Planning your elective - Kenya
Siân Knight finds that there is more to this East African country than safaris and coffee
Kenya, a country synonymous with safaris and coffee, is situated on the east coast of Africa. The country spreads over 583 000 sq km, of which 136 000 sq km is inland water. The deserts of Sudan and Ethiopia lie to the north of Kenya, Uganda and the massive Lake Victoria are to the west, to the east are Somalia and the Indian Ocean, and to the south of the country lies Tanzania.
Kenya is split into four main areas. The coastal belt covers around 480 km of the country adjoining the Indian Ocean and includes the coral reefs, beaches, and a narrow, fertile strip of land beyond which the ground rises to form a central plateau. These central highlands form the second area and are the most scenically spectacular part of Kenya. A rift valley cuts through the whole of the plateau and is studded periodically by extinct volcanoes and crystal lakes. The discovery of hominoid skulls dating back 2.5 million years in the rift valley led to it being dubbed the "cradle of life" - the discovery radically altered evolutionary ideas of the time. The capital of Kenya, Nairobi, is situated in the southern region of the central highlands.
The third area, western Kenya, stretches from the borders of Sudan to the border of Tanzania. The southern part is where the many wildlife sanctuaries are situated--the Masai Mara, Amboselia, and Tsavo. Mount Kilimanjaro, Africa's highest mountain, rises from the scrubland to the south of Amboselia.
The fourth area is the huge northern and eastern Kenya. Here the mountainous scrub land stretches for many hundreds of miles, and the land is suitable only for cattle grazing. This perhaps explains why this land is still unspoilt - native Kenya, at its most wild.
The people
Kenya's population is around 25 million, made up almost entirely of Africans. With an annual growth rate of 3.8% - one of the highest in the world - the population is rapidly growing, and economic expansion is trailing far behind. This has resulted in a great strain on the country's ability to provide a reasonable health service for its people, as well as providing other urban services such as education. There is also huge pressure to cultivate as much of the land as possible, resulting in environmental damage.
There are still more than 70 tribal groups in Kenya, although as Western culture becomes more commonplace the tribal distinctions become more blurred. The younger members of tribal groups are attracted to the cities, and the groups become scattered. Many tribal traditions are still prevalent. Male circumcision, for example, remains an important rite of passage to manhood. Kenya is politically stable compared with other African countries; this and the wealthly tourist trade almost magnetically attracts refugees. The cities attract large number of teenagers and young mothers; some are Kenyan, but most originate from Uganda, Rwanda, Sudan, and Ethiopia. They arrive with no money and very little else and are herded into overcrowded shantytowns, such as the ones which 60% of Nairobi's population exist in. Outside traditional tribal areas all undesirable urban alienation traits emerge, and theft, drunkenness, and rape, especially of schoolgirls, are commonplace. If a young girl becomes pregnant, she is expelled from school, signifying the death of her education and the hope of escaping the shantytown that accompanies it. If these girls are lucky, they will gain domestic employment for a wage of a dollar a day, if unlucky, they will be prostituted on the streets.
Beliefs
Owing to intense missionary activity right across Kenya, almost every Christian sect is represented. The missionaries place Jesus hand in hand with education and medicine--even now, in some outlying regions, the only place to gain medical treatment is at a mission station. Other major religions, apart from tribal beliefs, include Muslims and Catholics.
Languages
English and Swahili are the official languages taught in Kenyan schools. If you plan to do your elective in more remote areas a working knowledge of Swahili is essential - it is the language that most tribes use to communicate. In the major tourist areas, however, English is the spoken language.
Medical care
Medical treatment in East Africa is costly, and public hospitals are often crowded. British prescription medicines, however, are often available over the counter and are much cheaper than over here. There is one state general practitioner per 21 250 people and one private general practitioner per 2500. There is one state hospital per 212 750 of the population, and the number of private hospitals is only marginally higher, with one per 178 550 of the population. Malaria is endemic in Kenya, and you should take precautions to protect yourself against chloroquine resistant strains. AIDS is also a big problem.
Key facts
Capital - Nairobi
Languages - Swahili, English
Currency - Kenya shilling (Ksh) of 100 cents (Ksh124.8:£1 at the time of going to press)
Population - 29 292 000 (1994 UN estimate)
Population density - 50 per sq km
Illiteracy rate - 21.9%
Siân Knight, studentBMJ
studentBMJ 1999;07:394-436 November ISSN 0966-6494