine sea salt

1 tsp (6-7g) dried yeast, crumbled

325g milk from the onions

280g cooked onions


Place chopped onions, milk and bay leaves in a saucepan and bring to the boil, then remove from the heat and leave to cool for about 30 minutes. Pour through a strainer to separate the onions and bay leaves from the milk. Reserve the milk for use in the dough

In a large bowl, combine the flour and salt. In another bowl, whisk the yeast 325g milk from the milk in which the onions were cooked. Beat in the leaven until the mixture is smooth, then finally add the onions and stir. Pour the wet ingredients in with the flour, and stir until you have a soft sticky dough. Scrape any dough from your fingers in to the bowl, then cover and leave for 10 minutes.

Rub one tsp of olive oil on the work surface and knead the dough on the oiled surface for 10 seconds, ending with the dough in a smooth, round ball. Clean and dry the bowl, then rub with a tsp of oil. return the dough to the bowl and leave for a further 10 minutes. Remove the dough and knead once more on the oiled surface, returning the shape of the dough to a smooth round ball. Place it back in the bowl, cover and leave for 1 hour in a warm (21-25ºC) place.

Line a deep 20cm diameter bowl with a flour-rubbed tea towel. Lightly flour the work surface and shape the dough in to a ball. Place the ball of dough seam-sided-upwards in the cloth, then cover with exposed corners of the tea-towel. Leave the bowl in a warm  (21-25ºC) place for 1.5 hours, or until the loaf has doubled in height.

Preheat the oven to 210ºC. Upturn the loaf on to a semolina dusted baking tray. Spray the upper surface of the dough with a fine mist of water, then place the tray in the centre of the oven and bake for 20 minutes. Reduce the heat to 190ºC and bake for a further 30 minutes, until the loaf is a golden colour. Leave to cool on a wire rack.

Dan Lepard recommends eating this loaf toasted to serve with a good smoked kipper, grilled field mushroom and melted butter (not likely in Kenya but sounds delicious!)


Chocolate Eclairs | 90 down, 10 to go…


We’ve reached the final two months of our time in Kenya and before we know it the time will have come to pack up the eye equipment and Mixer and prepare to move home and country once again. There is little time to sit back and think about all that has been, as so much is still going on. We need to keep focussed in these final stages to ensure it all runs smoothly and that we have done all we can to ensure our team will go on to bigger and better things beyond this project. There are three further eye projects planned for Kenya, one of which is the schools one and the others we will explain later. The bakery is also looking promising. The right people are in place, the Ujima board have responded positively and once the paperwork goes through we can start renovations and sourcing equipment. We are no longer working on English timelines and deadlines but have moved in to a middle ground of pushing where we can and learning to wait. Certain things will happen in their own time, regardless of how much we rush or push.

Amazingly, while we have been debating the pros and cons of importing refurbished equipment from the UK or buying locally (there isn’t much choice in Kenya and the prices are really high) we were sent an email explaining a local bakery in the West of Kenya is closing down and selling its baking equipment! Pretty much all the items we need… This could be perfect but we will need to check on the quality and condition of them as well as seeing if we can get them within our budget.

To celebrate reaching a once inconceivable target of 90 we asked the team how they would like to celebrate. The usual roast goat or something a bit different? They deliberated and got back to us that they would like to go somewhere where they could order food from a menu. We thought this was a really sweet idea so booked a place at one of the top hotels in the town centre and enjoyed a meal together. One of our team (who has a brilliant sense of humour) commented on the security/metal detector you have to walk through at the main entrance – he thought the beeping meant he had malaria!

The amazing team enjoying a la carte…


Next week a film crew from the US will be with us all week making a documentary on the eye project in affiliation with TED so we will be flat out doing our usual combo of baking, eye work and the usual things that fill our days – we will try our best to keep up with the blog.

Recipe – Chocolate Eclairs


For the choux pastry
  • 65g plain flour, sifted
  • pinch of salt
  • 50g butter, diced, plus extra for greasing
  • 2 eggs, beaten
For the filling
  • 2 egg yolks
  • 5 tablespoons castor sugar
  • 1.5 tablespoons corn flour
  • 3 tablespoons double cream
  • 2 tsp vanilla extract
  • 50g unsalted butter
For the icing
  • 100g milk chocolate chopped
  • 50-75g yogurt


  1. Preheat the oven to 200ºC. Generously grease a baking tray with butter.
  2. Sift the flour onto a sheet of greaseproof paper.
  3. Put 120ml/4fl oz water into a medium-sized pan with the salt and butter and heat gently until the butter has completely melted – don’t let the water boil and begin to evaporate. Quickly bring the mixture to the boil and tip in all the flour in one go. Remove the pan from the heat and beat furiously with a wooden spoon – don’t worry, the mixture will look messy at first but will soon come together to make a smooth heavy doughPut the pan back on a low heat and beat the dough for about a minute to slightly cook the dough – it should come away from the sides of the pan to make a smooth, glossy ball. Tip the dough into a large mixing bowl and leave to cool until tepid.
  4. Put the pan back on a low heat and beat the dough for about a minute to slightly cook the dough – it should come away from the sides of the pan to make a smooth, glossy ball. Tip the dough into a large mixing bowl and leave to cool until tepid.
  5. Beat the eggs in a bowl until combined, then gradually beat them into the dough with an electric whisk or mixer, or a wooden spoon, beating well after each addition. (You may not need all the egg.) The dough should be very shiny and paste-like, and fall from a spoon when lightly shaken.
  6. Spoon the pastry into a piping bag fitted with a 1.25cm/½in plain nozzle and pipe 12 x 10cm/4in lengths onto the greased baking tray.
  7. Sprinkle the tray, not the pastry, with a few drops of water, and bake in the oven for 15 minutes. Then, without opening the door, reduce the oven temperature to 170ºC and bake for 10 minutes, or until golden-brown and crisp.\
  8. Remove the tray from the oven and carefully make a small hole in the side of each éclair to allow steam to escape. Return to the oven and bake for a further five minutes, or until the pastry is completely crisp. Remove from the oven and transfer to a wire rack to cool.
  9. For the filling, use a wooden spoon to beat the egg yolks with the sugar, corn flour and cream in a heatproof bowl until very smooth, add the 2 tsp vanilla extract.  Tip the mixture into a pan and heat until boiling stirring constantly until very smooth and thick, remove from the heat and add the butter stirring it in.  Cover to stop a skin forming and leave to cool.
  10. Once the éclairs have cooled, cut down the length of one side of each éclair and pipe in the filling.
  11. Melt the chocolate over a double boiler or a bowl suspended over a pan of simmering water (do not allow the bottom of the bowl to touch the water) then mix in the yogurt to make the ganache. Use a palate knife dipped in hot water to spread the chocolate ganache.