Joseph B. Treaster: Water and The World

A Continuing Discussion on Water and People on A Warming Planet

Jun 03 2010

In The War On Malaria Some Hopeful Signs, But A Long Way to Go

Published by Joseph B. Treaster under OneWater.org

KISUMU, Kenya—The rainy season in East Africa is also the malaria season.

Rain water collects in puddles and old tires and gutters. It also accumulates in discarded tin cans and in the folds of plastic shopping bags in garbage heaps. Malarial mosquitoes lay their eggs in the stagnant water and pretty soon you have killer mosquitoes hatching.

Around the world more than 800,000 people die every year from malaria, mostly young children. More than 90 percent of the deaths are in Africa, and Kenya is among a handful of African countries where the disease is at its worst.

The red clay flatlands and hills here in western Kenya, around Lake Victoria and the hard-scrabble city of Kisumu, lie in the worst part of a bad malaria zone - ground zero in Kenya. “There’s a very high chance of getting malaria here,” said Tom Guda, a Kenyan researcher at the International Center of Insect Physiology and Ecology in the nearby lake shore town of Mbita.

Western Kenya is an ideal place to study malaria and American and Kenyan researchers have been working together here for years at a joint laboratory of the Centers for Disease Control and Prevention and the Kenya Medical Research Institute. The Centers for Disease Control and Prevention, one of the main research institutes in the United States for malaria and other infectious diseases, began nearly 70 years ago as an important player in the ultimate elimination of malaria in the United States.

In the last few years malaria has caught the imagination of Hollywood entertainers, government leaders around the world, gazillionaires and ordinary people. Lots of money has been raised. The World Health Organization estimates that $1.7 billion was available for malaria in 2009, double the amount just three years earlier. The American Idol television show, alone, raised $9 million for the organization Malaria No More during a single charity broadcast, and the Bill and Melinda Gates Foundation has put more than $168 million into overcoming the disease.

This may be a time of great progress against malaria. But it is hard to be sure. The latest data compiled by the World Health Organization shows little change in recent years: 863,000 deaths and 243 million cases of malaria reported in 2008 compared with 881,000 deaths and 247 million infections two years earlier. But experts say that record-keeping on malaria is poor and that the numbers don’t tell the whole story.

Much of the malaria money is going into buying and handing out mosquito nets saturated with insect repellant–at $10 each–

and to spraying insecticide on the inside walls of houses. And it may be paying off.

“We know that sleeping under insect nets is effective and we know that the number of people sleeping under nets is increasing rapidly,” said Dr. Matthew Lynch, the director of the Global Program on Malaria at the Johns Hopkins Bloomberg School of Public Health in Baltimore in an interview.

Richard Tren, the director of Africa Fighting Malaria, a small organization with offices in Durban, South Africa and in Washington, told me that “progress in some places is phenomenal.” But, he added, “there are a lot of other places where things are not working.”

The World Health Organization says it believes there have been big gains against malaria in some small countries, including Rwanda and Zambia and on the island of Zanzibar off East Africa. But it is urging that anti-malaria efforts be concentrated more on bigger countries like the Democratic Republic of Congo and Nigeria, where malaria is rampant and where the situation has either gotten worse or not changed much.

At the Center for Insect Physiology and Ecology on Lake Victoria, Mr. Guda said that malaria infections and deaths are increasing in western Kenya.

“People are getting bed nets but it is still rising,” Mr. Guda told me one sweltering afternoon at his center. One reason, he said, is that “people are not using the nets properly.”

In the one-room huts that are home to many people here, Mr. Guda said, there is one bed. “The big people sleep in the bed,” with the net, he said. “The children sleep on the floor.”

Dr. Laurence Slutsker is the chief of the malaria branch at the Centers for Disease Control and Prevention in Atlanta, Ga. Dr. Slutsker, who worked at the Centers for Disease Control and Prevention laboratories in western Kenya for five years and still watches the area closely, said that after dropping sharply over the last 15 years, infections in children around here have begun to rise. Two years ago, 30 percent of those under five had malaria parasites in their blood. The latest samplings, he said, showed 40 percent were infected. Not a good sign.

