COVID-19 Further Complicates Kenya’s Health Care System

Kenya is facing a double burden of communicable and noncommunicable diseases. Clustering of infections, such as HIV and tuberculosis, and noncommunicable diseases, such as diabetes and high blood pressure, renders Kenyans vulnerable to COVID-19. This has pressured an already overstretched health care system.

Hospital entrance sign in Kenya’s Rift Valley province. Melanie K Reed. CC BY-NC-ND 2.0

In mid-March, shortly after Kenya’s first confirmed COVID-19 case, the word “corona” began circulating around western Kenya’s villages. Young people used the word as a novelty, and the overall population remained preoccupied with existing illnesses. “This is a disease for whites,” said Sylvanus, a local father of seven. When calling after white people on the street, children replaced their traditional “mzungu!” (white person) with “coronavirus!” At this point, Europe was the pandemic’s epicenter. Kenyans felt that this foreign virus was removed from their world. 

However, Kenya’s high prevalence of preexisting health conditions renders a significant portion of the population immunocompromised and therefore vulnerable to the coronavirus. In a country experiencing health issues such as HIV, tuberculosis, diabetes and malaria, the pandemic has posed a threat to an already fragmented health care system. Although less than 4% of Africa’s population is over the age of 65, countries such as Kenya have seen high coronavirus mortality rates. 

Global evidence shows that people with underlying medical conditions are at a greater risk from COVID-19. In 2019, half a million Kenyans were living with diabetes, and over half of accounted deaths were associated with noncommunicable diseases. Currently, Kenya’s health care system is structured to manage individual diseases, rather than multiple ones. Because patients frequently carry more than one health condition, the health care system has been overstretched and inadequate. HIV, tuberculosis and malaria treatments are easily accessible, but noncommunicable diseases such as diabetes and cancer often go undiagnosed, and care is costly. The COVID-19 pandemic has exacerbated these shortcomings, as social distancing restrictions prevent Kenyans from accessing medical resources, and a surge of coronavirus cases imposes a double burden of disease. Additionally, front-line workers with undiagnosed, chronic illnesses have critically compromised their health, and hospitals have dealt with equipment shortages. 

Transcontinental travel has heavily contributed to the increase in COVID-19 cases across Africa. In order to minimize Kenya’s number of infections, President Uhuru Kenyatta stopped all flights from Europe. Kenyatta also imposed a national curfew and restricted movement between populated areas. Domestically, middle-class, urban dwellers have carried the virus into rural areas. On Kenyan television, villagers have urged educated, urban residents to remain in the city, instead of threatening the lives of others. 

In African countries, lockdowns are nearly impossible to implement because they would spur social and economic crises. Many people rely on cash earned daily to sustain themselves and their families. A strict lockdown would result in poverty and starvation. Kinship systems also play a crucial role in social welfare, as relatives care for one another. For people already barely getting by, cutting these social ties would be dangerous. Finally, a lockdown would interrupt the supply chains of essential drugs, preventing access to tuberculosis, HIV and malaria treatments. 

According to several African presidents, developed countries are failing to fulfill their pledges of financial support and debt relief. Throughout the pandemic, outside aid has not met the continent’s needs. While wealthy countries in the global north have funneled trillions of dollars into their own stimulus packages and health initiatives, the global south cannot afford such measures. With limited testing capacity, Africa has not confirmed many of the world’s COVID-19 cases, but the continent has been grossly affected by the economic crisis and global trade disruptions. Furthermore, the global shortage of testing kits, hygienic material and personal protective equipment has left developed countries vying for their own supplies, without consideration for underdeveloped nations. 

Anna Wood

is an Anthropology major and Global Health/Spanish double minor at Middlebury College. As an anthropology major with a focus in public health, she studies the intersection of health and sociocultural elements. She is also passionate about food systems and endurance sports.

Blue Out on Insta

Blue Out on Instagram: Support for Sudan through Social Media Awareness

Sudan Flag Sticker on a Car. pjbury. CC BY-NC-ND 2.0

Recently, a specific shade of blue has been popping up around Instagram in the form of profile pictures. This Blue Out was started by Instagram influencer Shahd (@hadyouatsalaam). She is a Sudanese-born, New York City-based activist—or how she likes to identify herself, “a political scientist by degree and a social media influencer by interest”, according to her recent Insta post, introducing herself to her new followers. 

