If someone secretly filmed you for a month, capturing what you eat, where you eat and who you eat with, what would they find?
This is what scientists from the African Population and Health Research Centre (APHRC) asked residents of Makadara Sub-county in Nairobi, in a study that took place last year and this year, seeking to understand what people eat and why they eat it.
The researchers provided study participants (nearly 50 individuals and families) with cameras to take photos of what they ate, where they ate it and who they ate it with, to identify and understand the social (people) and physical factors (the food environment) that influence food choices.
The participants spent five days taking photos of their food environment: what they eat, where they eat and the people they eat with. Quality, freshness and food preparation methods were also considered as factors that inform the decisions around the types of food that people buy.
One of the participants, Henry Otieno, a 40-year-old family man who lives in Makadara with his wife (a housewife) and their 14-year-old son, gave consent for publicity.
“My wife decides what we eat. She budgets for, buys and prepares our food. We mostly eat githeri, rice and ugali,” he says of his family’s food choices.
“We eat the starches with green vegetables because they are cheaper than meat. We would love to eat fish and beef more often, but they are too expensive. We simply can’t afford it,” says Mr Otieno, the family’s breadwinner, who earns a living selling second-hand clothes in the neighbourhood.
One of the key findings from the study that used a methodology called Photovoices (see side bar), was that Kenyans, especially those in urban areas, love their street food or food sold by roadside vendors.
“This is driven by its cheapness, convenience and affordability,” explains Milka Njeri, a researcher at APHRC.
Otieno, for instance, eats lunch (mostly githeri and chapati because they are “convenient and affordable”) from roadside food vendors while at work. He trusts the food vendor, whose food he has been buying for years, and says that her manner of handling food is “acceptable.”
However, he worries about the possibility of catching cholera and other sanitation-related infections.
“Given that the food is prepared by the roadside, exposed to dust and fumes from passing vehicles, it might not be that safe. But what choice do I have? I can’t afford to buy food in the restaurants,” he shares.
Other participants who ate street food, also raised concerns about the state of hygiene and sanitation at the places where food is sold, and the risk of falling sick (or even getting cancer) from eating that food. There were also fears that the food is adulterated with unhealthy additives.
Apart from affordability, the study also found that one’s family and the food vendors people buy from, also determine what one eats.
Steve Ndambuki, a 31-year-old programme officer at the National Council for Population and Development, who did not take part in the study, said that though he loves his githeri and other indigenous foods, his wife’s and son’s love for pizza and fast food, have him eating those foods more often than he likes.
The study also identified a growing popularity of kitchen gardening among Kenya’s urban folk, to supplement household food needs and as an affordable and convenient alternative to purchasing food.
“We found that some families from Makadara, for instance, grow vegetables and rear chicken for eggs and meat. This is a cheap source of healthy food for families without a stable income,” says Ms Njeri, the researcher.
Being a neighbourhood with low to middle-income residents, the findings from the study in Makadara are representative of the average Kenyan urban household, and could, therefore, be used to determine the drivers of food choices among Kenyans living in towns and cities.
The researchers said that research on food choices in urban centres is important, because about 16.5 million Kenyans live in urban setups and more keep moving from rural to urban areas in search of better economic opportunities.
As cities grow, their social and physical environments change, altering their dietary habits. In towns, diets are unhealthier — high in trans fats, sugar and salt — which in combination with lack of adequate physical activity, triggers a surge in lifestyle diseases such as overweight, obesity, hypertension, heart disease, diabetes and cancer.
A study in 2014 showed that overweight and obesity had increased significantly between 2008 (25 per cent) and 2014 (33 per cent). Moreover, non-communicable diseases, the lifestyle diseases mentioned above, account for 27 per cent of ill health and a third of all deaths. Predictably, cases are higher among urban dwellers than among rural folk.
“We hope that this project will contribute new evidence on ways to enhance healthier and safer dietary practices in urban centres as a key strategy to curb overweight, obesity and related non-communicable diseases,” says Ms Njeri.
At the end of the study, Otieno, who admitted that he faces challenges eating a balanced diet at all times, gathered valuable lessons that he says will significantly shape what is eaten in his household.
“Before the study, food was just food in our house. But now we understand the need to eat a balanced diet and to handle food within proper hygiene standards. After the study, we are now making efforts to eat better quality food. We feel more empowered,” he explains.
To improve the quality of food people eat generally, the researchers recommend that street food vendors, who serve a significant proportion of urban residents, be empowered to provide clean, healthy and safe food.
“Poor hygiene, environmental sanitation and food adulteration are real concerns for people as they transition from rural to urban nutrition. Enforcement of legislation can promote healthy and safe food, and help lower the risk of infection,” says Ms Njeri.
The researchers also recommend interventions targeting, not just food vendors, but also families, to ensure that the general population eats healthier.
