As cities expand, calamities will grow from bad to worse

Earlier this in the month, I called a senior official at the Kenya Meteorological Department concerning the rains.

There had just been a heavy downpour the previous night and I wanted to know whether the intensity of the tempest was greater than usual.

The man, who is in the forecasting department, assured me that the levels of rain experienced were normal. He then quoted several data sets that bamboozled me and told me to ignore the frightful pictures I had seen on social media.

Then it came to the time for him to earn his money and forecast the weather. Nairobi, I was informed, will experience normal rainfall levels for the entire long rains period, so there was nothing to worry about.

I asked the same question thrice, more because I was sceptical of his dismissive note than anything else, and was given the same answer: Rain? Nothing to worry about.

Eventually, I bowed a knee to his years of expertise and wrote a news story saying that the rain would be adequate, and that there was nothing to worry about.

PASSING CLOUD OR BREWING STORM

“Passing cloud” isn’t news. “A storm is brewing” is what arrests attention, and so the story I did rightly got relegated to the county pages.

It has taken less than a fortnight to put paid to that forecast. A storm was coming and the forecasting department did not alert us in time.

Perhaps now isn’t a good time to remind people that, in October 2014, the mets warned that millions of Kenyans would be facing hunger in six months due to drought. Instead, Kenyans are dying of cholera and being swept away by the rains.

Nairobi experienced a massive increase in rainfall this past week that overwhelmed the water drainage system and laid bare its water management inadequacies. This recent disaster meshed well with the message of the book I was reading called The Resilience Dividend, by Judith Rodin.

The writer defines resilience as the capacity of any entity — corporation or society — to prepare for sudden unpredictable disruptions to their activity; their ability to recover from them and then to take advantage of new lessons and opportunities produced by the disruption for further growth and expansion.

Most of the examples in her book deal with global cities and their governance, and the book tackles the three great problems of the 21st century — globalisation, climate change and urbanisation.

Ms Rodin is the President of the Rockefeller Foundation, which runs the 100 Resilient Cities initiative from which she draws a number of the examples she cites.

Her message on tackling urbanisation is particularly important when it comes to our cities. The climatic disruptions that our city officials will have to deal with will be longer in length and severity. The world is becoming more densely populated and urban, the numbers concentrated on coastlines and near major rivers.

In Kenya, the two main cities will have to grapple with freshwater scarcity, and increased storm frequency and intensity.

Mombasa, in particular, faces deteriorating water quality and availability. Also, the effects of global warming and glacial melt mean that Mombasa’s future as a coastal city is a matter of great concern.

PERMEABLE PAVEMENTS

The situation in Nairobi is particularly fluid and ongoing, requiring constant checks due to an increase in peri-urban settlements.

On Tuesday we were flooded with pictures of houses filled with black water (rain mixed with sewage).

We saw buildings being swept away, walls collapsing and residents resorting to kayaking to move around.

Rodin’s book serves as a template for thinking about the crises facing cities and would help Nairobi’s chief executive with examples of how to deal with the problems bedeviling it.

The Resilience Dividend has numerous examples of how societies across four continents have dealt with disruptions such as floods.

In San Francisco, US, after a freak storm described as a once-in-a-century affair, engineers discovered that, just as in Nairobi, the drainage had been designed to handle huge quantities of water, but the increased volume from the storm, coupled with collected debris clogging the drains, had led to massive flooding.

The city began organising annual drain clearances before the rainy season. In Kenya, we note that the NYS only got on the job after the fact of the deluge.

The Netherlands is the world leader in flood prevention for the obvious reason that most of the country is below sea level.

Some towns have non-conventional ideas like permeable pavements that help in water drainage; while others have created large flat barriers called berms that accumulate water in order to ease the burden on the drainage system.

The book also puts in a good word about using insurance to protect against flooding. The state should ensure that all buildings above a certain value are insured to encourage thinking about flood and earthquake risks. If the cities’ prevention strategies are good the premiums will be low, and vice versa.

