The children at Bees Haven Kindergarten are about 15 minutes away from their weekly taekwondo class when their instructor has some harsh words for them. “You’re not panting,” Lizzanne Adhiambo says, with a smile. “I want to see power! Let’s punch!”
Aside from some confusion on the left and right hands, Adhiambo’s students obey. With their arms outstretched, they beat in front of them, 15 children aged four to six, dressed in white training uniforms, shouting “Yes!” since the teacher counts from 1 to 10.
“They really like it,” says Beryl Itindi, principal of the Syokimau School of Early Childhood Education on the southwestern outskirts of Nairobi.
After class, the children sit down to lunch with beef stew, green leafy vegetables, ugali (cornmeal porridge) and fresh fruit. “Thank you for our food and our many blessings,” they say. “Amen.”
These children are at the forefront of new efforts to promote lifelong exercise and healthy eating habits, and to prevent an increasingly visible enemy in Kenya’s cities: obesity.
The nursery emphasizes the importance of exercise and healthy eating. Photography: Brian Otieno / The Guardian
Like much of Africa, the number of people classified as obese in Kenya is rising: by 2030, the World Obesity Atlas says 1.4 million young people aged five to 19 will be obese. The WHO 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, found that 20% of Kenyan men and more than 50% of women were overweight or obese.
Quick guide
A common condition
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The human number of noncommunicable diseases (NCDs) is huge and increasing. These diseases end the lives of approximately 41 million of the 56 million people who die each year, and three-quarters of them are in the developing world.
MNTs are just that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental, and behavioral factors. The main types are cancers, chronic respiratory diseases, diabetes and cardiovascular diseases: heart attacks and strokes. Approximately 80% can be prevented, and all are on the rise, spreading inexorably around the world as the aging population and lifestyles driven by economic growth and urbanization make it unhealthy to be a global phenomenon.
NCDs, once considered the disease of the rich, now have control over the poor. Illness, disability, and death are perfectly designed to create and expand inequality, and being poor makes you less likely to be accurately diagnosed or treated.
The investment to deal with 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, non-communicable diseases (usually slow and debilitating illnesses) are being invested or given a fraction of the money needed. Care continues to focus on traditional disease threats, but cancer mortality rates have long outpaced the number of deaths from malaria, tuberculosis and HIV / AIDS combined.
A Common Condition is a new Guardian series that reports on NCDs in the developing world; its prevalence, solutions, causes and consequences, telling stories of people living with these diseases.
Tracy McVeigh, editor
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In a report last year, the Kenyan government recognized obesity as a major risk factor for noncommunicable diseases (NCDs) such as diabetes and cancer, which are responsible for 39% of deaths in Kenya. , 27% more than in 2014.
“Statistics show that obesity is growing at a very alarming rate, not just in Kenya, but in the region and around the world,” said Stephen Kimutai Tanui, director of strategy for Wellness for Greatness, the organization behind taekwondo classes.
The education that the group is giving to the children was greatly missed when Tanui, 32, was a child: “We were not told that physical activity has many benefits … not only for enjoyment and performance in the ‘school, but for our health’.
In a country plagued by hunger and where more than three million people are classified as acute food insecurity, the priority was to get enough food, regardless of its nutritional value, he says.
“When we were young, we lacked that link between good nutrition and good health,” Tanui says. “In Kenya and most African countries we have a problem of malnutrition, and that is what everyone is focusing on. People should have food, but we should also focus on getting good, healthy foods, because the pace at which obesity grows goes hand in hand: malnutrition and obesity. It’s a terrible burden. “
Magdalene Wanjiru has her BMI calculated by a nutritionist during a check-up at Kairatta National Hospital in Nairobi Photo: Benedicte Desrus / Alamy
In parts of the north and rural east, the worst drought in 40 years is driving thousands of Kenyans out of their homes. According to the International Federation of Red Cross, approximately 755,000 children under the age of five will suffer from acute malnutrition in 2022.