The researchers also recommend urban farming to promote access to healthy and safe foods at lower cost. If promoted, the researchers say, urban farming has the potential to eliminate (mostly financial) obstacles that affect ability to make healthy food choices.
And given that the temptation to eat unhealthy foods in the form of treats, soars in the festive season, even for people who have been keenly watching their weight throughout the year. While most people see this as a time to let loose and binge, nutritionists warn that this choice comes with a heavy price. Take-home from Ms Njeri? Eat everything in moderation and be physically active this holiday season.
“Make healthy choices in the food you buy and consume. Emphasise on whole foods and less refined foods, fast foods, sugary foods and sugar-sweetened beverages,” Ms Njeri advises.
What determines your food choices?
Daniel Mbugua, 26, PR practitioner
My family insists on healthy food at home, but I can’t resist nyama choma when I’m hanging out with my friends. Eating junk food is unhealthy, and it also feels like a betrayal of my family’s ideals, but this sentiment is not shared by members of my social group, who prefer eating out, and hence influence my eating habits in that direction.
Daniel Ogeta, 23, is a bachelor in Nairobi’s Umoja estate
I don’t have a stable job or income, so what I eat is determined by whether I have money. When I do, I buy food and cook at home. That’s the only time I eat a balanced diet. When I don’t have enough money, I eat whatever else is available. I mostly buy githeri and fry it at home or eat ugali and greens at kiosks in the neighbourhood, which are affordable.
Maureen Leina, student in Nairobi
My cravings determine what I eat, so I am more likely to eat snacks than eat a whole meal. I also have a busy schedule in school which does not allow time to prepare a proper meal, so fast foods from restaurants are my mainstay. Meat and meat products also feature heavily on my menu. I know it is unhealthy, but isn’t life too short to agonise over everything I eat?
Photovoices: Doing research using photos
Photovoices is a participatory research method that allows community members to capture issues affecting them through photography.
“Participants are provided with cameras to take photos of life around them. They later exhibit the photos to audiences and discuss their concerns and challenges and suitable remedies with researchers and policymakers. This way, the community acts as a catalyst for social change,” the researcher explains.
Photovoice is part of a diverse research project on drivers of food choices in urban cities. It makes it possible to engage marginalised or overlooked populations, based on the premise that everyone has something important to contribute to the development of societies.
Photovoice also challenges traditional views of what counts as knowledge and who creates knowledge. The photographers are the experts of their own lives and their photographs serve as a visual “voice” that tell difficult stories in a meaningful way to shape narratives.
Public officers above 58 years and with pre-existing conditions told to work from home: The Standard
Head of Public Service Joseph Kinyua. [File, Standard]
In a document from Head of Public Service, Joseph Kinyua new measure have been outlined to curb the bulging spread of covid-19. Public officers with underlying health conditions and those who are over 58 years -a group that experts have classified as most vulnerable to the virus will be required to execute their duties from home.
However, the new rule excluded personnel in the security sector and other critical and essential services.
“All State and public officers with pre-existing medical conditions and/or aged 58 years and above serving in CSG5 (job group ‘S’) and below or their equivalents should forthwith work from home,” read the document,” read the document.
To ensure that those working from home deliver, the Public Service directs that there be clear assignments and targets tasked for the period designated and a clear reporting line to monitor and review work done.
SEE ALSO: Thinking inside the cardboard box for post-lockdown work stations
Others measures outlined in the document include the provision of personal protective equipment to staff, provision of sanitizers and access to washing facilities fitted with soap and water, temperature checks for all staff and clients entering public offices regular fumigation of office premises and vehicles and minimizing of visitors except by prior appointments.
Officers who contract the virus and come back to work after quarantine or isolation period will be required to follow specific directives such as obtaining clearance from the isolation facility certified by the designated persons indicating that the public officer is free and safe from Covid-19. The officer will also be required to stay away from duty station for a period of seven days after the date of medical certification.
“The period a public officer spends in quarantine or isolation due to Covid-19, shall be treated as sick leave and shall be subject to the Provisions of the Human Resource Policy and procedures Manual for the Public Service(May,2016),” read the document.
The service has also made discrimination and stigmatization an offence and has guaranteed those affected with the virus to receive adequate access to mental health and psychosocial supported offered by the government.
The new directives targeting the Public Services come at a time when Kenyans have increasingly shown lack of strict observance of the issued guidelines even as the number of positive Covid-19 cases skyrocket to 13,771 and leaving 238 dead as of today.
SEE ALSO: Working from home could be blessing in disguise for persons with disabilities
Principal Secretaries/ Accounting Officers will be personally responsible for effective enforcement and compliance of the current guidelines and any future directives issued to mitigate the spread of Covid-19.