Shahd created this movement for the sole purpose of raising awareness to what is currently going on in Sudan. Protests in Sudan began in December of last year, when there was a price-spike in basic commodities (i.e. bread). It was not until April 11th, after a mass, multi-day sit-in, that the Sudanese people did see the change they wished for. The current President, a man named Omar al-Bashir, and his party were being jailed or put on house arrest. The protestors believed this to be a victory. They were wrong. General Awad Ibn Auf, the Vice President, soon gave a televised statement explaining the new governmental system that was going to be put in place—one run by three separate military factions called the Transitional Military Council (TMC). He stated that they intended to remain in power for two years until the country could elect a new President, also claiming a three-month state of emergency and curfew. The people did not accept these conditions and in under 24 hours, Ibn Auf resigned and General Abdelfattah al-Burhaan become the new chairman.

Since General Abdelfattah al-Burhaan’s new appointment, negotiations between the people and the TMC have been chaotic. Once again being fed up, the Sudaneese people, with the people of the Sudanese Professionals Association (SPA), organized a mass strike from the 28th of May to the 29th. These strikes immediately became violent and the TMC used these mass demonstrations to portray the SPA in a vicious light. On June 3rd, government forces began shooting at the protestors which, reportedly, left 118 dead and many more injured. Since then, an Internet black out has been in place and thus sparked social media outcry.

But why should this matter to us? The answer is simple: because we have the power and the privilege of accessing the Internet with the capable means of shouting loud enough that somebody will listen. Over the past two weeks, because of the uproar on social media, there have been an influx of articles written about what is going on, how long it has been going on, what is the important information that we need to know about the revolution in Sudan. One Instagram user, Rachek Cargle (@rachel,cargle), with the help of “an incredible group of activists” has even composed a masterlist of articles ranging from immediate updates to fundraising efforts, according to her post that calls for any more information to add. 

Unfortunately, with the uproar, there have also been people who cruelly want to capitalize on the movement for clout reasons. Just last week, a post went viral that claimed for every re-post to a page or story, the originators of the account would donate meals to the Sudanese people. Very soon, the page was labeled as a hoax given curious peoples’ inquiries into how they would provide the food, where is the funding coming from, and other questions which the page either did not answer or gave vague responses to. From these instances, it is important to remember that when trying to get information out, there needs to be a more thorough and conscious effort on the part of other social media users to not just mindlessly click-and-post, but rather, do a quick search about what the post is, and then determine whether or not it is legitimate. 

Using the privilege we have—whether it be from simply having the means to repost an article or getting in contact with local government officials so they can talk about what is going on—is a butterfly-effect that will change how the Sudanese revolution will go. Being complacent or a bystander is just as harmful as supporting the violence because inaction is not action, inaction does not bring about change but lets things remain as they are, because they are not directly affecting us. I encourage those of you reading this article to look at the Instagram influencers I have mentioned as well as the hashtag #Iamsudanrevolution. There you will find countless posts, articles, links, and organizations that can inform you, help you, and guide you on how you can help. For immediate action, check out Cargle’s post which is a picture of protestors with SUDAN in bold, blue letters and the subtitle of Information & Support Round Up. There you will find the link to the master document which will provide the beginning of any information you want to know. 

I must repeat—acting as a bystander perpetuates the actions that are harming individuals because it is neglecting them the action they need. Use your privilege for something productive. 




OLIVIA HAMMOND is an undergraduate at Emerson College in Boston, Massachusetts. She studies Creative Writing, with minors in Sociology/Anthropology and Marketing. She has travelled to seven different countries, most recently studying abroad this past summer in the Netherlands. She has a passion for words, traveling, and learning in any form. 



Forgotten, but not Gone: Zika’s Return to the Media

Earlier this week the Duchess Sussex of Meghan Markle canceled a trip to Zambia, citing exhaustion and concerns over the presence of Zika virus in the country. The Zika virus had been rather dormant in the media over the last year, all but vanishing in the wake of Trump speeches, trade wars, and Brexit. It had, however, remained a constant concern for those living in certain countries or traveling to them. Markle’s encounter with the Zika virus and the subsequent headlines have helped to push it back into public view, and once again, questions are being raised about its origin, transmission, and what is being done to fight it.

The Duchess of Sussex. Office of the Governor - General - GG.govt.nz. CC BY 4.0.

The Zika virus was first discovered in the Zika Forest in Uganda in 1947. The first recorded carriers were monkeys, but the forest was also home to over 70 species of mosquitoes, and they became the primary source of viral transmission. The disease was eventually discovered in humans in 1952, but for the most part remained confined to animals until 2007, when the first human outbreak was documented on the Island of Yap in the Federated States of Micronesia. In 2015, the virus made international headlines when Latin America and the Caribbean saw an explosion of human-related cases. As was the case in Africa, mosquitoes were the main culprits of transmission. However, in 2016, the virus saw a sharp decline in new cases, and with it a decline in news coverage.

