Wednesday, December 19, 2012

Sovereign will cannot be unconstitutional!

By Lukoye Atwoli
Sunday Nation 16 December 2012

Last week, the Supreme Court ruled that the one third minimum gender requirement for elective bodies will be realised progressively, and appeared to give an August 2015 date as the deadline by which legislative and policy steps must be taken to achieve it. In my opinion, this was a ruling that reflected the situation on the ground, even if it can be argued that the judges neglected to go as far as either party would have liked.

A commonly held view was that there would be a constitutional crisis if Kenyans did not elect sufficient numbers of either gender to Parliament, given that the constitution binds us to ensure that our supreme legislative body obeys the gender rule. This raises fundamental questions on the role of constitutions in the governance structures of constitutional democracies.

In my view, a constitution is a statement of intent from the sovereign. In the past, this sovereign would be the monarch whose word was law and had to be obeyed by everyone in the realm. It would be useful to consider a scenario in which a sovereign chooses not to obey an edict he has issued. What would law enforcers do? Would they attempt to compel the sovereign to obey the “constitutional” edict? How would they effect this?

My contention is that the sovereign does as the sovereign pleases, and it is not possible to enforce any law against such a person. In our own constitution, we declare ourselves collectively to be the sovereign. We make and give the constitution to ourselves and to future generations, the same way a sovereign would make decrees to govern the people for all posterity.

Keeping in mind that we cannot compel the sovereign to act in any particular way, is it possible to declare any sovereign action “unconstitutional” or even unlawful? Elections are the most powerful expression of our sovereignty in which we delegate legislative authority to a Parliament we have elected ourselves. Whoever we elect to Parliament represents our sovereign will. In my view, it is therefore ludicrous to argue that a product of a free and fair election could be anything but constitutional!

How, then, can we reconcile our sovereign intention of having fair gender representation in elective bodies with the reality that elections are unpredictable affairs where the people could elect anyone?

In my opinion, we should focus on the process leading up to the election itself. The problem with elections, however free and fair, is that the voter’s choice is restricted to candidates presented by the electoral commission. The commission, in turn, relies largely on candidates presented by political parties. The processes involved in selecting these candidates can be tweaked by legislative or policy measures to ensure that both genders are represented equally among the candidates. This will ensure that the voter has a fair chance of electing either male or female candidates, increasing the probability of achieving the gender requirement.

The electoral commission ought to make rules compelling political parties to have equal representation of the genders among their candidates, and further, to have party lists with such gender representation that it would be possible to nominate only candidates of the “minority” gender should the need arise.

This, in my view, can still be done before the next General Election. 

Dr Atwoli is secretary, Kenya Psychiatric Association and senior lecturer, Moi University School of Medicine.; twitter @LukoyeAtwoli

Sunday, December 9, 2012

Pre-election coalitions represent the Kenyan mindset

By Lukoye Atwoli
Sunday Nation 09 December 2012

Last week we witnessed a spectacle that would be funny were it not for the implications it has on Kenya’s future. Beginning two days to the deadline imposed by the Political Parties Act on the formation of pre-election coalitions, and continuing up to the deadline itself, politicians outdid themselves in the art of crafting alliances.

Within those two days, some of the politicians had held talks with dozens of “like-minded” colleagues, most of whom they had previously sworn never to talk to even if they were left alone in the same room. Many took only a few hours to move from one end of the political spectrum to the other, seeking assurances on their own political futures.

Apart from soaring rhetoric, none of the coalitions have indicated the reasons why they came together, and what they intend to achieve once they win power. We are only being bombarded with platitudes full of empty promises of peace and prosperity. To the objective observer, it seems clear that even without stripping away the thin veneer of pseudo-ideological differences, these coalitions are actually agreements between individuals keen on capturing and retaining power.

The tragedy is that they are presenting themselves as representatives of political parties, and even worse, of their own ethnic groups. This way, it is becoming easy for the voters to tie the personal fortunes of these coalition-builders with their own individual fates, and those of their tribes. The result is utterly predictable. After the 2013 General Election, one “coalition” will win the election, and the others will lose.

Due to the non-ideological emotions being whipped up as the politicians seek coalitions, it is foreseeable that the losing group will raise complaints about the legitimacy of the election. No matter how genuine the complaints will be, supporters of the group will gang up and attempt to stage protests, some of them turning violent. It is possible that the coalescing tribes will think to punish the ethnic “others”, either before or after the elections, by forcefully evicting them from “their territories”, Kenyan code for ethnic cleansing.

