More than 1.5 million people work in Nairobi but live in the neighbouring counties, according to 2019 data.
A good number of them commute from Athi River in Machakos where a booming real estate market, especially affordable middle-class apartments, has attracted many.
And so, in 2017, Charity and her husband could not resist an offer to own a three-bedroom apartment selling at Sh2.9 million.
“It was a deal; the kind that wouldn’t make you think twice. Typically, similar apartments went for Sh6.5 million at the cheapest,” she says.
The couple and their son moved into their house in Great Wall Gardens 1, off Shanghai Road, in October 2020. The family would later get two more babies; a girl and a boy.
All was well until January. The three-year-old girl developed respiratory complications that warranted a visit to the hospital.
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“It started off as a flu, running nose, watery eyes, wheezing and a cough. Then she became feverish and was struggling to breath. So, we took her to a children’s hospital in Kitengela.”
Endless hospital visits
She would be back in hospital again – within seven days – with the same symptoms.
When the problem could not go away, Charity the decided to consult a paediatrician. The doctor diagnosed the girl with broncho-pneumonia.
Within three weeks, she was admitted twice. The illness just wasn’t going away. “More tests showed that she still had pneumonia. On the second admission, I was told about 70 per cent of her lungs were clocked with mucus,” she recalls.
The little girl was scheduled for manual evacuation of the lungs – twice every day. She was also put on strong antibiotics, and stayed in hospital from March 8 to March 18.
But two days later, Charity was back at the same hospital with her youngest baby, just a few months old, who had similar symptoms.
One of the things that Charity would quickly learn about her new home area was a regular attack by a putrid smell.
“The smell often came alive at night. The very first time I smelled it I thought it was something in the house – like a leaky gas cylinder. I went out of the house to check for fresh air. I realised the smell was everywhere.”
Upon inquiry from neighbours who had been living in the estate before her, Charity was told about a long-drawn battle between Great Wall Gardens and a manufacturing company nearby, which the residents accuse of discharging toxic effluents.
Dr Warurua Mugo, a paediatrician who handled Charity’s daughter, says air pollution causes inflammations in the respiratory system, making the affected area susceptible to infections.
“Therefore children – and adults too – who live in an environment with high air pollution have higher risk of developing respiratory infections such as pneumonia,” he cautions.
Asthma attack
A few kilometres from Great Wall Gardens in Sabaki, Jennifer Mbuvi lives in a house she moved into in 2012. Since then, she has had surgery to remove pterygiums – fleshy overgrowths of the conjunctiva of the eye.
Jennifer is on inhalers and drugs that mitigate against asthma. Sometimes she goes for an injection that lasts her three months.
The National Environment Management Authority (Nema) says their mobile air quality laboratory needs to give accurate results.
“To get reliable data on air quality you have to monitor every day for at least one year – covering all seasons within the 12 months,” says Selelah Okoth, head of air quality section.
The agency has not yet collected such data.
Catherine Mutanu, the Water, Irrigation, Sanitation, Environment and Climate Change CEC in Machakos County, says her department does not have the tools to proactively conduct tests.
“We respond to an issue when members of the public call in to report a case,” she says.
Code for Africa, a network of civic technology and data journalism labs, has had air quality sensors in Sabaki area of Athi River at different times. The sensors capture and relay data every day, analysing the average concentrations of particulate matter (PM) with different diameters.
Dr James Mwitari, Director and Principle Investigator at Air Pollution Centre of Excellence domiciled at the Kenya Medical Research Institute, says of all particulate matter, PM2.5 is the one that should worry residents the most.
“This type of suspended particulate matter is the most dangerous to human health. PM2.5 is very fine and can be absorbed directly into the bloodstream.
“In the blood stream they can move to major organs such as kidneys, heart and pancreas, lodge there, and cause illnesses such as neurological problems, heart conditions, diabetes, lung function, cancer and so on,” he says.
Victor Nthusi, a researcher with Health Effects Institute, a US-based NGO, says air pollution short term effects include asthma, pneumonia, bronchitis and upper respiratory tract infections.
Slow killer
He warns that long term effects “don’t kill you immediately but they incredibly reduce life expectancy.”
“They include illnesses like lung cancer and chronic obstructive pulmonary disease (COPD),” he says.
Dr Andrew Owuor of the Kenyatta National Hospital is not shocked about the story of Charity and Jennifer.
“That’s how pollution affects the respiratory system. To be sure, actual disease is caused by pathogens such as viruses and bacteria.
“What the pollution does is that it causes inflammation, which then make the respiratory tract exposed to the pathogens,” he says.
According to 2023 health records, 27.4 per cent of cases treated at the Athi River Level Four Hospital were on respiratory tract illnesses, compared to 25.6 per cent nationally.
[This story was produced as part of Internews’ Earth Journalism Network’s 2024 Reporting Fellowship]