The big picture on malaria around the world? “I think it’s getting better in some places,” Dr. Slutsker said in an interview. “I think it’s basically the same in other places. We talk about our success, which is good. But there’s a lot of work that needs to be done.” #

No responses yet

May 13 2010

On the Road In East Africa: Bang, Bump, Ouch

Published by Joseph B. Treaster under OneWater.org

KISUMU, Kenya—The roads in a country can tell you a lot about a place.

Some of the roads here in Kenya and in the rest of East Africa are smooth, black ribbons of asphalt. But many are pure torture. They are unpaved or once-paved washboards with crisscrossing ridges and odd-shaped craters. You start running into them just beyond the center of cities and towns.

Even in Nairobi, the capital, lots of streets are dusty, bumpy cultural experiences – until it rains. Then they become slippery bogs and mini-lakes, channels that look like rivers and swallow cars. Open sewers run along side them, right there in the capital of what was once regarded as one of the most pleasant places in Africa – for everyone.

As in just about every country in the world, the leaders of Kenya have dreams, and they can imagine a bright future. But the country has been in decline for some time.

The roads are flat out dangerous. Kenya has one of the world’s highest road accident rates. The bad roads also stifle the economy. They make it hard for farmers and fishermen and furniture-makers and even people who make beaded jewelry for Kenya’s often substantial tourist business to get their goods to market. And they are health hazards. They make trips to clinics and hospital take longer than they should and some sick people don’t survive the journey.

According to the World Bank, Kenya has 38,400 miles of roads; 12 percent of them paved. In a place where more than 40 percent of the nearly 40 million people do not have easy access to clean drinking water, where malaria is worse than almost anywhere else, where more than 70 percent don’t have toilets, 30 percent are not getting enough to eat and perhaps 40 percent are unemployed, lousy roads do not tell the whole story. Of course the roads say nothing about Kenya’s heavy losses from HIV/AIDS.

But the roads are a pretty good metaphor. You see the roads. You feel the roads. You know this is no way to run a country. The roads look to me like very good supporting evidence for the Transparency International report that Kenya is among the most corrupt countries in the world.

With the roads in your face, it’s no big surprise to hear that another fairly simple thing like clean drinking water is not that common. People all over the developing world struggle to get safe drinking water and, in that sense, Kenya is a good example. It is also a good example of the worldwide sanitation problem, which is a cousin of the water problem.

People don’t have as much water as they need so they don’t wash their hands as often as they should. So many people live without toilets in Kenya that it is almost surprising when you find one. A farmer showed me how he digs a hole in his yard just beyond odor-range from his mud-walled, one-room house. The hole becomes the family toilet. No walls. No curtains. No seat. Not even any shrubs. At some point, he said, he covers the hole with a few shovels full of dirt and digs a new one.

In much of East Africa, especially in the slums, they use what they call flying toilets. “You do your business in a piece of paper or a plastic bag,” one health worker told me. “Then you wrap it up and throw it over your shoulder.”

The waste missile can go anywhere. Sometimes it ends up on the rusty tin roof of your neighbor’s house. Maybe it flies on to your own roof. Often it just lands on the grassless, rusty-red clay around the houses.

When it rains everything fuses together, mud, waste, garbage. And the health consequences are sure-fire. In some places, after a rain, you can barely walk the roads, they are so slippery. Diarrhea is so common that most people don’t think much about it until they start to weaken from dehydration. Often, by the time people realize they are really sick, it is too late. Small children, often malnourished, have the least resistance and are the first to die.

One morning here in Kisumu, I went to talk to fishermen at a village just outside town. I was in a bus with stiff springs and stiff seats. We turned off the paved main road and from there on to the shore of Lake Victoria we were creeping over what could have been a test track for manufacturers of off-road vehicles, or maybe army tanks. Bang. Crash. Whomp. It was a short stretch, but it took us forever.