If the above scenario sounds familiar, it should be! This is exactly what happened five years ago, with politicians coming together to win and retain power and, in the process, representing themselves as tribal king-pins who could not lose in a fair contest. The result was an election in which victory was claimed by all sides and the rest, as they say, is history.

Perhaps it may do Kenyans well to remind them that the two main “coalitions” presented to the registrar of political parties are not new, and can be traced back 10 or more years ago. The main protagonists in one group were the face of Kanu in the 2002 General Election that was won by Narc. The second group comprises the key members of the victorious Rainbow Coalition, only missing the then presidential candidate, President Mwai Kibaki.

It is my contention that the average Kenyan does not seem to learn from adversity and that, unless something drastic happens, we are due to repeat history in a very tragic manner. Obviously the coalitions being crafted represent the mindset of the average Kenyan, a mindset that has rigged the country onto a one-way track to oblivion.

I hope I am wrong, but I fear I am not. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association, and a senior lecturer at the Moi University’s school of medicine; twitter @LukoyeAtwoli

Monday, December 3, 2012

PEV a result of our individual votes

By Lukoye Atwoli
Sunday Nation 02 December 2012

Recently, I have had occasion to consider the meaning of the individual vote. It has been argued in the past that one vote is really meaningless and can only go so far in effecting change in society. Similarly, a position is often canvassed that, in times of crises, a single individual cannot do much to stem the hysterical tide, and is often swept along by the masses.

Using the example of post-election violence that rocked our country five years ago, many have argued that despite their best intentions and clear visions of how to react to disappointment in a civilised manner, they could not do much to limit the effect of the violence in their immediate vicinity. Some indicated that they got in touch with those of their friends they thought could make a difference, but the answer they got was a uniform one – “You will probably be spared because you are my friend. But keep your opinions to yourself”.

This argument often wins the day, and the discussion often ends with a shrug of the shoulders in a manner to suggest that not more can be done.

However, this position is not entirely accurate. Psychologists have conducted a series of experiments whose conclusions suggest that although people tend to conform to group norms and beliefs, even if this opinion is at variance with their own beliefs, this spell is often easily broken by at least one dissenting voice.

In one experiment, a group of students were told that they would be asked an obvious question, and that they would give a wrong answer in order to deliberately mislead one of them who was not present at the time. Later, the student who was not present when the instructions were given agreed with the group when they gave the obviously wrong answer.

In a slightly different experiment, after one member of the group gave the correct answer, the “ignorant” one followed suit. Clearly, then, when a large group agrees to do something outlandish, it may take only one dissenting voice to stop them in their tracks.

In my view, therefore, most of what happened in this country after 2008 was a direct result of each of our individual votes. Everything the coalition government has done or failed to do is a result of our preferred choices at the last General Election.

The failure of government to implement agreements it reached with various parties can be traced to each and every vote that was cast in 2007. For instance, medical students at my university were meant to have completed their examinations and to graduate before the end of this year, but this will not happen because lecturers went on strike and had a dispute with the government regarding their salaries and allowances.

Doctors, nurses, teachers and other government employees have recently gone on strike as well, resulting in immense suffering for Kenyans. This suffering and trouble can be traced to decisions made by each and every Kenyan in the polling booth. In short, every vote has consequences, and some of these consequences are deleterious even to the voters themselves.

It is, therefore, imperative that as we make our electoral decisions nationally and in our counties, we keep in mind the very personal results of our decision. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Monday, November 26, 2012

Attitude change crucial in reducing gender violence

By Lukoye Atwoli
Sunday Nation 25 November 2012

We recently concluded analysis on data we collected in Eldoret on the psychological factors associated with intimate partner violence experienced by women living in and around the town. Last week I had the opportunity to present the findings of this study at a conference in Lagos, Nigeria.

Compared to previous reports such as the Kenya Demographic and Health Survey (KDHS), we uncovered astonishingly high rates of intimate partner violence in our study. Over four out of five women who participated in our study reported having experienced at least one instance of emotional, sexual or physical violence in the 12 months preceding the study. They reported being slapped, insulted, threatened, beaten to within an inch of their lives and being forced into sexual acts that often resulted in serious injuries leading to hospitalisation.

