KENYA: Healthcare hurdles in Nairobi’s slums
Photo: Manoocher Deghati/IRIN
Slums are underserved in terms of access to basic amenities
NAIROBI, 11 July 2008 (IRIN) - Quality healthcare is a luxury often beyond the reach of those who live in Nairobi’s slums, such as mother-of-seven Grace Awour Opondo.
"When you are sick you buy medicine from the local shops," Opondo told IRIN. "If you are lucky you recover because the medicine is not usually the right one.
"Sometimes there is no medicine even in the hospitals, so they send you out with a prescription," she said. "Then the chemists are expensive so often one has to make do without the medicine."
According to Sakwa Mwangala, a programme manager with the African Medical and Research Foundation (AMREF), the fact that people are squatting on government land often prevents them from accessing essential services. Slums are regarded as informal illegal settlements, which means they are underserved in terms of infrastructure development and access to basic amenities.
"Government health facilities are also not easily accessible for most slum residents," said Mwangala, who heads AMREF's Kibera integrated healthcare programme. Kibera, on the southwestern edge of central Nairobi, is one of the largest and most densely populated slums in sub-Saharan Africa.
Most people operating health “facilities” in the slums are quacks, he said. “There is a lack of quality control, with the people in most of these clinics lacking skills."
The urban poor fare worse than their rural counterparts on most health indicators, according to a report, Profiling the burden of disease on the residents of Nairobi slums prepared by the African Population and Health Research Center (APHRC).
Pneumonia, diarrhoeal diseases and stillbirths account for more than half the deaths of children under-five, while HIV/AIDS, tuberculosis, interpersonal violence injuries and road traffic accidents account for more than two-thirds of deaths among people aged five years and older, stated the report.
The poor health status of slum children is in part due to continuous exposure to environmental hazards coupled with a lack of basic amenities.
"The chances of one becoming sick are high because of the poor sanitation; most of the houses are also poorly ventilated," according to Leonard Wawire, a teacher in the Mathare slum.
"Here, there are no trees to clean the air; any plant growing is usually growing out of waste," Wawire said.
Prevention measures
Eliya Zulu, APHRC’s director of research, told IRIN it was important to adopt a holistic approach to healthcare for the urban poor, one that focused as much on prevention – through improved nutrition and immunisation against major childhood diseases – as on treatment.
Photo: Julius Mwelu/IRIN
Grace Opondo, a resident of Mathare slums
“Increasingly, most people in the urban areas are living in deplorable conditions yet it is generally assumed that the better hospitals and schools are in the urban areas,” Zulu said.
When conducting general health surveys, urban areas tend to rank better than rural areas in terms of the health indicators. This, however, failed to bring into focus the health situation of the urban poor, he said.
The problems of the urban poor have often been overlooked while rural areas are seen as more vulnerable to shocks.
"In the rural set-up there is a sense of normalcy; you can have your toilet, the community also has a stream from which they draw their water - this is not the case in the slums," Mwangala of AMREF said.
Many deaths in the slums are caused by preventable and treatable conditions, according to the APHRC report; inadequate sanitation encourages the spread of skin and waterborne diseases.
In a bid to improve sanitation in Kibera, a Kenyan NGO, the Umande Trust, is running a project that not only provides quality toilets for residents but also transforms human waste into biogas and liquid fertiliser.
Residents in areas such as Katwekera and Laini Saba in Kibera, pay two shillings (three US cents) to use the toilets and showers, according to Josiah Omotto of the Trust. For a subscription of 80 shillings ($1.19) a month, households get unlimited access to the facility.
The buildings’ basements house bio-digester domes, which turn human waste into methane and liquid fertiliser.
''When you are sick you buy medicine from the local shops; if you are lucky you recover because the medicine is not usually the right one''
According to Omotto, these help reduce the local use of firewood. Already, he said, the methane from the facility in Laini Saba was being used for fuel by a local nursery school. There are plans to construct similar facilities in other slums to supply the gas to residents living near the facilities.
So far, at least 500 residents are benefiting from each facility.
The division of environmental health in Kenya's Ministry of Health is finalising policy documents aimed at ensuring that 90 percent of households have access to, and make use of, hygienic, affordable, functional and sustainable toilet and hand-washing facilities.
