Kenya’s hospitals have almost ground to a halt, with millions facing a third month in a row without healthcare as doctors strike over low pay and poor working conditions.
The public healthcare system has long been overburdened and underfunded, but has now virtually stopped functioning after 5,000 doctors walk out in December after attempts to reach a compromise with the health ministry stalled.
“The machines break down frequently, the doctors are overwhelmed. The patients, they are so many that they are lying on the ground,” said Dr Judy Karagania, an ophthalmology resident at Kenyatta National hospital (KNH) in Nairobi, who is taking part in the industrial action.
Karagania and her colleagues are refusing to return to work until the government makes good on a 2013 agreement to dramatically increase salaries, hire thousands of new doctors and address drug and equipment shortages.
As the standoff drags on, Kenyans are suffering from the lack of care.
“The army doctors are turning away patients,” said Karagania, who normally works as a resident medical officer at KNH. “They’re only handling the emergencies of emergencies.”
Read the full article in The Guardian.
At Kakuma refugee camp in Kenya, workers face few humane options.
From Turkey to Pakistan, from Iran to Ethiopia, refugee workers are being forced to make painful choices regarding the future of more than 21 million refugees, part of a record 65 million displaced persons around the world. They must choose between political and economic refugees, individuals and families, the healthy and the sick, the elderly and unaccompanied children, gay and straight. They try to move those most in need of help to the front of the line for resettlement somewhere safe.
But when it comes to triaging the world’s humanitarian crises, there are few humane choices.
Read the full feature article in the February 27, 2017 edition of The Nation magazine or online.
Kijabe, Kenya – At the bottom of a winding, tree-lined road, a crowd of patients spills out of the entrance of a private hospital waiting room on to a patio and a dirt parking lot. It begins to rain, and a man on crutches tries to hobble into the cramped building for cover.
Sitting in a wheelchair outside the door is Dorcas Kiteng’e, a 25-year-old woman suffering from cancerous growths in her ovaries.
“They’re pressing down on the spine, they’re paralysing her,” says Mwende Mutambuki, Kiteng’e’s sister-in-law. “She can’t walk. Back pain, leg pain – I’m hoping it hasn’t spread.”
Kijabe is the third hospital they’ve visited since they arrived in the Kenyan capital Nairobi last week, looking for an oncologist who could perform the surgery, only to be turned away.
“They sent us to Agha Khan,” says Mutambuki, referring to the private Nairobi hospital that’s regarded as one of the nation’s finest. “But we know we were not going to be able to afford that.”
She fears time is running out to save her sister-in-law: “It’s a matter of life or death.”
Two months ago Kenya’s public sector doctors walked out on strike, and millions of Kenyans who normally depend on them are beginning to overwhelm the nation’s private hospitals, particularly in rural areas.
In 1992, the U.N. formally recognized Kakuma as a refugee camp — a temporary shelter. A quarter-century later, Kakuma hosts more than 150,000 refugees — victims of all manner of East African calamities, from Ugandan homophobia to political unrest in Burundi. Presently, it is filling up once again with people fleeing civil war in South Sudan.
Long before the Syrian civil war, before millions of people began fleeing to camps in Turkey, Jordan, and elsewhere in search of safety, Kakuma was something of an icon in the global refugee crisis. Today, it stands as a solemn reminder of the permanence of humanity’s displaced masses.
NAIROBI, Kenya — On a sunny afternoon in Nairobi, 37-year-old Francis Raymond Adika climbs into the front seat of a matatu, or public transit van, and slides next to the driver.
“I lost my brother in an accident,” says Adika. On August 15, 2001, a matatu was speeding down the wrong side of a two-lane road in Nairobi trying to pass traffic. When it swerved back into the correct lane it slammed headfirst into a truck. Adika discovered his brother’s body in the Nairobi morgue. He was 19, just days away from his high school graduation.
A Jesuit missionary who travels extensively across Africa, Adika says it isn’t just in Kenya where people lose their lives to reckless driving. “I lived in Tanzania, Zimbabwe, Zambia – the carnage was just the same.”
Each year, 1.24 million people die in road accidents worldwide. By 2030 that number is expected to triple to 3.6 million, making road deaths the fifth-largest cause of death in the developing world – worse than AIDS or even malaria, according to the World Health Organization. Africa is the hardest hit, with 26 road deaths for every 100,000 people – nearly 50 percent above the global average.
But a series of scientifically rigorous, randomized control studies by Georgetown University may have found a simple way to dramatically reduce deaths on East African roads. By placing stickers inside buses and matatus that encouraged passengers to tell their driver to slow down, researchers discovered that the number of insurance claims fell by half for long-distance vehicles and by one-third overall.
Read the full article at U.S. News & World Report.
“We have a bad, bad story,” begins Gloria Ibara, a refugee from Burundi and the mother of four. Sitting on a mattress in a simple Nairobi apartment, she tells me of her problem: “They want to kill our family.”
Gloria, whose bright smile accents her worn face, was born in rural Gitega province to a family of farmers. As her children grew, Gloria came to realize her son Eric was gay. (The names of the family members have been changed out of concern for their safety.)