Adults infected with Zika often display no symptoms. Those who do usually report mild fevers, rashes and muscle pain. The impact on unborn babies is far more devastating. Zika infections during pregnancy have resulted in miscarriages and babies being born with microcephaly, a condition in which a child's head is much smaller than it should be (Markle and husband Prince Harry had recently announced that they were expecting a child, and concern for the child’s welfare was thought to be Markle's main concern when she opted out of her trip to Zambia).

The Zika Virus is spread mainly through mosquito bites. James Gathany - https://phil.cdc.gov/phil/details.asp?pid=9257. Public Domain.

While a full-on cure for the virus remains elusive, health and government officials have been able to curb infections by going after the mosquitoes that carry and transmit the disease. In preparation for the 2016 Olympics in Rio de Janeiro, the Brazilian government launched a large-scale effort to fumigate the city for the insects, while in England a biotech company called Oxitec developed genetically modified mosquitoes, which, when released into the wild, would mate with infected mosquitoes and pass a gene on that would prevent those mosquitoes from reproducing. In the United States, The Centers for Disease Control made a point of advising those traveling to countries with high rates of infection to use insect repellants.

Microcephaly- a birth defect linked to the Zika virus. Centers for Disease Control and Prevention. Public Domain.

Many world issues persist despite the ebbing and flowing of news coverage. Though not the hot story it once was, the Zika virus is still a viable threat and will remain so until a vaccine is found. Those traveling to countries that have been deemed areas of risk should take all necessary precautions to prevent infection, or, like the Duchess of Sussex, simply the put the trip off until another time.


JONATHAN ROBINSON is an intern at CATALYST. He is a travel enthusiast always adding new people, places, experiences to his story. He hopes to use writing as a means to connect with others like himself. 

SOUTH AFRICA: Dinner in Khayelitsha

South African apartheid is frequently written off as a memory, something that ended decades ago. But from the start of my visit to South Africa, it became clear that the violence of that period has continued to bleed into the present, manifesting itself in clear racial and economic divides.

I visited Cape Town in the summer of 2016. Cape Town is a city of contrasts—tall, imposing mountains cast shadows over clear blue seas, and seaside villas luxuriate only a few miles away from derelict townships.

These townships are the subject of this piece. Townships in South Africa are villages that remain from apartheid-era forced exoduses of non-white people, cast out of their homes and crammed into segregated areas.

These townships still stand today. They are mostly collections of mottled tin-roof shacks and cramped streets, and they are home to 38% of South Africa’s population of 18.7 million.

From the beginning of my arrival in South Africa, I was told by locals that the townships were unsafe, especially for outsiders. But one day, I returned to my flat in the town of Observatory and one of my roommates asked me if I wanted to visit one.

The visit would be hosted, she told me, by Dine With Khayelitsha, a program founded by four young township residents designed to foster communication between their communities and those outside. Dine With Khayelitsha started in March 2015, as part of a partnership with Denmark and Switerland intended on working as a fundraiser. It then grew and has now hosted over 100 dinners. Each dinner is attended by at least one of the founders, who assures the safe transportation of every participant.

Thanks to this organization, I found myself on a bus driving into one of the townships, and then I was suddenly in a house with a bunch of strangers, eating authentic South African beans and meat.

We arrived at the township’s president’s home, though she was not there—she was outside campaigning, and instead several locals were cooking the meal for the night.

I had come with my new friend, and among the other attendees were two Dutch women, an artist from Germany, a couple from France and Morocco, and a South African black woman. Noticeably absent were white native South Africans, a fact that we asked the hosts about. Apparently, South Africans themselves still persistently ostracize the townships, creating divisions between themselves and the poorer underside of their country.

Our hosts were a few young men from the townships. They had all attended college and one worked in IT and another in software engineering, and most of them also ran after school programs such as leadership and self-esteem workshops for township kids. They had started this organization in an effort to generate more dialogue among South Africans and to raise awareness and reduce stigma concerning the townships.

First, they asked us to discuss one act of kindness we’d performed recently. As night fell, the talk began to flow more easily.  We discussed the fact that so many kids from townships are forced to go through school and university, if they can make it that far, in order to get menial jobs that can support their families. For these kids, following their dreams is not an option, but it is rather an inconceivable luxury. One of the hosts said that he would love to run education programs for kids, but instead he had to become an engineer to support his family.

After dinner, as we were waiting for a bus to come pick us up, I asked one of the men if most people born into townships grow up wanting to escape, to find better lives. He told me that some did, but in his opinion, it is far more important to stay in the townships and to try to create a better life there. That’s what he had done; he’d gotten an education and a job and still lives in the townships, trying to create programs and to help uplift the state of the community.