The policies also aim at reducing the national rate of preventable sanitation-related diseases by half.
aw/am/mw
Theme(s): (IRIN) Children, (IRIN) Environment, (IRIN) Health & Nutrition, (IRIN) Water & Sanitation
Tuesday, November 3, 2009
Tuesday, October 27, 2009
Sanitation briefing
updated October 2008
 |
| Risky sanitation for children in Nepal © Mark Naftalin |
Development agencies must accept some responsibility, their publicity cameras preferring to linger on happy children working the pump handle, drops of water glistening in sunlight. Latrines offer less inspiring images and copy. Even the UN’s declaration of the period 2005-2015 as the “International Decade for Action - Water for Life” betrayed neglect of sanitation, in presentation if not intent.
The consequence is that 18% of the world’s population – including half of the population of South Asia – continues to suffer the indignity of open defecation, mostly in rural areas. Global access to safe sanitation increased only from 54% to 62% in the period 1990-2006, leaving 2.5 billion people without access, a figure which has barely changed in recent years. In sub-Saharan Africa progress from 26% to 31% extrapolates to arrive at the target sometime during the 22nd century.
The development industry has recently taken great strides to redress its lopsided focus on drinking water. The UN corrected its earlier omission by proclaiming 2008 as the Year of Sanitation and the development agencies have overhauled their presentations.
For example, the suggestion that diarrhoea is caused by drinking contaminated water presents an incomplete picture and more attention is now given to the link with unsafe sanitation and poor hygiene practices which ultimately are a major contributor to child mortality. The specialist international agency, WaterAid, has been referring to “sanitation and water” in its communications, inverting the more familiar phrase.
A further important output of this fresh approach has been the calculation that sanitation projects deliver highly impressive economic returns of $9 for each $1 of investment, thanks to lower healthcare costs and less disruption to school and work attendance.
Thursday, October 1, 2009
Kenya: Mathare Slum Dwellers Protest over Water
Casper Waithaka
30 September 2009
Nairobi — Transport on a busy Nairobi road was paralysed on Wednesday following violent protests over water due to illegal connections.
Police were called in to quell the protests and restore order along Juja Road as Mathare slum dwellers lit fires to protest over the disconnection of water.
Nairobi City Water and Sewerage Company communications officer, Ms Grace Some-Mwangi, said the disconnection had been prompted by the operation of illegal connections by many slum dwellers.
"Many residents have been selling the water and that is illegal," she said. Police lobbed tear gas canisters as they fought running battles with the rowdy crowd. Order was restore in four hours.
The slum has had flowing water even as other city areas continue to suffer rationing due to the shortage caused by a prolonged dry spell. The water company reconnected supply.
Pelted with stones
A number of people were injured and were treated at the nearby Moi Air Base dispensary and Kenyatta National Hospital. Motorists faced the full wrath of the crowd, which consisted mostly of young people, as they pelted vehicles with stones and shattered windows.
Thieves also took advantage of the situation to steal from people caught up in the ensuing confusion. Hundreds of passengers from Huruma were left stranded as matatus used alternative routes to escape the protests.
Ms Millicent Awori, a resident of Bondeni, said the protests were inevitable as they could not survive without water. "It was disconnected unfairly and we do not have the money to buy the commodity at high prices," she said.
However, other residents blamed water vendors for the protests. They said the vendors had made illegal connections that they were trying to protect. Representatives of the water company, residents and the government are expected to meet today to chart the way forward.
Ethiopia: OSA Calls for Assessment of Lake Koka Pollution - Letter to Pittards
September 28, 2009 at 4:42 am
Gadaa.com received a letter from the new president of the Oromo Studies Association (OSA), Dr. Haile Hirpa, with the subject: “Re: Pollution of Lake Koka” and addressed to the management of the Ethiopia Tannery S.C. (ETSC), Pittards plc.
| Case Study: April 2009 - This KMBC news reports on the link between chromium and brain tumor. The chromium was a by-product of a tannery in Cameron, Missouri (USA). Chromium was one of the chemicals found in lakes along the Ethiopian Rift Valley and a nearby tannery in Ethiopia. More @ Gadaa.com/Environment |
It’s to be noted that the former president of OSA, Dr. Abebe Adugna, wrote a letter to the management of ETSC to take responsibility for the pollution of Lake Koka, clean up the lake and compensate residents for damages; Dr. Adugna’s letter came after the airing of the Al Jazeera documentary on the subject in February 2009.
