Better roads are shot in the arm slum healthcare needs

A slum in nairobi. FILE PHOTO | NMG 

By EDWARD OMETE

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Summary

• Already just in my first month, a notable observation is that like many other areas of the country, change is happening in the slums too.
• Across the three metrics we are following; roads, housing, water and sanitation some progress is noted.
• In the last five years a mix of development partners, Kenya Urban Roads Authority, county roads department and the ward development fund all had projects.
• Roads, contribute to easier mobility but this isn’t the only positive impact: they are generally associated with easier delivery of sewer and water conduits as well as electricity or street lighting.
• As enablers in improving health service delivery in slums, the verdict is still out there between roads and electricity over which has the maximum impact.

As part of an ongoing project on determinants of infrastructure interventions on informal settlements, I’ll spend the next six months in the Mathare mapping out development projects and the health ecosystem for slum dwellers. One of the questions we are evaluating is what spillover impact projects like the Sh16.5bn ($165 m) World Bank Kenya Informal Settlements Improvements project (KISP) have.

Already just in my first month, a notable observation is that like many other areas of the country, change is happening in the slums too. Across the three metrics we are following; roads, housing, water and sanitation some progress is noted. The dwellers acknowledge this though they decry the slow pace.

In the last five years a mix of development partners, Kenya Urban Roads Authority, county roads department and the ward development fund all had projects. Roads, contribute to easier mobility but this isn’t the only positive impact: they are generally associated with easier delivery of sewer and water conduits as well as electricity or street lighting.

As enablers in improving health service delivery in slums, the verdict is still out there between roads and electricity over which has the maximum impact.

Perhaps highlighting the neglect slum dwellers face, private health facilities (pharmacies and small dispensaries) outnumber public establishments by about 315:1. For every 250 or so pharmacies, there is only one public dispensary.

My observation is that you are more likely to see a multi-floor building near a motorable road than where none exists. Similarly health facilities are clustered along motorable roads.

A good visualisation of the road: house type distribution is rendered by embedding road data in the area on Spatial Collectives’ “House Types in Mathare” mapping results. Stone houses are more likely to have electricity, piped water and a sewer system and proximity to a decent health facility. The enabling power of “numbers” allows business to go on in a safe and good manner uplifting economies and livelihoods.

By design, slums have the undesirable tendency of being “underproductive prime real estate”. A square foot of land houses ten times less than what it could optimally accommodate with development.

What isn’t identifiable easily is the difference on number of dwellers per room between the stone and other house types: a more impactful measure.

Sewage disposal is not adequately supported. Maybe due to its costly investment and maintenance needs. During the ongoing rains, burst sewer lines and leaking water pipes all mix contributing to a toxic cocktail responsible for gastroenteritis.

On average every 50 metres of waterway had a leaking water pipe and sewerage contact point.

To change the health face of informal settlements, more roads are needed and stricter regulation in terms of waste and sewage disposal as well water distribution.

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