Urban morphology, infrastructure and health in Nairobi, Kenya

Akuto Akpedze Konou (AAK): What is the theme of your research and what is the framework of the project?

Vitor Pessoa Colombo (VPC): The project aims to assess the impact of urban morphology and the distribution of certain infrastructures on the risk of diarrheal diseases, such as cholera or dysentery. The aim is to understand how the design of the built environment and its infrastructures can influence the incidence of these diseases, in the context of precarious and largely "informal" urban areas. For example, a better understanding of the impact of urban morphology on the use and quality of basic services, such as water and sanitation, is needed to make urban planning more relevant to the most vulnerable areas. At the same time, the notion of accessibility to services needs to be nuanced. Thus, the project also aims to understand the extent to which geographical distance is a determinant in the user's choice, particularly with regard to the choice of health services.

AAK: When did your fieldwork take place?

VPC: I traveled to Nairobi for almost three months, between June and August 2021. The purpose of the fieldwork was to conduct household surveys with people residing in two communities ("villages") located in the Mathare and Mukuru areas. These two communities were chosen because they are precarious neighborhoods with very heterogeneous levels of access to basic services. Also, these two neighborhoods present a very different urban typology (determined by the shape of the built environment).

AAK: Did you have any help in the field?

VPC: In the field, I was able to rely on a team of 18 young interviewers, all of whom were graduates in public health and at the time were doing an internship with Nairobi Metropolitan Services (NMS). These interviewers were trained on-site to conduct household surveys using the KoboCollect and OsmAnd applications.

The recruitment and organization of the fieldwork were done in close collaboration with our local scientific partners, based at the Kenya Medical Research Institute (KEMRI) and NMS. In addition to contributing to the quality of the study with their public health expertise, the scientific partners were essential in accessing the study communities and establishing a dialogue with local leaderships.

AAK: What exactly did the fieldwork consist of?

VPC: With the help of the above-mentioned partners, this fieldwork allowed the collection of geo-referenced data (with GPS location) on 1152 households. This data will be analyzed to understand the impacts of different environmental aspects on the risk of diarrheal diseases. This data will also be used to gain a more nuanced understanding of the accessibility of basic water, sanitation, and health facilities.

AAK: Were you able to achieve all the objectives of the trip?

VPC: With the completion of this data collection campaign, the objectives of the trip were indeed met. Above all, beyond the data itself, interpersonal links were consolidated at different levels: with the scientific partners, as well as with the assistants (interviewers) and residents of the studied neighborhoods. This opens doors for further studies in Nairobi on urbanization and health issues.

AAK: What personal conclusion do you draw from this experience in Nairobi?

VPC: From a personal point of view, it was very rewarding to coordinate such a diverse team, and in a context as complex as the neighborhoods chosen for the study. Nairobi is a seemingly difficult city: polluted, violent, and socially inequitable at first glance, yet it is home to the most well-intentioned people capable of changing the status quo. Faced with limited resources, solidarity often prevails as the only way out, while innovative solutions are emerging in several areas, including decentralized sanitation and water distribution systems managed by independent actors. In Nairobi, we find both the best and the worst of the human condition in the capitalist urbanization of the city.

AAK: Are there any preliminary results emerging from your data collection?

VPC: The data collected is currently being processed. Given the explicitly spatial dimension of the analyses, the results will be communicated widely in a cartographic format. For example, we will be able to see the distribution of diarrhea cases in the studied neighborhoods and compare them with various environmental aspects (proximity to waterways, topography, or entropy of buildings). Also, we will be able to visualize the routes from each household to the health service or toilet used by the habitat - and thus verify the importance of distance in the choice of these services.

AAK: What are the next steps?

VPC: The next steps are to publish these research results in Nairobi. The same fieldwork will be carried out in Abidjan in 2022, with the aim of comparing the results between two apparently very different cities: one located on a high plateau, resulting from the English colonization; the other located on the coast, resulting from the French colonization.

AAK: Thanks Vitor, and good luck with the next step!

VPC: Thanks Akuto!