Pittards plc denied the accusations in a letter sent to OSA in June 2009 stating that OSA’s evidence (a study about Lake Koka’s pollution) was from 2003 whilst Pittards took over ETSC in 2005. Pittards plc also affirmed its commitment to environmental stewardship and offered a meeting with OSA in the future to discuss the subject.
While letters are traded between OSA and ETSC management, thousands of people still remain affected by chemical poisoning in drinking water fetched from the polluted Lake Koka - with no action from the government of Meles Zenawi. Mr. Zenawi, who has ironically and deceivingly become the negotiator of African environmental issues at the UN Copenhagen Climate Change Conference 2009, has turned a blind eye on the thousands of people affected by Lake Koka’s pollution; the lake is located less than a hundred kilometers from his Palace. Mr. Zenawi has no moral authority to speak of the environmental ills the West has caused to Africa while his environmental policies at home are resulting in Lake Koka’s pollution and others listed at Gadaa.com/Environment.
——– Full Text of Dr. Haile Hirpa’s Letter to the Management of ETSC ——-
September 27, 2009
Mr. Reg Hankey
Pittards PLC
Sherborne Road, Yoevil
Somerset, England BA21 5BA
Re: Pollution of Lake Koka
Dear Mr. Hankey:
I am writing in response to your June 1, 2009 letter to my predecessor as President of the Oromo Studies Association (”OSA”), Dr. Abebe Adugna.
On behalf of OSA, I appreciate your stated commitment to sustainable development in Ethiopia and your willingness to engage in a dialogue on this important environmental issue, which impacts so many Ethiopians. I also appreciate your invitation to meet on this issue.
I respectfully disagree with your suggestion that my predecessor’s May 3, 2009 letter was not “fully research[ed].” As you know, a scientific study published in August 2002 observed that effluents from Ethiopia Tannery Share Company (“ETSC”) facility:
might very likely contain highly toxic forms. In cases where such forms are available, bioaccumulation of the metals by aquatic biota is inevitable. Such metal accumulations are also very likely to occur in the biota of the terrestrial areas around these lakes.
A preliminary determination of heavy metal concentrations in the extract of watermelon grown around Lake Koka contained alarmingly high concentrations of [chromium, iron, nickel and lead].1
As reported by “People and Power,” many local residents identify the Pittards-run facility as an ongoing source of pollutants contaminating Lake Koka.2 A local farmer whose livestock grazes by the tannery’s effluent stream recounted: “What comes from this factory has killed the cattle. It burns the plants. It’s no good for harvesting. It’s no good for people either.”3
Indeed, when interviewed on the subject, you apparently were unwilling to definitively rule out the Pittards facility as a source of pollutants: “Saying it’s all associated with the tannery in the northwest that we’re associated with is probably incorrect. That’s not to say that we’re saying there aren’t some issues. I don’t know if there are or aren’t. . . .”4
Unlike your earlier statement, your June 1, 2009 letter now denies without reservation that the tannery “is responsible in any way for any pollution found in Lake Koka.” None of the evidence you cite in your letter, however, appears to exonerate the tannery.
· While you mention that the tannery does not discharge effluent directly into the lake and that the effluent liquors are used to irrigate land within the boundaries of the ETSC compound, you do not state that those effluents are free of pollutants or that any pollutants do not find their way to the lake water. To the extent Pittards has conducted or is aware of any recent scientific studies showing that the heavy metals and other pollutants found around Lake Koka in the August 2002 study are not being discharged from the tannery, I ask that you please make those available.
· While you mention the tannery’s ISO 14001 accreditation, it is our understanding that obtaining ISO 14001 status does not require a firm to reduce pollution below specified levels or to use particular pollution control technologies. It is further our understanding that a firm does not even need to be in compliance with applicable regulations, but rather must declare a commitment to the goal of compliance. Moreover, critics have noted the conflicting interests of the consulting firms that perform ISO 14001 audits, which may call into question their reliability. I ask that Pittards make available all materials relating to ISO 14001 audits of the ETSC facility.
· While you include a statement from the Ministry of Trade and Industry (“MTI”), the MTI does not reference any recent water quality studies or other scientific evidence in connection with its claims. The statement merely recites – oftentimes word for word – the assertions made in your letter. I ask that Pittards make available any studies or other reports conducted by or on behalf of the MTI or any other agency of the Ethiopian government relating to the tannery.
