Kenya is located on the east coast of Sub-Saharan Africa and is bordered by Ethiopia, Somalia, Tanzania, Rwanda, Uganda and Sudan. Lake Victoria separates Kenya from Rwanda and Burundi.
Kenya has a land area of 582,650 square kilometres of which 13,400 are lakes. The east coast of Kenya stretches for more than 530 kilometres along the Indian Ocean.
Kenya is divided into eight provinces and the national capital is Nairobi, which is located in the central southern area of the country. The Rift Valley is the largest of the provinces with an area of over 173,000 square kilometres.
While Kenya is regarded as politically stable, most of its neighbours are currently or have until recently been - fighting civil or external wars. This has led to an influx of arms and refugees to Kenya, particularly from Somalia and Sudan.
Kenya is powerful in the region but is poor by world standards. The country has suffered from faltering economic performance over the past decade. In 2003, Kenya’s estimated Gross Domestic Product (GDP) per capita was just US$450 compared with US$633 for Sub-Saharan Africa as a whole and US$3,489 for South Africa. In comparison, Kenya’s GDP per capita in 1990 was US$1,180.
The population of Kenya is 33.5 million with a growth rate of 2.5% one of the fastest in the developing world. In 2005 Kenya ranked 152 out of 177 countries in the UNDP’s Human Development Index.
Some of the reasons for this include a drain on resources due to the country’s debt to other countries, population levels outstripping economic growth, prolonged drought that wreaked havoc on the agricultural industry, severe power shortages and disarray of Kenya’s infrastructure after years of corruption by Kenya’s Kanu Party.
In December 2002 the National Rainbow Party Coalition came to power in peaceful elections. This ended 39 years of Kanu Party rule under Daniel arap Moi. Since the elections, the new government has made some progress, including the introduction of primary education and the enactment of anti-corruption legislation. However, there is still a critical need to invest in the country’s health and economy.
Rift Valley Province
Rift Valley Province, where The Fred Hollows Foundation works in Kenya, is the largest province in the country, stretching from the north west around Lake Turkana and through the highlands in the south.
The province is composed of the fourteen districts some of which are semi-arid, especially in the northern parts of the province. However, the districts in the highlands are especially agriculturally rich due to their volcanic soil and rainfall. Tea is grown in the district of Kericho and is a primary export earner for Kenya.
Sources: Human Development Report 2006, DFAT
Population: 33.5 million
Life expectancy: 47.5 years
Infant mortality rate: 79 per 1,000 births
Percentage of population which is undernourished: 31%
Number of doctors: 14 per 100,000 people
Following a period of improved public health in the 1970s and 1980s, the trend in Kenya has reversed since the mid 1990s. This deterioration coincides with a slowing economy, rising poverty levels and the emergence of HIV/AIDS.
Life expectancy in Kenya improved from 44 years in 1963 to 67 years in 1993. However, it has fallen dramatically to 47.5 years in 2004.
Similarly, Kenya’s infant mortality rate improved for many years and then worsened. The infant mortality rate fell from 120 per 1,000 live births in 1963 to 67 per 1,000 births in 1993. It has now increased again to 79 per 1,000 births.
Common causes of mortality in Kenya include HIV/AIDS, malaria, tuberculosis, respiratory tract infections and diarrhoea. The health system in Kenya is administered through four levels.
The Kenyan Government’s Ministry of Health is the biggest provider of health care services. Fifty percent of hospitals are government funded as are 80% of community health centres and 61% of dispensaries.
Non-government organisations are a vital part of the Kenyan health system, providing funding for some hospitals, dispensaries and community health centres.
Sources: Human Development Report 2006, Ministry of Health, UNDP
Number of blind people: 300,000 or 0.7% of the population
Main causes of blindness: Cataract (43%), trachoma, glaucoma and childhood blindness
Number of people with cataract blindness: 107, 000 (backlog) and an annual incidence of 14,500 cases
Number of cataract operations performed annually: Kenya’s cataract surgical rate is 600 operations, per million people, per year
Number of ophthalmologists: 61 (33 of these ophthalmologists work in Nairobi). The ratio of ophthalmologists to the population is 1:1 million in urban areas and 1:2 million in rural areas
Reasons for low cataract surgical rates and backlog: Lack of consumables and equipment and a shortage of eye health personnel
Percentage of blind population with glaucoma: 9%
Percentage of blind population with corneal scarring and trachoma: 20%
Childhood blindness rate: There are 14,000 blind children in Kenya
Of the 300,000 people living with blindness in Kenya, approximately 43% are affected by cataracts, with an added annual incidence rate of more than 14,500 new cases annually.
Trachoma ranks second to cataract as the main cause of avoidable blindness in Kenya. Of the 18 districts where trachoma is endemic, 11 are found in the Rift Valley Province.
Eye health services are currently only available in a few major centres throughout Kenya. Until recently, the majority of eye health services were run by the Kenyan Ophthalmic Program (KOP), which is a program jointly managed by the Kenya Society for the Blind (KSB) and the MOH.
Blindness treatment and prevention activities are currently coordinated through the Prevention of Blindness National Working Group, which consists of zonal eye surgeons and representatives from the MOH, NGOs, teaching institutions and mid-level ophthalmic workers.
Universities in Kenya have stepped up their training of ophthalmologists, in-line with the World Health Organization’s Vision 2020 goals. However, there is a significant problem in retaining university graduates in their government postings.
One of the common frustrations heard from graduates is that they are posted to eye units which are ill equipped and not suitable for performing operations. As a result, many graduates move across to the private sector.
Sources: Human Development Report 2006, UNDP