Evalyne Nyangweso, the female paramedic taking on Nairobi’s slum where ambulances daren’t go
London, August 12, 2019 (AltAfrica)-In Kenya’s Kibera, where government ambulance teams daren’t go, a local has taken matters into her own hands
No day is the same for Evalyne Nyangweso, entrepreneur and owner of an ambulance service dedicated to an unforgiving community prone to poor health, disease and high crime rates.
Operating in Kibera, Africa’s largest slum, where traditional ambulances daren’t go and even police tread carefully, Nyangweso and her crew are the first responders to medical emergencies.
From domestic violence to gang rape, rapid response paramedics encounter extremes. Punctuality and compassion are key, and failure can result in being pelted with stones by frustrated bystanders. It’s not a job for the faint-hearted – homes in Kibera are constructed of timber stakes, mud walls and corrugated steel roofs and are built on animal and human waste. Cholera and typhoid are rife along with HIV, which infects 60% of the adult population
Despite this, Nyangweso remains dedicated and on call 24/7 to 250,000 of Kenya’s poorest people. In the little spare time she has, she advertises, handing out calling cards in hospitals and churches and posting stickers around Kibera.
Rapid Response is now in its third year. Nyangweso came up with the idea after she was made redundant from Nairobi’s St Mary’s Mission hospital.
Nyangweso and her husband are both trained nurses, with children aged nine, 14 and 19, for whom they have high hopes. “It’s a medical family. I like it and would like them to be in the same field. If not the ambulance [service], maybe doctors or surgeons,” she says.
She knew the Red Cross were struggling to cope with demand in Kibera. After completing a paramedic course, she bought a fully equipped ambulance and a second compact vehicle to negotiate the narrow dirt tracks. Both were second-hand. Next she recruited staff: Timon and George, trained emergency vehicle drivers, and Winnie, a Red Cross-trained paramedic.
The next challenge was communication. With no hi-tech call centre, Nyangweso uses her own mobile, juggling business and personal calls. She hopes one day she will make enough money for a second phone, as her current one has a broken screen.
“We collected a pregnant woman from Kibera and delivered her to hospital, but her child died. She had no phone and wanted to ring her husband to ask him to take the child to the mortuary, as the hospital won’t do this without payment. I lent her my phone. Carried away by emotions, she threw it, damaging the screen. She had no money to pay for it or the ambulance journey. It’s difficult when people live below the poverty line. There was nothing I could do,” she says.
“Some patients don’t pay. They promise and don’t honour it,” she says. “One woman had her baby prematurely, the baby needed to be taken to intensive care. She had no money but said she would pay the next day, so we took them. Unfortunately, the baby passed away. The next day I rang the woman who asked: ‘Why are you calling? Why do you want me to pay when my baby is no more?’ – so she didn’t pay. That is life in Kibera. If the result is not good, they do not care.”
The liveried vehicles sit on standby in Nairobi’s Uhuru Gardens car park from 8am to 6pm, six days a week and staff are on call throughout the night. Nyangweso monitors response times; drivers must be at their vehicle within five minutes of a call and ambulances must arrive at the scene within 20 minutes, even through the dark streets of Kibera where road accidents, muggings, assaults, and shuttle runs between hospitals are commonplace.
“Conditions in Kibera are not easy. It’s overpopulated, with no discipline. It’s every man for himself, which makes our work difficult,” says Nyangweso. “Problems occur during disputes. You’re there to take one party to hospital but the other side does not want you to, so they start pulling you about. We’ve never been attacked but I know of cases where ambulances have arrived late and the patient had deteriorated. The crowd became angry and beat the crew brutally.”
Kibera has a prolific rape crisis. Perpetrators target the young, the elderly and those with disabilities. “Incidents of rape are high at any time of the day. Girls aged 9–15 being raped by middle-aged men is most common,” she says.
“Yesterday we attended a call to a young girl who had had sex with man with HIV. We don’t know whether it was with consent or rape as she ran away. Here after 24 hours or a bath you cannot prove it was rape. We spent the day searching for her then gave up.”
If rape is suspected the paramedics have to stop at Kibera’s police station to report it before going to hospital. “At the police station they check outer clothing for signs of assault or semen. Only if they agree it’s rape – [then] we take the victim to hospital. If the family give consent the hospital will go through the examination process but up until recently it was not free, they had to pay. Likewise for DNA tests, but this changed recently. Sometimes having to pay is a problem, so maybe they leave it, treat the victim and go back home. Then later you hear that the father or husband of the raped woman has fought the suspect and a grudge builds between the two families.”
A significant number of the guilty go unpunished. “It’s bad, imagine as a parent, having a girl of 15 and a man who knows he has a disease goes with her. A girl whom you as a parent are trying to bring up to be somebody in society. Then he does something like that and goes unpunished. It hurts.”
Prostitution is rife in Kibera, including among the very young, says Nyangweso. “They do it to help their mothers … mothers send them to do it, saying: ‘Bring money so I can feed your younger brothers and sisters,’” she says. Women are also trapped into having sex with other men to feed their children, says Nyangweso.
She says the government must be stronger on rape, prostitution and violence against women “because that is the beginning of the family. Without rights there is no future.”
She adds that the government should create jobs for Kibera’s men. “Many are idle, drinking cheap brews, causing indiscipline and shortening their lives – but I think they simply don’t care. [They think:] ‘I will never be a victim because I can [punch] somebody. I cannot allow it to happen, I’m capable.’ These things happen to women in Kibera because they are not independent, but I can live my own life with my children and if my husband starts, I can tell him to leave. I am independent.”
First published by Guardian UK under the headline ‘We won’t refuse anyone in need’: the paramedics taking on Nairobi’s slum”