By Gitonga Njeru
In the heart of Athi River in Machakos County in Kenya, eight-year-old Anne Kuria’s life is a constant battle to breathe. Once vibrant and energetic, she is now weakened by respiratory illness. Her mother, Mary Wanjiku, spends countless nights at her daughter’s bedside in Kenyatta National Hospital (KNH), exhausted from months of sleepless nights and mounting medical bills.
“Every breath Anne takes is a struggle. The doctors say it’s the air she breathes, filled with dust from the factories and quarries around us,” Wanjiku says, holding back tears.
In the shadow of Kenya’s industrialisation drive, Anne’s story is becoming common. Mining, cement, and construction companies – many of them Chinese – have expanded rapidly across Kenya, fueling economic growth, but also unleashing a public-health crisis, particularly among children.
“The science is clear: prolonged exposure to particulate matter like PM2.5 and PM10 is directly linked to chronic respiratory illnesses, especially in children. What we are witnessing in Athi River is a preventable public health crisis,” says professor Elijah Martim Songok, the director-general of the Kenya Medical Research Institute (Kemri).
Songkok says that by the time children arrive at referral hospitals with advanced respiratory symptoms, the damage is often already done. “We must strengthen community-level detection and invest in prevention, not just cure.”
Athi River: Ground zero
Athi River is one of the worst-hit areas in the country. According to a 2024 Earth Journalism investigation, the town is home to about 400 industrial operations. Some 40 of these are companies focused on heavy manufacturing, eight of which manufacture cement.
A 2022 study titled ‘Cement Dust Spread as Influenced by Wind and Its Impacts on Settlement Patterns and the Biophysical Environment’, published in the East African Journal of Environment and Natural Resources, analysed data from an unnamed 250-bed hospital in Athi River and concluded that the most common dust pollution illnesses are skin infections, eye infections, and other respiratory complications.
“We are seeing an alarming rise in respiratory cases from areas like Athi River,” says Dr Evan Abwao, a pediatric pulmonologist in Nairobi.
“Children are especially vulnerable because their lungs are still developing. The combination of dust, industrial emissions, and poor air quality creates a perfect storm for serious health complications.”
Among the most common illnesses reported in these areas are asthma, bronchitis, pneumonia, upper- and lower-respiratory tract infections, chronic obstructive pulmonary disease-like symptoms and, in long-term cases, even silicosis – an incurable lung disease often associated with mining.
What the science says
According to World Health Organisation (WHO) guidelines, a safe level of PM2.5 is an average exposure of 15 micrograms per cubic meter of air per day. PM refers to particulate matter – or in lay terms, air pollution – tiny particles that penetrate deep into the lungs. However, a 2023 environmental assessment studying Athi River found that concentrations of PM10 and PM2.5 routinely exceed both Kenyan and WHO safe levels for air quality.
Air quality sensors in Sabaki, Athi River consistently show PM2.5 levels exceeding WHO limits. Data for the majority of days in December 2023 and January 2024 above the 15 micrograms per cubic meter threshold, according to the Clean Air (Africa) project, which focuses on air-quality-monitoring research. Industrial activity, vehicle emissions, and quarrying are suspected contributors.
“The persistent high PM2.5 levels in areas like Sabaki present a serious public health crisis,” says Dr James Mwitari, director of Kemri’s Air Pollution Centre of Excellence.
“Data from projects like Clean Air (Africa) underscore the urgent need for stronger enforcement of environmental regulations and targeted interventions to reduce pollution exposure and save lives.”
Communities fight back
China Wu Yi (Kenya) is a company in Athi River that produces precast cement. It is currently being sued by residents of Athi River, backed by environmental advocacy groups, with medical practitioners providing expert evidence. The plaintiffs are demanding compensation, accountability, and the restoration of their rights. Child plaintiffs form a distinct class within the lawsuit, given that their health is most at risk because their lungs are still developing.
The court papers, filed at the high court of Kenya, reference the statistically significant elevation of PM2.5 and PM10 in Athi River, before detailing how this is tied back to China Yu (Kenya)’s operations.
“This deposition of harmful airborne pollutants, directly attributable to the respondent’s mining and processing activities as evidenced by wind direction analysis and material composition testing outlined in … this report, has created a demonstrably hazardous environment for the residents of Athi River.”
The papers go on to state: “The direct consequence of this environmental negligence is the documented surge in pediatric respiratory illnesses, including but not limited to, asthma, bronchitis, and pneumonia, within the affected communities of Athi River, as corroborated by medical records submitted.”
The court papers also call into question China Yu’s claims of adhering to ‘best practices’, stating that it is ‘unequivocally contradicted by the empirical data’ presented on the plaintiffs’ behalf.
The court case is ongoing.
