Greed, chaos and concrete jungles are killing our children


Gone are the days when babies would get enough sunshine.

Wednesday March 18 2020

Brandon* was a chubby seven-month-old. He had severe pneumonia with impending respiratory failure and urgently needed admission to the critical care unit.

Unfortunately, our overstretched public referral facility could not accommodate him due to lack of an intensive care unit bed.

I begged the unit doctor on call to work a miracle and he stared back at me in despair. He was discharging a patient who was barely stable, to take in one from the operating theatre who had undergone emergency brain surgery following a road traffic accident.

The best the anaesthesiologist could do was put a tube in Brandon’s little airway to help him breathe mechanically as we prayed for a miracle. In the ward, we took turns to act as ventilators for hours on end. At three in the wee hours of the morning, Brandon died.

His 23-year-old mother was crushed beyond feeling. She had just lost her firstborn. She wept bitterly on the cold bench and nothing we said could ease her pain. The cold grip of death had robbed us of yet another angel.

A hush fell across the entire ward. Every mother clung tighter to her baby, instinctively trying to protect them from a similar fate. Mothers who had little ones on oxygen support became even more anxious as they feared that before the sun rose, they might be next in line to experience dreaded loss.

How did we get here? One word: greed. In Kenya, nothing is more precious than a piece of land. All over our major cities and even smaller towns driven by devolution, the green is fast fading, replaced by concrete jungles. Unplanned, awkward concrete monstrosities (apartments) are breeding illness and death.


Every open space taken away means lost access to free, God-given sunlight that feeds our bodies with vitamin D. Lack of vitamin D leads to rickets. To the lay person, rickets has always meant bow-legged or knock-kneed children. This is how I recall the illustrations in my science books in my primary school days.

However, studying medicine taught me that rickets is more than a leg problem. That it could strike in infancy leading to a myriad skeletal abnormalities, poor muscle function, convulsions and recurrent life-threatening respiratory infections and respiratory failure.

Brandon was a victim of greed, and absence of regulation. He grew up in the Eastlands area of Nairobi in an apartment on the fifth floor of a building that was so dark, it was impossible to tell the time of day when indoors.

The lights in the house were always on. With apartments lined up back to back, the natural sun had long been obscured. The poor boy had never experienced the simple joy of basking in the morning sunshine. With the congestion came pollution and insecurity. While his mother struggled to keep him safe by restricting him to staying indoors, this monster called rickets had quietly crept in and was endangering him from the inside.

 This was his second admission in the space of four weeks. He had recovered from his first bout of pneumonia and despite having been diagnosed with rickets and started on treatment, he got a second attack soon after, that proved fatal.

Babies like Brandon number the thousands, living in death traps all over our urban centres. Their parents have no information on the dangers posed by absence of sunshine in their children’s lives.

Gone are the days when apartment buildings had a concrete slab at the top where families hung their laundry and babies got exposed to the morning sunshine, uninterrupted by smog.

Who authorises these constructions? Where is the outcry from our public health department? Who is speaking for the little voiceless ones? Are we so tired of fighting infections, cancer and metabolic diseases that we have forgotten about such an easily preventable disease?

When it comes to health, we grossly underestimate the cost of corruption. Year in, year out, we witness substandard buildings collapsing, burying lives underneath the rubble, and shrug it off and forget.

For every collapsing building, there are a thousand others still standing that are slowly killing our babies. For every landlord smiling all the way to the bank because he managed to squeeze in one more house to cover every inch of his eighth of an acre and added one more level of apartments, there are a dozen babies who may never live to see their first birthday.

We must resist turning into a country that kills its children. This cannot be the cost of urbanisation. It is not right that 40 per cent of our paediatric ward admissions in city hospitals and those in its environs are a result of rickets.

Nature has provided us with vitamin D for free. We cannot be working this hard to deny the general population from accessing it. It is immoral!