NAIROBI (AlertNet) – Four-year-old Geoffrey is the height of an 18-month-old toddler. Severely stunted, he suffers from chronic malnutrition and tuberculosis.
Just a few kilometres away from Nairobi’s cosmopolitan bars and cybercafés, where people sip cappuccinos, Geoffrey is in a slum being treated with Plumpynut, high-energy therapeutic food normally given to starving children in emergency feeding centres.
“He was very weak. I was scared he was going to die,” said his father, Francis Odhiambo, as he cradled the small boy on his lap at home in Korogocho slum.
Geoffrey is just one of thousands of children who suffer from malnutrition in Kenya’s capital, where surging food and fuel prices pushed inflation to 12 percent in April.
Last year, international humanitarian organisation Concern Worldwide admitted 2,839 children with severe malnutrition into its therapeutic feeding programme, which covered six out of nine districts in Nairobi. Of those children, 64 died.
Another 3,400 children were diagnosed with moderate malnutrition, though lack of funding meant they were not given treatment. In the first three months of 2011, Concern admitted 1,021 severely malnourished children from eight Nairobi districts and identified moderate malnutrition in another 800.
Poor families spend most of their income on food. The price of potatoes has jumped 87 percent in the last year, while cooking fat and kerosene – which poor families use for cooking and lighting – is up 53 percent, according to the Kenyan government.
“There is no doubt that people in the urban slums are going to be the first to be affected (by) any small increase in food prices,” said Noreen Prendiville, head of the nutrition section at UNICEF, the U.N. children’s agency.
“This is an issue of extreme poverty.”
URBAN POOR OVERLOOKED
Odhiambo, 36, is a carpenter who earns 700 Kenya shillings ($8) a day when work is available. His family eat two small meals a day.
“Being that I have little money, I try to get what the children are required to eat but sometimes it is not enough,” said Odhiambo.
“If you don't have money, back at home is hell,” he said. “You don't feel comfortable coming home because you want to feed them but you can't.”
There are no comprehensive statistics on the number of malnourished children in Kenya's urban areas.
The World Health Organisation defines the nutritional situation as "critical" when 15 percent of children are malnourished, triggering a humanitarian response. With malnourishment in urban settings often overlooked, critics argue this definition needs to be revised.
Last year, 3,294 malnourished children living in rural Kajiado District were given emergency treatment because the rate of malnutrition was 11.5 percent, and drought had killed large numbers of livestock. But children living in Nairobi slums received no assistance as the malnutrition rate was an "acceptable" 3.5 percent.
Yet the total number of children at risk in the city was much higher. In Mathare, just one of Nairobi's 200-odd slums, a malnutrition rate of 3.5 percent translates into 2,961 children.
"One neighborhood in Nairobi showed almost as many cases of malnutrition as Kajiado, yet it was classified as acceptable, while Kajiado was classified as an emergency," said Lilly Schofield, Concern's evaluation and research advisor.
“The indicators we use are not appropriate for urban settings as they can mask significant suffering behind low percentages. This means that responses to worsening food security for urban poor often come late if they come at all.”
Humanitarian agencies are feeding 2.4 million people in Kenya’s rural areas, mainly pastoralists in the arid north where malnutrition rates reach 20 to 25 percent.
The 3.5 million “severely food insecure” people in urban centres are not included in the government’s and aid agencies’ bi-annual assessments which identify communities in need of food aid and nutritional support.
“The urban poor have been left out and we are trying hard to get the urban poor considered in any food insecure assessment,” said Anne Mahoney, Kenya country director for Concern.
“It’s a failure at the moment.”
EVERYTHING IS EXPENSIVE
While rural areas are currently home to most of the world’s poor, the World Bank estimates cities will become the predominant sites of poverty by 2035. Over 5 million of Kenya’s 38.6 million people live in slums, which are among the most dense, unsanitary and dangerous in the world.
“Life has become too hard,” said 30-year-old Nancy Muthoni, as she chopped wood in one of the narrow, muddy lanes in Korogocho.
“These days, everything is expensive.”
Muthoni lives in a small room behind her woodpile, with her three children, her sister and her sister’s two children. She sells the wood sticks at one shilling a piece.
In the morning she sends her children to school with empty stomachs. For lunch and dinner they eat ugali (maizemeal) with greens or beans.
“On Saturday and Sunday, there’s no work. They just drink tea,” she said.
Muthoni can’t afford to buy kerosene for cooking and searches on a nearby dumpsite for other people’s leftover charcoal.
She knows many women who sell sex to put food on the table. But it’s a risk she will not take.
“The way I see it, you could get the ‘big disease’ [HIV/AIDS] and that would leave my children in trouble,” she said.
In Nairobi slums, mortality rates for children under five years old are double the city’s average and greater than for rural areas, according to UN Habitat, the U.N. agency for human settlements.
Studies show children in slums are more likely to die from pneumonia, diarrhoea, malaria, measles or HIV/AIDS than those from wealthier parts of the same city and rural areas.
“If we neglect, at this stage, defining urban poverty, and urban hunger linked in with that, I think we are setting ourselves up for a future which is going to be very traumatic for a lot of people,” said Mahoney.
“We are seeing a growing disparity between rich and poor... that is a tinder box waiting for a fuse to be lit under it.”