The families left behind
Douglas Musau, a father of three, knows the toll first-hand.
“My six-year-old son was healthy and full of life. Now he battles asthma so severe that he can barely play outside.
The doctors link it directly to the dust from the nearby quarries.” In Kyang’ombe Primary School, just 3km from a major cement factory, teachers report increasing absenteeism.
“Many pupils are missing classes due to respiratory illnesses,” says Margaret Wanjiru, a schoolteacher.
“Their performance is dropping and some even drop out altogether because their families can’t afford constant hospital visits.”
Another parent, Josephine Njeri, has two children with persistent bronchitis. “We don’t know what else to do. We can’t move. This is where we live, but the dust is everywhere, even inside the house,” she says.
Government response
Cabinet secretary for mining, Hassan Joho, acknowledged the crisis. “We recognise the environmental challenges posed by mining activities and are working closely with stakeholders to ensure that operations adhere to the highest environmental standards to safeguard the health of our communities,” he said.
Pressed further, Joho admitted: “Enforcement has lagged behind, especially in rapidly industrialising zones like Athi River. We have instructed the National Environmental Management Authority to conduct surprise inspections and publish compliance reports quarterly.”
Joho also pledged a new government initiative focused on air quality. “In the coming months, we will launch a national air-quality-improvement programme targeting major industrial towns, beginning with Athi River.
“This will include the installation of real-time air-quality monitors, mandatory dust-suppression systems for quarries and cement factories, and the establishment of buffer zones between residential areas and mining operations.”
Joho confirmed the guidelines for the new initiative will be in place by 1 December 2025.
However, activists and health professionals argue that enforcement remains weak, with WHO and Kenya’s own air-quality regulations frequently flouted. Penalties for polluting companies are minimal, with fines of up to 500,000 Kenyan shillings (about $3,860) or jail terms not exceeding six months.
A climate-change activist, Mithika Mwenda, secretary-general of the Pan-African Climate Justice Alliance, urges for stricter penalties and harsh punishments, including lengthy prison sentences and the revocation of operating licenses.
“These companies operate with utmost impunity. Fines of $5,000 or less are not prohibitive and the same goes for prison terms of six months,” Mwenda says. “We need action to save lives.”
Pediatric pulmonologist Abwao warns that, without immediate interventions, Kenya could face a generational health disaster. “Air pollution now rivals infectious diseases as a leading cause of child mortality and morbidity. Unless we act now, we will pay an even greater price down the line.”
The road ahead
Environmental experts are calling for the following programmes to be implemented: strict enforcement of air-quality regulations; mandatory installation of dust-suppression technologies; creation of community-based respiratory health centres; and continuous air-quality monitoring and public reporting.
“The future health of children like Anne Kuria hinges on the actions taken today,” says Abwao. “Progress cannot come at the cost of the nation’s most vulnerable people.”
As Kenya races towards its Vision 2030 industrialisation goals, Athi River’s story stands as a sobering warning: the real wealth of a nation lies not just in minerals or cement, but in the health and future of its children.
Publication of this story was made possible by a grant from the Africa China Reporting Project (ACRP). Witwatersrand University.
Child plaintiffs residing in Athi River: The text specifically mentions “child plaintiffs,” indicating that children and/or their legal guardians are a distinct group within the lawsuit.
Therefore, Residents of Athi River are the biggest plaintiffs.
Others are Law Firms in Kenya and Environmental Advocacy Groups:. They mostly represent the communities in Athi River.
Doctors and healthcare providers in the Athi River region, and medical organizations, Mostly well conversed with the pollution challenges in Athi River.
They provide expert testimony or even join the lawsuit to highlight the health impacts of the pollution. They are members of KMPDU ( Kenya Medical Practitioners, Pharmacists and Dentists Union). Largest umbrella body of health workers in Kenya.
There are also a few independent interested individuals with a keen interest in environment.
A quote from a court paper reads:
“Exhibit A, the independent environmental impact assessment conducted in the vicinity of the respondent, China Wu Yi (Kenya clearly demonstrates a statistically significant elevation in particulate matter (PM2.5 and PM10) exceeding both Kenyan national standards and WHO guidelines in the Athi River region.
“This deposition of harmful airborne pollutants, directly attributable to the respondent’s mining and processing activities as evidenced by wind direction analysis and material composition testing outlined in sections 3 and 4 of this report, has created a demonstrably hazardous environment for the residents of Athi River.
It further reads: “The direct consequence of this environmental negligence is the documented surge in pediatric respiratory illnesses, including but not limited to asthma, bronchitis, and pneumonia, within the affected communities of Athi River, as corroborated by medical records submitted as Exhibit B.”
“The assertion by the respondent that their operations adhere to ‘best practices’ is unequivocally contradicted by the empirical data presented, revealing a clear and present danger to the health and well-being of the child plaintiffs residing in Athi River.” reads court papers at the high court of Kenya.
