Professional Documents
Culture Documents
By Joram H. Oranga
Table of Content
Abstract………………………………………………………………………………………………………………...iii.
Acknowledgement…………………………………………………………………………………………………….iv.
List of Acronyms…………………………………………………………………………………………………........v.
List Figures and Tables………………………………………………………………………………………….. ….vi.
List of Appendices……………………………………………………………………………………………………vii.
1.0 Introduction…………………………………………………………………………………………………………1
2.0 Objectives of the Study……………………………………………………………………………………………2
3.0 Theoretical/Conceptual Framework……………………………………………………………………………..3
3.1 Theoretical Framework of the study……………………………………………………………………….........3
3.2 Conceptual framework of the study………………………………………………………………………..........4
4.0 Study Techniques, Methods and Materials …………………………………………………………………….6
4.1 VCA Study Sites……………………………………………………………………………………………….. …6
4.2 Data and Data Collection Instruments…………………………………………………………………………..7
5.0 Results and Findings of the VCA Process………………………………………………………………….. ..10
5.1 Susceptibility to Disasters……………………………………………………………………………………….10
5.1.1 Exposure to Hazards…………………………………………………………………………………………..11
5.2 Susceptibility to Health Consequences and Nutritional Conditions………………………………………...12
5.3 Vulnerability Demographically……………………………………………………………………………….....16
5.4 Community Vulnerability…………………………………………………………………………………………
18
5.5 Disaster Preparedness Capacity…………………………………………………………………………….....21
6.0 Summary of the Findings………………………………………………………………………………………. 24
7.0 Conclusions and Recommendations…………………………………………………………………………..26
References…... ……………………………………………………………………………………………………....27
Appendices……………………………………………………………………………………………………………28
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Abstract
The purpose of this Report is to present a tentative framework for Reducing Vulnerability and Building
Community Resilience and determine variability, change, influence and transformation generally applicable
to a wide range of contexts, systems and hazards and address the cause-effects of hazards on the local
community studied. Social Vulnerability is distinguished from biophysical vulnerability, which is broadly
equivalent to the natural hazards concept of risk. A concise typology of physically defined hazards is
presented; the relationship between the vulnerability and adaptive capacity of a human system depends
critically on the nature of the hazard faced. Adaptation by a system may be inhibited by process originating
outside the system; it is therefore important to consider “external” obstacles to adaptation, and links across
scales, when assessing adaptive capacity. When disasters occur, they do not affect everyone in the same
way. In emergency planning, it is important to pay special attention to the needs of people who are deemed
particularly at risk, or the “most vulnerable”. The common view is that “vulnerable populations” include the
very young, the very old, women and people with disabilities, while partially accurate, this view of the “most
vulnerable” is often misleading and could result in inappropriate response expectations or activities. Stated
more specifically, not all seniors, youth or women are “vulnerable”. Some may in fact be more adept at
responding to disaster than their general grouping or population category might first indicate.
Most importantly, the VCA model focuses on the population of a community with the objective of answering
these three questions: who are the community’s “most vulnerable”; where do they generally reside; and,
what is their capacity to respond or recover? The VCA model is intended to be applicable universally
across diverse cultures, community sizes, geographic locations, or resource levels. However, to apply the
model successfully, two key ingredients are required: a team effort by a broad group of people who reflect
the community, as well as its key stakeholders; and a patient effort to continue to expand ones’
understanding of “vulnerability”, the “most vulnerable” and the reality of emergency situations.
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Acknowledgement
My sincere gratitude goes to the staff of the Kenya Red Cross Society, Mombasa Branch for giving me an
opportunity to lead the VCA Process. Many Special thanks go to Anwar Said-Branch Coordinator, Tom
Omollo-Regional Disaster Management Officer, Abdalla Athmani-First Aid Training Officer, Team Leaders
and Volunteers/Enumerators for their inputs, cooperation and dedication throughout the entire exercise.
Much appreciation also goes to the respondents who set aside personal time from their normal schedule for
the sake and interest of this exercise during data collection. I also acknowledge the invaluable support
received from the Area Chiefs of the 11 Locations by mobilizing community members, Village Elders,
Opinion Leaders and the Community Disaster Management Committee (CDMC) Members. Much
appreciation also goes to the key informants for their active participation and insight.
May this Report provide the much needed impetus to support Disaster Risk Reduction (DRR) activities and
programmes.
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List of Acronyms
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List of Figures and Tables
i. List of figures
Fig.1a………………..Vulnerability variables, 3
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List of Appendices
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1. Introduction
The main victims of disasters tend to be people who are already among the most vulnerable, with
livelihoods that are under constant threat and living in areas that are already impoverished and degraded.
These people live and work in places at risk because they cannot afford to be where it is safer. They lack
the protection that others have, and the ability to influence everyday decision making process. They are
often excluded from the discussions and studies that determine management policy, and live far from
where health and power are concentrated. This distance increases the likelihood of socio-cultural problems
that arise when efforts to assist these people are deployed, they are individuals merely controlled by their
own need for survival and nothing else. With no will and know how to change their situations, any project
introduced to them must first try to address their need for survival to enlist willingness to participate.
The global environmental change and sustainability situations increasingly recognize the need to address
the consequences of changes taking place in the structure and function of the biosphere. These changes
raise questions such as: Who and what are vulnerable to the multiple environmental changes underway,
and where? Previous studies demonstrate that vulnerability is registered not by exposure to hazards
(perturbations and stresses) alone but also resides in the sensitivity and resilience of the system
experiencing such hazards. This recognition requires revisions and enlargements in the basic design of
vulnerability assessments, including the capacity to treat coupled human–environment systems and those
linkages within and without the systems that affect their vulnerability. A vulnerability framework for the
assessment of coupled human–environment systems is presented in the theoretical/conceptual framework.