Later, we went out to some farms north of Kisumu. It took us two hours to go 35 miles. The roads tell you a lot about a place. #

No responses yet

Apr 29 2010

A Farm Is Blooming In An African Slum Where Water Is Scarce

Published by Joseph B. Treaster under OneWater.org

KIBERA, Kenya—For years Mohamed Abdullahi and his young friends made a living beating up and robbing their neighbors here on the outskirts of Nairobi in one of Africa’s most desperate slums.

Sometimes, though, the victims fought back. Ten of Mr. Abdullahi’s fellow criminals were “brutally killed,” he told me. Some were stoned. “Mob justice,” Mr. Abdullahi said.

Mr. Abdullahi and the others began to see that street robbery “was not a good idea.” At about the same time, an outburst of political violence shut down the slum, a jam-packed place of mud-walled shanties and putrid, open sewers.

Food supplies stopped coming in. A very scary place got even scarier and Mr. Abdullahi had an inspiration. He would start a farm inside the slum. Even if the slum were blockaded there would be food. And he and the others would have jobs.

Now Mr. Abdullahi’s Youth Reform Self-Help Group is growing spinach, eggplant, kale, bananas and sugar cane and selling it to neighbors. Most farmers in East Africa do not use irrigation – because of the cost – and rely on seasonal rains. Their yields are often low. The farmers get wiped out in floods. These are worldwide problems.

In the Kibera slum, water is scarce. But the farm is thriving with a frugal irrigation system that was developed long ago and gained widespread attention when it was refined in Israel and helped make the desert bloom. It is called drip irrigation.

In Kibera, black plastic tubing runs along each row of vegetables from a big water tank at one end of the field. The tubing is perforated with tiny holes. One tiny hole is lined up with the roots of a single plant.

To guard against the farm being swept away by the kind of flash floods that turn Kibera’s rutted clay roads into muddy bogs, the group has terraced its field, putting each long row on a slightly higher level.

The youth reform group built its farm on a piece of sloping land almost the size of an American football field. It overlooks a railroad ravine. The land had been waist-high in garbage. “It was an asset just lying there,” Mr. Abdullahi said.

On the walk to the farm, Mr. Abdullahi and I steered around clumps of roadside merchants and customers and made way for a boy herding a half dozen scrawny goats. We talked with a man who rents out shanties as shops and sleeping quarters and in his spare time chases people with sacks of garbage away from the creek beside his own place.

At the farm-site, about a dozen young people in their 20s and 30s had raked and shoveled and piled the garbage on the edge of the narrow ravine, 12 feet above the tracks of the battered diesel commuter train that disgorges passengers returning from mostly menial jobs in nearby Nairobi each evening. The group covered the wall of garbage with fine black netting to keep it from spilling onto the tracks and covered the netting with pumpkin leaves and weeds to create a green look.

The youth reform group got help from several Kenyans, including Su Kahumbu Stephanou, the founder of Green Dreams, an organic food company that is part of the Food Network East Africa. The youth reform group hauled in a truckload of fresh soil and agreed to use natural fertilizers. They had tested the original soil and discovered it had elevated levels of zinc, partly, Mr. Abdullahi said, leached from discarded flashlight batteries. He said the group decided it could grow food that would not harm people, but also planted sun flowers that Mr. Abdullahi said draws zinc from soil.

Al-Amin Ibrahim, who is 26 years old and supervises the farm workers, plunged a three pronged rake into the red clay beside a row of kale, big green leaves spreading like fans from a tight stem. In a moment he turned up a corroded double A-size battery. He kept digging and a D battery surfaced.

