Chased by hunger but battling obesity: Kenya’s hidden food crisis | Obesity

The kids from Bees Haven kindergarten are about 15 minutes into their weekly taekwondo class when their instructor has some harsh words for them. “You guys don’t yearn,” says Lizzanne Adhiambo, with a laugh. “I want to see the power!” Let’s get together! ”

In addition to a certain amount of confusion over left and right hands, Adhiambo’s students obey. With alternating arms they punch in front of them, 15 four- to six-year-olds, wearing white training uniforms, shouting “Yes!” because the teacher counts from 1 to 10.

“They love it so much,” says Beryl Itindi, principal of the pre-primary school in Syokimau, on the southwestern outskirts of Nairobi.

After class, the children sit down for lunch of beef stew, leafy vegetables, ugali – cornmeal – and fresh fruit. “Thank you for our food and our many blessings,” they will chorus. “Amen.”

These children are at the forefront of new efforts to increase lifelong exercise and healthy eating habits – and to ward off an increasingly visible enemy in Kenya’s cities and towns: obesity.

Children participate in a taekwondo class
Kindergarten emphasizes the importance of exercise and healthy eating. Photo: Brian Otieno / The Guardian

As in much of Africa, the number of people classified as obese in Kenya is rising: by 2030, the World Atlas of Obesity says 1.4 million five- to 19-year-olds will be obese. World Health Organization considers a person with a body mass index (BMI) above 25 to be overweight, while a BMI above 30 is obese.

A 2015 survey – the most recent conducted – found 20% of Kenyan men and more than 50% of women were or overweight or obese.

Quick Guide

A common condition


The number of human non-infectious diseases (NCDs) is huge and rising. These diseases end the lives of about 41 million of the 56 million people who die each year – and three-quarters of them are in the developing world.

MKJ is just that; unlike, for example, a virus, they cannot be caught. Instead, they are caused by a combination of genetic, physiological, environmental, and behavioral factors. The main types are cancer, chronic respiratory disease, diabetes and cardiovascular disease – heart attacks and strokes. About 80% are preventable, and all are increasing, spreading steadily around the world as aging populations and lifestyles driven by economic growth and urbanization make it a sick global phenomenon.

NCDs, once viewed as diseases of the rich, now hold the poor. Illness, disability and death are perfectly designed to create and widen inequality – and being poor is less likely to be diagnosed or treated accurately.

Investment to address these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is surprisingly high.

In low-income countries, NCDs – typically slow and debilitating diseases – see a fraction of the money needed to be invested or donated. Attention remains focused on traditional disease threats, yet cancer mortality rates have far exceeded the death toll from malaria, TB and HIV / AIDS combined.

A common condition is a new Guardian series reporting on NCDs in the developing world; their trope, the solutions, the causes and consequences, telling the stories of people living with these diseases.

Tracy McVeigh, editor

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In report last yearThe Kenyan government has recognized obesity as a major risk factor for non-communicable diseases (NCDs) such as diabetes and cancer, which cause 39% of deaths in Kenya – more than 27% in 2014.

“Statistics show that obesity is growing at a very alarming rate, not only in Kenya but in the region and the world,” says Stephen Kimutai Tanui., strategy manager for Welfare for Sizethe organization behind the taekwondo classes.

The education that the group gives to children was greatly lacking when Tanui, 32, was a child: “We were not told that physical activity has many benefits … not only to enjoyment and efficiency in school but to our health. “

In a country haunted by hunger and where more than three million people are classified as acute food insecure, the priority was to get enough food, regardless of its nutritional value, he says.

“When we were young, that link between good nutrition and good health was lacking,” Tanui says. “In Kenya and in most African countries, we have a problem with malnutrition, and everyone is focusing on that. People should have food, but we should also focus on getting good and healthy food, because the rates at which obesity is growing are going hand in hand: malnutrition and obesity. It’s a terrible burden. ”

Magdalene Wanjiru, a 46-year-old Kenyan woman, has her BMI calculated by a nurse during a check-up at Kenyatta National Hospital in Nairobi.
Magdalene Wanjiru has her BMI calculated by a nurse during a check-up at Kenyatta National Hospital in Nairobi. Photo: Benedicte Desrus / Alay

In parts of the rural north and east, the worst drought for 40 years is leading thousands of Kenyans from their homes. According to the International Federation of Red Cross, about 755,000 children under five will be acutely malnourished by 2022.

men Nairobi, where fast food chains such as KFC, Burger King and Domino’s stand at every other street corner, and billboards are pushing “enriched” chocolate drinks to motorists on the roads of Helema, the problem is “completely different,” says Dr. Davis Ombui. , diabetologist. “People come to work in the morning, go to the office, get back in their cars, go home. They don’t go to work that much, and fast food is a big deal in Nairobi now. ”

The result is clear at his private clinic surgeries. “We are seeing more and more young people being diagnosed at a younger age. Today I had someone who was 21. Type 2 diabetes. It’s all due to obesity; all because of the lifestyle. “

Last year the Ministry of Health published strategic plan respond to its “epidemiological transition” in disease burden of communicable diseases, such as malaria and tuberculosis, to the rising burden of NCDs. It has recognized obesity as a major risk factor, but doctors fear there is little concrete action.

