Health check: Most street persons sick

More than three quarters of street persons in Kenya are sick, highlighting the plight of thousands of such people who are now even at a higher risk of harm especially in the wake of the Covid-19 pandemic.

A newly published survey report by the Labour and Social Protection Ministry reveals that 84 percent of the 46,639 of persons living in the streets suffered from at least one type of disease—a pointer to the deplorable conditions they live in and need for quick intervention such as healthcare and housing.

The 2018 National Census on Street Families, established that 1,197 street people were suffering from HIV/Aids and other sexually transmitted infections (STIs), 8,201 had chest related diseases, 11,334 malaria while 4,615 reported suffering stomach ache. Some 3,141 of them had skin diseases while 6,404 had fever.

“Street persons are vulnerable in terms of their health because they live under difficult environments that predispose them to many conditions. The nature of their lifestyles puts them at risk,” reads the report.

The data indicates that 74 percent of the males suffered from skin diseases and 55 percent of the females from HIV/STIs. For females, this situation is likely to be attributed to forced sexual activities that expose them to HIV/STIs.

“About 68 percent of the street persons aged 10 years and above had sexual intercourse, and out of this, 63 percent of them did not use condom during their last sexual intercourse,” the report notes.

Despite female street persons accounting for 96.1 percent of the 406 homeless sex workers, the report shows that 70 percent of them were not using condoms compared to 59 percent of their male counterparts.

The lowest levels of condom use were reported among the youthful population aged 15-29 years.

“Analysis by age indicates that the percentage of the youthful population, aged 15-29 years who reported to have not used condom during the last sexual intercourse was higher compared to other age categories” the report says.

Access to quality healthcare is a challenge to Kenyans in most households and this is even worse for street families.

“Street families represent minority population which has been under represented in health research”, the reports notes.

About 2,820 of the street persons are self-medicating themselves while 13,313 sought treatment from public hospitals.

Majority of those that self-medicated were aged 15-19 years at 25 percent.

The recent statistics indicate Kenya currently has 46,639 street persons spread across the 47 counties, with 72 percent being male. Most (37,302) of the persons living in the streets were aged below 34 years and out of this, those not older than 19 were 15,752.

Nairobi had the highest number street people with a population of 15,337 followed by Mombasa and Kisumu at 7,529 and 2,746, respectively, while Uasin Gishu had 2,147 and Nakuru 2,005, closing the list of the counties with the highest populations.

To survive, street families engaged in begging (27.5 percent), garbage collection and sale (21.6 percent), scrap metal collection (19.6 percent), sex work (5.2 percent) and peddling drugs and alcohol (2.5percent).

Drug peddling exposed the male street children to drug addiction, an issue that was also found prevalent among this group in previous related studies. Unsurprisingly, the study cites drug addiction and relapse of beneficiaries as one of the key challenges facing street families rehabilitation institutions.

In addition, lack of clear policy to streamline the sector and guidelines to allow for the reintegration of the street children back into the society have been blamed for the growing number of street children and families too.

The social protection ministry has indicated that the new study offers data and findings that will be crucial in ensuring the best approach in dealing with street children. Already, the government in its social safety net programme occasionally sends stipend to the vulnerable and poor in society and plans are afoot to include the street people in the programme.

Overall spending on social safety nets in Kenya has remained relatively stable, fluctuating between 0.4 to 0.6 percent of GDP over the last decade. Although overall spending remained more or less constant, the spending on the programmes has increased as a percentage of GDP, from 0.18 percent in 2013/14 to 0.35 percent in 2018/19.

But compared to its peers in the region, expenditure on social safety net in Kenya is lower than other East African countries and much lower than countries in Southern Africa.

“My ministry in collaboration with the various stakeholders will utilise the information collected and analysed in this report to advocate for systematic and increased use of the data for evidence-based decision making. This will inform the targeting of street families for inclusion in the social safety net programme so as to ensure they benefit from the support,” said Cabinet Secretary Ministry of Labour and Social Protection, Simon Chelugui.

Mr Chegui added that the data will also go towards enabling the ministry to draft policies that will guide implementation of the rehabilitation of street families, develop the National Street Families Bill and a Street Families Trust Fund Strategic Plan.

“The data collected will also enhance monitoring and evaluation of the already existing programmes that focus on this segment of the population.

All the major urban areas in Kenya including Nairobi, Mombasa, Nakuru, Kisumu and Eldoret continue to witnesses rising numbers of street families with the survey blaming this trend on the children’s fear of being reprimanded for mistakes at home and subjected to corporal punishment.

The report shows that some 92 percent of the males interviewed preferred to remain on the streets than go back home for the fear of being reprimanded as 86 percent also cited fear of corporal punishment. About 50 percent of the females cited domestic violence as the main reason they went to the streets.

Male and female street children also cited mistreatment by relatives, in cases where the parents are dead or no longer living with them, at 81 and 36 percent respectively, as the other reason for going to the streets.