Anthropology in Action: Disease & Poverty in Nairobi, Kenya (Part 2)

City of Nairobi, Kenya

In my last blog post, I explained the research process behind a small research project that I conducted in Nairobi, Kenya in 2007. I detailed how I found a research topic (health & illness) and narrowed that topic into a research question (the relationship between disease and poverty). I chose a population to study (residents of slums in Nairobi, Kenya) and conducted a literature review. I did ethnographic research for 3 weeks with 24 participants. I collected data in 3 health clinics and during 13 home visits in the slums of Nairobi. Now, in this blog post, I’ll be discussing the data that I found and my conclusions regarding disease and poverty in Nairobi, Kenya.

My first research question was, what diseases are of concern in slum communities around Nairobi, Kenya?

Through this study, I found that there were 4 major diseases of concern in the slum communities: Homa ya Rift Valley, or Rift Valley Fever (RVF), “Bloody Diarrhea” (likely amoebic dysentery), “Chest” (possibly TB), and Virusi vya HIV (HIV/AIDS).

My second research question was, what is the relationship of these diseases to local living conditions?

Through this study, I found links between each of the 4 diseases and local living conditions. Here is a summary of what I found with each disease, including people’s concerns about the disease and the related local living conditions.

Disease and poverty in Nairobi. Image of a thermometer and a bunch of pills.

Rift Valley Fever

Local Concerns about the Disease

During the January 2007 outbreak, Rift Valley Fever was thought of as a “new kind of malaria that kills.” And, malaria was not seen as something that affected the slum communities. It was seen as a disease that only affected people in other communities. So, Rift Valley Fever also was considered to only affect other communities. As a result, the slum residents felt they were at low risk of infection of Rift Valley Fever.

Related Living Conditions

In January 2007, the Kenyan government ordered people though media channels to stop eating red meat because it was potentially infected with RVF. Also, all of the butcher shops were to be closed. However, slum residents had very limited access to information about the progressing RVF epidemic, due to a lack of televisions and radios. As a result, butcher shops in the areas that I studied remained open, and potentially contaminated red meat continued to be sold and eaten. 

Disease and poverty in Nairobi. Image of a glass of water.

“Bloody Diarrhea”

Local Concerns about the Disease

In January 2007, there was a small outbreak of what slum residents called “bloody diarrhea.” They were afraid of a larger epidemic happening. Many people had died in previous outbreaks, and the disease was recognized as a common killer in these slum communities. People thought the disease was caused by not boiling drinking water.

Related Living Conditions

Community wells were easily contaminated by human and animal feces due to an absence of infrastructure. There was a lack of toilet facilities in the area, and there were also open sewers. Also, numerous farm animals roamed the area and defecated in many places.

Disease and poverty in Nairobi. Image of a doctor listening to a child's breathing.

“Chest”

Local Concerns about the Disease

During the colder rainy season, there were frequent epidemics of what slum residents called, “chest,” which involved chest infection and coughing. However, even when “chest” outbreaks were not occurring, adults and children were frequently coughing in these slum communities. “Chest” was thought of as different from TB (Tuberculosis). TB was thought to only infect those with HIV/AIDS. However, symptoms of “chest” and TB were rather similar, and many people in the area were known to be dying of TB.

Related Living Conditions

The residents of these slum communities lived in crowded unsanitary conditions that made it easy for respiratory diseases to spread. Residents lived in home structures that were made of approximately 10×10 ft. tin and/or wood shacks. These structures often had simply a blanket for a door, and any windows did not have glass or screens on them. Several family members lived together in each small structure. These structures were strung together in rows, with only a few feet between the rows. These close living conditions resulted in easy exposure to those infected with respiratory diseases including “chest” and TB.

Disease and poverty in Nairobi. Image of the words HIV and AIDS on a red background.

HIV/AIDS

Local Concerns about the Disease

Many people in these slum communities had HIV/AIDS, and substantial stigma surrounded the disease. Slum residents were aware that HIV is eventually fatal, but state “it’s not HIV that’s killing us, its poverty.” They explained that people don’t die simply because they have HIV, but because of a lack of food. An HIV positive person may become too weak to work, and then cannot afford food, so they waste away and die of starvation.

Related Living Conditions

It was difficult for slum residents to access medical care, including HIV testing and treatment. They did not have vehicles or cash for public transportation and the costs of medical care. Resources for food and financial assistance were scarce, placing HIV/AIDS sufferers at risk of malnutrition and starvation.

Here’s a table that summaries the data that I described above about disease and poverty in Nairobi, Kenya:

RESULTS

In the three slum communities under study, conditions related to poverty increased the risk of infection and disease transmission. With Rift Valley Fever, slum residents were at higher risk of eating contaminated meat and therefore contracting the disease. This is because they did not receive information about the outbreak and how to protect themselves. 

In the example of “bloody diarrhea,” slum residents were at higher risk of being affected by epidemics of this water-borne disease. This is because community wells were the only available source of water, and the ability to boil water was severely limited by financial constraints. 

With “chest,” slum residents were at higher risk of being infected as well. This is because the crowded housing conditions made it easy for communicable respiratory diseases to spread.

In the situation of Virusi vya HIV (HIV/AIDS), slum residents were at higher risk of being infected yet again. There was limited access (or an inability to access) HIV testing and treatment due to travel and medical costs. This resulted in the potential for HIV infected individuals to unknowingly spread the disease to others.

CONCLUSIONS

Project Summary

This study examined the relationship between disease and poverty in the slums of Nairobi, Kenya. Data was gathered using ethnographic research methods, including participant observation and unstructured interviews with 24 research participants. Four main diseases of concern to the slum communities were examined in terms of the relationship to local living conditions. With each disease, poverty created situations that increased the risk of infection for slum residents.

Significance/Implications of Results

Each researcher needs to be able to explain the significance and implications of the results from their research study. The significance of my study was that the incidence and spread of disease in these slum areas involves more than just a host and pathogen connection. This means that you can’t just look at the virus or bacteria causing the problem—other factors need to be considered. In the slum communities around Nairobi, Kenya, the effects of poverty play a significant role in disease risk and transmission. The implications of my study were that health programs in these slums (and similar areas) need to be targeted to the unique needs of these impoverished communities. To make the greatest impact on health in these areas, issues related to poverty need to be addressed.

Applicability of Results

Researchers should be able to explain how their results can be applied to the real world. In my case, my research adds to the body of knowledge in Medical Anthropology, but also could be useful in the real world. My findings may be useful for public health programs that are trying to prevent the spread of disease and improve general levels of health in these communities (and in similar areas in developing countries). 

So, now you have seen an example of Anthropology in Action, through a study of disease and poverty in Nairobi, Kenya! I hope that sharing my research project with you has given you a glimpse into research in Anthropology.

Are you interested in learning more about research methods in Anthropology? Check out my Udemy class, “Exploring Surveys in Anthropology Research: Anthropology 4U” at this website: https://www.udemy.com/course/exploring-surveys-in-anthropology-research/. Over time, I’ll be adding more courses covering all the different research methods in Cultural Anthropology.

Thanks for reading!

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