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September 20, 2018

How the size of pavements can determine if you get diabetes

People walk on edge of the pavement along parliament road in  Nairobi after parliament put a cord along the perimeter fence barring pedestrians path putting their life in danger as they are forced to share road with speeding vehicles.pic\Charles Kimani
People walk on edge of the pavement along parliament road in Nairobi after parliament put a cord along the perimeter fence barring pedestrians path putting their life in danger as they are forced to share road with speeding vehicles.pic\Charles Kimani

When you hear matatu operators complaining about something, you know that likely someone has a good initiative to improve the quality of lives of Kenyans.

Perhaps the concern will be one of execution, that is, if the initiative will ever be carried out properly with the intended beneficiaries being the ones who benefit the most. There are three possible line of thought we could take on this.

The first is to be an absolute cynic and believe that nothing good can ever come out of any government initiative and that people are out to make deals out of everything and line their pockets. All they need is an intended target so as to avoid the tag that it was a plain robbery.

A second line is to imagine that there are good intentions, a few bad eggs, but mostly good people trying to do good, but unable to counter the forces of evil that are small but very powerful. As a result the only things that get done are the good ideas subverted by the bad people, because at least there is something in common that binds the good people and the bad people, a good idea.

The third way of thinking is to assume that people are good sometimes, bad at other times but often lack the knowledge, capacity, skills and motivation to carry out a project properly to the very end. In that mix a good idea often ends up being half done. In several towns including Nairobi, there is a good effort being done to build pavements for pedestrians.

This is nothing new. In years gone by tarmacked pavements existed, and towns were cleaner and safer. That is a long time ago, when towns were much smaller and people had a stronger sense of civic duty then they do today. Teachers were exalted as an important part of society rather than treated as an expensive nuisance, prone to disrupting development.

And teachers were proud to teach and taught. Still this effort to build pavements is to be lauded because two generations ago society was different and peoples’ health was also different. Forty years ago the major public health concerns malaria, diarrhoea, and childhood diseases like polio, diphtheria and measles. Today we have managed to contain immunizable diseases like polio, diphtheria, but still have a lot of malaria and diarrhoea. But added to this mix are HIV and AIDS; road traffic accidents and other injuries; and cancer, hypertension, cardiac disease and diabetes. Pavements take on new meaning given the changing profile of diseases in the country.

Most towns in Kenya are quite small. You can, at 3am drive round, within the speed limit, in minutes. What gives the illusion that out towns are big is often just the chaotic traffic coupled with a preference not to walk any length of distance. The addition of boda boda to the transport mix has enhanced the trend not to walk, despite the very high cost per kilometre of that form of transport.

The preference not to walk unless no otherwise, is logical for several reasons. The first is that it is often not safe, especially if you are carrying anything of value; your cell phone is but one example. The second is that walking to your destination and remaining clean has not been possible. You pick one or the other. If el-Niño is not there then the side of the road is likely to be very dusty, uneven so a risk of twisting your foot and not demarcated so what appears to be a footpath ends with you walking on the road, inhaling diesel fumes and watching for erratic vehicles; danger every way you look.

The rains remove the dust, but add mud. The third reason is Africans do not have a good societal time system. Because we are not well organized around a universal time such as a public transport schedule, we can chance it to catch a matatu anywhere at anytime. Under such circumstances why walk? A matatu will be by right now.

The new pavements being build are wide, mostly protected from the vehicular traffic and have bright security lights. And for now are being swept clean. In the some areas of Nairobi a few more people now jog in the early morning. Kids can walk from school a little safer. This should be encouraged as the addition of conditions like cancer, diabetes and hypertension are because of our lifestyles. A sedentary lifestyle, bed, vehicle, office, vehicle, couch, bed is over a period of fifteen to twenty years almost guaranteed to make the next 25 years of your life unhappy with many visits to the health facility. Even in the short term, fewer matatus and boda bodas mean less air pollution. Pavements around your house and workplace are one way that county governments can help reduce disease burden. It is very good, practical use of public resources.


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