By Hope Pheliane
Global narratives on East Africa’s climate crisis have been dominated by images of cracked earth, withered crops and swelling heat waves.
Yet an invisible, under-reported public health crisis is brewing in Kenya’s high-altitude regions. Increasingly unpredictable weather patterns are exposing communities to severe cold and sudden shifts in temperature.
For residents accustomed to seasonal weather patterns, these cold spells are more than an inconvenience. They are increasingly becoming a health concern, particularly for children, older people and those living with respiratory conditions.
According to Chris Mutai of the Kenya Meteorological Department, a single very cold day acts primarily as a short-term trigger of ill health. A prolonged cold exposure, exponentially increases the odds of more frequent infections, worsened chronic lung conditions and persistent airway inflammation.
“These severe seasonal cold shocks are driving massive spikes in upper respiratory tract infections, childhood pneumonia, and hypothermia, pushing rural dispensaries and county referral hospitals to their limits,” says Mutai.
Amid the rising scale of this crisis, are county health systems that lack specific, ring-fenced budgets for climate-resilient health supplies, relying heavily on national government and donor magnanimity for response.
Rose Mokaya, Assistant Director of Public Health in the Ministry of Health’s Climate Change and Health Unit, says counties currently do not have dedicated budgets for climate-related health interventions.
Instead, they draw funding from the National Treasury’s Financing Locally Led Climate Action (FLLoCCA) programme, which has decentralised climate finance to local communities to implement climate resilience and adaptation projects.
But as climate-related health risks become more complex, experts argue that health systems need to be better prepared before extreme weather strikes rather than relying mainly on emergency responses once patients begin filling hospital wards.
“Climate change is contributing to changing weather patterns in Kenya’s eastern highlands. This has led to a sharp rise in respiratory illnesses such as flu, pneumonia, and asthma besides severe frost risks that damage local crops,” says Mutai.
He revealed that, though some households have introduced different ways of coping with extreme cold, some methods can create other health hazards. One of the common method is burning charcoal jikos to warm the homes, particularly at night when temperatures fall sharply.
While this may provide immediate relief from the cold, burning charcoal indoors exposes households to smoke and potentially dangerous levels of carbon monoxide, especially in poorly ventilated spaces. This creates a vicious cycle in which one climate-related hazard can produce another.
Nyandarua is rated among the coldest counties in the country, with nighttime minimum temperatures regularly dropping to as low as 7°C. Other counties along the eastern highlands, including Nyeri, Kirinyaga, Murang’a, Kiambu, Meru, Embu, Tharaka-Nithi and Laikipia, can also experience severe cold spells.
Even Nairobi County experiences cool and cloudy conditions, with minimum temperatures hovering around 12°C during some periods, although temperatures can fall further during severe cold spells.
The cold-weather risk extends beyond the eastern highlands. Mutai says the Western Highlands, the Lake Victoria Basin and parts of the Rift Valley also experience dangerously cold nights. These areas include Kisumu, Siaya, Homa Bay, Migori, Kisii, Nyamira, Kericho, Bomet, Nakuru, Uasin Gishu, Nandi, Elgeyo-Marakwet, Trans Nzoia, Baringo and Narok.
In some areas, nighttime temperatures can fall to around 6°C before rising sharply during the day. Such dramatic temperature swings can place additional stress on vulnerable populations, particularly when cold nights coincide with thunderstorms and heavy rainfall.
The risks go beyond illness. Heavy rains can trigger localised flooding, damage infrastructure and leave roads muddy and impassable, making it harder for patients to reach health facilities and for health workers and essential supplies to reach communities.
This combination of changing weather, disease risk and disrupted access to healthcare underscores the need for health systems to anticipate climate-related threats rather than respond to them after they occur.
“To prevent seasonal spikes from triggering similar structural collapses, the Ministry of Health has established a coordinated framework involving the Climate-Change and Health (CCH) Unit, dedicated Technical Working Groups (TWGs), and the Alliance for Transformative Action on Climate and Health (ATAH),” says Rose Mokaya, assistant director of public health at the Ministry.
She says under this framework, the ministry is systematically undertaking comprehensive climate-health vulnerability and adaptation assessments to align directly with Kenya’s 26th Climate Change Conference of Parties (COP26) commitments, adding that “rather than waiting for pediatric wards to overflow in July and August, early warning networks built-in direct collaboration with KMD and the World Health Organization (WHO) aim to trigger defensive logistics weeks in advance.”
Addressing concerns about why real-time data from weather monitors does not feed directly into automated health department alerts, Mutai explains that this happens so that end-clients don’t consume unverified, real-time raw information. KMD utilizes a strict protocol where raw information flows from its instruments straight to its central communication hub to be verified against spatial coverage, temporal duration, and severity.