The disaster risk scenario for Mombasa County can be described as moderate. The county experience
moderate risk conditions owing to a high vulnerability due to critical poverty conditions in most locations. A
bigger number of people continue to be highly vulnerable to water and sanitation, water/air borne diseases,
diarrhoea, flooding due to poor drainage, poor waste disposal and much of this vulnerability is chronic and
as a result of high levels of poverty projected at 40% at urban levels. The increase in the price of staple and
general impact of inflation on household expenditure means that very poor households will miss some of
their food entitlements further plunging these families in to severe malnutrition. In the areas studied, most
Sources of income for the ‘poor’ and ‘very poor’ are predominantly casual labour opportunities in the
manufacturing plants, informal sector, Kilindini port, small kiosk businesses, food vending, water vending,
car washing and clothes washing and other manual labours. Employment and remittances is the major
source of income for the ‘middle and upper levels’. The difference in employment activities for the wealthier
and the poorer households is that while the poorer households predominantly depend on casual labour, the
‘middle’ and ‘upper levels’ are engaged in skilled and semi – skilled labour activities.
The need to have safe and safer communities have pushed the local people to develop their own initiatives
as the services from the responsible government ministries/agencies are never forth coming, and when
they do, they are inadequate and substandard. The local population in the studied areas feel cheated and
short changed by the responsible parties. Municipal Council of Mombasa (MCM) is only visible when
checking for operating licences for small business and collecting rates and fees, when it comes to service
provision it is almost nonexistent. In some local villages it was even much harder to define MCM which was
more associated with councillors and politicians rather than organ of service for the locals.
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An evaluation of community capacity and resilience presents key information to aid better decision making
when it comes to disaster situations. The effort to assess existing preparedness, response and recovery
plans and missions would facilitate realignment of resources for better mitigation practices including
awareness and knowledge development. Stakeholders and partners analysis also provided a proactive
approach towards resource management and consolidation.
Furthermore, this study finds that the level of exposure and vulnerability of the areas studied can actually
be brought to manageable level as they mainly point towards, lack f essential services like water supply,
sewerage system, housing, sanitation facilities, access roads, community security and by and large
information materials and access to information n disaster management.
This exercise was carried out as part of the Kenya Red Cross, Disaster Preparedness Programme geared
towards reducing disaster risk and promoting community safety and resilience.
Help communities understand the hazards they face, assist them to improve the prevailing situation
based on local skills, knowledge and initiatives and prevent hazards from turning into disasters and
better understand the local environment including predication and pattern of risks and hazards.
Provide a wide range of information to support decision making, assist in monitoring and evaluation
of disaster projects and support the communities to embark on viable livelihood efforts to reduce
vulnerability.
Gather baseline information to serve as reference for emergency needs assessment to aid the
development and designing of response, prevention and preparedness programmes that contribute
towards building community resilience and promote increased community education, awareness
and safety and disaster risk reduction.
To analyze the local capacity to cope with risks and hazards with patterns and local authorities to
prevent or reduce the potential effects of disasters including mapping stakeholders and outlining
their capacities, roles and responsibilities.
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3. Theoretical/Conceptual Framework of the Study
3.1 Theoretical Framework of the Study
The background of this study is a postulation of a cause-effect relationship between Vulnerability, Hazard
Events and the Impacts of Disasters. Necessitating further the need to understand and recognize the
presence of Independent, Dependent and Moderating and Intervening Variables in the event of analyzing
VCA process, see further illustration in fig 1(a) and (b) below.
The illustration above in 1(a) explains the cause-effect relations between Vulnerability (Independent
Variable), Hazard Event (Dependent Variable), Exposure (Dependent Variable) and Impacts (Dependent
Variable) while Dose-response is the Moderating Variable.
When analyzing the risk factors surrounding the vulnerable population, it is important to understand what
would be the probable intervention and at what levels. Fig. 1b illustrates a situation analysis in the event
that there is a need to address the unstable systems that happen to a larger extent contribute towards the
disasters experienced. Base Vulnerability Variables are the Independent Variables, Disaster and Hazard
(perturbation) is the Dependent Variables.
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3.2 Conceptual Framework of the Study
The conceptual framework illustrated on the table above fig 2a. shows the Relationship between variables
at different levels, the contributors of community vulnerability and what cause of action the community is
willing and would be willing to take and at what levels. The conceptual framework below fig 2b. illustrates
the relationships and correlations between different attributes existent at the local levels and the
vulnerability levels. Vulnerability rests largely within the condition and dynamics of the coupled human–
environment and the system exposed to hazards. Vulnerability analysis must be comprehensive, treating
not only the system in question but also its many and varied linkages, comprehensive vulnerability analysis
ideally consider the totality of the system. Failure to consider this larger context could lead to the
identification of ‘‘response opportunities,’’ which, if implemented, lead to significant unintended
consequences or ‘‘surprise’’ the vulnerability framework presented here is guided by the need to provide a
template suitable for ‘‘reduced-form’’ analysis yet inclusive of the larger systemic character of the problem.
The framework is not explanatory but provides the broad classes of components and linkages that
comprise a coupled system’s vulnerability to hazards. The basic architecture (Fig. 2a) consists of: ( i)
linkages to the broader human and biophysical (environmental) conditions and processes operating on the
coupled system in question; (ii) perturbations and stressors stress that emerge from these conditions and
processes; and (iii) the coupled human–environment system of concern in which vulnerability resides,
including exposure and responses (i.e., coping, impacts, adjustments).
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Fig 2b: An illustration of the Conceptual Framework (Specific focus on Vulnerability)
These elements are interactive and scale dependent, such that analysis is affected by the way in which the
coupled system is conceptualized and bounded for study. The full framework is illustrated in Fig. 2a by way
of spatial scale, linking place (blue) to region (yellow) to globe (green), and various parts are elaborated in
Fig. 2b. The coupled human–environment system, whatever its spatial dimensions, constitutes the place of
analysis. The hazards acting on the system arise from influences outside and inside the system and place
but, given their complexity and possible nonlinearity, their precise character is commonly specific to the
place-based system. For these reasons, the hazards themselves are located both within and beyond the
place of assessment. These hazards hold the potential to affect the coupled system, including the ways in
which the system experiences perturbations and stressors. The human–environment conditions of the
system determine its sensitivity to any set of exposures.
These conditions include both social and biophysical capital that influences the existing coping
mechanisms, which take effect as the impacts of the exposure are experienced, as well as those coping
mechanisms adjusted or created because of the experience. For the human subsystem, these mechanisms
may be individual or autonomous action and or policy-directed changes. Importantly, the social and
biophysical responses or coping mechanisms influence and feed back to affect each other, so that a
response in the human subsystem could make the biophysical subsystem more or less able to cope, and
vice versa. In some cases, coping mechanisms per se give way to adaptation, significant system-wide
changes in the human–environment conditions. The responses, whether autonomous action or planned,
public or private, individual or institutional, tactical or strategic, short- or long-term, anticipatory or reactive
in kind, and their outcomes collectively determine the resilience of the coupled system and may transcend
the system or location of analysis, affecting other scalar dimensions of the problem with potential feedback
of the coupled system in question. The framework illustrates the complexity and interactions involved in
vulnerability analysis, drawing attention to the array of factors and linkages that potentially affect the
vulnerability of the coupled human–environment system in a place.