As my predecessor mentioned in his May 3, 2009 letter, Pittards can still do much good to help address this situation. As an initial matter, I ask that Pittards work with OSA and other appropriate organizations to conduct environmental assessments of the Lake Koka area in order to establish conclusively the sources of pollutants and to assist the relevant authorities in Ethiopia in devising and implementing a viable remediation plan. If Pittards believes that it is not causing harm to the Lake Koka environment, participation in such an endeavor would go a long ways towards dispelling the belief among local residents and others about the tannery’s impact. Participation would also provide very tangible evidence of Pittards’ stated commitment to sustainable development in Ethiopia. I would be happy to arrange a meeting with Pittards by representatives from my group to devise a plan agreeable to all interested parties.
I look forward to hearing from you.
Sincerely,
Haile Hirpa, Ph. D
OSA President
References:
1. G.M. Zinabu & Nicholas J.G. Pearce, “Concentrations of heavy metals and related trace elements in some Ethiopian rift-valley lakes and their in-flows,” Hydrobiologia 429, 171-178 (2003) (emphasis added, internal citations omitted).
2. “Green Lake,” People and Power (aired February 21, 2009).
3. Id.
4. Id.
————————–
RELATED:
- Oromia - Environment in Peril @ Gadaa.com/Environment
- OSA Website
- OSA: The Ethiopian Tannery Responsible for Lake Koka Pollution
- Oromia: Pittards plc and the Ethiopian Ministry of Trade/Industry Respond to the Oromo Studies Association’s Concern About the Pollution of Lake Koka
Ghana: NGOs Institute Sanitation And Hygiene Awards
Michael Boateng
25 September 2009
African Media Aid (AFRIMA) and Global Media Foundation (GLOMEF), human rights and social development non-governmental organisations (NGOs) based in Sunyani, will from next year institute Sanitation and Hygiene Awards to recognise outstanding achievements of organisations, individuals and communities in the country, in the area of sanitation and hygiene.
The Chief Executive Officer (CEO) of AFRIMA, Raphael Godlove Ahenu, who announced this, said the awards would help motivate individuals and organisations to support and mobilise communities to improve upon their sanitation and hygienic conditions.
Mr. Ahenu was speaking at the launch of a campaign dubbed, "Access to Clean Water and Sanitation." The event was on the theme: "Investing in Water and Sanitation: A Wise Investment for Health, Dignity and Development," at Odumase in the Sunyani West District of the Brong-Ahafo Region.
The CEO of AFRIMA noted that records indicate that over 1.8 million children die from diarrhoea, which could be prevented with access to clean water.
He continued that school days were lost to water-related diseases, and that the majority of the populations in developing countries, suffer from health problems caused by lack of clean water supply and poor sanitation.
According to him, a survey conducted by AFRIMA in the Brong-Ahafo Region, indicates that many schools and communities in the region do not have toilet facilities and potable water.
Mr. Ahenu said it was against this background, that AFRIMA/GLOMEF initiated the campaign, with the main goal of creating public awareness on the negative effects of unsafe water and poor sanitation.
He said under the campaign, toilets and water would be provided for needy communities and schools. The District Chief Executive (DCE) for Sunyani West, Kwadwo Osei Asibey, in a speech read on his behalf said, considering the importance of water and sanitation in the life of man, it falls on all to invest in those sectors, to ensure quality life.
He noted that the assembly had rehabilitated seven boreholes in some communities, at the cost of GH¢4,090, and commended AFRIMA/GLOMEF for the initiative, and pledged that the Assembly would support the campaign.
The District Environmental Health Officer, Isaka Adamu, on his part, appealed to the Sunyani West District Assembly to provide the sanitary inspectors in the district with motorbikes, to make them more mobile in their duties.
Kenya: Water Kiosks to be set up in Estates
Johnstone Ole Turana
30 September 2009
Nairobi — Water selling points are to be constructed in Nairobi's housing estates in a bid to ease the shortage of water facing residents.
The Athi Water Services Board, (AWSB), which has invited bids for the construction of the water kiosks, is also seeking to improve sanitation facilities in informal settlements and arrest illegal connections that are being used to divert water and rob the Nairobi Water and Sewerage Company of revenue.
"The construction of the water kiosks is intended to ease the high cost of water residents are paying to existing privately-owned water outlets", said Kenneth Owuocha, public relations officer at the Athi Water Services Board.
The AWSB is mandated to develop water and sanitation infrastructure within its area of jurisdiction and hand over such facilities to the Nairobi City Water and Sewerage Company for management.
