People with disabilities in poor urban communities of Kenya and Nigeria faced disproportionate hardship during the COVID-19 pandemic. Anna Nzioka, injured in a 2017 road accident, now walks with a crutch and runs a small tailoring shop in Viwandani, an informal settlement in Nairobi. The hospital she uses is about 16.8 kilometres away and a visit cost almost 350 shillings. Kenya’s 2019 census recorded 918,270 people aged five or more living with disability, of whom 385,417 (almost 42 per cent) had mobility impairment.
In 2020 governments introduced curfews and movement limits to contain the virus. Many specialised clinics and lower-level health facilities closed or were converted into COVID-19 treatment centres, which reduced access to routine care, increased queues at the remaining facilities and raised the cost of drugs. Poverty amplified the problem: Kenya’s statistics agency reports that 53 per cent of the country’s 50 million people live below US$1.90 a day, while in Nigeria, as of 2022, four out of every ten people lived below the poverty line. Nigeria’s population is 223 million, with 25 million living with a disability. Lockdowns that began in late March 2020 in parts of Nigeria and in Kenyan hotspots forced many small businesses to close, and many people with disabilities who rely on trading lost their livelihoods.
Several personal stories illustrate these effects. Tom Okwiri, born with cerebral palsy, lost his teaching job in April 2020 and contracted COVID-19 twice. Mercy Wanjiru could not afford daily anti-seizure medication for her son and paused his physiotherapy after losing work. Rafiat Adebajo, a Lagos food vendor, lost night-market income and returned to her home village. Researchers from the African Population and Health Research Center conducted phone interviews in two Nairobi slums; the study was part of a larger project in Bangladesh, Kenya, Nigeria and Pakistan that covered 1,000 households at each site from 2017 to 2021. The common finding was severe disruption to healthcare access and higher costs, and advocates say communication and relief were often inaccessible for people with sensory or mobility disabilities.
- Bring health services closer to slum communities.
- Increase the capacity of community health workers.
- Ensure relief and information are equitable and accessible.
Difficult words
- disproportionate — Greater in amount or severity than is fair
- informal settlement — A poor urban area without official services
- mobility impairment — Difficulty moving or walking because of a condition
- curfew — Official order limiting people's movement at set timescurfews
- livelihoods — Ways that people earn money and support themselves
- disruption — A large interruption or disturbance to normal services
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Discussion questions
- How would bringing health services closer to slum communities improve access for people with disabilities? Give examples.
- What challenges might community health workers face when increasing their capacity in informal settlements?
- Which specific measures could make relief and information more accessible for people with sensory or mobility disabilities?
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