This is the latest part of the EQUALS #InequalityVirus mini-series, from what can only be described as the frontlines. A fascinating look into what coronavirus looks like from one of Africa’s biggest cities: Nairobi, Kenya. Max and Nabil speak to a doctor from a major hospital and a security guard who lives in one of Africa’s biggest slums about what they are seeing – and what must be done.

A healthcare worker

As the numbers rise in Kenya, Nabil asks his doctor friend (let’s call her Julie*) how it feels to be a doctor now. “…there is a lot of anxiety…we have been seeing what’s going on around the world. You are looking at nations that have really good healthcare and are struggling to cope and the numbers are insane. So, you’re obviously worried about what’s going to happen to the country…you’re worried about getting exposed at work. Are you going to get infected? Am I going to carry this home to my family? Is my safety assured? What happens if I get sick? Right now, I believe insurance companies aren’t covering your bills should you get infected, so that puts you in an interesting position as a healthcare worker. In private hospitals they have a fund that caters for it, but that is not the same case in public hospitals. As you’re working in the frontline, you have healthcare workers that are at risk. There are some that are getting infected, there are some that are potentially exposed.”

As it happens, Julie* is in quarantine after being exposed to a positive patient. Nabil asks how that’s going for her. Nabil also reflects on the fact that in addition to their being fewer healthcare workers than required, many are out of action, in quarantine. Julie* says, “it takes a toll on your mental health…you start imagining some symptoms. It is a very long two weeks, of staying at home trying to pray for the best. It also makes the anxiety worse, of going back to work. Once you’ve been through this, you honestly don’t want to have to go through it again.”

Nabil asks if people are covered by their health insurance should they get sick. “I don’t think that they are covered, it’s not clear. There are a lot of things that need to be clarified.”
How ready does the health system feel in Kenya? According to Julie*, “we’re in a country where our healthcare system was already struggling even before the crisis, especially the public system. You have ill-equipped hospitals, understaffing, so many problems. You have a lot of people who are dying over diseases that could have been better managed should there have been a better healthcare system. Now you add a crisis on to this. Honestly if the numbers were to increase, we won’t be able to cope. I have read somewhere that there are over 500 ICU beds, of which over 60% are in private hospitals which are not, obviously, accessible to every single person. You also have to remember that COVID-19 isn’t the only disease, so half of them are probably already occupied… I appreciate that the Government is trying to acquire ventilators and creating isolation beds, but it is not enough.”

Nabil wonders whether healthcare workers are well equipped with Personal Protective Equipment (PPE). “…it varies with the hospital and the counties. You will have places where in majority of the outpatient departments (Accident & Emergency), you will have at least most of the staff where a surgical mask, gloves. If you’re lucky, sometimes a gown. The N95 masks are used more sparingly because they are not as many… But you will also have facilities where they don’t even have surgical masks. The amount of PPE available is not balanced, there is shortage. We need a lot more. When you watch the news and see people with full suits, with the face shields and goggles, that’s not how we are in the outpatient departments. That is probably just in the isolation wards. So here it is almost a situation where you are trying to pick which patient looks relatively safe, that I can just see with a mask? Which patient do I need added protection? It is almost like a gamble when it shouldn’t be.”

Nabil asks about the risk in the slums, in informal settlements where social distancing isn’t possible, where water isn’t running for most days of the week. “in informal settlements, you step out of your house and you’re almost inside the next house. You have several people sharing a small room. People who have not had running water for the longest time. Now you are telling them, wash your hands every so often. These are things that should have been put in place way before a crisis. In these places, you will find something like cholera, which should have been eradicated a long time ago… You’re worried about an infection getting there because it is going to spread remarkably.”

