As I admired an aerial shot of one of the billion-shilling road networks that the government is building, on Twitter, an email from the World Health Organisation popped up on my screen with a chilling message.
“One in five adults and one in 10 children and teenagers are projected to be obese by December 2023 in 10 high-burden African countries if no robust measures are taken to reverse the trends,” it read.
What a coincidence it was because I was thinking the elaborate roads ease movement, all right, but they also reduce Kenyans’ time for activities that keep obesity at bay like walking, cycling and running. The rapid population growth in cities does not help the situation either as space is axed out for housing and roads, leaving no space to walk. There are 5.1 million people in Nairobi now, up from 3.2 million in 2010.
When people walk, run or cycle less as they feed on unhealthy diets, they are not only likely to be overweight and obese but more predisposed to cardiovascular diseases, diabetes, muscle and skeletal disorders, and some types of cancer.
Covid-19 demonstrated how deadly obesity can be. Research published in the journal Obesity Reviews showed that people with obesity who contracted SARS-CoV-2 were 113 per cent more likely to land in the hospital than those who are not obese. Obese people, the report showed, are 74 per cent more likely to go to intensive care and 48 per cent more likely to die of Covid-19.
Obesity does not spare children and that is why Kenya’s 2016 Report Card on Physical Activity and the roads should concern us all. The report showed that one in two children (58 per cent) in Nairobi used buses or cars to get to school as compared to 87 per cent of their rural counterparts who walked or ran to school.
This can explain why young people in urban areas spend as little as only four minutes daily on rigorous physical activities such as running, while the World Health Organisation recommends 60 minutes.
As I looked at the picture, I resisted the temptation to urge people to shun cars and buses and rather walk, run or cycle. It is not as simple as asking people to walk more.
Infrastructure and policies should make it possible for them to lead healthy active lives, and this is where the government intervenes the same way it did when there were no roads. Leaders and the government need to put on their regulatory hat in different sectors to protect vulnerable populations.
The contractors and engineers who designed our roads had cars in their minds, not people. The roads lack pedestrian footpaths. I am yet to see cycling pathways in the design of these roads. Do not get me started on motorists’ reckless driving habits that have killed pedestrians and discourage those who would still want to overcome these structural challenges and try walking, jogging or cycling along our roads.
One of the solutions, according to Prof Christopher Murray, Director of the Institute for Health Metrics and Evaluation at the University of Washington, is “policy attention”.
It will cost the government very little time, money or resources if makes a policy that it will not approve or pay for the services of a contractor who has no footpaths or cycling lanes in their road designs. The government can also have incentives for people to leave their cars at home and walk or cycle.
I would imagine government intervention is what it took our neighbours in Rwanda to have such functional roads that also accommodate healthier lifestyles with walking and jogging paths.
The Netherlands built its road infrastructure around cycling. The BBC reported that the central station at Groningen has an underground car park for more than 10,000 bikes where cyclists can park their bicycles with electronic counters at the entrance registering how many spaces are available.
The cities have separate paths for cycling and cars. Where the cyclists and motorists have to share, the Dutch government has erected signs with the message 'Bike street: Cars are guests'. The Dutch experienced the results instantly. The country experienced fewer deaths in road accidents, as well as fewer cases of obesity.
Footpaths and cycling lanes will also cut costs tremendously for Kenya. When you have more people walking or cycling to work and other places, there is less congestion leading to less air pollution in our cities.
The 2020 State of the Global Air report showed that ambient air pollution was responsible for around 5,000 premature deaths in Kenya in 2019 alone. The 2017 Kenya Economic Survey reported that 19.9 million Kenyans suffered from respiratory ailments exacerbated by poor air quality.
We are going to vote in a few months. We can ask our leaders to support these simple interventions with high impact.
Medical doctor, public health specialist and Kenya country director for John Hopkins affiliate, Jhpiego
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