Providing accessible, quality and sustainable medical services to the marginalized and vulnerable as well as creating an environment for prevention and awareness for a healthy living, making them custodians of their health.
Mathare Slum is the second largest slum in Kenya and is located in the Northeast of Nairobi. The population size is approximately 443,000 people in 139,000 households, whereby a household is defined as a group of persons sharing the same income sources and eating together. The average family size is 3.9 for the whole slum area.
Mathare Valley slum has experienced a huge amount of violence throughout the years. On all levels – social, political, and economic – the slum population has been left behind with no perspectives. Coping strategies, such as prostitution, criminality, or brewing of alcoholic beverages are widespread. Single mothers and children make up the most vulnerable social categories. Many are forced to practice prostitution as the main source of income with the accompanying high risk of getting and spreading HIV/AIDS.
A big part of the population is migratory: depending on the socio-economic situation people move from Nairobi to “up-country” and back. This imposes a big challenge for the care of patients with chronic conditions including HIV/ AIDS.
German Doctors Nairobi-Baraka Health Centre is located in Mathare valley, the 2nd largest slum in Nairobi, situated 5km North East of the city. It was started in 1997 to provide basic health care through the General health clinic in Mathare 4A. The Nutrition centre followed in 1998. The Comprehensive care clinic and the Community were later started in 2001. The overall program has grown following demand for services coupled with increase in work load from increasing client base. The Comprehensive Care Clinic was then started in 2001 with the provision of VCT-services. In the subsequent years care components were gradually introduced and scaled up. The clinic became a satellite of Nazareth Hospital in 2005 and in the year 2008 it became a primary site mainly sponsored by PEPFAR (= President’s Emergency Program for AIDS Relief) through AIDS Relief, a consortium of several US-American mainly Christian organizations.
The whole of Baraka comprises of about 96 permanent local staff, 5 Volunteer German Doctors who always rotate after every 6 weeks, 1 long term German Doctor who stays for a period of about 3 months. Every day Baraka opens its doors to over 500 people living in Mathare and the surrounding Estates.
Insufficient hygiene and sanitation facilities continue to be the main vulnerability factors. Drinking water is not available in the huts. It must be bought in jugs. There is no electricity available for the “poor”; fire wood and charcoal are used for cooking which increases the vulnerability for asthma and other diseases of the respiratory tract.
In terms of employment, about 56% of the households have casual jobs or small-scale businesses, and 13% have regular jobs. Unemployment is high among the slum population, and the presence of an unemployed member in a household is strongly correlated with poverty. Under-/unemployment is a common problem among single fathers, youth, and bachelor men and ladies and is blamed for high crime rates (e.g., burglaries, shoplifting, robbery, smuggling of stolen goods, mugging, hijacking, etc.)