The most interesting aspect of this study, however, was the finding that two major psychological factors in the women increased their risk of being battered by their partners.

Firstly, holding traditional gender role attitudes significantly increased the risk of being battered. No matter how educated or otherwise empowered a woman happened to be, the fact that she agreed to take a subordinate role in the family hierarchy, instead of offering some protection from violence, actually increased the risk.

Previous work has suggested that women with more egalitarian attitudes had a high risk of being battered, but this was not immediately evident in our study. Instead, we found that differences in gender role expectations were more significant in predicting intimate partner violence than a woman’s egalitarian gender role attitudes. In other words, when a woman had expectations of an equal relationship, and her partner had more traditional patriarchal attitudes, the risk of violence escalated significantly.

Secondly, women who used more passive coping styles were at increased risk of violence from their partners. Surprisingly, even those who used the available social support structures such as extended family, religious organisations and women’s groups were not protected from violence.

In our study, it seemed that having been abused or traumatised as a child also increased the risk of being battered, a finding that is consistent with what others have reported in the past. Further, having a partner who uses alcohol or other drugs significantly increased the likelihood of abuse.

Interestingly, the age or level of education in both partners seemed not to affect the difference in gender role expectations, confirming an important principle in psychology that one’s upbringing plays a huge role in determining their personality and behaviour as an adult. In other words, the child is indeed father to the man.

The key message from this small study we conducted is that despite efforts by government and NGOs geared towards reducing intimate partner violence, there seems to be a missing link in the area of assertiveness and gender role expectations. Empowering women without dealing with their role expectations and those of their partners is actually likely to increase the risk of violence, rather than lowering it.

Perhaps a new approach is called for. We may need to start focussing on changing attitudes towards what constitutes violence in a relationship, since the traditional role expectations seem to condone it in at least some circumstances. A focus on the male partners may in fact have more impact. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Sunday, November 18, 2012

Securing our children’s future against tribalism

By Lukoye Atwoli
Sunday Nation 18 November 2012

Whenever one wants to quit a destructive habit, they are advised to find an alternative wholesome habit to replace it. Spending time on more useful things ensures that little time is left to spend on the destructive habit, and in time, the habit is eventually lost.

In my view, we could apply this principle in dealing with one of our most destructive national vices. Most Kenyans appear to agree that making political choices based on a politician’s ethnicity is a stupid habit that we need to lose if we are to make any headway in achieving any of our national goals.

Since Independence, we have tried several strategies to deal with tribalism – the philosophy that tribal affinity is the primary consideration whenever a political or socio-economic decision is being made. We have tried the path of nationalism and patriotism. We have been exhorted to put our country first whenever we are making decisions.

We have been reminded over and over again about there being unity in strength, and that our ethnic diversity should be our source of strength. We have even walked down the Najivunia kuwa Mkenya (Proud to be Kenyan) route with former government spokesman Alfred Mutua.

Nothing seems to work. Despite all the efforts to remind us that we must think of ourselves as Kenyan first, we have had nepotism and tribalism reigning supreme at the pinnacle of power in our country. We have consistently voted for presidential candidates from our own tribes or those who have been endorsed by our favourite tribal chieftains.

We have even had several mini-civil wars pitting us against our fellow citizens from another tribe. It has gotten so bad that political parties are now known as “vehicles” for tribes and their leaders to compete for positions against other tribes and their leaders. Indeed, the current frenzy of political alliance-making is an ill-disguised prelude to continued loot-sharing between tribal chieftains.

Luckily, there is a way we can finally lay this ogre to rest if we really want to change our way of doing things. Although it is absolutely true that we need to start with the youngest children for lasting change to be realised, this idea always raises the question – who will bell the cat? 

Strategy two

An adult with a rotten mind cannot teach purity to a child. It follows, therefore, that we have to rely on the second-best strategy.

Let us allow the adults to make their decisions whichever way they want. Let them elect their political leaders based on their tribal inclinations if they want to. Let them buy all their food and clothes from people who speak like them, look like them and dress like them. These are their inalienable rights.

But let us also do something else to protect our children from this filthy ideology.

