Your baby has a fever, pain, cough – what to do? A visit to the doctor would be good, but it is often not possible for parents from Kenyan slums. Instead, they buy cheap antibiotics – with dangerous consequences.
By Caroline Hoffmann, Good Stock Invest Studio Nairobi
Rose Midecha doesn't remember. Her young child Collins has been ill for three months. No pause. Coughing and sneezing. Midecha keeps giving him medicine. "I went to the pharmacy and bought antibiotics," the 37-year-old says. When they were empty, he still felt bad, so they got new ones for him. But they only alleviate the symptoms and Collins is ill again. Not for long, then his mother would resort to the next antibiotic.
Midecha lives with her two children in Mathare Youth in Nairobi. The hygienic conditions in the slums are poor – there is garbage in the streets, often fecal matter. There is only poor access to clean water and no drainage systems work. It adds a high population density to it. Here, bacteria spread easily and lead to disease. Antibiotics are often used against them.
Pharmacist without education
A study in Kibera slums in Nairobi found that between 70 and 87 percent of households surveyed were taking antibiotics within a year. By comparison, in Brandenburg antibiotics were prescribed on average in 6.5% of households in one year, according to one study.
Midecha gets antibiotics from pharmacists around the corner. These are in small corrugated iron huts with a choice of medicines. In most cases, pharmacists do not have pharmaceutical training, often not even a marketing authorization. Here, antibiotics are cheap and easy without a prescription. Midecha has no other option. "I would go to the hospital, but I can't, if I get a job, I have to accept it," says the single mother.
“If I wait in the hospital all day, who will make money for my children’s porridge?” Midecha asks. Plus: a visit to the hospital alone costs money. And Midecha doesn't have that. He works as a home helper, earning only so much money to rent his own cottage, food and child care.
High consumption of antibiotics in Mathare or Cyber often results in poor quality or misuse of medicines. All this encourages resistance. "Orphans are the focal point for antibiotic resistance," says Sam Kariuki, director of research and development at the Kenya Medical Research Institute (KEMRI). According to the researchers, the bacteria are in the environment – transferring resistance to each other. "If many antibiotics are given that are of different quality or even fake, then straws are like incubators for resistant bacteria."
In Kenya, hospitals are experiencing a growing problem. For ten years, the Kijabe Hospital has noticed that the rate of resistant bacteria is increasing. They have developed additional new treatment standards and are more closely monitoring resistance, so they still have effective medication in the closet.
In addition to transfers that could occur at the hospital, more and more patients with resistant germs would be coming to them. "One reason is that you can easily get antibiotics in Kenya," says George Otieno, a doctor at Kijabe Hospital. To this is added the great use of medicines by veterinarians in agriculture and livestock. This also favors greater resistance.
National Action Plan for Kenya
The question remains how the African country wants to prevent the danger. The doctor sees responsibility with the Kenyan government. "We need to talk about our healthcare system," Otieno says. "How much is available? Can a normal citizen find out with a doctor if he really needs an antibiotic?" Researcher Kariuki thinks the problem must be solved locally. "So we can drive people around the world without transmitting resistant germs," he says. Because air travel already has such movements. If managed locally, the global effects of the problem could be counteracted.
But it's not easy. Two years ago, the Kenyan state created a national action plan, which aims to raise awareness and prescribe antibiotics prescriptions. But in the slums that haven't changed much, the cures are still there. And for example, the population density in the slums of the world is expected to increase in the coming decades.
For Midech, only the pharmacist remains. He cares very much for his child. "I think about it a lot," he says. "You have no peace if your child is sick, and you don't know why."