September 20, 2020

COVID-19 MITIGATION: Do We Know Most Kenyan Homes to Propose Home Based Care?

Prof Halimu Shauri. Image (Courtesy)

Episode 43
BY PROF DR HALIMU SHAURI

(Dean; School of Humanities and Social Sciences; Pwani University)

In our previous article on COVID-19 MITIGATION, with my co-author (lol): Home Based or Community Based Care, we paraded which among the two is the best in mitigating COVID-19 infected persons.
Our position was and is that of supporting Community Based Care (CBC) as opposed to Home Based Care (HBC).
Today, I want to reiterate that HBC for a highly infectious disease like COVID-19 is not the best approach from a pragmatic point of view.
You may be wondering why? Yes, I have asked myself serious questions and discussed this HBC approach with my co-author and our consorted and concordant professional view is that it is not feasible based on what the home is in many families. 
UNPLANNED SETTLEMENTS
Yes, let’s look at the home in many Kenyan families. You will agree with me, majority of Kenyans live in humble homes and some in unplanned settlements.

An example of an unplanned settlement in Kenya. Image: (Courtesy)

Let’s go a little deeper into the home and describe it for purposes of understanding it. Some homes in low income families in particular are one bedroom, if you have to call it so, where the cooking, eating, entertainment (lol) and sleeping happens at the same space.
In some instances, goats and chicken are part of the single space or bedroom decor. What changes are the settings?
Indeed, when you see smoke, it has become a kitchen, when you hear laughter, it has become a living room, if you hear nothing, maybe a study room and when you hear what I know you know, and then you know I know! Hihihi and I know you know.
The furniture also changes to adapt to the needs of the family. In essence, the small or modest sheltered space, either made of wood, mud, cow dung or plastic bags is where the father, mother and children spend their lives.
In such homes, the toilet is either shared or non-existent and the Community bush or neighbors farm is the place, hahaha! In urban slums remember they even have flying objects in form of toilets.
In these homes we don’t have luxury of each member having their utensils during meals, nor luxury of running tap water, nor luxury of privacy or individual rooms, nor luxury of own shower basin, you must share with others.
SOCIALIZATION
The socialization of family members is such that sharing is a common and acceptable norm. What about kids and the way they interact with adults in the family.
They have no boundaries and restrictions because even the space limits them to observe social distance.

 Health Chief Administrative Secretary Rashid Aman in one of the government daily briefings on the corona pandemic. Image: (Courtesy)

I thus fail to understand the pragmatics of How COVID-19 Home Based Care will be done in Kenyan homes! Am I overthinking or am I in order? How do you isolate a COVID-19 positive patient in such circumstances? Are we not courting a disaster in a pandemic!
Someone should pass this message to the powers that be that HBC for COVID-19 is a disaster in the making given the way we know the physical and social structure of Kenyan homes.
Rather than wait and see, we would rather caution the implementors to rethink HBC for COVID-19 infected persons.

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