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4. Study Techniques, Methods and Materials
4.1 VCA Study Sites
Mombasa County is composed of four administrative districts namely Changamwe, Kisauni, Likoni and
Mombasa curved from what was originally Mombasa then later Mombasa and Kilindini Districts as the
government continues to reorganize its services with several divisions and locations spread out from Shika
Adabu in the South Coast to Bamburi in the North Coast to Miritini in the West Coast.
Mombasa County lies between latitudes 3 0 8 and 40 10 south of equator and longitudes 39 0 41 and 390 80
east of Greenwich Meridian with an estimated population size of 945, 785. Mombasa is the main business
and industrial hub of the Coast Region providing essential finished goods, processing raw materials and
providing essential access to goods and services through the Kilindini Port and transportation further
hinterland. Kilindini Harbour also provides docking facilities for both merchant and cruise ships. Availability
of world class tourist hotels ensure continued free flow of tourist both domestic and foreigners visiting the
County. Moi International Airport serves the county and links internationally providing vital connection for
tourism and business travels.
The County lies within the coastal strip in the hot tropical region where the weather is influenced by
monsoon winds. The total annual rainfall ranges between 1025-1270mm while the annual mean
temperature is 27.90c with a minimum of 22.7 0c and a maximum of 33.10c. Average humidity at noon is
about 65 per cent. The livelihood patterns are mainly characterized by small enterprises, small scale
agriculture, fishing, construction related work, permanent and temporary employment. Population
distribution and settlement patterns are mainly influenced by proximity to roads, water, electricity and other
essential amenities.
With Chaani, Changamwe, Mikindani, Miritini and Port Reitz Location being in what is now known as
Changamwe District previously part of Kilindini District. Majengo, Mwembe Tayari, Shimanzi and Tononoka
Locations are part of Mombasa District while Shika Adabu is in Likoni District.
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4.2 Data and Data Collection Instruments
A step by step approach to conducting VCA through the CVCA Model was employed to address the
objectives of this study. A checklist, questionnaire and tools for VCA were designed and developed through
extensive consultation. Having designed the process and tools, a list of data type, strategy that conforms to
the universal VCA standard was followed. The analysis process of the VCA model is intentionally
sequential. One should firm up knowledge at one level or step before moving on to the next. The intent of
each step is to provide further meaning or greater context to the understanding that one has of the “most
vulnerable” segment of the population. The CVCA model (see Diagram below) contains the following steps.
(Each of the steps is explained separately below.)
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Create planning team (1)
Yes No
Understand MV areas?
Identify MV/High risk Yes
over lap (11) overlap (11)
Prioritize (16)
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The study area was delineated after careful considerations and interrogation of disaster trends in
Mombasa. Deliberate attempts were made to include all key respondents who possess rich and vital
information that can add value to the VCA Process. The desire to generate reliable and valid data was
highly emphasized with respondents clustered in consultation with KRCS Mombasa Office.
The respondent groups were drawn from community organizations i.e. women groups, youth groups,
village elders, opinion/religious leaders, chiefs, government ministries/agencies that have previously
experienced impacts of disasters, intervened during disasters and or responded to disasters. Purposive
Sampling Technique was used to narrow down and identify subjects because they are informative or
possess the required characteristics that the VCA sets to study or understand. Random Sampling was
thereafter employed to get the respondents to participate in the exercise to reduce the level of bias from
purposive sampling. Data was sorted and sieved by use of excel and analysis of quantitative data through
Strata and SPSS software while qualitative data was analyzed through NCT Techniques (Notice Think
Collect). The following data collection tools were picked from the toolbox
The Community VCA Investigations were carried out by the VCA teams in the eleven communities and the
information gathered presented here, for all the communities.
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S/No. Respondents No. in attendance % represented
1. Women 139 29
2 Men 201 42
.
3 Youth 125 26
.
4 Elderly (187) Crosscutting (men/women
. atleast 55%)
5 Disabled persons and Children 14 3
.
Total 479 100
The table below is an illustration of ranking of risks/hazards according to impact on the communities. The
ranking is an analysis of the number of mentions a specific attribute received from the respondents and
community social groups on weight-basis according to effects, frequency and impact either in the past or as
currently projected. An investigation in to the nature of disaster trends and patterns elicited mixed reactions
and very interesting debates as most disasters were mentioned according to occupation and or
households, meaning that the respondents had firsthand knowledge of the disasters. The respondents then
were allowed to draw a list of different disasters that affects and or has affected them in the past. An
explanation was done to ensure the community understands disaster in the same context as the objectives
of the study. A final list was drawn after a resolution was carried out as shown in the chart.
Floods
Community
5% 2% Hazard and Risks
12%
4% Fire
4% Drugs/S.A
W. Shortage
4%
RTA
13% Poor Drainage
6% Diseases
Pollution (Water)
Derilicts
Building
Prostitution
17% 13% Sexual Violence
Landslides
Insecurity
5%
12% 4%
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The Ranking showed a particular pattern of the disasters/hazards/risks some closely related, for instance,
where the community complained about poor drainage there was also a mention of flooding, pollution and
disease outbreaks which strongly appeared in all the eleven locations studied. Where there were problems
of drugs and substance abuse the cases of HIV/AIDS and sexual violence were also mentioned especially
in Miritini, Shimanzi, Tononoka, Shika Adabu, Port Reitz and Chaani. Road Traffic Accident (RTA) was
mainly attributed to the highway with cases in Changamwe, Mikindani, Miritini, Shika Adabu and Tononoka
Locations. Water shortage was another teething problem extensively repetitive in most locations and
closely related to diseases outbreak. Where the community complained of water shortage as a problem
there were also cases of Typhoid, Cholera, Diarrhoea and Intestinal Parasites/Worms reported, mainly
because of the levels of hygiene observed in the areas of Mikindani (Bangladesh Slums), Changamwe,
Chaani, Port Reitz (Wayani/Bokole Slums), Shika Adabu and Miritini. However, community organizations
and individual respondents mentioned disasters that directly affected their livelihoods and or would impact
on their lives in the short run if not properly addressed. More interesting was the continued reference to
disasters that adversely affected communities in the past like Mtongwe Ferry Mishap, ‘Kaya Bombo’ Likoni
Clashes, El Nino Floods and Gas Leakage at the Refinery. Meaning the ranking was based on personal
understanding of the disasters affecting the community.
