Economic Impact of COVID-19 on elderly, needy with HIV positive status

By Tebby Otieno

“I can go for ARV drugs but I don’t even have food to eat before I take them and you know they are very powerful” Narrates an elderly woman.     

Mumbi Kamau (Not her real name), 59, has called Korogocho slums in Nairobi, her home since 1978. She faces water shortages, and is in this congested slum where observing social distancing, as advised by scientists in the effort to prevent the spread of COVID-19 pandemic, is difficult.

Mumbi used to collect old used hair weaves at the dumping site in a market near her home. She would wash them, comb them out nicely and resale to various saloonists in her neighbourhood. 

This stopped following a road accident she was involved in. On 26 June 2020, she took a motorcycle home from the market. The motorcyclist lost control and landed in a nearby bridge. 

She was later rescued by other motorcyclists who accompanied her to a health facility. She is currently in her house nursing leg wounds and other injuries sustained from the accident.

 “I used to make KShs 200 per day from the sales of old weaves, each package at twenty shillings. I can’t go look for that hair anymore.  I am now thinking of what I can do next,” she says.

At 59 she is among the elderly in the community and this makes her more susceptible for catching the coronavirus disease.

“My five children have even more problems than myself. At this point my grandchildren would be going to class but with coronavirus they have started doing casual jobs to help their mothers,” she laments. 

Mumbi’s children wash clothes for people but with coronavirus this is not acceptable.

She has been on Antiretroviral (ARVs.) which she picks from a nearby health centre. The drugs, according to her, affect her health especially with the increasing COVID-19 cases being reported in Kenya, which she says she fears most whenever she is to be in public.

She is now calling on the government, through the Ministry of Labour, to consider her in the Inua Jamii package set aside to cushion the most vulnerable people from the COVID-19 pandemic in Kenya.

Korogocho informal settlement where she stays is highly populated, with a majority of residents here depending on nearby factories or casual jobs, as a source of income. A resident who identified himself to me as Uncle, says there is a lot of unanswered questions about COVID-19 cases in the area

“We need the Ministry of Health to break cases of coronavirus to villages, like now we hear there are cases in our Sub County but we don’t know whether those are positive within this particular village. If you look around, people are going on with their normal lives, face masks are worn because of police officers, some don’t put them on at all, we are so crowded, no social distancing. Factories are testing employees, what will happen when they find me positive and everyone in my family depends on me,” asks Uncle.

Youth make up a majority of Kenya’s population and have been asked to observe health measures put in place to control spread of COVID-19. Like Uncle, many do not think they will catch COVID-19 because they are young and healthy. Uncle adds that he does not trust the government.

Findings of a study on age dependence in susceptibility and clinical fraction published on 16 June 2020 by Nature Medicine, indicates that cities with younger populations are expected to show fewer cases of COVID-19 than cities with older populations depending on all cities having the same age-dependent clinical fraction. 

Findings however, indicate that the relationship between age and clinical symptoms could differ across settings because of a different distribution of comorbidities or setting-specific comorbidities such as human immunodeficiency virus (HIV)

Alfred Nandwa, a health worker in Nairobi explains why the elderly and those with other underlying health conditions are more susceptible to COVID-19 disease

“Most of the elderly people’s immunity system is compromised due to age so in that case you find most of time they are very vulnerable because their immune system is actually very low and weak, so they cannot withstand any infection. You know HIV what it does is to weaken immunity system, when immune system is weakened this person is very much vulnerable in that he/she is able to get any kind of infection. We find most people who are HIV positive their immune system is very low and in that case when they get any kind of infectious diseases or bacterial infections like Tuberculosis or this COVID-19 they are very much at a very high risk of being infected with this virus,” he noted.

The number of people staying in densely populated places living per square meter is high making it difficult to implement various preventive COVID-19 measures recommended by healthcare workers. 

Dr Ephantus Njagi says “The proper distance for you to protect yourself and the other person from COVID-19 is to stay six feet (Two meters) each away from the other person, there is a science behind that, if you are speaking or coughing the droplets cannot travel that much distance, that is why that distance is important.”

He also emphasizes on proper use of face masks and observing hygiene

“We should wear a mask because as you talk or breathe, it captures the droplets and they don’t travel that distance and if you happen it can also capture on top. The third one is cleaning the hands with soap and water. These three are very critical in ensuring that we do not move COVID-19 from one person to the other, wherever you stay, you should actually ensure that those three are actually applied.”

During the tenth Presidential address on the COVID-19 pandemic, on 27 July 2020, President Uhuru Kenyatta ordered and directed a nationwide curfew to remain in force for a further thirty days. There is to be no sale of alcoholic drinks and beverages in eateries and restaurants across the country for the next thirty days. President Kenyatta also ordered bars to remain closed until further notice, and asked citizens to continue wearing face masks and frequently wash their hands, in efforts to stop the spread of the virus.

“If a waiter in a restaurant is not complying with the health rules, speak up, report them, and even refuse them your business. Do your part knowing that it will keep you and your loved ones safer. The power is in your hands to save them. Wear a mask and wash your hands because you are a responsible and caring person, not because the government is telling you to do so,” said President Kenyatta.