Kenya – Nairobi is a cholera time bomb waiting to explode
Nairobi – Cholera time bomb waiting to explode
Nairobi is a cholera nightmare waiting to happen as thousands of residents buy their food off the streets from unregulated vendors and kiosks, a Nation survey shows.
The dietary habits of residents have also changed; many have stopped preparing and cooking their own food and have turned to roadside fare, often prepared under suspicious hygienic conditions.
Last week, the Red Cross warned of a possible cholera outbreak in Nairobi as people who had travelled upcountry over the Easter holidays — some to areas already hit by the disease — start settling back into the city estates.
Water, an important component in maintaining personal hygiene and a major ally in controlling cholera, is being rationed in parts of Nairobi with health authorities having no capacity to provide alternative water in case of an outbreak.
One of the measures that have proved effective in checking the spread of the disease in smaller rural towns is the banning of food hawking and illegal roadside kiosks, but this may not be possible in Nairobi’s estates considering the vast number of informal ready-to-eat food outlets.
Informal food stalls or “mama pima githeri” eateries as they are popularly known, and roadside open air food outlests are now the only affordable places for poor and middle income Nairobi residents.
These are to be found on every street corner, near bus stops, in the neighbourhood, the local market and even next to open sewers. But they have two things in common — affordability and poor or no hygiene.
According to a Nation survey carried out in several city estates, cost is the most important factor on where and when to get a meal.
Githeri, a boiled mixture of maize and beans, usually doled out in tea cups and selling for between Sh10 and Sh15, is the most popular food for dinner.
Madondo, boiled beans and chapati at about Sh20 and mandazi with tea for breakfast for Sh10 are some of the popular choices but the majority opt for one meal a day.
Other foods like chips, vegetables, samosas, sweet potatoes and fruit are mainly considered as luxuries to be had on special occasions or in case of a windfall.
Elsewhere in Viwandani and Kawangware, one can get a meaty meal from a cow’s head or lower part of the leg for Sh10.
At Kamae Village, behind Nairobi West shopping centre, residents live on the undesirable parts from a local pig slaughtering factory traded at Sh10 a meal.
According to Emmah Waigwe, or Mama Jonte to her clients in Dandora, she has been making take-away githeri for seven years and does not know any other source of income. She wondered why we were talking about cholera yet she has not heard a single complaint from her customers for the last seven years.
But the bottom line is to keep the price down, no matter what happens to the economy. When the price of charcoal goes up alternatives such as sawdust, waste paper and firewood are used, oblivious of the health and environmental consequences.
To speed up the cooking of dry cereals and save on fuel, some outlets have been accused of rusing sodium carbonate, magadi, which in not good for the health.
The informal food sector, which started as a service for construction workers in the 1990s, has now blossomed into a big industry, giving a full new meaning to outside catering.
Fuelled by demand created by poverty, the issue of human health is rarely factored in, with the take-aways attracting all from the Jua kali sector to white collar workers.
Mama Jonte, who says her services are in great demand as she serves over 500 portions per day, scoffed at a possible ban.
“It would not work. The caterers would simply go underground and our hungry customers would follow us.”
The city council is aware of the problem of roadside food sales in Nairobi as its askaris collect Sh25 per day or bi-weekly depending on the market location.
While proprietors may not be required to have running water and toilet facilities because these are mainly take-away places, they are expected to have a food handling health certificate and appropriate dressing including aprons, but this is hardly the case.
They are also supposed to have a portable water source, which is rarely evident.
While several of the businesses claim to observe high hygienic standards, this has often been found to be untrue.
A study presented at the annual Kenya Agricultural Research Institute scientific conference last year concluded that roadside food outlets in Nairobi are a health threat.
Carried out in Kangemi and Korogocho estates in Nairobi by Dr M Oyunga-Ogubi, it said that almost half of the residents in these areas lived on street food despite the fact that they had “…been prepared in poor hygienic conditions and could be of little nutritional value.”
“A whole one-fifth of the population in the two estates was found to be consuming street food on a daily basis and most of the rest for about five days in a week,” says Dr Oyunga-Ogubi.
Consequently any blanket ban on such foods for whatever reason could lead to serious social disruptions.
An earlier, but similar study carried out in Dandora and Korogocho estates in 2001 demonstrates how poverty has changed feeding habits in Nairobi in less than a decade.
The study, carried out by the universities of Nairobi and Wageningen of the Netherlands and published in the European Journal of Clinical Nutrition, concluded that street foods in Nairobi were only taken for breakfast or as snacks while dinner was usually home-made.
In such a case, if a health-related ban was initiated residents could tolerably survive.
Another popular food item in the city is the omena or dagaa fish that find its way into Nairobi from the lake region.
Last year, researchers from Kenyatta University, the Department of Fisheries and the Kenya Medical Research Institute in a study published in the East African Medical Journal found Omena to be highly contaminated with some organisms that can cause serious food poisoning such as E.coli and Salmonella.
They said contamination could occur during storage, transportation and sale at open-air markets.
Such findings are not new to Kenyan health authorities. In July, a report by the ministry of Health said 50 per cent of preventable diseases in Kenya are the result of poor hygiene mainly because of appalling lapses in the country’s environmental sanitation system.
Currently, the Nairobi City Council has about 200 health officers with the daunting task of protecting more than three million residents — and visitors — by inspecting more than 1,500 licensed eating places and several other hundred illegal ones.
Ministry of Health officials say that regulation of unhygienic and illegal food outlets does not form a major part of their job description.