Residents of Changamwe and Chaani are exposed to the following hazards; gas leakage, poor drainage,
dust, sewerage, TB, respiratory problems, diarrhoea, skin conditions, petroleum fumes, oil tankers parked
in residential areas, garbage disposal, overflowing sewerage, blocked drainage, fire, alcoholism, drugs,
contaminated water, poor sanitation and lack of toilet facilities.
Mikindani and Miritini is exposed to floods, landslides, fire, rampant local brew/alcohol trade, intestinal
worms, cholera, poor human waste disposal, garbage, collapsed sewerage system, respiratory problem,
skin conditions, dust, RTA, sexual violence and TB.
c. Shika Adabu
Shika Adabu is exposed to the following hazards; fire, garbage, RTA, drugs, contaminated water, sanitation
and floods.
Hazards rampant in the 3 locations are fire, drugs, HIV/AIDS, TB, Cholera, contaminated water, poor
sanitation, poor drainage, prostitution and derelict buildings.
e. Tononoka
Tononoka has the problem of drugs, derelict buildings, and lack of sanitation facilities in some areas, TB,
HIV/AIDS and Diarrhoea.
f. Ganjoni
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Ganjoni is mainly faced by insecurity cases but in the slums it is more of drugs, lack of water and sanitation
facilities, diarrhoea, TB, HIV/AIDS and to some extent skin conditions.
Diseases on weighted-basis ranked highest accounting for 17 per cent of the disasters that the
communities collectively are aware of and or directly affect their livelihoods. Relatively, disease based risks
and hazards have strong correlations with the prevailing community conditions like Cholera weighed highly
on communities with heavy presence of slums and or informal settlements, severe to frequent water
shortages, poor drainage system and malfunctioning and or lack of sanitation facilities and problem of
garbage and dumping sites in residential areas including medium to severe sanitation, waste and drainage
problems. Strong cases reported in Ganahola, Bangladesh/Kisumu Ndogo slums in Mikindani, Chaani,
Wayani and Bokole slums in Port Reitz. While areas like Shimanzi, Shika Adabu, Changamwe and upper
Mikindani have garbage disposal problems. Mikindani and Miritini suffer severe air pollution that spreads
TB, Respiratory and Coughing and skin problems due to the levels of dust in most places within the
residential areas. Below is an illustration of the diseases reported to be affecting the community.
A woman’s nutritional status has important implications for her health as well as the health of her children.
Malnutrition in women results in reduced productivity, an increased susceptibility to infections, slow
recovery from illness, and heightened risks of adverse pregnancy outcomes. For example, a woman who
has poor nutritional status as indicated by a low body mass index (BMI), short stature, anemia, or other
micronutrient deficiencies has a greater risk of obstructed labour, of having a baby with low birth weight, of
producing lower quality breast milk, of mortality due to postpartum haemorrhage, and of morbidity of both
herself and her baby.
Child nutrition rates were found to be alarming as per the analysis according to the District Public Health
Officer for Kilindini District. Nutrition and other related basic care for children are at the lowest level this was
attributed to failure by parents to attend follow medication and care. The data obtained from the District
Health Information and Records Office at Port Reitz District Hospital showed that the health facilities handle
only new cases of infants and children upto 1 year old. Children above 1 year old were the highest
defaulters when it comes to basic care and nutrition. The highest and most common nutrition elements was
found to be Vitamin A supplements where 61.9 percent of children were found to be compliant. While
children under 5 years attending clinics were 60 percent clearly indicating the level of personal awareness
among parents were high. However, the general health status of children were found to be unsatisfactory
as the Mid Upper Arm Circumference (MUAC) with greater than 13.5cm was only 5.13 percent of the
number of children attending clinics, with the biggest number not known as there are no follow up records
35 percent of children under five are stunted (low height-forage), while 7 percent of children are wasted
(low weight-for-height) and 16 percent are underweight (low weight-for-age).
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Children under 5 receiving Vitamin Confirmation from data of the patients
A supplements in health facility seeking treatment at the facilities.
2 60
These are mainly new cases. Old cases
Children Under 5 attending growth lack adherence as parents do not turn up
3 monitoring clinic new visits 31.3 for monitoring.
Children under 5 with MUAC less These are new cases. Old cases cannot
than 13.5cm confidently build assumptions as the follow
4 5.13 up rates is negligible.
Lactating mothers with MUAC These are id upper arm circumference
greater than 21.5cm measurements taken at the facility for
5 2.15 mothers seeking medical attention.
Pregnant mothers with MUAC These are id upper arm circumference
greater than 21.5cm measurements taken at the facility for
6 2.57 mothers seeking medical attention.
Table 7: Infant and Maternal Malnutrition Rate
The chart below illustrates the level of deaths among infants and children under 1 year. In 1000 births
recorded in the facility 80 deaths are reported while in 1000 births recorded outside the facility 60 deaths
are reported.
Maternal mortality rate was realized to be much higher in the health facilities as compared to outside. This
was mainly due to the level of referrals carried out in the district as most facilities cannot offer the level of
service and attention needed for pregnant and ailing mothers. Meaning that fewer deaths are likely to be
reported at the community level as compared to the facilities, maternal health was another issue of concern
as the safety and health of the children could directly be comparable to that of the mothers. The main
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contributor to the mortality rates of mothers apart from nutritional issues was realized to be the lack of
enough capacity at the local community to handle such cases which is worsened by the poor roads network
and accessibility. Patients from Shika Adabu suffer a lot as their referrals are to the Coast Provincial
General Hospital which takes a long time due to the inconsistent and slow ferry services. Even though
there exists emergency considerations there are always ineffective to be relied upon.