The numbers behind the crisis
According to KNH’s department of occupational health, respiratory-related cases referred from Athi River average 21 children per month, with peaks during the dry season.
“The cases linked to air pollution, particularly respiratory diseases among children from Athi River, have seen a sharp increase” says Dr Samier Muravvej, chairperson of the KNH board. “Four years ago, we would only get five such cases monthly.”
“Children are arriving with advanced symptoms – chronic coughs, wheezing and, in some cases, full-blown respiratory failure requiring ICU care.”
“We have expanded our pediatric respiratory unit capacity by 15% to accommodate the influx, but it’s still not enough,” he adds.
“The hospital has initiated a dedicated respiratory-health outreach programme targeting affected communities, including Athi River, to improve early detection and treatment.”
“We are collaborating with the ministry of health and environmental authorities [the National Environmental Management Agency] to collect data that will better inform interventions both inside and outside the hospital,” Muravvej says.
“Our biggest challenge remains the lack of preventive measures upstream. We can treat the symptoms, but unless air quality improves, we will keep seeing more young patients suffer.
“It is heartbreaking to witness how industrial success is shadowed by the suffering of innocent children,” he said.
The families left behind
Douglas Musau, a father of three, knows the toll first-hand.
“My six-year-old son was healthy and full of life. Now he battles asthma so severe that he can barely play outside.
The doctors link it directly to the dust from the nearby quarries.” In Kyang’ombe Primary School, just 3km from a major cement factory, teachers report increasing absenteeism.
“Many pupils are missing classes due to respiratory illnesses,” says Margaret Wanjiru, a schoolteacher.
“Their performance is dropping and some even drop out altogether because their families can’t afford constant hospital visits.”, she explained further.
Another parent, Josephine Njeri, has two children with persistent bronchitis. “We don’t know what else to do. We can’t move. This is where we live, but the dust is everywhere, even inside the house,” she says.
Government response
Cabinet secretary for mining, Hassan Joho, acknowledged the crisis: “We recognise the environmental challenges posed by mining activities and are working closely with stakeholders to ensure that operations adhere to the highest environmental standards to safeguard the health of our communities,” he said.
Pressed further, Joho admitted, “Enforcement has lagged behind, especially in rapidly industrialising zones like Athi River. We have already instructed the National Environmental Management Authority to conduct surprise inspections and publish compliance reports quarterly.
”He continued: “Mining is important for our economy, but it cannot come at the expense of human life. Children should not be the collateral damage of development.”
Joho also pledged a new government initiative focused on air quality: “In the coming months, we will launch a national air-quality-improvement programme targeting major industrial towns, beginning with Athi River.
“This will include the installation of real-time air-quality monitors, mandatory dust-suppression systems for quarries and cement factories, and the establishment of buffer zones between residential areas and mining operations.”
Joho confirms during the interview that all these new guidelines will be in place by December 1st this year. Joho admitted that enforcement by NEMA still remains weak.
However, activists and health professionals argue that enforcement remains weak and penalties for polluting companies are minimal. Penalties of 500,000 Kenya Shillings or jail terms of six months are not punitive according to many activists.
Last year, immediate former Environment Cabinet Secretary Adan Duale warned companies dumping industrial waste along Nairobi River of severe fines and revocation of operation licenses
Abwao warns that, without immediate interventions, Kenya could face a generational health disaster. “Air pollution now rivals infectious diseases as a leading cause of child mortality and morbidity.
“Unless we act now, we will pay an even greater price down the line.”
WHO air quality standards and Kenya’s reality According to the WHO global air quality guidelines, safe levels for PM2.5 are 5 µg/m³ (annual mean) and PM10 is 15 µg/m³ (annual mean). Recent measurements in Athi River exceed these levels by three to five times, especially during dry months.
Kenya’s own air quality regulations, outlined in the Environmental Management and Coordination (Air Quality) Regulations 2014, are regularly flouted, with minimal enforcement. https://kam.co.ke/highlights-on-the-air-quality-regulations-2014/
The road ahead
Environmental experts are calling for the following programmes to be implemented: strict enforcement of air quality regulations; mandatory installation of dust-suppression technologies; creation of community-based respiratory health centres; and continuous air-quality monitoring and public reporting.
“The future health of children like Anne Kuria hinges on the actions taken today,” says Abwao. “Progress cannot come at the cost of the nation’s most vulnerable people.”
As Kenya races towards its Vision 2030 industrialisation goals, Athi River’s story stands as a sobering warning: the real wealth of a nation lies not just in gold, titanium, or cement, but in the health and future of its children.
Publication of this story was made possible by a grant from the Africa China Reporting Project (Witwatersrand University).