Research

This semester instead of taking classes, I will be conducting research from January until the beginning of April. I have returned to my internship at OGRA Foundation in Kisumu and have decided to do my research through OGRA. As a Community Health student, I wanted an internship that would allow me to work in the field on the grassroots level working with the people who need help. As I have mentioned in previous blog entries, my organization operates a feeding center in Ombeyi (a small village about 30 minutes outside of Kisumu). Interacting with the children during my first few months, I knew I wanted to work to improve their lives. The feeding center currently feeds 36 orphans and vulnerable children 2 meals a day, 6 days a week due to budget/funding constraints. For some of the children, the food they receive at the feeding center is the only food they eat which means that from Saturday afternoon until Monday morning, some of the children may not eat at all.

My research is focusing on the community of Ombeyi, more specifically, children at Kiliti Primary School. I met with the headteacher of the primary school and he gathered information from each class about numbers of orphans and vulnerable children. For the purpose of the study, vulnerable children are defined as children from extremely poor families who although they may have both parents, the parents may suffer from mental or physical disabilities that prevents them from providing for their family. In Kiliti Primary School alone, there are nearly 200 orphans and vulnerable children! As I said, our feeding center currently provides for 36 children - there is obviously a need to expand the program.

For my research I will be focusing on a group of 21 orphans and vulnerable children from the feeding center who are under the age of 13 (pre-pubescent) and a similarly sized group of orphans and vulnerable children from the primary school who are currently not receiving any help from an organization. I measured their height and weight for an initial reading to measure their Body Mass Index (BMI). Body Mass Index can be a good indicator of if a person is underweight, at normal/healthy weight or if they are overweight. Measure your Body Mass Index here

In the initial reading 14 of the children in the study were either underweight or very underweight according to their Body Mass Index. Five children were considered to be underweight at the Feeding Center and nine children were considered to be underweight (1 was very underweight) at the primary school.

The second major component of my research is conducting household surveys. I will be visiting the homes of each of the 42 children in the study to perform a wellness analysis. The parent or guardian is given or read a detailed informed consent form in either English or Luo. For many of the study participants so far, they have been illiterate so they are read the entire consent form by a Community Health Worker and then they grant their consent through their thumb print.

Summary of research results thus far:
In most of the homes I've visited, there have been 2 main rooms in the house. All of the walls are made of mud with a stick frame. Some of the houses have metal sheet roofs while others have a thatched roof. Many of the children don't brush their teeth, and for those who do, they use a stick. None of the houses have had a toilet or pit latrine so far which means that people just go to the bathroom in the brush.

One of the survey questions asks if they know how HIV is transmitted. A very common response has been that HIV is contracted through infidelity. When I ask them to elaborate, they usually don't but state that they have just heard that it is spread when people are not faithful. This signals a very basic understanding of how HIV is transmitted which can help to explain the very high rate of HIV prevalence in the community. A few months ago I participated in a Community Health Worker training where we discussed sexual health. We asked the people in the training to write down myths that they've heard in the community about family planning. A response that surprisingly came up a lot was that women were concerned that the condom might slip off and become lodged in the uterus. People also kept saying that condoms were expensive even though they can be found in that village for about 10 KSH per (13 cents) and several organizations supply them for free at clinics in the area. When we engaged people further they started talking more about the shame, embarrassment or stigma of buying a condom.

For most of the families I've met with so far, the only meals their children eat come from the feeding center. The feeding center only provides 2 meals a day, 6 days a week. So for most of these children, they may not eat at all between Saturday lunch and Monday breakfast. I have not started meeting with families of the children who don't receive meals at the feeding center, but I feel like the responses will be very interesting.

I am hoping to get a lot more surveys done this week so I will update when I can.

Oil Tanker Explosion

Less than a week after the Nakumatt Downtown fire, another fire tragedy has struck Kenya. On Saturday an oil tanker overturned on the Eldoret-Nakuru road near Molo town. Hundreds of people ran to the oil tanker to collect/siphon any fuel they could. The crash happened in a poor part of Kenya and the people siphoned the fuel to try to sell it. Most of the people who rushed to the scene were women and young children. Among the crowd of people that gathered were a group of boys who were playing football (soccer) at a nearby field. Several Kenya Police officers were at the scene trying to prevent the looting.

Without notice the oil tanker exploded severely burning many people. The first fire engine to respond arrived at the scene an hour after the explosion.

The death toll continues to climb but the latest report is that over 111 people have been killed and over 117 are still hospitalized with severe burns. Of the 111 people killed, 16 of the 26 children who were playing football (soccer) at the nearby field were burned to death. The Daily Nation reported today that the Kenya Red Cross has declared 36 children are still missing. Among the dead were also the three Kenya Police officers.

