Raising Air Pollution Awareness in Kenya: Interview with Dr. Malkia Abuga

OpenAQ, an international non-profit providing open access to air quality data, has concluded its Community Ambassador Program 2023 with its final presentation in March. 

​​This annual program aims to help emerging air quality leaders in developing countries develop skills to advocate for clean air. ATMO has been a program supporter.

We talked with Dr. Malkia Abuga (PhD), Deputy Head Community Health Strategy Coordinator at Nairobi County and the OpenAQ Community Ambassador, about the major air pollution problems in Kenya and her efforts as a public health specialist to increase air quality awareness in communities in Nairobi County.

ATMO: Thank you so much for agreeing to an interview. Can you please introduce yourself and share your primary reasons for joining the OpenAQ Community Ambassador Program?  

Malkia: My name is Malkia Abuga. I work in Kenya as a public health professional with Nairobi County.

As a public health officer, one of our key roles is to ensure that we can monitor air quality and use the information to design interventions that mitigate air pollution and improve the health of our community. So, one of the things that drew me to the program was that I didn't have optimal knowledge about monitoring air quality, using sensors, and exploring air quality data.

So, it is one of the things that drew me to the OpenAQ Community Ambassador Program.

ATMO: Have you achieved these goals during this program? 

Malkia: Yeah, through the community ambassadorial project — I'll say I achieved my goals — especially on building my capacity. It enhanced my knowledge and skills on how to use air quality data for decision-making. Number two, it provided us with air quality monitors. Air quality monitors, especially portable ones, such as Atmotube, helped me meet my objectives because I could go with it to any place to measure the air quality and use it to inform or educate others.  

Thirdly, I had the opportunity to network with other community ambassadors from different countries.

Learning what was happening in their countries was a very good opportunity. We used to have working group sessions where you could learn about what is happening in another person's country and share what is happening in my country.

So for me, it even exceeded my expectations. 

ATMO: The OpenAQ program seems to be very practice-oriented. As a public health expert, can you please share the primary sources of indoor air pollution in Nairobi County?

Malkia: We have done an emissions inventory, and data analysis is ongoing, but from my observation, while doing the data collection analysis, one of the contributing factors is the source of energy for cooking, heating, and lighting. Most households in low-income areas use charcoal or kerosene for cooking.

Of course, they use all kinds of stoves. A few households use LPG gas, and others use ethanol for cooking, but a considerable population still uses charcoal and paraffin. 

The design of households in such areas also contributes to the severity of indoor air pollution. Some households have a single room, meaning the cooking, seating, and sleeping areas are the same, contributing to inadequate ventilation. So, you find that we have a concentration of bad air.

If you have somebody who is asthmatic or has respiratory illnesses, it might trigger their respiratory condition, especially asthma. It is estimated that 60 percent of households in Nairobi are in informal settlements. A significant proportion of these households are overcrowded and lack adequate ventilation. 

Also, it means that purchasing power is low. LPG gas prices are not cost-friendly for some households, which means they will not use clean energy at the household level as they should, and of course, it will increase the number of respiratory illnesses.

ATMO: And what are the possible scenarios for solving this issue, at least partially? It's also a social and economic problem, so you can't solve it immediately. But what are the possible mitigation measures? 

Malkia: Policy and practice do not go together. We are all advocating for clean air energy, but if this energy is not cost-friendly, people might not be able to purchase it. 

That's one of the challenges. 

ATMO: When you educate people about the negative aspects of using, for example, paraffin, what kind of measures do you propose? For example, dividing the cooking areas from the living spaces, or what are other possible mitigations?

Malkia: We recommend that they open the window and the door when they are cooking so that they can get some circulation from outside. 

Then, if they use charcoal for cooking, once they are done cooking, they should take the jiko (note: charcoal stove) outside. Recently, we have even had some children or family members die from indoor air pollution and, of course, carbon monoxide inhalation when they sleep with the jiko throughout the night.

One mitigation measure is to ensure good airflow in the household by opening the windows or doors while cooking because the house is usually one room.  But the best solution is to reduce the cost of clean energy so as to increase access.

ATMO: So we talked about indoor air pollution. What about outdoor air quality in Nairobi? What are the primary sources?

Malkia: All right. Primary sources include several studies that show that transport is the largest contributing factor to outdoor air pollution in Nairobi. Industries are also major contributors. Some use biomass as their energy source; some use diesel, and, you know, you have to supplement because electricity is very expensive.

Another is roadworks. We are a developing country; we have some construction sites and things like that. So, those are the three largest sources of outdoor air pollution. 

