By Milliam Murigi
For two years, living with Type 1 diabetes meant nine-year old Maurice Mwaniki and his family had to rely on neighbours to store his insulin because they had no safe way to keep it at home.
Without a refrigerator and living in an iron-sheet house that traps intense heat, keeping the life-saving drug at the right temperature was nearly impossible.
However, today, his insulin sits inside a metallic pot, remaining usable even as temperatures climb past 30°C.
The shift came after healthcare workers from Ngaira Health Centre, located in Nairobi Kenya introduced a simple local cooling technology, two metallic pots, one nested inside the other, with wet sand and charcoal in between.
“He was diagnosed with Type 1 diabetes when he was six. For two years, we struggled to store his insulin because we did not have a refrigerator at home. Since we started using the pot-in-pot cooling system last year, we can now store his insulin safely at home, even when the temperatures are high,” John Kamau, Mwaniki’s father said.
Through evaporation, the system works by creating a cooler environment capable of preserving insulin even in high temperatures. Maurice’s caregivers have since been trained on how to effectively store the insulin using this innovation, giving the family greater control over his daily care.
Handling and storage of insulin is vital for effectiveness as it is stored at optimal temperatures of between two to eight degrees. High temperatures reduce insulin potency, affecting its ability to control blood sugar. Freezing also destroys the insulin’s structure, making it ineffective.
According to Erick Owino, a diabetes educator at the centre, the innovation was introduced after health workers conducting home visits found that many families caring for children with Type 1 diabetes could not afford refrigerators for insulin storage.
Because of that, some families had resorted to improvised methods of keeping the insulin cool, including wrapping it in ice, cotton and methylated spirit. Practices that used to compromise the medicine’s effectiveness.
“We found out that most families didn’t have the capacity to have a fridge for insulin storage. So, five years ago we initiated a strategy of storing the insulin through a locally-made fridge”, he says.
The locally-made fridge consists of two containers, which can be made of either clay or metal, with one larger than the other. The smaller container is placed inside the larger one, leaving a gap between them. The space is filled with a mixture of sand and small pieces of charcoal, which is kept moist with water.
Insulin is then placed inside the smaller container, which must remain dry. Evaporation from the wet sand and charcoal helps cool the inner container, creating a refrigerator-like environment for storing insulin.
The innovation is increasingly being used among children and young people attending the facility. According to him, the facility currently cares for about 300 clients including children and youths aged up to 25 years who are on insulin for type 1 diabetes, with approximately 80 per cent about 200 using the homemade cooling system.
“The innovation has become particularly important for low-income families who cannot afford conventional refrigerators. However, cost remains a challenge. The more advanced metallic version, fabricated locally by artisans, costs about Sh1,000 (US$8), which some families still struggle to afford,” he said.
According to Owino, the innovation has made it easier for patients to safely carry and store their insulin while travelling, particularly when visiting rural and remote areas where access to electricity and conventional refrigeration is limited or unavailable.
The portable nature of the refrigerator also allows families to move with insulin without relying on ice or other improvised storage methods that could compromise the medicine’s effectiveness. The container can hold around 50 vials or 20-40 pens. This can last one for about three months.
Since people started using this innovation, Owino says that caregivers have reported better temperature control and more stable blood sugar readings among children using properly stored insulin.
“When they come to the clinic, where we see their sugar diary, we find that their sugar levels are very stable,” he adds.
Kenya is not the only country where this innovation is being used. It is also used in Sudan, where extreme temperatures and fragile health systems present comparable challenges.
Sarah Musa, a pediatric consultant who has worked extensively with diabetic children, notes that Sudan was among the countries that helped test and validate this method years ago.
Early studies demonstrated its potential and humanitarian programs have since distributed clay pots to vulnerable households, especially in rural and conflict-affected areas.
“Before the introduction of clay pots, many parents struggled to keep insulin effective. Some traveled long distances daily to health centers just to store medicine, while others risked using insulin that had been compromised by heat,” says Musa.
However, experts caution that the solution’s success depends on proper use. Many families lack clear guidance on how much water to add, the type of sand required, the appropriate pot size, or how many insulin vials can be safely stored.
In eastern Ethiopia, for example, pilot programs showed that while communities embraced the innovation, they needed hands-on training and consistent follow-up. In some cases, poorly assembled pots or incorrect water levels reduced the cooling effect, undermining trust in the method.
“Proper construction and use are essential. Always ensure that the smaller pot where you place insulin remains dry. The insulin should not come into contact with water or other fluids, since this could compromise its effectiveness. Also always ensure that the sand mixture remains moist since this acts as a coolant thus preventing temperature fluctuations,” says Owino.
