Kenya's post-election violence and the 'hapa-hapa' syndrome

Outbreaks of violence following Kenya's disputed general election in December, 2007, left many houses burnt.

"I came here when they attacked my village and burnt it. We have nothing. All I could save was the mattresses for my husband and my children. We've been staying in this church for 12 days now. My husband was with us for the first few days but then he went to stay with his brother nearby because there are no blankets here. He used to come and visit everyday, but I haven't seen him for the last two days. My eldest daughter is not well, she has a fever and has had a rash for days now." - Judith

The violence following the Kenyan election on December 27 has shocked many. The country is still reeling from outbursts that have seen houses being burnt and looted, thousands of people displaced and over 600 deaths.

The psychological trauma is evident in the consultations done by a Kenyan nurse, Albina Aluda, who is employed by MSF to work in a temporary clinic in the Langas camp: "Many people come to us saying they have headaches or aches and pains. We call it 'hapa hapa' (here here) syndrome. They point to themselves and say they have pains 'here' and 'here' but really their pains are more emotional than physical."

On January 2, an MSF team of one nurse and one logistician went to Eldoret, a Kenyan town 250 km northwest from Nairobi, the capital city. In the wake of the recent violence following the contested general elections, the town was faced with a large influx of displaced people, which led MSF to begin an emergency intervention. Today, the situation has calmed down but the poorest displaced people wonder what could be their future now.

Mwania has been here before. During the clashes of 1992 he came to this exact place, the Langas police station in Eldoret, to seek safety. When he returned to his village after the violence of 17 years ago his, house was still intact.

"This time there is nothing to go back to. My house and all my belongings have been burned," he said. The future for this grandfather, and the ten family members he has with him, is uncertain. For now they will stay in the camp that has sprung up around the police station.

"My parents are still in my village, but my sister and I left with my daughter because they told us they would burn our house. We came in a big group by foot. Now there are ten of us living in this tent. We can't go back as our house is completely burnt, it is like a field now. Anyway, those people are still there so it is too dangerous. Me, I don't know what to do. It is a difficult life we are starting, because we are starting with nothing." - Christine

Although things seem to be getting calmer, the situation is unpredictable. In the last few days MSF teams working in Eldoret, Kenya's fifth largest city, where thousands of people came to escape the violence, have witnessed a rapidly changing situation.

Some displaced people's camps that were packed with hundreds of families just a few days ago are now empty as many have decided to go home. Others remain crowded. Conditions in the camps vary greatly. A few are well organized as the people living there left their homes when they were threatened and so managed to bring most of their possessions with them. Their shelters are packed with bicycles, clothes, blankets, food, buckets and more. Others ran as their houses burned and have nothing.

But the thousands of people still living in the settlements and camps all have one thing in common: they are not planning on leaving anytime soon.

"The displaced people who are in Eldoret now are some of the most vulnerable," explains Pierluigi Testa, MSF's Project Coordinator in the city. "Many of them are too scared or poor to return home, but the majority cannot leave as they no longer have homes to go to."

"It's difficult here, but at least it's safe. We left our village because they beat the men and threatened us. There are 15 of us living here now. The police are taking some people back to collect their stuff or to stay if they want to. I don't think we will go though. My grandfather says it is too dangerous, if we go back they might surround our house and burn it while we are inside." - Margaret

MSF has been working in Eldoret since January 2. At present, an international team of eight staff visits camps and settlements, providing assistance to the displaced. On January 3, MSF chartered two planes loaded with supplies. Since then, teams have distributed 6,000 blankets as well as 2,250 kits containing essential items such as blankets; plastic sheeting for building some kind of shelter; jerry cans for transporting and storing water; and cooking sets, all to around 20,000 beneficiaries.

Logistical teams have constructed showers and latrines and ensured clean water in two camps. In some of the camps, nearby health clinics are slowly resuming normal activities, so MSF assists by supporting staff and providing drugs and supplies. In others, MSF doctors and nurses provide on-the-spot consultations and treatment for the sick. The most common complaints are diarrhoea, skin rashes and respiratory tract infections.

Everyone has suffered and everyone is scared.

"The other day one of the houses nearby caught fire accidentally," explained Maina, one of the people living in Langas camp, "and everyone just ran."

Yet despite the trauma of the recent weeks, the medical needs in Eldoret are not acute. If the situation in Kenya continues to stabilize, MSF will consider phasing out its activities. A number of other organizations have now started working in and around Eldoret, many of which are better suited to meet the long-term needs of the displaced people.

Health clinics and hospitals, which were closed or hampered by a lack of staff during the worst of the violence, are up and running again and should be able to meet people's health needs. MSF will continue to monitor the situation in Eldoret but will concentrate its efforts on other more remote locations, such as the rural areas around Molo, where more assistance is needed.