A beautiful use of shipping containers is visible in a range of forms across Kenya. Whether stationary as small shops that generate street life or as storage space, these micro interventions are being explored as opportunities for a kind of urbanism. 

Image © inABLE

Every day in Mathare Valley, inhabitants gather from many homesteads to create one lively triangular forum underneath an aluminium canopy. Most of them are single mothers with children. They come here to the German Doctors to receive counselling about preventative and curative measures of common health conditions in their community. 

Image © German Doctors Nairobi

This building is the Comprehensive Care Clinic (CCC) dedicated to one of three programs of the mission in Mathare, the German Doctors Nairobi receive members of the community afflicted by HIV/AIDS. The center began to operation in 2001 with the provision of VCT – services for HIV/AIDS patients and has evolved to specialize in outpatient care for the cases it handles.

Mathare Valley is Nairobi’s second largest slum. It is located in the Northeast of Nairobi, home to approximately 443,000 people in 139,000 households, according to the German Doctors. One household is defined as a group of persons sharing the same income sources and eating together. Beginning in 1997, the German Doctors and the community of this city settlement have pursued the goal of creating an environment for prevention and awareness for healthy living. Three centers running one program each – the nutrition center, general health center, comprehensive care center – are key to their strategy. Together with local staff, more than 600 patients can be consulted every single day.

Image © German Doctors Nairobi

Mathare is not different from other slum settlements in Nairobi. Like in Mukuru Slum, where we learned about a social movement of youth who narrate their everyday life through film, there is severely limited to, or no access, basic services like potable water, electricity and waste disposal. It has experienced moments of serious violence in its history.

Image © Mathare Valley

Beyond their grass-roots involvement, the German Doctors have observed that on all levels – social, political, economic – the slum population has been left behind with no perspectives. Insufficient hygiene and sanitation facilities continue to be the main vulnerability factors. Coping with strategies, such as prostitution, criminality, or brewing of alcoholic beverages, are widespread. Many single mothers are forced to practice prostitution as the main source of income with the accompanying high risk of getting and spreading HIV/AIDS.

Image © German Doctors Nairobi

Armed with the best practices in healthcare, the main focus of the project is the treatment of patients with AIDS as well as a feeding program to combat child mortality. Indeed, social cases of single mothers and children make up the most vulnerable social categories. 

In conversation with Samira Hussein, a dietary nutrition specialist who has worked with German Doctors more than 6 years, she explained how they achieve their goal of sustainable change in their pateints' lifestyle. 

"We ensure correct infant and young child feeding practices are emphasized from child birth on. To simplify the implementation of healthy child practices, mothers are taught and demonstrated proper positioning and attachment of the child during breastfeeding and attend cooking lessons using locally available and affordable foods. We also educate community health volunteers to bolster care at the home," said Samira Hussein.

Image © German Doctors Nairobi

The Nutrition Centre has made an effective guarantee in keeping HIV and TB patients on treatment. In addition, it has helped to prevent adverse effects of malnutrition. Change is taking place because of commitment of the community with consistent support of partner organizations who include Concern worldwide, World Food Programme and UNICEF.

Image © German Doctors Nairobi

The productive journey of the people hand in hand with their friends echo a sentiment in the words of French author Paul Bourget who wrote that, "the simple power of necessity is to a certain degree a principle of beauty." Such an initiative as this is and will remain testimonial that invisible change is often more lasting than what’s visible.

Top image: Mrima Health Center in Likoni, Kenya. Image © Yann Libessart/MSF

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