Uhuru convenes summit to review rising Covid-19 cases: The Standard
President Uhuru Kenyatta (pictured) will on Friday, July 24, meet governors following the ballooning Covid-19 infections in recent days.
The session will among other things review the efficacy of the containment measures in place and review the impact of the phased easing of the restrictions, State House said in a statement.
This story is being updated.
SEE ALSO: Sakaja resigns from Covid-19 Senate committee, in court tomorrow
Drastic life changes affecting mental health
Kenya has been ranked 6th among African countries with the highest cases of depression, this has triggered anxiety by the World Health Organization (WHO), with 1.9 million people suffering from a form of mental conditions such as depression, substance abuse.
Globally, one in four people is affected by mental or neurological disorders at some point in their lives, this is according to the WHO.
Currently, around 450 million people suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
The pandemic has also been known to cause significant distress, mostly affecting the state of one’s mental well-being.
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With the spread of the COVID-19 pandemic attributed to the novel Coronavirus disease, millions have been affected globally with over 14 million infections and half a million deaths as to date. This has brought about uncertainty coupled with difficult situations, including job loss and the risk of contracting the deadly virus.
In Kenya the first Coronavirus case was reported in Nairobi by the Ministry of Health on the 12th March 2020. It was not until the government put in place precautionary measures including a curfew and lockdown (the latter having being lifted) due to an increase in the number of infections that people began feeling its effect both economically and socially.
A study by Dr. Habil Otanga, a Lecturer at the University of Nairobi, Department of Psychology says that such measures can in turn lead to surge in mental related illnesses including depression, feelings of confusion, anger and fear, and even substance abuse. It also brings with it a sense of boredom, loneliness, anger, isolation and frustration. In the post-quarantine/isolation period, loss of employment due to the depressed economy and the stigma around the disease are also likely to lead to mental health problems.
The Kenya National Bureau of Statistics (KNBS) states that at least 300,000 Kenyans have lost their jobs due to the Coronavirus pandemic between the period of January and March this year.
KNBC noted that the number of employed Kenyans plunged to 17.8 million as of March from 18.1 million people as compared to last year in December. The Report states that the unemployment rate in Kenya stands at 13.7 per cent as of March this year while it stood 12.4 per cent in December 2019.
Mama T (not her real name) is among millions of Kenyans who have been affected by containment measures put in place to curb the spread of the virus, either by losing their source of income or having to work under tough guidelines put in place by the MOH.
As young mother and an event organizer, she has found it hard to explain to her children why they cannot go to school or socialize freely with their peers as before.
“Sometimes it gets difficult as they do not understand what is happening due to their age, this at times becomes hard on me as they often think I am punishing them,”
Her contract was put on hold as no event or public gatherings can take place due to the pandemic. This has brought other challenges along with it, as she has to find means of fending for her family expenditures that including rent and food.
“I often wake up in the middle of the night with worries about my next move as the pandemic does not exhibit any signs of easing up,” she says. She adds that she has been forced to sort for manual jobs to keep her family afloat.
Ms. Mary Wahome, a Counseling Psychologist and Programs Director at ‘The Reason to Hope,’ in Karen, Nairobi says that such kind of drastic life changes have an adverse effect on one’s mental status including their family members and if not addressed early can lead to depression among other issues.
“We have had cases of people indulging in substance abuse to deal with the uncertainty and stress brought about by the pandemic, this in turn leads to dependence and also domestic abuse,”
Sam Njoroge , a waiter at a local hotel in Kiambu, has found himself indulging in substance abuse due to challenges he is facing after the hotel he was working in was closed down as it has not yet met the standards required by the MOH to open.
“My day starts at 6am where I go to a local pub, here I can get a drink for as little as Sh30, It makes me suppress the frustration I feel.” he says.
Sam is among the many who have found themselves in the same predicament and resulted to substance abuse finding ways to beat strict measures put in place by the government on the sale of alcohol so as to cope.
Mary says, situations like Sam’s are dangerous and if not addressed early can lead to serious complications, including addiction and dependency, violent behavior and also early death due to health complications.
She has, however, lauded the government for encouraging mental wellness and also launching the Psychological First Aid (PFA) guide in the wake of the virus putting emphasis on the three action principal of look, listen and link. “When we follow this it will be easy to identify an individual in distress and also offer assistance”.
Mary has urged anyone feeling the weight of the virus taking a toll on them not to hesitate but look for someone to talk to.
“You should not only seek help from a specialist but also talk to a friend, let them know what you are undergoing and how you feel, this will help ease their emotional stress and also find ways of dealing with the situation they are facing,” She added
Mary continued to stress on the need to perform frequent body exercises as a form of stress relief, reading and also taking advantage of this unfortunate COVID-19 period to engage in hobbies and talent development.
“Let people take this as an opportunity to kip fit, get in touch with one’s inner self and also engage in reading that would help expand their knowledge.