5.2.2(b.)Area of
92%
study Majengo,
Mwembe Tayari,
Tononoka and Shimanzi Locations
Malnutrition rate according to the clinical data reviewed indicated low levels among infants and children
under 5 years. The explanation for this can be in two folds (1.) being that the areas studied are within the
island which is the CBD of the county or (2.) the levels of information, income and living standards are
average or above average. Further analysis of the data showed a similar trend with the data collected in
Changamwe indicating that a good number of the mothers seek and or are referred for further assistance in
health facilities in Mombasa. However, feedback from informants indicates that the common ailments they
suffer from were Malaria, Respiratory Ailments, Diarrhoea, occasional Cholera and STDs which were
corroborated by the data from the District Health Office in Mombasa as indicated below. Infant mortality
rate recorded at 59.3%, malnourished children at 10, 080 out of 66714 or 15.11%.
Comparatively, susceptibility to health risks is more high in the west coast in the locations studied than
within the island. More households are prone to illness with women and children under 5 years being the
most vulnerable.
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5.3 Vulnerability Demographically
Community vulnerability cannot directly be linked to specific households but more so on the general
practices of an entire community. The common view is that “vulnerable populations” include the very young,
the very old, women and people with disabilities, while partially accurate, this view of the “most vulnerable”
is often misleading and could result in inappropriate response expectations or activities. Stated more
specifically, not all seniors, youth or women are “vulnerable”. Some may in fact be more adept at
responding to disaster than their general grouping or population category might first indicate. However, the
feedback from the respondents provided a vital insight on why certain cadre of the community is vulnerable
or dimmed to be more vulnerable than the others. The graph below indicates the most vulnerable in
percentage.
30
25
20
15
10
0
Women Elderly Men Youth Children Disabled Children
U5 5-14yrs
Women are the most vulnerable in the 11 locations studied this can also be attributed to the cultural
practices, community beliefs and attitude towards women and the unwillingness of men to let women
participate in decision making at the household and community levels. Even though, direction observations
and individual interviews intimated a few women taking leadership positions including political and
organizational. The results strongly indicated a correlation between the level of women vulnerability and
that of the children under 5 yrs and between 5yrs-14yrs. Because women are vulnerable they are more
likely to rub and or impact the same on their children at all levels, this attribute is strongly repeated in the 11
locations with worse case in Miritini where women and children face sexual violence and exploitation in
equal measure. In most of the households interviewed, Women are expected to take care of their families,
look after their households and ensure the household properties are secured.
The top ranked risk factors are household related and this is where women and children are likely to be
found most of the time. High cases are found in Bangladesh, Chaani, Port Reitz (Bokole, Wayani,), Shika
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Adabu, Changamwe (Kisumu Ndogo slums) and Tononoka (Moroto, CPGH slums). Another key element of
concern is the household or domestic violence reportedly in the slums that further weakens women resolve
in building their own resilience towards disasters. Youth Vulnerability is mainly attributed to lack of
employments opportunities, costly higher education and lack of pass time/social recreational facilities that
have made them susceptible to drugs and substance abuse. Youth vulnerability is correlated to drugs and
substance abuse which is rampant and strongly repeated in the 11 locations with worse cases in
Tononoka, Shimanzi, Port Reitz, Mwembe Tayari, Mikindani and Shika Adabu. The elderly vulnerability is
attributed to neglect and lack of old aged care services with exception of Majengo and Shimanzi that have
a closer proximity to such services. While men’s vulnerability is the lowest and strongly attributed to low
cadre employment and local brews/alcoholism. A trend that repeats itself in all the slums and low economic
endowed households.
More surprising was the level of individual awareness on disasters, understanding of risk factors seemed to
increase with the level of exposure and proximity, this is explained by the information levels of the people in
slums and informal settlements on the dangers that surrounds them (Mikindani-Bangladesh slums, Miritini,
Chaani slums and Port Reitz slums) unlike in the middle level settlement people are oblivious of the risks
around them, there’s is a feeling of safety ‘Self fulfilling prophecy’ i.e. Ganjoni, Mwembe Tayari, Tononoka,
Mikindani and Port Reitz (middle class settlements). Vulnerability to risk and disasters is pegged more to
the levels of income a household generates rather than awareness and education levels. Resource
endowment was particularly the main causal factor of the community living conditions. Most respondents
expressed strong feelings of wanting to move out and or live somewhere else that is much better and safer.
Community vulnerability is presented by developmental challenges that are neither regulated nor checked
with some within the control of the locals while some quiet beyond their efforts exposing them to all manner
of risks. The following attributes were noted from the respondents which further highlighted the in depth of
the causes of vulnerability among the local people.
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taking advantage of the problem to earn a living. However, it might be a coping mechanism but further
analysis indicates that the water vendors observes no water transportation standards or water handling
safety measures exposing the consumers to more water borne related diseases. Hygiene conditions are
much lower in the locations studied characterized by informal settlements and collapsed system. On
sanitation, only 17 percent of Mombasa County is connected by Sewerage system managed by Mombasa
Municipal Council at Kipevu plant, the rest 83 percent are left to find their own means of disposing solid
waste including human waste.
The Problem is more pronounced in Chaani, Changamwe, Port Reitz, Miritini and Shika Adabu where
human waste is mainly collected in wells which act as septic tanks and most toilet facilities are mainly pit
latrines. While the sewerage system in Mikindani has collapsed pouring effluent to Bangladesh slums all
the way to Changamwe then Chaani to the ocean at Kipevu exposing close to 150,000 people to various
ailments from the overflow. The lack of proper waste disposal, sanitation facilities and systems have
caused major pollution problem in the studied locations, with garbage lying everywhere, fresh water wells
mixing with effluents as they are sunk closer to each other. Common ailments are malaria, cholera, typhoid,
food poisoning, diarrhoea, skin conditions and intestinal parasites/warms in both adults and children all
strongly related to hygiene conditions. Food handling and vending was pointed out by health specialists as
one contributor to the ailments.
The water and sanitation bit pose more public health related concerns. As the water shortage continues the
locals find an alternative means to bridge the gap to ensure their normal lives is not drastically affected.
The same was also noted with the failure by the landlords and municipal council to connect houses to a
functioning sewerage system, septic tanks are bit to act as holding area for human waste before it drains its
content in to wells sunk to serve the purpose sewerage system would have served.
