Lucy Hannan in Nairobi
Surrounded by filth and terrorised by crime, residents of the suburb of Korogocho routinely refer to themselves as the “forgotten ones”. But even their misery could be ignored when a cholera epidemic took grip in Nairobi’s slums as a nurses’ strike entered its third week.
Government hospitals have remained deserted since the nurses began a national strike on November 28. They stuck to their demands, despite being confronted in some provinces by police with tear gas. Striking health workers have threatened private hospital staff and warned of disrupting services.
The strike is the second serious wave of industrial action to sweep Kenya before the general election on December 29. Nurses – like teachers in October – want a 200% to 500% pay rise.
Emergency tents have been erected in two slums and volunteer nurses and health workers have been brought in. So far, the response has come almost exclusively from the non-governmental sector; government representatives visited Korogocho cholera patients for the first time this week. Health workers have confirmed at least 30 deaths in Nairobi so far.
But grim accounts of dying patients and suffering failed to push President Daniel arap Moi’s government to the negotiating table until Tuesday, when the strike leaders were finally allowed to express their grievances.
Corruption, low wages and low morale have undermined the Kenyan health system. Patients routinely bribe hospital staff to get treatment, or are expected to produce their own syringes, plastic gloves, cotton wool, drugs and other medical equipment.
Patrick Chege, whose kneecap was broken in a police beating, was in Kenyatta Hospital for a month without receiving treatment, because “doctors kept asking me to give them a little something”. Some patients who cannot afford to pay their bills are kept in the wards – sometimes for months.
Ling Kitui, a Nairobi GP, said doctors were often forced to make difficult decisions on scarce resources, “because the greatest problem is misuse of funds at a ministerial level”.
Government hospitals often lack adequate supplies, and Moi’s regime appears to be unwilling or unable to plug the holes. Pharmaceutical companies have even placed adverts in local papers advising “how to spot real drugs”.
Kitui says that telling patients how genuine drugs are packaged has become a crucial part of treatment, “otherwise sick people pay a lot of money for flour-and- sugar pills”.
In Korogocho, people cannot afford bribes. They save their money to buy buckets of clean water and a daily meal of green leaves and maize meal.
An estimated 20% of children in Korogocho are malnourished and on assisted feeding programmes, according to John Kitheka of Provide International, a Kenyan aid organisation.
Moi knows he will get few votes in these urban districts. An energetic campaigner in the provinces, he leaves these areas alone. George Mburu, a 28-year-old volunteer community-health worker who was born in Korogocho, says he will probably not bother to vote at all in the elections, which he says will “make no difference”.
Moi is seeking to extend his 19-year rule by another five-year term, and is expected to win the election. Mburu says several opposition candidates have visited the slum, but no representatives from Moi’s party, Kanu.