The last few evenings, this oil tanker explosion has been the top story as the death toll continues to rise. One of the evenings on the news, they interviewed a mother who had lost both of her children in the explosion. As much as the government has made promises in the days after the Nakumatt Downtown fire and the oil tanker explosion, unless the underlying issues are addressed instances like this will continue to happen. The reason why hundreds of women and children rushed to collect fuel from the overturned tanker was not because of greed but because they like 10 million other Kenyans are facing extreme poverty and starvation. You cannot tell hungry people not to collect fuel from an overturned tanker if this fuel can mean that a family can feed their children more than just one meal of ugali a day.

Downtown Nairobi Fire

On January 28th, a fire broke out in a downtown supermarket called Nakumatt. Nakumatt is basically the Kenyan equivalent of Wal-Mart in that it sells virtually anything you could possibly want. There are branches all around the country in most major towns. The branch that burned down was called Nakumatt Downtown and was located on the main road in town, Kenyatta Avenue. When I watched the news on Wednesday evening, it came as a shock to me to watch this building engulfed in flames. Just 3 weeks ago Rachel and went shopping in that very store. I've shopped at that branch a few other times during my time in Nairobi. The cause of the fire is being attributed to malfunctioning electricity which resulted in a black out in the store in the minutes before the fire started.

The footage from the scene showed utter panic and fear in the eyes of many people. The building had two floors but the windows on the top floor were too small for anyone to fit through which left only one clear exit for all of the people in the store. In my experiences in that store, it was very cramped and difficult to maneuver around. Some of the employees fled to the roof of the building and then climbed down light poles with the help of people below.

Watching the footage from the scene, it was clear that there was widespread confusion. As the crowds of hundreds of people gathered at the scene, they blocked the fire vehicles trying to get to the fire. As is the case with many accidents or crime scenes in Kenya, flocks of people gather to see what is going on. People often say that when Kenyans hear gunshots, instead of running away they run towards the sound because they want to see for themselves whats going on. Many of the policemen who responded to the fire had to be used for crowd/riot control. Hundreds of people in the crowd were dangerously close to the building as containers of gas and kerosene exploded inside. The police were also worried about looting.

The first vehicle to respond to the fire was not a fire engine. Various agencies responded to the fire including Nairobi City Council, government vehicles, and private companies. Although the fire station is literally down the block from the Nakumatt, the response time was very delayed. Many cars were parked in front of the store blocking the firetrucks from even getting close to the store. The cars were physically picked up and moved by dozens of people from the crowd.

None of the firefighters at the scene had any protective equipment. With no protective equipment, no effort was made to enter the building to rescue people who remained inside.The hoses were all held by dozens of volunteers from the crowd that had gathered. The water being sprayed was being aimed at the top of the fire and not even at the base showing indications that the firefighters were grossly under trained and ill-prepared. I think the worst part of the entire fire response is that at one point, all of the trucks RAN OUT OF WATER and were unable to continue fighting the fire. They had to find a private truck that sells water to donate to the cause of trying to extinguish the fire.

Wednesday on the news, there were several reports from the scene. As the reporter wrapped up their segment from the scene hours after the fire had started, I remember the reporter stating that thankfully there were no casualties to report. The next day, the accounts from the scene were not as positive with more and more reports of missing people coming in. In the days after the fire, the number of missing people has climbed as high as 50 people.

Twenty-fours after the fire started, the fire had still not been completely extinguished. The next day, the Kenya Red Cross examined the scene and started to recover bodies. Bodies continue to be discovered in the various parts of the building. Just yesterday they discovered a mother and child in the corner on the ground floor - their bodies still holding one another.

In the days after the fire, there has been a lot of speculation about what exactly happened at the Nakumatt. From accounts of survivors and people at the scene, the exit doors were closed by some of the Managers who feared looting. When they closed those doors, they locked dozens of people inside who became victims of the fire's heat and intense smoke. The building and the merchandise all had insurance but the more than 27 lives lost in this fire cannot be replaced.

If this fire showed anything, it was that the city of Nairobi is not prepared for any sort of major disaster. One government official was interviewed at the scene and quoted as saying that they are considering developing an emergency services department for Nairobi. I'm no expert but I'm pretty sure an emergency services department should have been formed decades ago especially for the third largest city in Africa; one that has also been the scene of a major terrorist attack in the bombing of the U.S. Embassy in 1998. When the U.S. Embassy was bombed, it was the Israelis who organized a rescue team before the Kenyans did. The dogs from the Israeli rescue team were the ones who helped find survivors buried in the rubble. If a second fire started in a different part of Nairobi, the entire city would be crippled. In many ways the city of Nairobi has plenty of landmarks that are vulnerable to attack and this past week it has shown that it can not organize an adequate response.