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Kenya: Why Malaria Kills the Poor Most
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The Nation (Nairobi)
OPINION
25 April 2008
Posted to the web 25 April 2008
Dorothy Kweyu
Nairobi
EARLIER THIS MONTH, THE director of Medical Services, Dr James Nyikal, made a presentation on the World Health Day that has great significance for today - World Malaria Day.
Dr Nyikal, who has since been promoted to permanent secretary, Ministry of Public Health and Sanitation, drew vital links between malaria and climate change in a topic that also looked at cholera and East Coast Fever.
The transmission of malaria is seasonal and is associated with variations in rainfall and temperature, with peak transmission occurring during the short and long rains.
Invoking the old hygiene lessons we were weaned on, Dr Nyikal explained how rainfall affects the availability and suitability of breeding habitats, with temperature affecting the rate of mosquito and parasite development, as well as the suitability of habitats for the mosquito vectors and their blood-feeding rates.
The good old rules - keep the home environment free of puddles and objects in which water could collect to form breeding grounds for mosquitoes - hold today just as they did when we were first introduced to the linkages between health and the environment.
But the DMS also raised other issues to which we have not paid close attention, as evidenced in perennial flooding in many parts of the country, with Budalang'i in Western Province and Kano plains in Nyanza being classic examples.
While flooding may be deemed to be a natural phenomenon, the truth is that most flooding seen in parts of Kenya today with increasing regularity is a result of climate change, linked to abuse of the environment.
Trees have been cut across the country, with Kenya today said to have only two per cent forest cover, against the global recommended minimum of 10 per cent.
AS DR NYIKAL POINTED OUT IN HIS presentation, deforestation creates puddles and stagnant waters, and increases local temperature - perfect situations for mosquito-breeding.
While the debate about environmental conservation versus development continues to excite intellectual debate, the truth is that the price of environmental destruction is being paid by the many millions of poor Kenyans.
Ironically, they are caught in a vicious circle of being both perpetrators and victims of environmental abuse. Although anybody can suffer from malaria, its worst effects are felt by the poor due to two main reasons.
First, the poor tend to live in environments conducive to mosquito breeding since they are pushed to the fringes where high population density only adds to activities like over-cultivation of land that leads to soil erosion.
And, because of the pressure to survive, the poor, by and large, lack the time to invest in environmental conservation and sanitation for their own good.
And when they fall ill from malaria, they are caught is a situation where they cannot afford the recommended drugs.
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Currently, for instance, the recommended drugs for treatment of malaria are well above the means of the poor, who, by definition, live on less than Sh60 a day.
But while the most logical option to put malaria under control would be to target activities that damage our environment, even simple logic like banning settlement in the forests is so riddled in politics that, as things stand, the incidence of malaria in most of the country is likely to get worse before it gets better.
Ms Kweyu is a revise editor, Daily Nation
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