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Community Vulnerability on Weighted
Basis Water and Sanitation
Roads and Infrastructure
14% 12%
Insecurity
Inadequate Health
8%
Services Delivery Point
10%
Landlessness/Squatters
Slums/Informal
5%
Settlements
6%
Housing Problems
8%
Unemployement
Drug Trafficking and
14% Abuse
12%
Poverty
12%
The locations studied being mostly urban, the main roads network is tarmac/macadam roads not prone to
flooding. However, an analysis of the feedback on roads showed that the connecting and main roads were
designed for low volumes of traffic to facilitate movement of vehicles from the mainland to the island, it was
also realized that the roads are narrow and characterized by heavy traffic jams apparently an indication that
the roads are overwhelmed, particularly by heavy commercial vehicles in Changamwe, Miritini, Mikindani
and Port Reitz causing heavy snarl up of vehicles.
The roads serving the residential areas are mainly all weather and marrum roads. The transect walks and
direct observation noted that most of the access routes have been blocked by barricades and tyres leaving
only space passable by foot and not vehicles. An interview of the locals showed this as a mitigation
measure against insecurity in the areas. However, in disaster risk reduction, it was noted that this pose
more danger to the locals but they are unaware as in case of an emergency it would be difficult for the
response teams to carry out any meaningful assistance especially when it is fire related. The access routes
are characterized by individual footpaths rather than known and designated roads and leave-ways. The
results also showed that the road networks existing in the eleven locations are overwhelmed and unable to
handle the nature of traffic it currently experiences. Some of the interior roads are floods prone with bridges
suffering the brunt of storm water during the rainy season especially in Shika Adabu, Chaani, Miritini and
Mikindani. The sewerage pipe serving Mikindani collapsed after being washed away by storm water and
has not been repaired, the effect is, the sewerage effluent drains into Changamwe to Chaani posing more
serious health threat to close to 150,000 people.
In terms of vulnerability of the household to disasters, it was evident that the Swahili type is more prone to
all manner of hazards and risk; this was after a careful assessment of the type of risks on a weighted scale
pertaining to a specific area. High risk areas were found to be predominately Swahili type housing areas,
this was also supported by the community through the number of mentions during hazard mapping
exercise. This can also be seen by the number of cases reported outside Mombasa Island as compared to
the island which is substantially built. The problem is more pronounced and worst case scenarios in
Mikindani, Miritini Shika Adabu, Chaani, Port Reitz and Changamwe. In terms of Districts, Changamwe is
far much worse.
Safety of the houses looking at age, construction type, alarm and the capability to withstand fire for
sometime before the arrival of fire brigade was found to be zero, as the materials used and the type of
housing are highly flammable. The results also indicated lack of supervision during construction to
ascertain standards and quality after approval is granted, every builder constructs as pleased, and this is
evident in how the houses are laid out in a particular area, facing no particular direction. More interesting
was the government owned houses which were found to be very old, unsafe and dilapidated but still have
people living in them especially in Changamwe, Shimanzi and Tononoka.
The study finds the residential areas under the VCA to be extremely dirty, polluted and water logged in
most places with Ganjoni being average. This can also be attributed to the type of housing, the Swahili type
of houses encourages communal utilization of facilities like water points, toilets and common areas which
further makes it difficult to maintain and control sanitation and general hygiene. The houses also lack toilet
facilities, the few that are lucky to have, are inadequate and not connected to a sewerage system. The
houses are prone and susceptible to flooding and fire due to their construction, materials and closeness to
each other.
Health facilities are spread out all over Mombasa County with some privately owned and others
government owned, yet lacking adequate services, delivery points and personnel. Most of the facilities are
shells providing no more than first aid services upto 5 O’clock in the evening when they close for the day.
This quickly translates to lack of emergency Medicare services that are affordable and within the reach of
the locals. Any cases of emergency are referred to Port Reitz Hospital for those living in the West Coast
and the Coast Provincial General Hospital for those living in Likoni and Mombasa sometimes being too late
especially for women in labour characterizing the high number of facility maternal mortality rates. Likoni
faces the worst scenario in terms of emergency preparedness and care, with only one public health facility
and a dozen dispensaries and private clinics, all the cases are referred to Mombasa for more improved
attention, there are no known bed capacity for other ailments apart from 12 beds that cater for maternity
cases. The furthest point in Shika Adabu to the Health Centre in Likoni is averagely 12 Kms while to Coast
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Provincial General Hospital is averagely 25Kms. The results also showed that most people prefer to
recuperate at home than use the busy and congested ferry services to seek treatment in Mombasa Island.
Ferry Services was identified as one of the biggest hurdle in accessing health care for people living in the
South Coast, it is a tiring and painful process for ailing and sick people, by the time they get to the hospital
their condition has worsen. More sad for pregnant mothers with complications and require emergency
operations. Gender considerations indicate that women seek Medicare more than men, this is salient in the
number of women being treated or seeking various outpatient treatment services in the health facilities, the
number of women being much higher than that of men.
Capacity Assessment was categorized in three levels household, community and individual. The
interpretation was at what point would any level intervene in the event of a disaster, how and by what
means? More surprising was the lack of exhaustive ideas on the capacities individuals and households
posses. At the community level capacities were more pronounced due to the local initiatives put in place,
notably was the establishment of community disaster management committees to disseminate and create
awareness and continuous knowledge development including monitoring of early warning system.
Floods, fire and disease outbreaks are the most common disasters but the preparedness level is lacking
this is salient when looking at the number of functioning fire fighting engines and teams which can
effectively deal with fire hazards. The fire engines operational in Mombasa were bought in 1976 and only 1
is functioning, the districts also lack water hydrants out of the 164 built only 2 are working indicating the
lack of preparedness. Most of the disaster committees at the community lack basic knowledge on disaster
management even though, they serve the community and have contributed to reduced cases especially in
respect to fire. Floods were attributed to poor drainage facilities and the grabbing of public land by property
developers who hardly consider issues of drainage. Those found to be functioning were either clogged or
blocked at some point or incomplete draining their content in residential areas and roads this was seen as a
challenge and the community has taken local level initiative to reinforce road reserves with sand bags, build
drainage and water ways
The results also showed the availability of cash reserves in the Constituency Development Fund (CDF) and
local government trust fund (LATF) that can be used to build capacity and or respond to emergencies.
