Displaced Kenyans lack critical health care

WHO expresses concern for the health of the people who have fled their homes in the midst of the conflict in Kenya’s Rift Valley, and who are now sheltering around Nairobi, Eldoret, Nakuru and Naivasha.

Since the unrest began at the end of December 2007, more than 800 people have been killed and many more have been injured. UN agencies have prepared relief plans for 500 000 internally displaced people (IDPs). They estimate that up to 250 000 people so far are gathering in make-shift camps or are living with host communities. Estimates indicate that over 75% of the IDPs are women, children and young people. The majority of the young people are below the age of 18 years, many of them orphaned or unaccompanied.

The number of sites hosting IDPs appear to increase by the day. Initial WHO assessment has found that these sites are very crowded, with poor shelter, water supply, sanitation (in some camps, one toilet exists for every 500 persons) food shortages, no cooking fuel, precarious access to health care and shortages of antibiotics, children’s medicines, malaria medicines and life-saving drugs for chronic illness. Nearby hospitals are facing similar shortages of drugs and supplies.

Violence continues in Nakuru, Eldoret, and Naivasha. These towns already host hundreds of IDPs. In a worrying development, hospitals report dramatic increases in cases of sexual violence. In many cases, survivors have no access to even the minimum health and psychological support, leaving them vulnerable to a range of potential health problems, including HIV/AIDS.

The WHO teams based in Eldoret and Nakuru are coordinating health activities, visiting the camps, hospitals and sites to assess health in the camps; and monitoring disease outbreaks and the availability of medical supplies and health workers. For security reasons, in several areas, health workers are still unable to report for duty.

Risk of diseases and shortage of drugs

In Turbo IDP Camp, situated 33 km from Eldoret, there are piped water and storage tanks. But long queues at the tap have driven some people to draw untreated water from a nearby stream, increasing the risk of water and foodborne diseases. Several nongovernmental organizations are providing health services in the Turbo camp, but shortages of drugs such as pain killers and antibiotics are being reported.

The Munyaka PCEA Camp in the Rift Valley hosts about 3000 residents, and has running water but no storage tanks. Less than 25% of the households have containers to store water. The camp receives no regular health services. Many other camps are reported to have no access to safe water supply.

The most prevalent health concerns in all the sites are diarrhoea in children and acute respiratory infections. Malaria, HIV/AIDS and TB patients cannot access their medicines regularly, as also patients with asthma, hypertension and diabetes. Counselling services are not available for reproductive health, sexual violence or HIV/ AIDS.

WHO, the Kenyan Red Cross and other partners are helping the Kenyan Ministry of Health to assess the services needed in 62 identified sites, covering at least 92 000 people in the south Rift Valley. WHO has reinforced its presence in the country with the deployment of a senior epidemiologist, a logistician and a security office. As of today, WHO has deployed a team of 12 public health specialists in the affected areas.

While strengthening its security and operational infrastructure in the country, WHO is working to improve the health information base, strengthen strategic operation and technical coordination and reactivate health services.

(Source: Fadéla Chaib: World Health Organisation: February 2008)