Showing posts with label Designed Apartheid. Show all posts
Showing posts with label Designed Apartheid. Show all posts

Tuesday, May 12, 2020

OPPORTUNITIES FOR KENYA & FIGHTING THE COVID-19 PANDEMIC


The Government of Kenya faces an unpresented crisis for which it instituted certain measures to respond, in order to secure its population. When the WHO declared the 2019-nCoV outbreak a public health emergency of international concern on 29th January 2020, countries started rolling out evolving strategies to curb the pandemic's ravaging consequences in a fluid and fast paced environment.    
Although the exact magnitude of the spread and impact of the virus in Africa is unclear, it is noteworthy that the WHO had warned that up to 190,000 people in Africa could die of COVID-19 related illnesses in by July 2020.  Other models by Western Epidemiologists had predicted even larger numbers resultant from the pandemic.  However, Africa’s weakness was perhaps its greatest strength with African Governments – cognizant of the threat posed by weak health systems – responding early, to avoid an apocalypse. Convened by the relatively young African CDC, an emergency meeting of African Health Ministers endorsed an Africa Joint Continental Strategy for COVID-19[i] leading to early political engagement and preparedness which demonstrated an ability to address future public health challenges. The other unintended impact is the increased focus of hygiene - with focus on fumigation and washing of hands - is  likely to impact other germ related illnesses.
From a clinical lens, health issues have taken center stage and forced the conversation around weak health systems and poor investment in health into the limelight. This should see more funding into the Health Sector in line with the 2001 Abuja Declaration[ii] where the African Union countries pledged to set a target of allocating at least 15% of their annual budgets to improve the health sector. UNECA indicates that COVID-19 has led to unanticipated increases in Health spending of up to USD 10.6 bn in Africa. If this is sustained year on year, then Africa will have the potential to meet the needed health financing gap.
 
Various press articles reported that Pasteur Institute in Dakar, Senegal[iii] and KEMRI in Nairobi, Kenya[iv] (in partnership with international research organizations) had started working to authenticate test kits that would produce test results for COVID-19 in 10 – 15 minutes.  The acumen in these innovations can be attributed to the fact that – with enough investment - technological know-how can be promulgated regionally for the benefit of the Continent.  Building on the COVID-19 momentum provided the opportunity to address outstanding human resource for health challenges with countries like Kenya recently advertising for 5000 additional health positions and expanding hospital capacity.  Public private partnerships have been enhanced to resolve what is otherwise a public health problem with bodies such as the the Kenya Health Federation - representing the Kenya Private Sector Alliance - rising to the occasion to influence public policy and bridge the gap left by the public sector.  Medical personnel of Kenyan origin from across the globe have rallied together through virtual platforms to exchange solutions on case management which is cheaper than alternative modalities for capacity building.
On the enabling front, COVID-19 has created a hub for innovation at the local level with citizens adapting local solutions to local problems in the absence of external support. The interruption of global supply chains has provided impetus for the revival & adaptation of garment factories in Kenya to manufacture & supply personnel protective equipment for health workers and masks for the general public in the face of the pandemic. Indirectly the revival of such factories has boosted the agricultural sub-sector for cotton farming and will increase household spending in health (and other social sectors) as people retain jobs despite the lock down.  It also became evident that the alcohol/ethanol industry could produce large volumes of hand sanitizers that are always in demand in hospital settings but have heretofore been imported. Travel restrictions occasioned by the pandemic have revived the debate around an over reliance on South Africa & India for treatment of many health conditions & importation of basic health requirements which have been poor policy choices.


Not to waste this crisis, African states must – through the African Union, African CDC and African Development Bank - continue to approach Health System Strengthening from a multisectoral & continental lens.  Investing in continental, regional & local institutions will increase the level of preparedness to address future pandemics.   In so doing, Africa can overcome its structural challenges to not only fight the pandemic but also inform long term policy positions that will enable it recover from an adverse post-COVID-19 impact. Beyond simply a medical response, Africa at large and Kenya more specifically, must look to the plethora of expertise at its disposal to define acceptable policy solutions to address what is the continent’s largest challenge since Independence









Wednesday, November 28, 2012

Steven Otter - Khayelitsha uMlungu in a Township

In 1999, I had the distinct pleasure of visiting Capetown, South Africa for a five week stint.  From the safety of my classroom I enjoyed the beauty of the Table Mountain and the Harbour. Whilst there, I had the pleasure to visit various places such as V&A Waterfront, Jakkalsfontein, Saldanha, Cape of Good Hope, Cape Agulhas (where the Atlantic meets the Indian Ocean) and Khayelitsha. You must remember that this was just 5 years after historic 1994 elections that saw Nelson Mandela elected as the first black president in a 'free' South Africa. I must digress to add that I was the only other black student in my class and my visits to all these places including Khayelitsha was at the courtesy of my 'white' classmate Tim who was determined that I should have something positive to say about this great nation that had just escaped the claws of a political system that was so difficult to understand.