Though the funds have not been properly utilized to respond to emergency the community is increasingly
getting aware of its existence. Most importantly, there were strong indication of contingency planning by the
District Steering Group on Disaster supported by Kenya Red Cross and the DCs Office, the contingency
plans are mainly geared towards risks reduction. The existence of corporate organizations both private and
public in the areas of disaster management boost the capacity of the county in handling small to medium
level disasters. The assessment pointed out the following organizations and the area of interventions.
The above organizations have in earnest contributed collectively to the capacity of the local communities to
disasters management, supporting the locals to respond to fire cases, disease outbreaks and phenomena
that exceed the local capacity to cope.
Community capacity to reduce disaster risks has not been fully tapped, data from Municipal Council of
Mombasa Fire Brigaded Department, shows that fire incidences have drastically reduced in the last two
years can directly be attributed to the community disaster teams, increased personal awareness and
continued surveillance of early warning system. Increased community awareness to disasters has also
indicated increased potential at the local levels to reduce vulnerability and disaster risks.
The risks extensively repetitive in the 11 locations are strongly health related, meaning the community
vulnerability is contributed by their exposure to health hazards and risks with Diarrhoea and Malaria being
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the lead causal factors. Skin conditions, intestinal parasites/worms, respiratory conditions and TB can
highly be attributed to hygiene levels, pollution, garbage disposals and human/solid waste disposals in the
locations studied. Even though, Cholera and Typhoid is repeatedly mentioned and recurrent, data from the
specialist indicate isolated cases that are not rampant. Drugs and substance abuse and STDs were the key
contributor to the levels of vulnerability among the youth which strongly correlates to the levels of criminal
activities, recourse to violence and insecurity among the youth. This also corresponds to the levels of
prostitution and HIV/AIDS.
The results also showed that women are more vulnerable to most of the disasters because they are largely
presumed to be household or occupational based and they happen where women are likely to be found
most of the time, it is an indication that women are likely to be exposed to most risks. The results show that
exceptions are however, when it comes to skin diseases, intestinal worms, TB and cholera men are mostly
affected, this can be attributed to the nature of work men do especially in Changamwe District that expose
them to the hazards. Incidentally, children under 5 years share the same or near level of vulnerability with
women, infant mortality and malnutrition rates also are at levels that can be considered as high in this time
and era.
Roads and infrastructure poor maintenance have made them prone to flooding in Miritini, Mikindani, Shika
Adabu and Port Reitz where bridges and feeder roads are sometimes completely cut off. Health facilities
are not properly equipped with materials and personnel to handle the level of cases they do, most are
merely first aid posts, holding and stabilizing patients before disposing to hospitals which averagely is about
25Kms or more to the furthest village which was part of the areas of the study. In Chaani, Port Reitz and
Mikindani illegal houses are built below or near high voltage electricity lines, gasoline pipelines and
petroleum pipelines being more catastrophic further, showing how people place themselves in the path of
hazards in these areas.
Severe to acute water shortage levels in the 11 locations have exposed the communities to water
contamination due to water vending and handling. This is a practice where water is sold in jerry cans in
handcarts, the handling does not follow any universal recognizable or acceptable standards. The effects of
this has been poor hygiene standards, diarrhoea, skin conditions, intestinal worms and to worse extents
cholera outbreaks. Sanitation largely is another key concern, lack of toilet facilities especially in the slums,
collapsed or nonfunctioning sewerage system and uncoordinated disposal of human solid waste is the
largest single contributor of the increased levels of health hazards. In most households interviewed, the
results indicate the use of septic tanks sunk as wells. Incidentally there are water wells and boreholes
supplying the same households with water within the same area and not meeting the required 30m
distance for safety of the water for domestic use. The effects corresponding to the situations are cholera,
typhoid, diarrhoea, skin conditions which reportedly are rampant. The entire Mombasa County has no well
functioning sewerage system, what is referred to as sewerage system serves only 17 percent of the total
population. An alarming percentage especially when Mombasa is considered to be the second largest town
in the Country.
Landslides are hardly reported and have currently reached devastating levels in Mikindani especially
affecting the informal settlements of Bangladesh, the same has also been experienced in Miritini where
roads and other essential amenities like water points and toilets have been swept away during the rainy
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season. RTAs are mainly associated with the highways at Shika Adabu, Mikindani and Miritini. This is also
due to narrow roads , heavy tracks and heavy traffic.
Disasters are not frequent in the areas studied, however, the prevailing conditions, living conditions and
economic endowment force people to seek cheaper and less costly way of life. This was salient in what the
local people call residential areas, very much pronounced in the nature and type of houses found in these
places. The house type poses more danger to the locals than they would want to openly admit, prone to
flooding, collapse and landslides as they are muddy and mainly thatched or iron sheet roofed or blocks but
haphazardly done. Lack of effective services has left gaps in the community that is being exploited by other
unscrupulous people. Lack of water and severe shortages has created unregulated water vending which
increases water contamination due to the unsafe handling, food kiosks and vending have increased food
poisoning and intestinal worms with resultant diarrhoea.
Disaster preparedness is generally low, with no clear and distinct authority despite the national disaster
policy providing an outline in terms of coordination, response and recovery strategies. At the local level it is
equally worse in most cases appealing to government and well wishers to support measures requiring
substantial financial commitments. In the study areas it was presumed the DC to be incharge of all disaster
operations in the district. The following are the pertinent recommendations made from the results of the
VCA process.
1. Prioritize major programs for rigorous monitoring and evaluation. Many programs would benefit from
systematic monitoring and evaluation, such as the Constituency Development Fund emergency kitty,
disaster management committees, disaster response teams and disaster based organizations. Since
strong technical skills in research design, management, analysis and reporting are required,
collaboration with independent research institutions can help ensure the quality and credibility of
results. This is mainly due to the lack of credible data on how disaster initiatives are carried out,
involvement criteria and who are responsible for what and how at the local levels. Management of data
is a key concern when it comes to building scenarios as what is available is inadequate with the
exception of health records.
2. There is an urgent need to carry out extensive Hygiene and Sanitation awareness to build the capacity
of the local people to handle risks and hazards pertaining to health, water and sanitation as these are
found to be the key concern and most common on weighted-basis. Collectively they have largely
affected community health and safety than any other single occurrence causing epidemics in some
areas and increasing vulnerability to high proportions.