Let us not publicly ask our compatriots how they make their important decisions. Let us not give them an opportunity to spout ignorant ethnocentric tripe, and thus justify their primitive instinctual decision-making processes. Perhaps then our children will grow up believing that we are cleverer than we really are, and are always rational whenever we are called upon to make decisions.

By not discussing the evils of tribalism, we may finally allow this ogre to slink back into the dark, dank cave from which it periodically emerges to torment us. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Sunday, November 11, 2012

Involvement of religious groups in education

By Lukoye Atwoli
Sunday Nation 11 November 2012

The Kenyan Constitution, like any other negotiated document, is decidedly vague in some parts, and apparently contradictory in others. Different interest groups were involved in several stages of its writing, and their fingerprints are all over the document.

Despite the largely liberal tone of the original drafts centred on individual liberties, the final document became an ideological hodgepodge meant to satisfy the loudest interest groups. However, for a document written largely by Harambee, it is remarkable that the original spirit of the citizen managed to shine through despite the best efforts of those that would stifle freedoms and keep the citizen encumbered by opinions masquerading as fact.

In order not to disturb the delicate balance of beliefs and traditions in our country, the final draft was conciliatory to the various cultures, and even deferred to religious organisations, promising respect for all religions and cultures, and freedom of worship for the individual. However, vestiges of the original intent to fashion and maintain a truly secular society remain, as encapsulated in Article 8 of our Constitution: “There shall be no State religion”.

At only six words, this is perhaps the shortest complete article in our Constitution. Its brevity probably encapsulates the uncertainty in the minds of the drafters of the document, as to what the actual will of Kenyans was on this matter. A plain reading would suggest that the State shall not promote any one religion and, taken to its logical conclusion, would mean that religion is outlawed in the corridors of state.

Were the government to take the path of equality of religions, promoting all religions equally, there would be no space enough to hold all the religious groups that would want to be involved in State activities.
The Kavonokya sect that prefers its children to die of preventable illnesses in the name of God would occupy pride of place at the same level as the Catholic Church and Islam.

The Naivasha doomsday sect whose members buried themselves underground in anticipation of a nuclear catastrophe would be represented wherever the Anglican Church is found in a State function or institution. To avoid this sense of entitlement from every sect and denomination, and in order to remain faithful to Article 8, the only rational thing for government to do would be to avoid entanglement with any religious organisation.

This brings us to the hue and cry about provisions in the Education Bill allowing the government to control all instruction in schools, whether public or private.

Religious organisations have argued that they have a right to provide religious instruction in their own institutions without government oversight. The wisdom of this argument is up for debate, given the role of any responsible government in protecting children from potentially unwholesome teaching that may interfere with their normal development.

However, the more interesting demand from the religious lobby is that they would like to have representation on State education boards and institutions. One suspects that this would run afoul of Article 8, as it may constitute promotion of religion, creating de facto “State religions”.

It will, therefore, be useful for both the religious lobbies and the government to examine more carefully the meaning of this brief constitutional injunction before discussing the role of religious organisations in the education of Kenyan children and youth. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association, and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Sunday, November 4, 2012

Are we going to claim we never saw this coming?

By Lukoye Atwoli
Sunday Nation 04 November 2012

It has been said over and over again, but it bears repeating. Our beloved country Kenya is not out of the tribal woods yet. No matter how much we congratulate ourselves and repeat the mantra that “Kenyans have become cleverer”, the truth is that we are constantly one step away from apocalyptic disaster.

After the conflagration that followed our last General Election, many of us thought to ourselves that that was as bad as it could ever get. We watched on television as hundreds of thousands were displaced, as hundreds of our fellow-citizens were butchered for being born in the wrong tribe, and a few of us shed a tear in despair. We wrung our hands and begged the principals to reach an agreement and prevent an all-out civil war. We reached out to the international community and asked them to mediate an agreement.

Finally, we sighed with relief when on the steps of Harambee House in late February 2008, former United Nations Secretary-General sombrely intoned, “We have a deal”. We took to the streets in joy, embracing total strangers, swearing that this would be a new beginning in the history of our country, and telling anyone who cared to listen that we had triumphed over adversity.

Sadly, reality sank in soon enough. The same ethnic considerations re-emerged in making state appointments, and cronyism continued to rule the roost as epitomised by the now immortal incantation by our former deputy Chief Justice, “You should know people”. 

