The research team and I plugged our noses as we crossed through garbage cluttered streets to make it to our matatu (public transport vans in Kenya). I clutched my bag tightly as I pushed through the busy marketplace. Unfortunately for the store owners trying to pull me into their shops we were just taking a short cut not there to browse. We were entering the not so posh part of Nairobi. The bumpy drive in the bus was attributed to roads in direr need of maintenance and driving over garbage piles that have spilled over from the ditch. Eventually we made it to the Clinic an hour behind schedule, and from then on decided to Uber from town. Yes, they have Uber in Kenya too!
This particular day the research the team and I conducted an environmental scan for my research. The environmental scan for this project entailed noting resources and barriers to heath, and in specific healthy eating. The Community Health Care Workers from Cana Clinic graciously guided us around the area of the Clinic to see what life is like in the slums and what foods are available there. They showed us the garbage dump not too far from the Clinic, where industries in the area dump their trash. I could see the smoke billowing from the sections being burned, not more than 100 feet away from people’s tin homes. In this same area there had been a pipe burst in 2011, which lead to a massive explosion and fire. Fatalities from this incident were over 100 and there were 116 people hospitalized with burn injuries. People are still recovering from this incident, both physically and emotionally.
There definitely was an abundance of food in the area, and at affordable prices. But in comparison to the minimal or non-existent amount some people may be making it might not be affordable. The other question would be the food safety and sanitation of some of the food venues. Meat hung form store front windows unrefrigerated while some meat was being prepared on sacs placed on the dirt ground. Stews and flat breads were being prepared on the street side, where dust and bugs could easily access the food.
As we walked along the dirt streets, the Community Health Care Workers shared about the living conditions of the women here. Many families live in or behind their shops, where they sell fruits and vegetables they have purchased from the market. Homes are fitted with illegal electricity that is not up to code, through unregulated sellers. To my surprise many homes in the slums do not have proper washroom facilities, but they do have access to public washrooms that are often shared by hundreds of people in the area for a cost of 5 Bob (about 5¢). When the choice becomes purchasing food or paying to use a toilet, the decision is obvious. There are small dug outs with sewage that flow in front of homes and shops as a result of improper waste management. Garbage bags, cluttered on the curbside are also used as a means to dispose of human waste.
Another shocking fact that the Community Health Care Workers share with me is that some mothers will stop breastfeeding their babies at one month old! Many of the women may be single mothers, and need to work to support their families. They may leave their babies with family or an unregulated daycare center where they will be feed cow’s milk or porridge. Pumping breast milk may be difficult and unsanitary for the mother and infant. Giving babies solid food too soon has been linked to a higher risk of obesity and diabetes (Journal of Pediatrics). Also, starting infants on solids before 4 months can lead to allergies and eczema (Dr. Jennifer Shu, pediatrician and AAP spokeswoman). Infants should be exclusively breastfeed for at least 6 months to gain the most nutrition and benefits. Unfortunately the situation these women are in make exclusive breastfeeding very challenging. Despite these challenges and barriers there is a light for these women. People those that work at Cana Health Clinic are providing health care and education to these women along with the hope and peace of the Gospel in partnership with Deliverance Church Sinai. I am looking forward to getting to know the women living in these areas more, and meeting their babies at the clinic!