COVID-19 Experience Among Slum Dwellers In Nairobi: A Double Tragedy Or Useful Lesson For Public Health Reforms?

 

While the devastating consequences of the COVID 19 pandemic have not yet been felt by many countries in Africa, the same is not true for many others . For people living in the slums of Nairobi, this disease and the resulting government response have only worsened their livelihood. Despite being a significant size of the city’s population, slum dwellers have historically been marginalized in government health policies. This has become more severe in the wake of the COVID 19 outbreak. The concern over the vulnerability of slum dwellers is not only limited to the spread of the virus. The negative economic effects, uncertainty over loss of job and police brutality are also important issues. The recommendations by the National COVID-19 taskforce reflect other previous inactions by the government when dealing with issues that affect people living in informal areas.

The political economy of slums in Nairobi continues to hurt the poor, unskilled migrants who move into the city and end up in the informal areas. Lack of planning, investment, and neglect by the government have left informal areas with inadequate health facilities, lack of proper sanitation and housing, and insufficient electricity as well as water. In the wake of the COVID- 19 pandemic, residents of these informal areas have found themselves experiencing a double tragedy. The blanket policies[1] characterized by curfews, partial lockdown, and “social distancing” that the government has adopted appear to be a cruel joke for slum dwellers. These policies are either unattainable or have interfered with the meager livelihood that residents of slums depend on. The seemingly loud oversight on the unique challenges people living in informal areas face is concerning and worth reflecting upon going forward. The impact on lives, the cost and technical capacity needed to respond to a potential mass spread of the virus as seen in countries like the USA, Spain, and Italy is beyond the reach of Kenya and many developing counties. This means that any preventive response by the government should go beyond blanket measures and interrogate different circumstances that could undermine its efforts.

Slum houses do not offer any comfort to their inhabitants who are now being forced to spend more time in a low-quality accommodation unit as a result of the lockdown measures. Several people are forced to share run -down even at times overflowing sanitation facilities. Yet, as the government continues to insist on implementing similar measures across the country, the number of COVID-19 positive cases has steadily been increasing.  The cash transfer package announced by the government can hardly cover half a million people leaving a majority of the 35% of Kenyans who live below the national set poverty line.[2]

Despite the negative impact COVID 19 has had globally, it should serve as an eye-opener for governments with regards to the need to address problems in informal settlements  . In the short term, the government needs to ensure its preventive measures are effective and relevant to the challenges facing people from different socio-political and economic backgrounds. These can include a slum specific policy document outlining socio-economic relief measures that are uniquely meant for the slum dwellers. Efforts such as providing food and medical vouches, leveraging on technology and community health workers to reach out to people deep inside the slums, mobile clinics with essential stockpiles can be strategically positioned in slums . Identifying potential gender-based challenges and outline measures that can cushion vulnerable women from domestic violence and abuse is equally important as the psychological impact of COVID 19 measures have been confirmed to result to increase violence. Urgent environmental rehabilitation can help reduce the pollution in slums and support the establishment of temporary sanitation facilities. More importantly, apart from the national sensitization exercises, the messaging and communication avenues used to educate slum dwellers is very critical. We live today in an era of fake news and misinformation which at times affects how citizens react to the pandemic.

In the long run, the government can use adopt some of the lessons from COVID-19 to offer long -term solutions. (1) Serious slum upgrading projects that can adopt cheaper technology to establish well-organized prefab houses with population limits per area. (2) Urgent reforms in the national health insurance fund to shoulder further low -income earners, (3) ensuring sustainable supply chains not only to the formal residential areas but also informal areas.  The government needs to acknowledge the need for constituting responses that can avert or reduce the risks associated with pandemics for slum dwellers.

About the author

Israel Nyaburi Nyadera, Department of Government and Public Administration, University of Macau, Macau. Department of Political Science, Ankara Yildirim Beyazit University, Ankara Turkey. He is interested in public policy, governance, and national security. Twitter @hizram

Competing Interest 

No competing interest declared

[1] Aluga MA, Coronavirus Disease 2019 (COVID-19) in Kenya: Preparedness, response and transmissibility, Journal of Microbiology, Immunology and Infection, https://doi.org/10.1016/j.jmii.2020.04.011

[2] KNBS. The Kenya Integrated Household Budget Survey 2015 [Internet]. Nairobi; 2018. Available from: http://statistics.knbs.or.ke/nada/index.php/catalog/88

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