Going nowhere

Those that had been left out of the loop quickly realised that they were going nowhere, and nothing had changed. Poor Kenyans living in squalor in our slums and rural hamlets soon realised that the deaths, rapes and displacements were all in vain, and that the country was soon settling into its “anything goes” routine.

Despair set in once again. Unemployment, extreme poverty and a feeling of disenfranchisement pervades the country in the setting of soaring economic growth numbers and a trillion shilling budget. Our leaders have lost touch with the common mwananchi. They only fight to secure their own fortunes and those of their immediate family and hangers-on. The rest of the citizenry survive on crumbs from their tables. And this is fertile ground for dissent, disengagement, and ultimately, disorder.

We are already seeing signs of disorder. From Tana River to Mombasa, from Samburu to Kisumu, Nairobi all the way to Garissa and Mandera, Kenyans are rising up against fellow citizens. Grenade attacks, killings of policemen and other violent crimes on a large scale no longer merit newspaper headlines.

Let us not repeat the fallacy next year that we never saw this coming. Let no one say that they were never warned. From Justice Kriegler’s warning to the conversations at middle class dinner tables tonight, the warning signs are all around us. From unthinkingly mouthed ethnic epithets to blatant favouritism in allocation of state resources, we are laying ground for the final assault on the idea of Kenya.

Disenfranchised youth have tried the ballot several times and failed to win emancipation. When they tried violence to claim their freedom last time, they were stopped in their tracks by a political settlement.

One shudders to imagine what it will take to stop them once they get going after the next national crisis. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Sunday, October 28, 2012

Lessons from the American electoral process

By Lukoye Atwoli
Sunday Nation 28 October 2012

The American political system is far from perfect, and suffers from many of the same problems our own system consistently throws at us. It is entirely conceivable that in their upcoming election, many Americans have already made up their minds to vote for a person whose ethnic background is similar to their own. There is little any one can do about that.

But that is as far as any similarity between the American and Kenyan political systems goes. The contrast becomes very stark after this.

First, the vast majority of Americans are agreed that if their candidate does not win the election, the world will not necessarily come to an end, and there will be an opportunity to get their favourite candidate elected at the next election. In Kenya, we have invested so much emotionally in political aspirants that in ego terms, there does not seem to be a boundary between the individual supporter and his favourite candidate.

The result, of course, is that whenever anyone denigrates the politician’s position on any issue, it comes out as though it is a personal attack on the supporters. The outcome, as obviously expected, is a catastrophic hysterical reaction that often ends in open conflict between opposing camps.

Second, despite the apparent gulf in their positions on various issues, the American candidates have maintained a healthy respect for each other, with no insults or intemperate language flowing between them. 

Debate vigorously

They are able to sit in the same room, debate vigorously and sometimes very roughly, but in the end they shake hands and say nice things about each other.

Third, the candidates have stuck to attempting to demonstrate real differences in their policy proposals, instead of engaging in personal attacks. Even in areas where an objective observer would notice similarities, such as in foreign policy, the candidates continued to show how they would do things differently from each other.

If our politicians want a peaceful country to govern after next year’s General Election, there are several things they will do as a matter of urgency.

One, they will make it clear to their supporters that there is a very real chance that they may not win the election, and that in any case the margin between the winner and the others may be razor-thin. They will then tell their supporters in no uncertain terms that they will not be associated with violence, and will in fact denounce anyone engaging in violence in the candidate’s name.

Two, they will run an issue-based campaign, clearly indicating their planned policy initiatives in health, education, security and infrastructure. They will canvass their positions on trade, agriculture and social issues such as family, religious freedoms and immigration. They will demonstrate to Kenyans how progressive their positions are, and how they will benefit the country should they win the election.

Finally, the candidates will maintain respect for each other, and use wholesome language when referring to their opponents. Using derogatory language in reference to their opponents will be avoided and punished by public condemnation. Calling their opponents snakes, horses or donkeys will be avoided, keeping in mind the amount of emotional investment and lack of ego boundaries among the supporters.

This way, we shall have a government that is committed to the welfare of all Kenyans after March 2013. 

Dr Atwoli is the secretary, Kenya Psychiatric Associaton and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Continuing neglect of mental health dangerous

By Lukoye Atwoli
Sunday Nation 21 October 2012

Just under two weeks ago, the world marked the World Mental Health Day. In Kenya, it was in a low-key manner unlike in the past when there would be processions and speeches at a public health facility, and usually around the Mathari Hospital in Nairobi.

