Tropical Health Matters

Last month we shared the reaction of Kenyans and the international community to the newly passed “media bill that journalists say will curtail press freedom (BBC).”  The BBC reported yesterday that President Kabaki has now signed the bill and quoted him as saying that the bill will “safeguard our culture, moral values and nationhood.” Most observers fear the bill will serve as a gag to prevent the press from holding government accountable.

According to the Daily Nation (Nairobi), media advocates promised that, “the media would move to court to oppose the constitutionality of the new law and ensure that freedom of the Press is upheld.” They also made it clear that, “The media would not allow the Government to infringe on its independence and vowed to fight on until it is changed.”

Government is not unanimous on this issue. Although Parliament passed the Bill, the Nation notes that, “The Parliamentary Committee on Communications is going to come up with supplementary amendments on the offensive sections of the signed Bill once Parliament reconvenes, said its chairman, Mr James Rege on Friday.” Another angle is internal government “lack of harmony in the sharing of executive authority between President Kibaki and Prime Minister Raila Odinga, who had opposed the Bill.”

One area where government needs to be held accountable is Global Fund support. The Principle Recipient for existing malaria grants is the Ministry of Finance and the sub-recipient is the Ministry of Health.  According to the most recent Round 4 Progress Report (August 2008), Kenya is not performing well in the area of malaria treatment. What if the Kenyan media were to publicize these readily available results to encourage better grant performance? Would bringing such problems into the public forum and investigating reasons for poor performance be seen by government as a threat to the “culture”?

Ensuring that malaria interventions reach all in need requires an open and accountable process.  Will the media in Kenya be able to promote this process?

The growing problem of urban hunger and urban food insecurity was featured in the Wall Street Journal today. In Monrovia, Liberia, “The cost of a cup of rice has risen to nearly 50 cents from 20 cents, a huge leap for many families who live on less than $1 per day.” The result: “Escalating hunger in African cities is forcing aid agencies accustomed to tackling food shortages in rural areas to scramble for strategies to address the more complex hunger problems in sprawling slums.”

One of these strategies, according to IDRC is urban agriculture:

Urban agriculture (UA) is wrongly considered an oxymoron. Despite its critical role in producing food for city dwellers around the world, urban food production has largely been ignored by scholars and agricultural planners; government officials and policymakers at best dismiss the activity as peripheral and at worst burn crops and evict farmers, claiming that urban farms are not only unsightly but also promote pollution and illness. Contradicting this image, recent studies document the commercial value of food produced in the urban area while underscoring the importance of urban farming as a survival strategy among the urban poor, especially women heads of households.

Urban farming requires water. The International Water Management Institute reports that, “Manual water fetching with watering cans is most common.” They often get water from “polluted streams or they do farming along storm water drains and gutters.” This sometimes leads to “wastewater irrigation.”

Of course malaria vectors need water. In urban Accra, Ghana, Klinkenberg and collaegues found that Anopheles and Culex “outdoor biting rates were respectively three and four times higher in areas around agricultural sites (UA) than in areas far from agriculture.”

The solution to the problem of urban malaria is not to stop urban agriculture, but to intensify integrated vector management interventions.  We certainly don’t want to protect people from malaria and then have then suffer from food insecurity.