Mr. Abdullahi says he has learned a lot from working the farm in Kibera over the last two years and wants to pass on the knowledge. His country is among many in the developing world that are having trouble feeding themselves as people abandon small farms and cram into slums. Mr. Abdullahi wants to go into Kenya’s schools and encourage young people to take up farming. “So far,” he said, “the government and the schools don’t agree.” #

No responses yet

Apr 22 2010

In An African Slum, Clean Drinking Water Gets Low Priority

Published by Joseph B. Treaster under OneWater.org

KIBERA , Kenya —The government clinic gets a shipment of water purification tablets every three or four months. In a week or two the tablets are gone. And then the people here in this rambling slum on the edge of Nairobi are on their own.

So how bad is that? This is one of those places around the world where the water can make you very sick. But, just like a lot of other places, it doesn’t always make you sick. Many people are convinced that the water is fine, or almost fine. People take the purification tablets because they are free. They don’t routinely use them, just like they don’t routinely boil their water. Most people in Kibera don’t have toilets and that adds to health problems.

The worn , reddish clay hills of Kibera are packed with tin-roofed shanties. The stench of sewage is strong in the air . Little clouds of smoke from charcoal cooking fires and burning garbage st ing the eyes. The slum is a microcosm of horrible conditions in much of the developing world . The United Nations estimate s that more than a billion people in places like Kibera – and places that are not nearly so extreme – don’t have consistently safe drinking water piped into their homes or within easy walking distance. Perhaps 2.5 billion people don’t have toilets. This adds up to a lot of sickness and about two million deaths every year. Over the last decade or so the situation has improved only slightly and it may very well get worse as the world population relentlessly rises.

Governments in many developing countries pay very little attention to clean drinking water and toilets and I could see from conversations in Kibera that there is little or no demand for improvement from many people living withiffy-water and unspeakable sanitary conditions. They don’t see a problem with their water. Some non-governmental organizations put a lot of energy into water and sanitation. But the going is tough.

In Kibera I sat on a railroad bridge with two men in their 30s who said they work from time to time as laborers in Nairobi . They said they were never sick because of the water. Just about everyone I spoke with said the same thing. Dolith Okello has set up a sports bar with four television screens in a three-room shack that she calls the Miami Inn Café. Ms. Okello, who roots for a British soccer team and speaks colloquial English, s aid the water never made her sick either.

“We don’t boil our water and we don’t get sick,” she told me. “There are diarrhea outbreaks, but they’re not related to the water . It’s because we don’t have proper latrines and we don’t have proper garbage disposal. ”

She thought a little more about water having nothing to do with diarrhea in Kibera and added: “ That’s 75 percent no and 25 percent maybe. ”

At the hot, dusty government clinic, Joyce Omune, a registered nurse who is in charge, said most of the patients are very young children. “Number one on the list” of problems,” she said, “is diarrheal diseases.” There are five other nurses, two of them registered nurses, and no doctors. There is no electricity. The paint is peeling. Each morning about 60 children are brought in with diarrhea, Ms. Omune said. One day like that would be a crisis in the United States and Europe.

Dr. Onesmo K. Ole-MoiYoi, a Kenya n graduate of Harvard University and an expert on disease in East Africa, said the problem in Kibera w as almost certainly a result of “drinking contaminated water.” Malnutrition, he said, makes children more susceptible. In turn, frequent diarrhea contributes to malnutrition, said Dr. Linda K. Ethangatta, a former United Nations nutritionist .

Some treated municipal water lines flow into Kibera , but the pipes are corroded and sewage seeps in. Middlemen routinely intercept the water and sell it. P eople end up with just enough to get by. They don’t wash their hands often en o ugh. There is garbage and filth everywhere. Flies dip into open sewers, then dance on fish and chunks of meat sizzling in open pots.

During surges of diarrhea, Ms. Omune said , people ask for purification tablets. “But when things settle down,” she said, “they go back to their old routine of just using the water the way it is.”

Ms. Omune said several non-governmental organizations had conducted campaigns to help people understand the bad things that can happen with drinking water . But there is still a lot of work to do here and around the world. And most of it is not getting done. #

No responses yet