Supporting COVID-19 prevention in Kenya

NAIROBI, Kenya – Mathare settlement isn’t an easy place to stay clean and healthy on an ordinary day, so preventing COVID-19 from infecting people in a crowded slum of Kenya’s capital city of Nairobi is a challenge.

Most of the 500,000 people who have taken up residence in Mathare are living there because they can’t afford to live elsewhere. They make, on average, less than $1 per day by doing manual labour or domestic chores in other neighbourhoods.

Public water and sewer services are non-existent in most of Mathare, so people either pay private vendors for water and toilet privileges or figure out ways to take care of their personal needs for free.

Some pathways between the tin rowhouses are strewn with garbage: flattened water bottles, snack wrappers, a few bags of human waste, rotting vegetation and a layer of garbage that has no discernable origin.

When it rains hard, the water flows downhill toward the river, sliding under doors and walls and waking those who are sleeping on the floor. Five to 10 people typically live in each 10-foot-square, tin rowhouse.

In this situation, COVID-19 could spread quickly, says Judith Siambe, program director for The Centre for Peace and Nationhood (CPN), a ministry of Kenya Mennonite Church. Mennonite Central Committee (MCC) supports CPN’s work with maternal and child health in Mathare.

Judith Siambe directs programs for CPN that support the wellbeing of the Mathare community — both COVID-19 prevention and protection of the health of mothers and children.MCC photo/Matthew Lester

“If this disease were to get in the area where we are working, it would mean that the whole population of their area could be cleared out,” she says. “We really need to preserve this community for the future.”

CPN already has an established information network of health promoters and care group volunteers from Mathare who conduct group trainings and facilitate sharing about health with pregnant mothers and mothers of young children. So when COVID-19 cases appeared in Nairobi, CPN knew they had more training to do.

Through the established channel of information, CPN staff, health promoters and care group volunteers helped to spread the government’s directive to wash hands and to follow the curfews and rules that limited movement within the city.

Houses are crammed together inside Mathare settlement, making social distancing impossible when everyone is home.MCC photo/Matthew Lester

Social distancing is “practically impossible” in the community, says Christabel Awuor, a CPN project officer and midwife who works with the maternal and child health program. “But we keep insisting that… if you are going to go to work, wear a mask and try to maintain a social distance.”

Instead of sharing information in group settings, CPN’s health promoters and care group volunteers visit mothers individually to share information about COVID-19 symptoms and prevention. Those mothers share the information with their neighbours.

Joseph Mwaura, a community health promoter for MCC’s partner Centre for Peace and Nationhood (CPN), uses a megaphone to inform people living in Mathare settlement of Nairobi, Kenya, about signs and symptoms of the coronavirus. CPN photo/Christabel Awuor

CPN also hired people with portable public address systems to walk through the neighbourhoods with information about prevention, symptoms and phone numbers to call if someone has signs of the disease. Siambe says she hopes that if people report potential cases, health authorities might be able to contain its spread.

Care group volunteers are making masks to sell to the community at a lower cost than they can be purchased elsewhere. They also make homemade liquid soap, using ingredients CPN provided, which is much less expensive than buying soap at a store, Siambe says.

Before masks were required, Munee Matheka, a Centre for Peace and Nationhood’s (CPN) health promoter, shows other health promoters and CPN staff how she makes inexpensive liquid soap for the handwashing stations. CPN photo/Christabel Awuor

CPN uses the soap to supply the 50 handwashing stations they established in sections of Mathare, one for every 20 households. These MCC-funded stations will serve 5,000 to 10,000 people.

Volunteers protect and manage each water station, keeping the water and soap resupplied and teaching anyone who will listen about the importance of washing their hands.

Nelius Wanjeri washes her hands at a handwashing station provided by CPN. She runs a roadside fast food business, so having this handwashing station next to her business helps her and her customers to protect themselves from the coronavirus. CPN photo/Christabel Awuor

“Everyone is scared and anxious right now about the coronavirus,” says Awuor. People wonder, “What if this goes on for a while, a year or two. How will we survive?”

The survival question is especially critical in this community because staying home is not an option, said Siambe.

“These people work on a daily basis to look for food. Yes, they are scared of the disease and no one wants to get it, but sometimes they feel, ‘If I stay home, me and my children are going to die of hunger.’”

Recently, one of the neighbourhoods where many people get day jobs was closed. No one was allowed in or out.

“Also, there is a kind of stigma,” Siambe says, “because people who come from this kind of community are poor. They cannot afford sanitizers. They cannot afford high-quality masks. So [people in] places they work despise them and don’t want them to work anymore because they fear they will infect their families with the disease.”

CPN’s active presence in the community, even during the time of coronavirus, sends a message to people in Mathare that they are valued and cared for, Siambe says.

Children from Mathare settlement of Nairobi, Kenya, and Mama Margaret, second from left, as she is known in the community, share the excitement of receiving a handwashing station. CPN photo/Christabel Awuor

Krista Snader, an MCC representative in Kenya, says CPN’s long-term maternal and child health-care work in the community has built trust among many mothers. Snader and her husband Brian, also an MCC representative, are from Ephrata, Pennsylvania.

“When they go door to door and share accurate information, truthful information, it’s received well by the mothers,” Snader says. “When they are advocating for these changes of behaviour, they are received well because they are trusted. When there’s false news out there, they listen to CPN.”

The people served by CPN make up a caring community who help each other, says Awuor.

“Somebody will extend far to help another person who is in need of something. The sense of togetherness is so high in Mathare community, if someone knows that someone is hungry, the little that they have, they share.”