At first “I told him to stop, that it’s not good,” Gloria says. But over time she decided that “that’s the way he was, and he couldn’t change it.” So she went on loving and caring for him just the same.
In many parts of East and Central Africa where homophobia is rife, parents react harshly on learning that a child is gay. Parents feel enormous pressure to either “fix” their gay kids or disown them. I’ve met dozens of LGBT refugees who have fled their home countries and escaped to Kenya, and only one—a woman, also from Burundi—wasn’t disowned by her family. So when Gloria learned that her son Eric was gay, it was extraordinary for her not to reject them. Stunned as she was when she later found out that her older son, Claude, then well into his teens, too was gay, she supported him too. It’s for that reason that they are now a family on the run.
Randomized controlled trials are the popular centerpiece of an emerging data-driven approach to figuring out precisely the best way to end poverty. Can a return to the scientific method fix the global aid industry?
For too long, “accountability” in the aid industry has meant nothing more than ensuring that a donor’s money was spent the way an agency said it would be. Rarely did organizations examine whether their spending achieved a positive impact (improved access to water, for example), much less one that stood the test of time (meaning the well didn’t dry up).
But recently, many aid organizations, including theInternational Rescue Committee, a New York humanitarian aid group specializing in refugee assistance, have used RCTs to, among other things, evaluate methods for nudging parents in Liberia toward more effective parenting techniques and tocreate highly effective community savings-and-loan programs to combat poverty in Burundi. It’s easy to see why charities are attracted to RCTs: They can make an aid agency’s work more efficient and generate solid evidence of progress to show funders.
As organizations continue to conduct more of them, RCTs are disproving many myths upon which we’ve designed development aid for years, not least of which is our longtime preference for projects over cash. If the data shows, as the RCT of GiveDirectly’s Kenya program did, that it’s most effective to hand a family $1,000 with no strings attached, then that’s precisely what we should do.
Read the full article in the July/August print edition of Pacific Standard or online.
On an overcast morning in Nairobi, commuter buses drive down a crumbling road into Kibera, a densely packed slum. A sign at the bus station reads “public toilets,” but the doors are locked.
It’s estimated that Kibera has just one toilet for every 2,500 of its approximately 250,000 residents. Without toilets to relieve themselves, people “use any means, whether it’s a [plastic] bag or a can,” explained Fred Amuok, Community Liaison for a Kenyan rights-based organization called Umande Trust.
The World Health Organization estimates that 1.5 million people die every year from diarrhea, often the result of poor sanitation. There’s also a financial cost: studies show that Kenya loses US$324 million each year in missed work hours due to sickness brought on by poor sanitation. According to the sanitation company Sanergy, four million tonnes of fecal sludge escape into Kenya’s waterways and fields every year.
But Umande Trust has come up with an innovative approach to providing affordable toilets for Kibera’s residents and turning human waste into cooking fuel–one that’s already been working for more than a decade.
For months, nearly two dozen gay, lesbian and transgender Ugandans had been living in a large house on the outskirts of Nairobi in an area called Rongai. Long after a court struck down Uganda’s infamous anti-gay law—dubbed the “Kill the Gays” bill for a death penalty provision in an early draft—LGBT people in Uganda were still being disowned by their families, hunted down by neighbors, jailed by police, even killed. Hundreds fled Uganda—mostly to Kenya, where they are faring little better.
Many of these refugees grew up in urban, middle-class families and loathe living in a hot, squalid refugee camp, as Kenyan law requires of all refugees. They are city people, accustomed to partying at secret gay clubs in Kampala.
One afternoon last December, a Kenyan man came to the gate of the Rongai house with a warning: Neighbors were plotting to attack the gay refugees that night and run them out of town. The refugees didn’t wait. They fled, scattering to different apartments across the city.
Read the full story in the June 10, 2016 print edition of Newsweek, or online.
The economic growth that has taken China to second place in the world by size of gross domestic product after the United States has been astounding — and its numbers are staggering in Africa too. In 2009, China surpassed the United States as the continent’s largest trading partner. By 2012, its trade with Africa was double the United States’.
Western media tend to inflate the rhetoric surrounding China’s rise in Africa. Headlines are often resentful and sometimes border on fear-mongering: China is “winning” Africa from the West. The United States must “catch up” to China if it hopes to maintain economic, security and cultural relevance in Africa. A monolithic “China” sees Africa as a place to get rich quick, and doesn’t care much about the consequences.
But behind these hyperbolic headlines there are people, actual Chinese moving to Africa — one million over the past 15 years according to the rough but generally accepted estimate. Some come to work for large Chinese companies that mine copper or cobalt. Others come to build those roads and railways. Many come to open small businesses: restaurants, pharmacies, furniture and electronics stores.
“Big projects completed by big, government-owned companies dominate the headlines about the advancing Chinese agenda in Africa,” wrote Howard French, a longtime New York Times correspondent in both China and Africa, in China’s Second Continent. “But history teaches us that very often reality is more meaningfully shaped by the deeds of countless smaller actors, most of them for all intents and purposes anonymous.”
Read the full article at VICE, and watch the full documentary, Chinafication of Africa, which I helped produce, on VICE HBO on April 22nd.