So, are lessons being learned? “This pandemic has exposed what doctors have been fighting for for the longest time. We are constantly demanding for better hospitals, better staffing…better healthcare. It has not been a priority for our government but now you have a situation where the rich or the middle class can’t travel (abroad) to get better healthcare. We are all ‘confined’ in this space and we have to deal with what we’ve got. That has exposed how lacking our healthcare system is. I am hoping that that is a wake-up call so that at least more can be invested. This can be a chance to make things better for everyone.” What would Julie* say to world leaders who are really worried about the exceptional risk faced by developing countries? “We do not have enough doctors (yet) we have thousands of doctors that are unemployed. I believe we have 1 doctor to every 16,000 people. That is a little considering we have so many unemployed doctors. Secondly, they need to be adequately compensated. There are some in some counties, who are not being paid. Third, we need enough PPE throughout the country. We need better facilities. Additionally, we need to support Kenyan citizens in these harsh economic times. Lastly, a fund for healthcare workers that would ensure should one get infected or affected by this disease, they are taken care of. We are important as healthcare workers and we go down, it will be a problem for everyone.”

A security guard

Jacob is a resident in Kibera, one of Africa’s biggest slums. Max asks about food and water in Kibera, in the wake of COVID-19. “I can confirm we have a problem with food and a lot of problems with water.” Max wonders if they are struggling to get money to buy food. “Yes, we struggle…you have to pay rent and food (prices) have risen. You have to buy food for your family. If you don’t put food on the table, then you see when the disease comes, you’re weak. It can easily sweep you and your family.”
What are people more afraid of: hunger or the virus? “They are worried about hunger. If there is no food on the table, there is no way you can stay in the house and you have kids and they need food. You have to walk out and see how your kids can eat.” Considering the curfew in Kenya, Max asks how the police are handling it. He wonders if there is an apparent attitude towards poor people and whether the police are too violent. “Yes, (they’re too violent)…If you walk out, you meet with police, and they are there to beat you. You can see them walking with rungus (big sticks). They chase everyone, they beat everyone. You have to ask me where I am going. Maybe I am going to work. Before they ask me you that, they start beating you as if you have stolen someone’s property.”

How bad is the situation in Kibera? “I have lived in Kibera for 15 years, and I have never seen anything like this. During the Post-Election Violence (2007-2008), I saw people fighting and killing but this one, it is very bad. It is affecting everyone, every household.”

If Jacob was President, what would he do about the current situation? “the best thing the government can do for now, instead of taking food to Kibera where people are going to take the donations in large crowds, they can send money to our MPESA (accounts)”. Jacob suggests giving cash grants to the poor, as opposed to chaotic food donations. “You can bring food, but it may not reach everyone. For instance, I could choose to stay in my house instead of going there to get another problem. People are going there without masks. If someone is infected, how many people do you think will get infected tat day? They are many.”
What can the government do on the cost of housing? Jacob suggests a ban on evictions. “You get that a landlord comes to your house and removes the iron sheets (roof) or the door. How will you stay in that house? If the door is open, there are chances of small boys stealing from you. They are going hungry without food. They don’t go to work.”

Jacob is convinced crime rates will rise if the situation gets worse. “If I am not going to work, where do I get food? Where do I get the money to buy food.”

What is the justification for the increase in food prices? “These shopkeepers can raise the prices as they please. The government is supposed to control these people.”

Max asks what Jacob feels about the rich and their response to the virus. “I know we have rich people in our country. They could say, let us start donating an amount of money so that we can see how these people in the slum can get something to eat. They’re not doing that. They have decided to lock their houses and to chase their workers.” On the tax cut issued to the rich, Jacob asks, “my friend, do you think that will help (us)? It will not help anything. It cannot help the common mwananchi (citizen).”

What worries Jacob about the virus and healthcare in Kenya? “(if you don’t have insurance), you depend on your money. Many Kenyans do not have health insurance…” During this time, “anyone who is infected with the virus will be treated by the government, but the problem is food.”

To listen in, head on to #InequalityVirusFromKenyanFrontlines . If you have interesting angles you would want us to look into and discuss, please email Similarly, if you have any stories to share on this virus and how it impacts inequality from your personal experiences or what you are seeing around you, share your story at