“You may find that these policies are on paper,” Ombui says. “But no one translates that into action on earth. I am sure that if you go to the cabinet you will find really nice political documents that were sponsored by WHO and [other] organizations – just collecting dust. “

The health ministry was contacted for comment. The government’s goal is to reduce the obesity prevalence from 28% in 2020 to 26% in 2025, and the clock is ticking. By 2030, NCD deaths are expected to increase by 55%.

And there remains a lasting association in society between excess fat and material success.

Stephen Ogweno the CEO of Stowelink
Steven Ogweno, the CEO of Stowelinka youth-led enterprise aimed at combating NCDs. Photo: Brian Otieno / The Guardian

“You find young people in college will add weight and grow belly as a status symbol. It’s so bad, “says Stephen Ogweno, CEO of Stowelink, a youth-led enterprise aimed at combating NCDs. “It’s still this perception that needs to change.”

For wealthy Kenyans, Dr. Wyckliffe Kaisha has the answer. One of the few surgeons in the country to perform bariatric – or weight loss – surgery as a gastric bypass, he has seen a significant increase in patients, in part because of Covid-19, which has alerted more people to the consequences of obesity, diabetes and hypertension.

One of his patients, a 29-year-old woman who had a manic gastrectomy last year – involving the removal of part of her stomach – has no regrets.

“It requires someone to be psychologically and emotionally prepared because it’s not easy, especially if you’re used to taking a lot of rubbish. [food]. I loved fries. I can’t stand the smell of fries right now, ”she says.

Fast food restaurant in Nairobi, Kenya.
In urban areas such as Nairobi, fast food is becoming increasingly popular. Photo: Brian Otieno / The Guardian

The woman, who does not want her name published, says she has lost 40 kg: “At least now I can go upstairs. I don’t have to depend on elevators.”

Bariatric surgery has its criticisms, but Kaisha insists it is beneficial for the vast majority. His bugbear is with insurers who refuse to cover the procedure, meaning only the rich can pay their $ 5,000 charges.

He told insurers that bariatric surgery is cost-effective because it prevents the development of conditions. “They still reject it and say it’s cosmetic surgery. But it’s not at all,” he says.

TThe village of Njathaini, on the northern outskirts of Nairobi, is a world away from Kaisha’s clientele. With high unemployment and low disposable income, it is in such places that intervention is urgent, says Ogweno.

Thanks to genetics, diet and lack of exercise, Ogweno, 26, once weighed in at almost 20 years old. Driven by a desire to “look like Dwayne ‘The Rock’ Johnson” he lost weight in college and competed in Mr Fitness competitions.

He wants to prove that obesity, diabetes and cancer not only affect “the elderly and the rich”. What he and his colleagues found in Njathaini shocked them: “[This is] a very low-income community, and almost 70% of the households here live with diabetes or hypertension, ”says Ogweno, sitting in the village chief’s office.

Pasta is sold at a nearby store.
In low-income areas, cheap foods and snacks are loaded with carbohydrates and fats – healthier choices are more expensive. Photo: Brian Otieno / The Guardian

Traditional diets in slums rely heavily on carbohydrates and cooking fat with dizzyingly high levels of trans fats, known to increase the risk of heart disease. At one Njathaini shop, you can buy cabbage for 70 shillings (50p). At another, a few doors down, are bags of parcels for 20 shillings, and fried breads are 10 shillings.

Then there is the sugar. “Non-alcohol is more available than clean water,” says Ogweno. The shops are fully stocked with carbonated drinks, and buckwheat advertising Sprite, Coca-Cola and Fanta, as well as water, greets every customer.

Francis Njuguna, community health worker
Francis Njuguna, a community health worker, advises local people on growing vegetables. Photo: Brian Otieno / The Guardian

Francis Njuguna, a community health worker, was born and raised in Njathaini. “It simply came to our notice then [obesity] it was a non-issue. There were very few cases. But there are a lot of people nowadays, ”he says.

Working with Stowelink, Njuguna advises local people on growing vegetables as well as other cash crops. “Kale, tomatoes, onions, spinach” are all possible, he says.

The worst aspect, Ogweno says, is that once people are diagnosed with conditions associated with obesity, they struggle to get treatment.

“If you are not formally employed… you are almost always not covered [by national health insurance] and if you’re sick you have to pay out of pocket, ”he says. This is true, for example, of insulin for diabetes. “People literally have to gather the whole village to contribute cash to later go and do that because otherwise it’s a death sentence.”

Ogweno, whose aunt died of diabetes after seeking help from a traditional healer, feels the government is moving, slowly and slowly, to take NCDs seriously.

For the time being, then, the children of Bees Haven are forging the way. After their training, the kindergarten martial artists eat their lunch enthusiastically – even the managu greens. Often the children arrive quite timid, says Itindi, the director, and the exercise “really opens them up both mentally and physically.”

Students at Bees Haven Kindergarten are eating a healthy lunch.
Students at Bees Haven Kindergarten are eating a healthy lunch. Photo: Brian Otieno / The Guardian

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