Why are more children dying in Kenya?
There was good news yesterday from UNICEF, which reported that the number of deaths worldwide of children under 5 years old has dropped by more than one-quarter since 1990. The new estimates show a 28 percent decline in under-5 mortality, from 90 deaths per 1000 live births in 1990, to 65 in 2008.
That means that about 8.8 million kids died before their fifth birthdays last year -- still tragically too many, but the lowest figure on record, as The New York Times noted.
How did it happen? UNICEF attributes the gains to simple, cheap interventions: widespread immunization campaigns against measles and other diseases, mosquito nets to prevent malaria, Vitamin A supplements. A rise in breastfeeding has also helped prevent diseases from drinking dirty water.
One of the best stories comes from impoverished Malawi, which had one of the highest rates of child mortality in the world. In 1990, one in five Malawian children didn't make it to their fifth birthday. Today that number has nearly halved.The news isn't all good, however. In four countries, all in Africa, the under-5 mortality rate went up. Two are Chad and Congo, conflict-ridden and desperately poor places where governments provide almost no services and aid agencies struggle to keep up. A third is South Africa, which has a gigantic AIDS crisis fueled by a government that long denied HIV was a problem.
The fourth laggard, however, might surprise you. It's Kenya.
Why is Kenya on a list with war zones and derelict governments? One of the largest UN missions in the world is housed here, as is the largest US humanitarian office in sub-Saharan Africa. The political situation has deteriorated sharply, but even one year ago, according to statistics I compiled using a nifty tool on the UNICEF website, the child mortality figures here were depressing:
I haven't studied the issue enough to make more than a guess. But the answer has to lie somewhere between Nairobi's gleaming Westgate shopping center and the raggedy-clothed children who beg for pennies on the next block. There is plenty of money in Kenya, as the prices as Westgate's Benetton store will tell you. But the government seems utterly uninterested in the well being of its people, especially the poorest of the poor.
Yesterday the aid agency Oxfam released a damning report on urban poverty in Kenya. Nairobi’s population is expected to double to 6 million by 2025, yet three in five Nairobians live in slums, most without clean water or access to health care. "The Kenyan government has repeatedly ignored the growing magnitude of the urban crisis," Oxfam wrote.
Children in Nairobi slums are now some of the least healthy in the country. In some parts of the city, infant mortality rates are double those of poor rural areas, and half of young children suffer from acute respiratory infections and stunted growth. Acute child malnutrition is a growing concern.
Plenty of cities in the world face massive inequality. Kenya's problems are not unique. Yet the country is moving backward compared with its poorer African neighbors. The fact that more children die in Kenya today than do in Tanzania, Ethiopia and impoverished Malawi is a stunning thing to contemplate.