BREIMAN: It's actually very hard to imagine
that there are people
in the second decade of the 21st century
that are living under these conditions.
One of the other things you'd notice,
as you walk around in Kibera,
is that the people that are there are almost always smiling.
They're within the moment
and accepting the condition that they're in,
and doing the best they can
to live well within those conditions.
MAN: In Kibera, I think I'm okay, because I'm getting
my day-to-day bread, so I'm fine.
BREIMAN: Kibera is the largest continuous slum in Africa.
And we have somewhere between
600,000 and 1.2 million people living
in basically a river of informal huts and structures.
We have a very unique project going on in Kibera.
The point of the work is to understand
what diseases are causing the most problems
for the people living in this environment.
And so the way we do this is, we have
a group of what we call community interviewers --
they're basically field workers --
most of them actually come from Kibera.
They're residents of Kibera.
OLACK: We have a total of 25 field staff
who go around into the villages,
collecting household mobility surveillance.
[ Ouma speaking Kenyan language ]
BREIMAN: And they carry personal digital assistants,
you know, PDAs.
These PDAs are programmed
with the questions that we're trying to get answers for.
OUMA: Like, we can talk of cholera.
H1N1 was found in the community.
Through the community interviewers
visiting the households, the questionnaires they ask.
ODENGO: Karen came to our house every week.
She wanted to know how we are going on,
anyone who has been sick, anyone who has been in hospital
for two weeks, maybe.
BREIMAN: And we're about to go into a home, where one
of our community interviewers will be collecting data
about illnesses in the home.
OUMA: So, in this last one week,
Wednesday last week until today...
BREIMAN: This is an area of about 30,000 people,
about 8,000 households.
And they go to every single household every two weeks,
and they collect information
about who's sick in the household
and what kind of illness they have.
And if someone's very sick,
they encourage them to go to the field clinic.
It's right smack in the middle of the surveillance area.
And so everyone in our surveillance area,
the 30,000 people that we do surveillance on,
lives within, oh, no more than a kilometer --
most, much, much closer -- to this clinic.
ODENGO: Like one day, I fell sick of pneumonia.
I couldn't walk. I couldn't do anything.
So my neighbors carried me up to CDC.
BREIMAN: When they go to that clinic,
if they have a condition that we're surveying for,
that we're concerned about -- let's say
it's pneumonia, as an example --
then we collect information about that illness
in the clinic by one of the well-trained clinicians
that we have working there.
OJUGUNA: We have identified quite a number of bugs --
initially, diseases like flu were not considered to affect
Third World countries, especially in Africa.
BREIMAN: And now, we're preparing,
over the next couple of months, to introduce influenza vaccine
in the population that we're working in.
The way we conduct our surveillance, we can extrapolate
to much larger populations, and therefore influence policy
that is not just limited to the population
that we're doing the work in.
Being able to identify that we have huge incidence rates
of typhoid fever, for instance,
enables us to go back to the ministry and say, you know,
"If you use typhoid vaccine in similar environments,
you can prevent a certain number
of these severe infections per year at a certain cost."
It's clear that,
like it or not, we live in a global village these days.
And, because of market practices,
because of air traffic, it's very possible for a disease
to move from one corner of the Earth
to another within a day.
And so diseases that emerge,
for instance, in the urban slum of Kenya,
that might seem so remote and not relevant
to someone living in North America,
are actually quite relevant and quite important.
[ Children speaking Kenyan language ]
BREIMAN: There is progress that will be made,
and we have tools now that we can bring to bear
that will make a difference.
It is somewhat helpful to know that there are people,
there are organizations, there are governments
that are willing to focus on those problems.
OLACK: There's nothing that motivates me as much
as seeing somebody or a child who was sick
getting back on his feet again.
OUMA: They are positive,
especially the women and children,
because they know what they are getting from CDC.