On Wednesday, I got to visit the CDC field site in Kibera, the largest slum in Nairobi and the second largest slum in Africa. There is also a really good documentary called "Good Fortune" if you are interested in learning more.
Map of Kibera
I haven't been in a slum since the last time I was in Kamalapur in Dhaka, Bangladesh. I was very curious to see what differences and similarities there were between the two. I have spent much more time in Kamalapur and seen much more of it, where as I only spent a few hours in Kibera and only got to see a small part of it. From afar, Kibera looks much more uniform than Kamalapur. There was a wide range of economic classes (all poor, just different degrees of poor) in Kamalapur and building materials and methods varied by class. In Kamalapur, I visited homes made of concrete surrounding a courtyard with a shared cooking area with gas stoves. The residents of these home often had a TV and some even had a refrigerator; on the other extreme, I also visited homes made of bamboo and corrugated tin with a wood burning stove made of earth just outside the front door. The latter were in long narrow rows of homes without courtyards. Kibera was much more uniform in the type housing available to the residents, all of it was made from mud with corrugated tin roofs. There were no courtyards, but the homes that I went into all had TVs and two rooms, a bedroom and a living room, and they were very clean and tidy. They all had a lot of furniture and TVs. Alice, who was taking me around, said that the homes I visited were very nice and that some do not have any furniture to sit on during the weekly surveillance interviews.
View of Kibera
Another view of Kibera that includes some apartments with an interesting history. Many people living in Kibera were displaced to build them with a promise that they would be affordable housing that they could move into once they were completed. They sat empty for many years because of government corruption. People are now living there; however, I don't know if they are as affordable as the housing that once stood there. The documentary I mentioned earlier has much more detail about it and shows a very interesting perspective of international development efforts.
A building in the CDC surveillance area (section 5, building 56)
Looking down a row of homes. If the mud were replaced with bamboo it would look very similar to the poorer area of Kamalapur that I visited.
I went on three household surveillance interview visits. It is fascinating how technologically advanced the surveillance infrastructure is given the setting it is taking place in. The staff conducting the interviews all carry PDAs and enter the responses right into them. The data is uploaded to the server at the end of each day. There is no paper. It is quite efficient.
After the household visits, I was taken to the CDC clinic in Kibera and given a tour. The clinic has a wonderful story of how it came to be what it is today. It was funded by CDC and a non-profit called Carolina for Kibera. The latter was the original group that was involved with the clinic. Apparently, a researcher from UNC came to Nairobi to do some research in Kibera and decided to live in Kibera while he was doing it. He met a woman named Tabitha there who wanted to start a clinic but did not have the capital to do it. He gave her a micro loan of around $30-$40 so she could open the clinic. She opened it in her home, half of the home was the clinic and she lived in the other half. You should keep in mind that the dwellings in Kibera are maybe, and I mean maybe, 150-200 square feet. Eventually, there was enough demand to expand her clinic. The researcher again helped her, but this time as a partner, to move the clinic into a three room building. I can't remember the story perfectly, but I think this is when Carolina for Kibera came to be. A few years after this clinic was opened, Tabitha died and the clinic was renamed Tabitha Clinic in her memory. Again, it grew so large that it needed to expand again, so a second location was opened. Once CDC came to Kibera, there was a desire to increase the capacity of the clinic even more to make the research and surveillance efforts more efficient. That's when they started building the current clinic. It took several years. The building was completed and dedicated in March of 2009, but construction began around 2006. The unrest after the 2007 presidential election stopped construction for a while since Kibera was one of the main places where there was a lot of violence (also in the documentary I mentioned). The name of clinic is technically Carolina for Kibera Tabitha Medical Clinic, but apparently everyone calls it the CDC clinic (it is less of a mouthful if nothing else I suppose). The clinic itself is amazing. Everyone participating in the CDC surveillance receives free medical care there for the syndromes under surveillance and they all have medical cards for the clinic. The entire medical record and research infrastructure at the clinic is electronic. It is more state-of-the-art with respect to medical record technology than many physicians' offices, clinics, and even hospitals in the US. It is incredibly impressive. They do, however, have paper back-up, in case the power goes out. I was in awe of everything they showed me, it is really such a dichotomy from everything surrounding it.
A few pictures from on may walk out of Kibera.My favorite sign. It must be left over from when President Obama visited Kibera as a US Senator.
The railroad tracks marking one of the boundaries of Kibera. They, and most of Kibera, were lined with garbage, mostly plastic bags. It made me dislike plastic bags more than I already do. I am happy that I use canvas bags in the States and that I have been reusing the same plastic bags from my first grocery trip while I am here (despite the odd looks I get from the cashiers and baggers). Plastic bags are awful.
Tiny dried fish for sale
Charcoal for sale
