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Sanitation and health

Poor health clearly undermines people’s ability to improve their circumstances. Alice, who is 35, was disabled by an accident in which her hands were burnt. She later contracted TB. She received lengthy hospital treatment on both occasions but now unable to work, she hasn’t the money for the medicine or nutritious foods her doctor recommends. She has become too weak to do more than beg.

Kibagare inhabitants suffer much ill-health because of their environment. Sanitary facilities are non-existent and there is no provision for rubbish disposal. People are forced to defecate into bags which they then throw away, often indiscriminately. These bags of faeces have been given the name ‘flying toilets’.

Waste dumping, particularly of the ‘flying toilets’, contaminates the river that runs through the settlement. Despite this, children play there and many use it to wash clothes in. Water-borne disease is widespread, and every narrator in Kibagare mentions lack of sanitation as a major environmental problem.

Many narrators talk of the situation with shame – the loss of privacy and dignity for people having to live in such conditions is apparent. “Sometimes you will find somebody has thrown something at your door and it is faeces. If your iron roof sheets have a hole, you may find that someone has thrown their waste on top of your roof and it is pouring into your house,” explains Nyiva.

Improved sanitation facilities and better hygiene in and around the household is a major development priority for these narrators – yet it is being ignored. When people tried to dig their own toilets they were told they were not allowed to because they live in “a slum”. When they applied to the Constituency Development Fund for help, they were told it could not be used for this as they did not have “permanent residences”. Requests to their MPs for help have also been unsuccessful.

Kibagare has no hospital; the only health centre is run by missionaries but it is not free. The people of Oloitokitok escape some of the health problems of over-crowded and under-serviced Kibagare, but they too lack health facilities. Doctors are few, says Helen, but she praises them for being so hardworking. Lemaron’s view is that “most of the diseases are caused by ignorance, poor hygiene and lack of sanitation”. Malaria persists, he says, not least because people ignore advice to sleep under mosquito nets.


Sanitation and health is a key theme of the Living with poverty: Kenya oral testimony project.


Alice: sleeping hungry

Deborah: widows have rights

Elias: cultural change

George: no jobs

Helen: poverty of war

Joseph: keeping optimistic

Lemaron: challenging discrimination

Martha: battling corruption

Mary: life of struggle

Mercy: completely forgotten

Nyiva: cardboard homes

Peter: search for work

Key themes






Self-help initiatives

Sanitation and health

Political representation


Crime and unrest



Homelessness and insecurity

Pastoralism and agriculture