So when I saw this book in a bookstore thirteen years after my first visit I was evidently drawn to it.  Interestingly, on the flight from Jo'burg to Cape Town, I had sat next to the 'black' Bishop of South Africa and a 'coloured' South African now at Howard University and I took time to educate myself by discussing the continued disparities - 18 years after the fall of Apartheid - in this rich nation that reminds me, ever so often, of the mighty Tshaka Zulu.

Khayelitsha  is one of the fastest growing informal settlements in the Western Cape. It is hidden somewhere beyond the mountains where it does not 'disturb' the average visitor's view...almost as one would hide a step child.  Khaya - as it is known in short - is 99.5% black - mostly Xhosa - with the remainder of the populace being of mixed race. Now I cannot strictly tell how this came to be but there was a time when South Africa's political system was famously known for Apartheid - to be set apart - with very strict pass laws.  My 'coloured' classmate in 1999 had attempted to educate me on the 1950 race laws when people were confined to live in certain areas in accordance to their race.  He explained to me the challenge that arose when a 'coloured' child was born to a 'black' mother and 'white' father (or vice versa)...All the three had to be separated unless the child could be defined as either black or white.   Then there is the complex story of SKIN where a dark child was born to two white parents. Officials struggled to define whether this child was black, white or coloured for the purposes of where she would live & school.  There was strictly no mixing of races - and the church condoned it - but that is another topic altogether for another day.

This book is not about the sin called apartheid but the effects thereof that continue to plague an otherwise great nation.  It is the true story of Steve Otter, a white South African, who throws caution to the wind and against the advice of his kinsfolk, takes a conscious decision to live in Khayelitsha during his journalism internship.  It is an extremely interesting read because the book  - in a very unassuming and non judgemental way - educates the reader on life in Khayelitsha.  In reading the book one faces the issue of informal settlements.   I could not help but compare Khayelitsha to the Kibra Townships in Nairobi, Kenya of which a lot has been said and written. Googling Khayelitsha I got 237,000 hits as compared with 2,200,000 hits for Kibra.  The issues in the Brazilian Favelas, the Kenyan Slums, The Egyptian City of the Dead and South African Black Townships are similar.   Most of the people who stand, squat, sleep or hang around these areas pay rent and try their best to eke a living despite the extremely unfair situation that they find themselves in. The human being is resilient and those who are forced to live in these settlements make the best of their situation.  A few even thrive but this does not reduce the tragedy of that existence.  That one is forced to raise their children in such deplorable conditions - either by choice, circumstance or design - is a mockery of the vote that they carry in a democratic society and a waste of the tax they pay either directly or indirectly. 

Governments find it impossible to do anything to address urban poverty given the entrenched interests at play, interests more powerful than drug & sugar barons or other mafia.  The story of informal settlements is a complex one for which there is no easy solution.  Some settlements are better than others and Khayelitsha & Soweto cannot compare to Alexandra, Kibra & Korogocho.  The elite, rich & middle classes sleep easy and blame those who live in such abject poverty for their own plight.  They glorify, explain or ignore informal settlements without understanding the challenges of poor sanitation, lack of space, lack of basic amenities, poor security and the stigma of that post code.  These challenges are best explained by the summary on "A House For Mr Biswas" by VS Naipaul which ponders about the dishonour of one having to live and die as one had been born, unnecessary and unaccommodated.


The question I kept asking myself as I flew back home is whether I - an African - would have the courage to experiment living in the informal settlements of Kayelitsha, Alexandra, Soweto or even Kibra. As it is, a cursory visit to Korogocho, left me traumatised for weeks on end.  I also wondered what God - in his mercy - would do with the folks who write, justify and perpetuate unjust laws, aided and abetted by those who condone them.  Is there a mansion waiting in heaven or will we be forced - in the sweet by and by - to live in shacks?