I had only lived in Kibera for 15 minutes when I saw a police officer and was arrested. But it would be years before I saw a real doctor.
In 2001, at the age of 13, I had come to Kenya’s largest informal settlement on the outskirts of Nairobi with my sister. When we arrived at 3 a.m., we dutifully called my uncle from a phone booth to pick us up. Before he could arrive, the police arrested me for loitering. Just as capriciously, they released me an hour later.
The swift work of police was a contrast to the lack of proper medical care in Kibera, where hundreds of thousands live on just a few dollars a day and wait extremely long periods of time to access health care. Many do not receive health care at all, especially in emergency situations.
Within days of arriving to Kibera, my sister and I contracted chest infections and bloody, watery bowel movements that are symptomatic of dysentery. We relied on local “doctors” who doubled as “pharmacists,” prescribing paracetamol and antibiotics that may or may not have been the active agents in the pills they sold us. It was a shoddy practice, but at least it was something.
It is these memories that guide me as I now lead an NGO working to improve public health and economic prosperity in informal settlements in Kenya.
CFK Africa was started in 2001 by an American undergrad, a local community organizer, and a nurse in Kibera who wanted to deliver services not provided by the government. It has grown to offer state-of-the-art health care services, including vaccine distributions and prenatal care; youth sports initiatives; and career training and educational programs. In Kibera, where hundreds of thousands of people live in an area about 3 square kilometers, we run two health care clinics, including the first maternity ward in the community, and operate one of the few ambulance services.
CFK Africa started the same year I came to Kibera, and soon after my arrival I learned about their first efforts organizing soccer tournaments in the community. In 2009, I became involved as a youth leader, working with my peers to calm ethnic tensions after post-election violence. Soon, I was working on one of our biggest initiatives at the time, as a community health volunteer helping educate the community on sexual and reproductive health issues.
These volunteer positions are one of our most critical resources in addressing health issues in informal settlements in Kenya such as Kibera. With few institutions serving informal settlements, there aren’t many sources of information that people trust, and poor health advice can spread through the community as quickly as a virus. When the Covid-19 vaccine first became available, residents had many fears and misconceptions about how it worked. Our community health volunteers were able to address these issues as trusted friends and neighbors.
This is the model that I wish more charities and philanthropic efforts would follow. Some people call it “participatory development,” but I prefer to use a term first popularized in English by South African disability rights advocates: “Nothing about us without us.”
A lot of charitable efforts begin with big plans drawn up by people in another country or communities that run into trouble when conditions in the area don’t match their expectations. But CFK Africa’s philosophy is simple: Collaborate with the people you want to serve. Ask them what their problems are and how they think they can solve them. Provide them with the resources to try those solutions. Study what works and replicate it.
That’s how our program for teenage moms started. Our research in Kibera showed high rates of teen moms being kicked out of school; they were often unable to return because of the stigma around teen pregnancies. With input from teenage mothers in the community, we created a program to provide them with nutritional services and information about reproductive health and maternal care, and also reconnected them with schools through advocacy so that they could continue their education.
Sometimes these efforts can seem quite small, but they can have a huge effect.
Millions of people who live in informal settlements in Kenya lack access to proper nutrition, adequate sanitation, and quality health care, leaving them vulnerable to preventable diseases. To some, these medical interventions can seem so minor that it can be easy to overlook how profound an impact they have on the course of someone’s life in Kenya’s informal settlements.
For example, a dear friend of mine had pain in his lower right abdomen, a key indicator of appendicitis — a disease with an extremely high survival rate in the United States. I went with him to two different private hospitals, where we were turned away from livesaving services because we didn’t have enough money.
We then headed to a government-run hospital farther away. While waiting in line to be admitted, my close friend died.
Health care is a privilege in Kenya, especially for residents of informal settlements who often get into debt to receive some of the most basic health care services. Most of the residents here are day laborers, and time off work often means lost income.
As a result, many people put off seeing a doctor when they first become sick, and by the time they finally do, it’s often too late. At CFK Africa, we are advocating for more investment in prevention, especially for both infectious and non-communicable diseases among youth. Early detection and treatment could significantly reduce the cost of health care for both the patients and the clinics while also lowering the mortality rate.
When I think back to how I came to this point, it seems remarkable that I made it this far. Too many of my friends and neighbors growing up fell victim to drugs and crime. Others had their potential cut short by preventable illnesses or, like my friend, died needlessly due to lack of care.
These memories only strengthen my resolve to make the most of this opportunity leading CFK Africa, to ensure I’m making a positive difference in the community.
If there is a 13-year-old out there in Kibera today feeling sick, I want them to get the quality medical care I never had.
Jeffrey Okoro is executive director of CFK Africa, which was founded in 2001 and works to improves public health and economic prosperity in informal settlements in Kenya through integrated health and youth leadership initiatives.