I talked to another local who was a writer, and his eyes shone as he talked about how he can capture strange and vivid moments with words—and another who spoke passionately about his desire to hear stories from people all around the world. There was an undercurrent of kindness that seemed to link these people together that I have rarely seen; a desire to include others, to tell stories and to share parts of their lives, to not build walls but to rather create open streams of connection. To create rather than to destroy.

Conversations like this one cannot heal or make up for old wounds inflicted upon non-white people in South Africa—only physical reparations and policy changes can truly begin that process. But they are a step in the right direction—a step towards understanding that we are all part of the same global community, and the walls between us are really made of dust.

EDEN ARIELLE GORDON is a writer, musician, and avid traveler. She attends Barnard College in New York.

The Cape Town Water Crisis: Delaying Day Zero

In the Broadway musical Urinetown, people line up to use the toilet because a 20 year old drought has made private toilets a thing of the past. And when the protagonist rises up finally and allows unrestricted toilet use, the water supply completely evaporates. The final scenes ominously hint at more worrisome issues for the citizens, who, once concerned only with toilet use, most grapple with dying of thirst among other problems.

Although Urinetown is a satire, residents of Cape Town might see it as a scary prediction of their future if Day Zero arrives. As apocalyptical as it sounds, it does accurately embody the looming doomsday scenario: Day Zero is when the taps run dry. How? An unexpected three year drought, starting in 2014, drastically depleted the six dams that serve Cape Town. Whereas 20 years ago water management in Cape Town could rely on seasonal rainfall patterns and small conservation measures, it is now relying on unreliable rain and big changes.

Since Day Zero has been first predicted in early 2018, it has been continuously delayed. Projections now suggest Day Zero will occur in 2019. And in recent weeks, many are rejoicing in water returning to the dry dams. In the words of Anton Bedell, minister of Local Government, Environmental Affairs, and Development Planning:  “It’s…good to see Clanwilliam dam at 20.4%. A few weeks ago the dam was below 6%.” The other dams have reflected similar increases, but the relief is only temporary as the dams await more rain—if it will come.

Theewaterskloof dam in February 2018 (source: 2oceanvibes)

Waters return in early June (source: Storm Report)

The biggest assistance in delaying Day Zero is restrictions implemented on February 1st. The main restriction was the allowance of 50 liters, a little more than 13 gallons, of water per person. Comparatively, the average individual in the United States uses 80-100 gallons of water a day and the average family over 300 gallons a day.  The question of how Americans end up using so much illustrates just how little 13 gallons is for a Capetonian. For example, imagine the average bathroom break. A toilet flush requires at least 1.6 gallons with water efficient models, but if it is an older model it will need up to 4 gallons. Then you will wash your hands with about 3 gallons of water. Considering most people take at least four bathrooms breaks a day, that’s already 18.4 gallons used in one day (on a water efficient toilet): more than what one Capetonian is allowed in a single day.

So it is no wonder people are following the “if it’s yellow, let it mellow” rule and putting reminders in bathroom stalls around Cape Town. Even restaurant and bar washroom taps are shut off. But it is not just in the bathroom that changes are being made. Any use of municipal drinking water for irrigation, watering, hosing down paved surfaces, washing vehicles, or filling a private pool is not allowed. Agricultural users have to decrease water usage by 60% and commercial places by 45% compared to their pre-drought usage in 2015. And for residential units that use too much, you’ll face a fine or have to install water management devices.

And globally, Cape Town is a sign of the future. As population increases, especially in urban centers, water resources are straining to accommodate.  This is against a backdrop of climate changes that favor extreme weather events like frequent droughts. What might have worked in the past, is not necessarily the solution for the future.  California, Beijing, Sao Paulo, Jakarta, Mexico City are just some cities that may be the next unwilling host of Day Zero. And water shortages lead to other problems such as famine and violence. The International Panel on Climate Change predicts the Middle East and North Africa will face the most severe water shortage problems. And already, many Somalis have become climate change refugees—leaving their rural farms for the capital, Mogadishu, in hope of different sources of income with farming no longer possible. Millions more are projected in the years to come as climate change makes itself even more apparent.

It is a bleak picture, but subtle changes are happening as global leaders are becoming more aware of the looming water crisis. But we can also start at home with our own water usage. Maybe you don’t need to take a long bath after a hard day and use 36 gallons of water simply to unwind. Instead, take a quick shower and find something else to help you relax. The small changes might sound silly but it is the little things that matter as Capetonians will tell you.

 

TERESA NOWALK is a student at the University of Virginia studying anthropology and history. In her free time she loves traveling, volunteering in the Charlottesville community, and listening to other people’s stories. She does not know where her studies will take her, but is certain writing will be a part of whatever the future has in store.