Kenya: Healthcare hurdles in Nairobi’s slums

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.
NAIROBI, 11 July 2008 (IRIN) – 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.