Rispha Adhiambo and her daughter

A safe pair of hands Risper is just 20 years old and lives in Nyalenda A in Kisumu. Nyalenda A is one of many informal settlements that surround the city of Kisumu. She lives on a plot with other families, and currently lives with her brother and her young child in a small one roomed house. Just to the right of her plot is a small patch of land which is covered with rubbish, waste and flying toilets. She is the mother to one daughter, who is a year old. When her daughter was just three months old she had diarrhoea and Risper had to rush her to hospital as her weight continued to drop. “It started when she was three months. I was disturbed because I didn’t know what was wrong.” “She started with diarrhoea but I didn’t know what caused it. So, she was admitted to hospital. She also had severe pneumonia. She stayed in the ward for two weeks. “Then, I came back and I went to the clinic. There, my sister invited me to a nutritionist. She told me that I should bring my baby to the nutritionist because she has lost a lot of water. That’s where I started the nutrition. My doctor advised me on how to prevent it because I didn’t know what caused it but my doctor told me that she was eating a lot of sand and dirty things. That’s what caused it.” Since this time, Risper has continued to improve her hygiene and now washes her hands regularly, she explained how she now knows to wash her hands after visiting the toilet, before and after eating and when she has washed her daughter. She has noticed that their health has improved and they have not suffered with diarrhoea like before. “He [the doctor] advised me on how to keep my baby clean and the environment also to be clean. Wherever she is and whatever she plays with should be clean. Also, her clothes should be clean. I followed his advice and she went to 10kgs, before she was only at 8kgs.” Risper and her family have access to a toilet but it’s in a poor state and she dreads having to use it. They are standard pit latrines and full of waste. The smell is strong and many maggots fill the pit. Furthermore, the doors have been removed, so people have to bring their own cloth to cover the doorway, so that they can have privacy. “We have a toilet, we share with many people. At least twenty households. It’s a pit latrine but sometimes there are problems. We find it hard to clean it. We don’t have a cleaning rota so nobody cleans it, you clean it if you want.” Access to clean water in Nyalenda A is a big problem. There are taps, with readily available water (for a small fee) but the pipes often burst, meaning that the water becomes contaminated, often with human waste. During these times, disease can be rife. For Risper and her family, they always boil and treat the water, to protect themselves from disease.