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Nairobi, Kenya
 
Jose Stoute


PROFILE:

Doctor Jose Stoute


Doctor Jose Stoute and his colleague Doctor Alfred Odindo are studying malaria's affect on the most vulnerable - young children.

"Children here are repeated exposed to one bout of malaria after another after another after another until they begin to develop immunity," says Stoute. "But in the meantime, they are susceptible to complications from those repeated attacks, and that's why children here have a high mortality from malaria. The reality is that it doesn't have to be that way."

Hospitals in Kenya can't begin to handle the burden of its malaria epidemic. As much as eighty-percent of the local population may be infected with malaria at any given time.


East Africa's Lake Victoria, which is shared by Tanzania, Uganda, and Kenya, this is one of the world's largest fresh water lakes. Its fertile waters sustain more than thirty million people. Each morning the villagers of Kombewa, a small fishing settlement in Kenya, prepare to work Lake Victoria's shallow but fertile waters.

As the men ready their nets and boats, the women sort through what's left of yesterday's catch. If the weather holds and they find the right feeding grounds, the fishermen could earn twice Kenya's average income for a day's labor. It almost seems like an idyllic way of life.

Fishing boat on Lake Voctoria

Fishing boat on Lake Voctoria


But this region is located in one of Africa's unhealthiest environments. Lake Victoria is the malaria capital of the world. Thirty five hundred children live in the village of Kombewa. Over six hundred will never see their fifth birthday. The towns along Lake Victoria are located on the equator; the weather is hot and steamy — the perfect breeding ground for the deadly Anopheles mosquito, the only carrier of malaria.

In this region, twenty-percent of children under the age of five die of malaria.

Little Yvonne Dhiambo is three years old and just recovering from her fourth bout with malaria. She still hasn't developed immunity to the disease. If she can survive a few more years she may be one of the lucky ones. In this region, twenty-percent of children under the age of five die of malaria.

Though the village of Kombewa has been hit hard by malaria the people are now faced with an equally dangerous threat. Although they appear calm, the men work with a sense of urgency. Raw sewage, over-fishing and agricultural run-off are slowly destroying the lake's ecosystem. Livelihoods and traditional lifestyles are threatened. Many are left with few choices but to abandon their ancestral fishing grounds and migrate to larger cities. Despite the optimism suggested by a soft-drink advertisement, reality here is harsh.

Local bus stations are jammed. Most are escaping from severe economic pressures. They bring with them all their possessions; very little is left behind — including the lethal malaria parasite. The most popular destination is only six hours away.

A crowded bus carries villagers to Nairobi

A crowded bus carries villagers to Nairobi


Once a small trading post in the middle of the grasslands, Nairobi is now a metropolis of over 2 million people. At first glance Kenya's capital seems like a prospering modern city.

Nairobi is ringed with impoverished shantytowns like Kibera. Over two hundred and fifty thousand migrants are crowded into less than two square miles. For those fleeing from the environmental and economic hardships of Lake Victoria, life here is even harder — unemployment is over eighty-percent — and nearly all live on less than $2 a day.

Once a small trading post in the middle of the grasslands, Nairobi is now a metropolis of over 2 million people.

With no sanitation facilities Kibera suffers from a variety of deadly infectious diseases. Even the act of collecting a few drops of tainted water is a daily struggle. Yet, until recently, Nairobi was malaria free. Today, it's hit the city with a vengeance — thousands of children are infected. The epicenter is Kibera.

Medical researchers Amy Korman and Juma Makasa are investigating the outbreak. The research team suspected that the massive migration from the countryside was linked to the spread of malaria.

And that is exactly what researchers discovered. The Anopheles mosquito was present in Nairobi because the environment was changing. Typical of many newly arrived slum dwellers, Paulina Karugo grows vegetables on a small plot of land behind her home.

Urban gardens are breeding grounds for mosquitoes.

Urban gardens are breeding grounds for mosquitoes

But in the process, she and hundreds of others have unknowingly created the perfect breeding ground for the Anopheles mosquito — a hot zone of infection.

The implications of what was discovered in Nairobi are significant; there is a definitive link between the spread of infectious disease and manmade changes to the environment. It's happening in Kenya and its happening in some of the most remote places on the planet.


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