| This study examines the existing environmental sanitation infrastructure and how it affects the lives of different populations in the slums of Kibera, Kenya. Specifically, the study looks at Kibera's existing water and waste disposal infrastructure and considers how current conditions shape sanitary behaviors, patterns of disease, health care and health seeking behavior. The study is based on in-depth interviews with 41 informants, including Kibera residents, clinicians working in Kibera, local leaders, and representatives from active community organizations. In addition, data was gathered through direct and participant observation, personal investigation of conditions, and behaviors reported by informants. The following conclusions are based on these investigations.;Water and waste disposal. (1) Existing toilets and washing facilities fall short of current sanitation needs. (2) Facilities are controlled by building owners or private micro entrepreneurs and are expensive for many residents to purchase. (3) Facilities are generally located outside the home and are poorly maintained thus insecure and dangerous for weaker members of society to use. (4) Responsibility for cleaning facilities and disposing of waste is unclearly defined. (5) Lack of proper cleaning poses a significant environmental blight and hazard to public health. (6) The detrimental impact of poor toilet facilities falls disproportionately on women and children.;Hygienic behavior. (1) Lack of water, soap, and toilets makes proper hygiene, such as hand washing and bathing impossible. (2) Poor hygiene results in food contamination and pest infestations. (3) Poor hygiene contributes to the spread of diseases such as diarrhea, scabies, malaria, and typhoid that affect the residents.;Health care and health seeking behavior. (1) Lack of money, rather than lack of knowledge about symptoms and diseases, deterred the majority of the population from using the biomedical facilities available in the slums and in the Central Business District. (2) The majority of people sought treatment through traditional, alternative healthcare, medicines offered by vendors on the streets, and through spiritual and traditional healers. (3) Biomedical facilities were few and privately owned. (4) Biomedical facilities treated more children than adults and more females than males. |