3. Community Disaster Committees require more specialized training to be able to monitor early warning
system, create awareness and reduce risks to build enough capacity at the local levels for disaster risk
reduction. In the 11 locations disaster committees exist but with no clear terms of reference, training
nor formal knowledge on managing or coordinating disaster situations, nevertheless disaster
committees are underutilized and untapped local resource. The districts were also found to be lacking
in disaster preparedness plans, it was also difficult to understand the operations of the existing
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committees at the district levels and the terms of reference that guide them. The contingency plans
were evident and well spelt out, there is a need to share the contingency plans with the local
communities, disseminate what is expected from the plans, enforcement terms and criteria and the
expectations from the community.
4. Drugs and Substance Abuse especially hard drugs and alcohol contributes to the vulnerability of youth
and men who are the majority of the working groups, this shows a trend that might affect and threaten
the community livelihood in the long term due to reduced manpower capacity which again will affect
household earnings and living standards. Advocacy, lobbying and increased awareness on substance
abuse need to be scaled up including security surveillance and law enforcement to eradicate the
practice.
5. Enforcement of environmental laws and regulations on solid and liquid waste disposal especially
human waste. The areas studied are an eyesore, dirty and polluted in many parts with no sewerage
system, poor sanitation, garbage collection and disposal problem and acute water shortage, there is
urgent need to lobby jointly with stakeholders for better services to improve community safety.
6. Disaster response is skewed, despite corporate organizations’ presence and willingness to assist
during disasters, the coordination is lacking, and this is evident in the manner in which disasters are
managed. The local communities and stakeholders need to develop a system for coordination and
management of disaster situations to improve efficiency and reduce the interface between disaster
occurrence and the vulnerable community.
7. Concerted efforts to track and explore predictive mechanisms for various disasters have not been
made, the efforts currently are reactive and preemptive rather than preventive. Historical profiles of
disasters from the communities indicate a consistency of occurrence and impacts of the same disasters
almost on a yearly basis and the local people would tell you the same things over and over.
Stakeholders and partner’s consultation and collaborations need to be strengthened through more
networking, joint/inter-agency planning and further research.
8. Public Health Department needs to be integrated in the enforcement of regulations and continued
public education as the laws are largely violated in the 11 locations studied. This would bring about
improvement of living conditions, personal hygiene and sanitation levels to reduce health hazards.
More public education on child and maternal health to reduce the malnutrition among children under 5
years and their mothers.
9. Disaster Risks Reduction programmes in Mombasa need to focus more on community education,
awareness and continued knowledge development, capacity building and training as a means to recruit
and enlist local support and get the people to take action through their own initiatives to bring about
much needed transformation.
References
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1. Assessment of Severe Malnutrition Among Hospitalized Children in Rural Kenya Comparison of Weight for
Height and Mid Upper Arm Circumference: http://motherchildnutrition.org/resources/pdf/mcn-comparison-of-
weight-for-height-and-mid-upper-arm-circumference.pdf
3. Kilindini District Development Plan 2008-2012, Government Printers Nairobi June 2009, Office of the Prime
Minister, Ministry of State for Planning, National Development and Vision 2030
4. FAO (1990), The Toolbox: the idea, methods and participatory assessment, monitoring, evaluation in community
forestry. D’Arcy Davis Case: http://www.fao.org/documents/show_cdr.asp?
url_file=/docrep/x5307e/x5307e00.htm
5. Development Association for Self-reliance, Communication and Health. Participatory Rural Appraisal on Health
6. VCA Toolbox International Federation of the Red Cross and Red Crescent Societies 2008
7. Mombasa District Development Plan 2008-2012, Government Printers Nairobi June 2009, Office of the Prime
Minister, Ministry of State for Planning, National Development and Vision 2030
9. Interworks (2001), Disaster Management Community Baseline Data, Jim Good and Charles Dufresne;
www.interworksmadison.com
10. A Guide to Library Research Methods: Thomas Mann, Oxford University Press, ISBN 0195049446.1987
11. BPI reference, International Federation of the Red Cross and Red Crescent Societies, (2003) Aid: Supporting or
undermining recovery? Lessons from the BPI, international Federation, Geneva.
12. Catholic Relief Services (1999), Rapid Rural Appraisal and Participatory Rural Appraisal Manual, K.
Freudenberger.
13. Institute of Economic Affairs 2008: Socio-economic impacts and political profile of Kenya
14. Kenya Poverty and Inequality Assessment Volume I: Synthesis Report June 2008. Report No. 44190-KE
WORLD BANK
15. National Disaster Management Policy Sessional Paper, Office of the President, Ministry of State for Special
Programme 2006.
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Appendix 1:
1. Chaani
2. Changamwe
3. Ganjoni
4. Majengo
5. Mikindani
6. Miritini
7. Mwembe Tayari
8. Port Reitz
9. Shika Adabu
10. Shimanzi
11. Tononoka
Appendix 2:
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List of respondents/key informants/ stakeholders interviewed
Stakeholders/partners
Key informants
1. Business people
2. Vendors
3. Local hawkers
a. Susceptibility to Disasters
- What people are most at risk during disasters (age, gender, occupation, area)?
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- In what specific ways are they vulnerable?
- What are the causes of their vulnerability?
- How frequent are the disasters?
- What items are valued most as the key contributors to the locals’ livelihoods?
- What challenges ahs the community faced when it comes to disasters over space and time (probable time/recurrence)?
- What makes the community so vulnerable to disasters?
- What is the impact of the problem/challenges so far?
- Who are the most vulnerable (children, women, men, youth)?
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- Condition and type of construction for emergency shelter
i. Economic Endowment
- What nature of economic activities do the locals engage in?
- Is there a diversified local economy?
- What are the main sources of livelihoods for the local people?
- How is the land tenure and ownership?
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- What are the coping strategies for each specific area addressed?
- What are some of the constraints and pitfalls in managing disasters?
- What are the roles of the different agencies in disaster mitigation?
- What kind of assessment has the (local) government carried out, and did it involve the community?
- What do most people do when affected/victims of disasters?
- Are losses and damages incurred during disasters more/less frequent than in the past?
- Do you have a community disaster response team/committee/management team?
- Is there a disaster contingency/response/preparedness plans? When was it developed? Has it been operationalized? What
is the community and stakeholders response?
- Who is responsible for disaster coordination?
Appendix 4. Photographs
1. Graphic presentation of the areas studied
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