The sukari (sugar)

I came to the hospital here expecting to see many medical conditions that I’d never see in the states. Indeed I have; malaria, leprosy, elephantiasis, to name a few. I spent some time in clinic with one of the doctors and guess what the visits were most frequently for? Diabetes and hypertension. I’m not certain of the exact rates, but these are no longer disease of the Western world. Many areas of the world that have become “Americanized”, and in some ways, especially with music and dress, Kenya is no exception. However, there are no McDonalds here (not even in Nairobi), and it is uncommon to see overweight Kenyans. Most people have enough food, but in some regions, such as Turkana in the northeast portion of the country, people are starving and eating their dogs.

The areas covered by this hospital are rural (as in, no electricity), and most people do physical work, so the population couldn’t be much more different from the American population. I’m sure the rates of diabetes are not the insane ~30% that we have in America, but seeing that these diseases were common at all here was surprising to me. I think that the reasons are twofold. 1) Though most of what people eat here is not terribly familiar, it is creeping toward the “processed foods” end of the spectrum. Sitting at break time and drinking chai and eating six slices of white bread slathered with margarine is a daily occurrence for many Kenyans. It’s cheap, tastes good, is filling, and devoid of nutrients; sounds a little more like McDonalds now. 2) People are living longer, and since they’re not dying at a very young age of smallpox or whatnot, something has to kill them.

Kenya remains a country where being overweight is considered a positive thing; it indicates that you’re prosperous enough to pack on some pounds. We had a few of E’s fellow teachers over the other day (young women), and they were saying how whenever they go home, their dads tell them that they should eat more and get fat, and how food is “wasted” on them if they don’t show signs of weight gain. E got a little slack-jawed at this point; this is not a directive typically heard in an American home, especially toward women. While gross obesity is not the goal, the typical Kenyan man definitely prefers somewhat larger women than most American men. This ideal used to make a lot of sense, as one could store some fuel for lean times, but now, as calories become cheaper, more processed, and less nutritious, the extra weight stops being an asset and starts being a liability. The Kenyan health system is ill-prepared to deal with complicated chronic disease management, which is a struggle even in the resource-rich US.