NAIROBI, Kenya — Mathare settlement isn’t an easy place to stay clean and healthy on an ordinary day, so preventing COVID-19 from infecting people in a crowded slum of Nairobi is a challenge.

Most of the 500,000 people who have taken up residence in Mathare are living there because they can’t afford to live elsewhere. They make, on average, less than $1 per day by doing manual labor or domestic chores in other neighborhoods.

Public water and sewer services are nonexistent in most of Mathare, so people either pay private vendors for water and toilet privileges or figure out ways to take care of their personal needs for free.

Some pathways between the tin rowhouses are strewn with garbage. When it rains hard, the water flows downhill toward the river, sliding under doors and walls and waking people sleeping on the floor. Five to 10 people typically live in each 10-foot-square house.

In this situation, COVID-19 could spread quickly, said Judith Siambe, program director for The Centre for Peace and Nationhood, a ministry of Kenya Mennonite Church. Mennonite Central Committee supports CPN’s work with maternal and child health in Mathare.

“If this disease were to get in the area where we are working, it would mean that the whole population of their area could be cleared out,” Siambe said. “We really need to preserve this community for the future.”

Sharing information

CPN already has an established information network of health promoters and care group volunteers from Mathare who conduct trainings and share about health with pregnant mothers and mothers of young children. When COVID-19 cases appeared in Nairobi, CPN knew they had more training to do.

CPN staff, health promoters and care group volunteers helped spread the government’s directive to wash hands and limit movement within the city.

Social distancing is “practically impossible” in the community, said Christabel Awuor, a CPN project officer and midwife who works with the maternal and child health program. “But we keep insisting that . . . if you are going to go to work, wear a mask and try to maintain a social distance.”

Instead of sharing information in group settings, CPN health promoters and volunteers visit mothers individually to share information about COVID-19 symptoms and prevention. Those mothers share the information with their neighbors.

CPN also hired people with portable public address systems to walk through neighborhoods with information about prevention, symptoms and phone numbers to call if someone has signs of the disease.

Care group volunteers are making masks to sell to the community at a lower cost than they can be purchased elsewhere. They also make homemade liquid soap, using ingredients CPN provided, which is much less expensive than buying soap at a store.

CPN uses the soap to supply 50 handwashing stations they established in Mathare — one for every 20 households. These MCC-funded stations will serve 5,000 to 10,000 people.

Volunteers protect and manage each station, keeping water and soap resupplied and teaching anyone who will listen about the importance of washing their hands.

Anxious times

“Everyone is scared and anxious right now about the coronavirus,” Awuor said. People wonder, “What if this goes on for a while, a year or two? How will we survive?”

The survival question is especially critical because staying home is not an option.

“These people work on a daily basis to look for food,” Siambe said. “Yes, they are scared of the disease and no one wants to get it, but sometimes they feel, ‘If I stay home, my children and I are going to die of hunger.’ ”

Recently, one of the neighborhoods where many people get day jobs was closed. No one was allowed in or out.

“Also, there is a kind of stigma,” Siambe said, “because people who come from this kind of community are poor. They cannot afford sanitizers. They cannot afford high-quality masks. So [people in] places they work despise them and don’t want them to work anymore because they fear they will infect their families with the disease.”

CPN’s presence in the community, even during the time of coronavirus, sends a message to people in Mathare that they are valued.