There is a challenge that may come with that, though. This will deflate the property bubble as the presence of an added cost of a premium and a mandatory risk assessment to a house will lead to its value going down.

However, a deflationary effect is better if we all end up being safer from floods.

I strongly recommend the book to Dr Evans Kidero and offer Mombasa governor Ali Hassan Joho my copy of the book. Joho will need it more because he faces greater challenges than the Nairobi governor.

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NEW TECHNOLOGY

Science can help us better our species, all we need to do is trust it

In April, Chinese scientists reported that they had edited genomes of human embryos with the aim of improving them.

They had tried to get rid of a fatal blood disorder from a non-viable embryo and, understandably, several bodies raised concern about this development.

The reason this study scared so many people was that those changes, called germline modifications, are inherited.

If you get it wrong, you could be dooming a future generation.

In the past decade DNA sequencing has become cheaper, meaning we now know more about the various forks in the evolutionary road that we took to get here.

Scientists are working harder towards achieving the aphorism of “know thyself”, and today we know more about migration and changes — not just of ourselves, but of the animals that have sustained us — and diseases that have plagued us for millions of years.

There has never been a better generation of scientists primed to experiment with human DNA.

There is really no point worrying about scientists playing god, because someone has to.

We are still imperfect products of a random system and, as such, our bodies are littered with errors. Mother Nature has been hard at work for four billion years, grafting animal DNA.

We have helped her when with the plants and we are helping her regarding livestock; it is time we helped her with what is arguably her greatest creation.

Our bodies are a universe of cells, some of which self-sabotage while others go rogue, and errors at a basic level could kill trillions of other cells. Constant improvement of the stock of human potential is a duty that every generation should aspire to.

Disease has been our enemy for too long, death’s sting too heavy a burden.

Mathematically, due to all the possible ways of combining genetic information, there must be other ways of putting together better humans than the ones that exist. Shouldn’t we at least consider the possibility?

There are risks, but there are also possibilities. Let us concentrate on the possibilities.

FEEDBACK: On whether we need more doctors or video links in hospitals

LINKS ARE USEFUL:

Waga, I believe the main purpose of the video link between Kenyatta National Hospital and Machakos is sharing and exchanging information among colleagues.

I will cite two examples: (i) if an X-ray examination is done in Machakos by a technician but there is no radiologist to study it, it can be transmitted in real-time to KNH and save the patient a trip to Nairobi, and (ii) a breast biopsy with inconclusive diagnosis on nature or type of cancer can be projected from a microscope in Machakos and read by another doctor in Nairobi, India, or anywhere else.

I suggest that you visit the Lancet lab or Aga Khan Hospital’s radiology department as these have satellite stations in various parts of the country and East Africa.

Also, at University of Nairobi’s Chiromo campus, where First Year medical students are inducted into medicine, this technology has been in use for a couple of years.

At Chiromo, surgical operations and cardiac procedures can be transmitted in real-time to an audience in a remote site as a learning process.

Jane W Karioki

GOOD JOB:

Waga, l greatly and highly congratulate you for your columns because of the great concern and deep wisdom in them.

They have greatly inspired and motivated me.

Thank you, and keep up with the good work!

Muriithi Duncan

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MISPLACED PRIORITIES:

Waga, I just want to let you know that I am in full agreement with your article about doctors.

I am a doctor who trained abroad and did some medical tourism in our local hospitals.

The state of the wards and lack of personnel and basic equipment such as electrocardiogram machines in cardiology wards is immoral.

Don’t even get me started on the low amount of blood in blood banks, or the inane administrative rules about how many theatres remain open and are available over the weekends for emergency surgeries!

I have witnessed many deaths of patients who came in walking but passed on a couple of hours later due to the unavailability of theatre space. This saddens me and I pray for our people.

Thank you for sympathising with our plight and highlighting the folly of misplaced priorities.

Dr S K Maina