Challenges of Poverty

This week has continued to challenge my thinking about how to best care for the people of Kenya.  It all stemmed from a difficult day at work.  While collecting data for an ongoing research project of mine, I was called to help out in Casualty.  We had a mass casualty from another matatu accident.  Unlike the usual three or four patients received from motor vehicle collisions at home, we were presented with thirty-three patients at once, twenty-two of whom died.  How can such tragedies be prevented?  In high-income countries, increased road safety legislation, education, and enforcement have led to a reduction in motor vehicle collisions and fatalities.  So why haven’t the few attempts at injury prevention worked here?

Legislation in Kenya mandates matatu drivers/owners to only carry one passenger per seat and to ensure each seat has a safety belt; however, the country has yet to see any change from this law.  The issue boils down to poverty.  On one of my recent matatu adventures, twenty-three of us rode snuggly in the fourteen-seat vehicle.  Despite the legislation, matatu drivers can’t afford to travel with fewer passengers unless raising prices and Kenyans can’t afford to pay more for transportation.  On our journey, we were pulled over at a police check, but a small fee for the policeman’s pocket put us back on the road without any further penalty for breaking the law.  This is just a small example of the corruption that is entrenched throughout the Kenyan law enforcement and government.  Why have laws if they're not enforced?  It is even the issue of poverty that has led to increasing corruption as people become greedy for power and money, feeling entitled after years of struggling.

Many of the issues faced every day at the hospital stem from poverty.  In addition to preventable injuries, patients present in late stages of their illness as they have delayed their care due to concerns over ability to pay.  Illnesses related to malnutrition and poor sanitation are overwhelming.  According to the World Bank, more than one billion people today live on less than $1 per day. About 70% of those people are women, and almost half of the population of sub-Saharan Africa survives at that income level. We know that every 3.5 seconds, a child dies in the developing world from poverty-related circumstances. 

Map of world poverty - Sub-Saharan Africa is the worst

While on the surface poverty is often defined as a lack of income or assets, in the lives of the very poor, poverty becomes a network of disadvantages, each one exacerbating the others. The result is generation after generation of people who lack access to education, health care, adequate housing, proper sanitation and good nutrition. They are the most vulnerable to disasters, armed conflict, and systems of political and economic oppression.  The poor are often powerless to improve their circumstances, leading to a sense of hopelessness.

So, what can we do to help?  The problem seems so overwhelming to me without really any idea of where to begin.  It is clear that handouts and traditional aid are not enough to solve the problem of poverty.  Handouts typically just create dependency without empowering the poor to remove themselves from their current situation.  Finding solutions that help build infrastructure, organization, and education within resource-limited countries is critical.  We need to find ways to invest in the poor, to enable them to improve their situation in a way that is sustainable for themselves and their families.  Maybe then we can make greater strides on global health issues like malnutrition, death from preventable diseases, and child sex tourism.  May we develop a greater awareness and wisdom to know how to best serve the poor and needy with the love of Christ.

"If anyone has material possessions and sees his brother in need but has no pity on him, how can the love of God be in him? Dear children, let us not love with words or tongue but with actions and in truth." 1 John 3:17-18