Also, we have a lot of street food. The cooking of street food and their energy sources contribute to high pollution.

ATMO: What do you usually address in your awareness campaign about outdoor air pollution? Do you have any recommendations for people? For example, if they live next to a factory that is using biomass, you should do this.

Malkia: Yes, we do have awareness campaigns to educate the population on some of the mitigation measures because regulating issues like the transport sector might take a while.

However, the government recently introduced electric buses and motorcycles, but their use is still low and not affordable. Most use petrol or diesel two-wheelers and three-wheelers. So, it's important to educate the population so they can know how to protect themselves and reduce exposure to outdoor pollution as we wait for government legislation and the rollout of other means to help us reduce pollution. 

Industries are receiving extensive education to help them adapt to clean energy, but we must also make this affordable. The problem is the cost. The majority want to adapt to clean technology, but the costs aren’t favorable. When we talk to the population, we tell them it's good to wear a mask to reduce exposure. 

We observe slow progress, but I know that one day, we'll reach the goal. Funding for air quality issues has not been that big. Even currently, the funding is mostly external. However, we have very good, positive political goodwill, especially in the transport sector, where they have introduced means of transport that reduce our emissions.

ATMO: We also wanted to talk about your activities related to air quality awareness during the OpenAQ program. You said that your work was divided into several categories: community dialogue, forums, household visits, and school visits. Can you please briefly tell us what exactly each activity involves? For example, what does community dialogue mean? 

Malkia: I'll start with community dialogue. Community participation is key in the country as indicated in the Kenya constitution and county acts.

In the healthcare system, we have embraced community dialogue. This is where you call community members on a quarterly basis and share health data. We usually collect health data from different populations. So, when you call a certain village, for example, for a community dialogue, you'll share their health indicators for that quarter. 

For instance, how many diarrhea cases did they have? How many children missed going for growth monitoring? When you're looking at maternal and child health, how many pregnant women do they have? 

So, I leveraged these forums to educate the population of different communities where I was doing the project on air quality. I sensitized them about air quality, the effect of air pollution, and how they can embrace mitigation measures for air pollution. It was also an opportunity to show them the Atmotube and let them know what a gadget that measures air quality looks like.

Because the app is open on the phone, I could explain what different measurements meant and, for example, what they should do to protect themselves when the LED light on the device is red (note: if the LED light on Atmotube is showing red, it means the current air quality is poor). For example, when you enter a household that has closed windows and doors, Atmotube frequently showed that the air quality was bad. In the outdoor environment, if we are in a densely populated area with a lot of traffic, the Atmotube will also show red. It triggers a conversation depending on the condition and what it shows you. 

Then, in the healthcare system, we have the community level, which is considered level one. We have community health promoters who visit households. So, I also leveraged that and went with the CHP (Community Health promoter) to visit households for a one-on-one session with the household members. Because of the time constraints, I was largely interested in households with pregnant women and children under five who belonged to vulnerable groups.  

Then there was a school visit, but I only visited one school. Schools are a good setup to raise awareness about air quality. You can show the gadget to schoolchildren, who get very excited when they see visual data. 

Lastly, I participated in the stakeholder forums, where I spoke about air quality issues, trying to relate gender and air quality issues.

Those are the four areas in which I did my project.  

ATMO: Can you please tell us a little bit more about gender and air pollution exposure? 

Malkia: Yes, I was trying to relate how gender and associated roles affect our exposure to air pollution. In the African setup, women are usually found in the kitchen and exposed to smoke from firewood and charcoal burning. You’ll also find women sweeping the dust all the time.

However, the majority of men work in the transport and industrial sectors. So, we were trying to relate the different setups and genders and how men and women are affected by air pollution. The consequences of women’s exposure are more serious as they're the ones carrying the pregnancy. So if they're exposed to air pollution, then even their children, the fetus in their womb, automatically might be affected. 

So, we should advocate for clean energy so that LPG gas becomes more affordable and other means that can protect the health of our population.

ATMO: And the last question is, what are your next steps after your ambassador program ends?

Malkia: I'll just continue with the projects mentioned earlier. I'll continue with community dialogues, and I aim to ensure I'm part of publishing the emissions inventory data that we have done so that the information can go outside there. 

That is our next step. 

And then another step is to look for funds. There is a need for resource mobilization to do some of the activities such as training our community health promoters on household indoor pollution and community engagement. I believe our community members should be empowered by being provided information that is understandable. Otherwise, whatever measures we are bringing in place, we might not achieve much. We need resources – resource mobilization, data publication, and data collection indicators at the household and health facility levels. 

Lastly… If it didn't happen in the community, it didn't happen anywhere.