In Nairobi, where fast food chains such as KFC, Burger King and Domino’s are on every street corner, and billboards distribute “vitamin-enriched” chocolate drinks to motorists on busy roads, the problem is “completely different.” , says Dr. Davis Ombui. , a diabetologist. “People get to work in the morning, go into the office, get back in their cars, go home. They don’t walk so much to work, and fast food is now an important thing in Nairobi.”
The result is clear in your private clinic consultations. “We are seeing more and more young people being diagnosed at a younger age. Today I had someone who was 21 years old. Type 2 diabetes. It’s all due to obesity; all for the lifestyle. “
Last year, the health ministry released a strategic plan to respond to its “epidemiological transition” in the disease burden of communicable diseases, such as malaria and tuberculosis, to the growing burden of NCDs. He acknowledged obesity as a major risk factor, but doctors fear there will be little concrete action.
“You may find that these policies are there on paper,” Ombui says. “But no one is translating this into action on the ground. I am sure that if you go to the cabinet you will find very nice political documents that were sponsored by the WHO and [other] organizations, just collecting dust. “
He approached the health ministry for comment. The government’s goal is to reduce the prevalence of obesity from 28% in 2020 to 26% in 2025, and the clock is ticking. By 2030, deaths from NCDs are expected to increase by 55%.
And there is still a persistent association in society between excess fat and material success.
Steven Ogweno, CEO of Stowelink, a youth-run company dedicated to fighting ENT. Photography: Brian Otieno / The Guardian
“You find that young people in college want to gain weight and grow a belly as a status symbol. It’s so bad,” says Stephen Ogweno, CEO of Stowelink, a youth-run company that aims to combat NCDs. . “There is still this perception that needs to change.”
For wealthy Kenyans, Dr. Wyckliffe Kaisha has the answer. One of the few surgeons in the country who has performed bariatric surgery – or weight loss – such as gastric bypass, has seen a significant increase in patients, in part due to Covid-19, which alerted more people to the ramifications of obesity, diabetes and hypertension.
One of her patients, a 29-year-old girl who underwent a sleeve gastrectomy last year, which involved removing a part of her stomach, does not regret it.
“It requires someone to be psychologically and emotionally prepared because it’s not easy, especially if you’re used to getting a lot of junk. [food]. I loved the chips. Today I can’t stand the smell of french fries, ”he says.
In urban areas like Nairobi, fast food is becoming more popular. Photography: 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 up the stairs. I don’t have to depend on elevators. “
Bariatric surgery has its critics, but Kaisha insists it is beneficial for the vast majority. His mistake is with the insurers, who refuse to cover the procedure, which means that only the rich can pay their $ 5,000 charges.
He told insurers that bariatric surgery is cost-effective because it prevents conditions from developing. “They still reject it and say it’s cosmetic surgery. But it’s not at all,” he says.
The village of Njathaini, on the northern outskirts of Nairobi, is a world away from Kaisha’s clientele. With high unemployment and low incomes available, it is in places like this where it is urgent to intervene, says Ogweno.
Thanks to genetics, diet and lack of exercise, Ogweno, 26, weighed nearly 20 years. Driven by wanting to “look like Dwayne ‘The Rock’ Johnson”, he lost weight in college and competed in Mr Fitness competitions.
He wants to show that obesity, diabetes and cancer don’t just affect “the old and the rich.” What he and his colleagues found in Njathaini surprised them: “[This is] a very low-income community, and almost 70% of households here live with diabetes or hypertension, ”says Ogweno, sitting in the village chief’s office.
In low-income areas, cheap food and snacks are loaded with carbohydrates and fats; healthier options are more expensive. Photography: Brian Otieno / The Guardian
Traditional diets in slums depend heavily on carbohydrates and cooking fats with dizzyingly high levels of trans fats, which are known to increase the risk of heart disease. In a Njathaini shop, you can buy cabbage for 70 shillings (50 p.). In another, a few doors down, there are bags of fries for 20 shillings, and the fried buns are for 10 shillings.
Then there is the sugar. “Soft drinks are more available than clean water,” says Ogweno. The shops are fully stocked with soft drinks, and Sprite, Coca Cola and Fanta advertisements, as well as water, greet all customers.
Francis Njuguna, a …