COVID-19 Further Complicates Kenya’s Health Care System

Kenya is facing a double burden of communicable and noncommunicable diseases. Clustering of infections, such as HIV and tuberculosis, and noncommunicable diseases, such as diabetes and high blood pressure, renders Kenyans vulnerable to COVID-19. This has pressured an already overstretched health care system.

Hospital entrance sign in Kenya’s Rift Valley province. Melanie K Reed. CC BY-NC-ND 2.0

In mid-March, shortly after Kenya’s first confirmed COVID-19 case, the word “corona” began circulating around western Kenya’s villages. Young people used the word as a novelty, and the overall population remained preoccupied with existing illnesses. “This is a disease for whites,” said Sylvanus, a local father of seven. When calling after white people on the street, children replaced their traditional “mzungu!” (white person) with “coronavirus!” At this point, Europe was the pandemic’s epicenter. Kenyans felt that this foreign virus was removed from their world. 

However, Kenya’s high prevalence of preexisting health conditions renders a significant portion of the population immunocompromised and therefore vulnerable to the coronavirus. In a country experiencing health issues such as HIV, tuberculosis, diabetes and malaria, the pandemic has posed a threat to an already fragmented health care system. Although less than 4% of Africa’s population is over the age of 65, countries such as Kenya have seen high coronavirus mortality rates. 

Global evidence shows that people with underlying medical conditions are at a greater risk from COVID-19. In 2019, half a million Kenyans were living with diabetes, and over half of accounted deaths were associated with noncommunicable diseases. Currently, Kenya’s health care system is structured to manage individual diseases, rather than multiple ones. Because patients frequently carry more than one health condition, the health care system has been overstretched and inadequate. HIV, tuberculosis and malaria treatments are easily accessible, but noncommunicable diseases such as diabetes and cancer often go undiagnosed, and care is costly. The COVID-19 pandemic has exacerbated these shortcomings, as social distancing restrictions prevent Kenyans from accessing medical resources, and a surge of coronavirus cases imposes a double burden of disease. Additionally, front-line workers with undiagnosed, chronic illnesses have critically compromised their health, and hospitals have dealt with equipment shortages. 

Transcontinental travel has heavily contributed to the increase in COVID-19 cases across Africa. In order to minimize Kenya’s number of infections, President Uhuru Kenyatta stopped all flights from Europe. Kenyatta also imposed a national curfew and restricted movement between populated areas. Domestically, middle-class, urban dwellers have carried the virus into rural areas. On Kenyan television, villagers have urged educated, urban residents to remain in the city, instead of threatening the lives of others. 

In African countries, lockdowns are nearly impossible to implement because they would spur social and economic crises. Many people rely on cash earned daily to sustain themselves and their families. A strict lockdown would result in poverty and starvation. Kinship systems also play a crucial role in social welfare, as relatives care for one another. For people already barely getting by, cutting these social ties would be dangerous. Finally, a lockdown would interrupt the supply chains of essential drugs, preventing access to tuberculosis, HIV and malaria treatments. 

According to several African presidents, developed countries are failing to fulfill their pledges of financial support and debt relief. Throughout the pandemic, outside aid has not met the continent’s needs. While wealthy countries in the global north have funneled trillions of dollars into their own stimulus packages and health initiatives, the global south cannot afford such measures. With limited testing capacity, Africa has not confirmed many of the world’s COVID-19 cases, but the continent has been grossly affected by the economic crisis and global trade disruptions. Furthermore, the global shortage of testing kits, hygienic material and personal protective equipment has left developed countries vying for their own supplies, without consideration for underdeveloped nations. 

Anna Wood

is an Anthropology major and Global Health/Spanish double minor at Middlebury College. As an anthropology major with a focus in public health, she studies the intersection of health and sociocultural elements. She is also passionate about food systems and endurance sports.

Colorism Shows its Face through India’s Skin Whitening Creams

Since 1975, India has had a market advertising products that can achieve being “fair and lovely” by whitening the skin, but what effect has this had on Indian society?

People on the street in India. Craig J Bethany. CC BY-NC-SA 2.0.

On June 26, Unilever made the decision to remove the word “fair” from its whitening creams sold throughout India and parts of Asia. It is assumed that the decision to rename the product was due to the global response to the death of George Floyd and the rise of the Black Lives Matter movement in the United States. For Indians, skin lightening is a painful reminder of their colonized past.

Commercials for whitening creams have advertised the products as the solution to all of life’s troubles. Along with that, they have carried the notion that having darker skin is harmful and will set you back in life. It only perpetuates colorism, when people within the same race discriminate against skin colors. Often, colorism takes on the form of favoritism toward lighter skin shades over darker ones. 

Colorism is a byproduct of colonization. From 1858 to 1947, India was under British rule in hopes of extracting the resources that were making India so profitable through the East India Company. Britain took advantage of the wealth by imposing strict policies and limiting government representation across India. However, those that had lighter complexion were favored and often offered more better jobs than those with darker complexions. Britain maintained its control over India until the country’s independence after World War II. 

Thus, in 1975, Unilever’s “Fair & Lovely” cream first debuted. Despite a decadeslong appeal toward fair skin, this “luxurious” type of cream would not become popular until the 1990s, when it became more accessible in the form of cosmetic products such as deodorants, creams and at-home treatments. Even though it is a more recent trend, skin lightening still reflects and enforces the mindset of British colonizers. Bollywood even joined the trend by selecting lighter-skinned actors who can “better represent Indian life.” Since the first release of Unilever’s product, the skin lightening industry has become a multimillion dollar market, with some estimates around $4 billion globally, due to the high demands to meet the beauty standards. The highest usage is across Asia and Africa.

Typical usage for skin lightening creams, also known as skin bleaching, is to help reduce the appearance of scars or age spots. In India, though, the products are also used to reduce the melanin levels in one’s skin. Most products must be applied over the course of six weeks to see results. Often, there is a combination of different steroids or chemicals used to help change skin tone.

Research by the World Health Organization has found that mercury is often an active ingredient. Even though it is banned for use in the U.S., other countries do not have much regulation over mercury’s usage. Mercury can cause a range of problems, from neurological to fertility in nature. 1 in 4 skin lightening products made in Asia has been found to contain mercury. Other risks include skin cancer, premature aging of skin, skin thinning and allergic reactions.

Skin lightening treatments at a convenience store. Sophia Kristina. CC-BY-NC-ND 2.0

Additionally, the color of one’s skin in India is critical when it comes to arranged marriages. Often, parents place advertisements in newspapers known as matrimonial ads in order to find potential spouses for their children. Often in these ads, there are descriptions of the child’s skin tone ranging from “fair” to “wheatish,” with “fair” individuals pursued the most. Along those lines, many dating websites for arranged marriages, such as Shaadi.com, allow users to select preferences based on skin tone. However, Shaadi.com representatives did announce earlier this month they were removing the search option.

This is not to say that the skin lightening industry is to blame for colorism today. It has become a deeply-rooted mechanism, with discrimination and racism existing in Indian society since the 1850s. Activists have encouraged the stop of these products’ production, as organizations such as Women of Worth have found that skin lightening practices cause a sharp decrease in self esteem for brown girls.

Eva Ashbaugh

is a Political Science and Gender, Sexuality, and Women's Studies double major at the University of Pittsburgh. As a political science major concentrating on International Relations, she is passionate about human rights, foreign policy, and fighting for equality. She hopes to one day travel and help educate people to make the world a better place.