The plans envisage the construction of 10 water kiosks and 12 ablution blocks as well as the improvement of the sewer lines and provision and installation of 376 individual and 50 communal water meters.
The programme will cover Kahawa Soweto village, Gitathuru, Madoya, and Mahira villages. Other informal settlements that will benefit from the construction are Kambi Moto and Kiambiu villages.
According to Mr Owuocha, the installation of the meters will reduce the level of unaccountable water use and curb revenue loss to the water company. The board faces the daunting task of upgrading its ageing infrastructure which has been blamed for water leakage and illegal connections.
The improvement of water and sanitation facilities in the informal settlement is a five-year programme funded by the European Union. It comes at a time when the country is facing acute water shortages as failure of rains that has led to drying of major rivers across the country.
Nairobi and its environs are currently undergoing a water rationing programme.
According to the water board, "Kenya is a water scarce country and with intermittent drought the acute water shortage is exacerbated. Hence the urgent need to develop adequate storage facilities that will guarantee adequate water supplies in the face of unpredictable weather patterns."
The current crisis is blamed on the failure to implement previous recommendations to expand water reservoirs.
Kenya: Slum Dwellers to Get Sh1.7 Billion Sanitation Upgrade
Nairobi)
Allan Odhiambo
30 September 2009
Nairobi — Thousands of poor urban households will gain access to water and sanitation services in a Sh1.7 billion deal targeting the slums.
"This initiative specifically targets the slums," Mr David Stower, the Water PS, told journalists in Nairobi on Tuesday after signing the agreement on behalf of the government.
The targeted water and sanitation projects will be run as part of a special initiative dubbed the Urban Programme Concept (UPC) and funded through a multilateral agreement between Kenya, the German government and the European Union (EU).
"Households in these urban slums have serious challenges in accessing water year round," the PS said.
Funds from the Sh1.7 billion grant will be managed and disbursed by the Water Services Trust Fund (WSTF) even though the actual implementation of the project will be carried out by Water Service Providers(WSPs) operating in the target areas.
Some 800,000 people are expected to benefit from the initiative to be implemented over the next four years, starting with locations that fall under the Lake Victoria North Water Services Board (LVNWSB).
Estimates by the Water ministry show that only about 60 per cent of Kenya's urban population has access to water while only 55 per cent have access to basic sanitation facilities.
"We expect this initiative to improve the lives of households," Mr Eric van der Linden, the Head of the European Commission delegation in Kenya said.The WSTF made the first call for proposals under the UPC initiative earlier this year.
According to initial estimates, the first phase was projected to encompass 15 projects to reach 100,000 inhabitants of low income urban areas with quality water at a cost of Sh100 million.
Each of the five WSPs that fall within the territory of the LVNWSB including Western, Eldowas, Nzowasco, Amatsi and Kapsabet were invited to submit three proposals each.
A total of 12 proposals were received, with 9 approved upon evaluation.
Call for proposalsAccording to the scope of work outlined in the approved proposals, some 42 new water kiosks will be built, 20 existing ones renovated and 97 new yard taps constructed.
In addition, the existing water supply pipeline within the region will be extended by 25,585 meters and an elevated tank with a storage capacity of 648 cubic meters installed.
On completion, the nine new projects approved in this initial phase within the LVNWSB zone are now projected to cost Sh74 million and to about 150,000 people.
Another call for proposals is expected to be announced next week with the WSFT looking to finance about 25 projects at an estimated cost of Sh200million and to benefit 300,000 people in the low income bracket.
The signing of the funding agreements for this call is planned for January 2010 upon the evaluation and approval of the proposal.
WSTF chief executive officer Mrs Jacqueline Musyoki said the fund targets supplying water to 1.4 million people and sanitation facilities to 400,000 people by 2011.
Relevant Links
"Currently the urban poor pay more for water that is of poor quality and the women and girls take longer to fetch water," she said.
Mr Stower said projects under the UPC would be rolled out in urban areas such Nairobi, Mombasa,Nyeri and Kisumu where thousands of poor households have difficulties in accessing the basic services.
Meanwhile the government expects the current water shortage in Nairobi and its environs to ease in the when the anticipated October-December rains come.
"The Ndakaini dam is currently at 30 per cent of its capacity but we expect it to fully recover within a short time if the rains come.
The rehabilitation of the Sasumua dam is also near complete and we expect stable supplies," the PS said.
Subscribe to:
Posts (Atom)