Perhaps the low-key commemoration was an appropriate metaphor for the amount of attention being paid to this very important aspect of our national life. Despite going through the annual ritual of lamenting under funding for mental health and neglect of the national referral mental hospital, very little seems to change each year.

Indeed, it could be argued that things are getting worse. Predictably, rates of mental illness are increasing as a function of industrialisation and “development”. Further, as people become more and more aware of mental health issues, demand for mental health services continues to rise.

Finally, as the national population continues growing rapidly, the absolute numbers of people with mental illness will follow suit, even if the prevalence rates remain constant. The upshot of this increased demand is that we need more mental health facilities and workers to address this need.

Unfortunately, the health sector as a whole is suffering from systemic neglect born of government policy that considers health to be a side-issue that can be addressed after “more important” sectors have been taken care of. Despite government commitment to spend 15 per cent of the budget on health, current expenditure is still less than half that figure.

Health facilities are still largely understaffed, have old and battered equipment, and suffer from shortages of essential supplies. To make matters worse, less than one per cent of the health budget is spent on mental health, with the bulk of it going to pay salaries. The Kenya Board of Mental Health, established by statute over two decades ago, has yet to be facilitated and its effect has not been felt across the land. Regional mental health boards as provided for in the same Act are unheard of.

Mental health programmes are rare and completely dependent on donor funding. Sponsorship for training in mental health is dwindling, and most postgraduate students in psychiatry have lately been from other countries in the region.

The truth of the matter is that this continued neglect of mental health poses a grave danger to the well-being of our country. The danger is not as abstract as saying that a nation whose mental health is unattended to cannot prosper socially or economically.

It is the real danger that mentally unwell people are running this country and making decisions that affect all of us. Mentally unwell people are teaching our children, preaching in our places of worship, driving our public transport vehicles, and treating our sick relatives in hospitals.

Mentally unwell people are shaping national discourse in the media, and others are leaving their homes in droves to join Al Shabaab and related militias. Mentally unwell people are roaming our streets unattended, posing unspoken dangers to themselves and others. Mental ill-health, running the entire gamut from mild afflictions to the more severe disorders, is very common in this country.

And unless we start funding mental health programmes and paying attention to staffing and infrastructure needs, we might as well give up on all the other national endeavours we are pretending to pursue. 

The writer is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Monday, October 15, 2012

There’s a need to do more to tame MPs’ greed

By Lukoye Atwoli
Sunday Nation 14 October 2012

President Kibaki has declined to sign into law a Bill that, among other things, sought to award members of parliament a “winding up allowance” of close to Sh10 million each. This would have cost the exchequer upwards of two billion shillings at a time the government was adamant that there isn’t enough money to pay teachers, lecturers and other public sector workers demanding a pay rise.

This show of insensitivity only goes to demonstrate the inaccuracy of the belief that one should go to parliament with the intention to serve the country, rather than to enrich oneself. In Kenya, parliament has become one of the ways an individual can say goodbye to poverty without too much trouble.

To cure this malady, it may be worthwhile considering paying MPs a salary based on the average income of the citizen. This way, they may become more likely to support legislation that improves the average income of Kenyans through sound economic policy and prudent management of available resources.

Alternatively, their pay should be pegged on their income immediately prior to their election or that of someone with their qualifications and experience in the public service. This will ensure that they get remuneration commensurate with whatever they would be getting were they in other areas of the public service, eliminating parliament’s current reputation as a cash cow.

The President’s argument that he rejected the Bill due to its unconstitutionality also raises interesting possibilities. Article 2 of the constitution proclaims the supremacy of the constitution, and provides that any law that is inconsistent with constitutional provisions is a nullity to the extent of the inconsistency.

It, therefore, beats reason why the executive arm of government found it necessary to send back the Bill to an avaricious bunch in parliament who will, in all probability, find ways to get it enacted anyway. In my opinion, President Kibaki should just have assented to the Bill and then refused to implement the unconstitutional sections.

The constitution makes it the duty of every citizen to protect its integrity, and the President could have argued that implementing an unconstitutional law would expose him to the danger of impeachment and possible prosecution now or in the future.

Interestingly, it has been argued that the golden handshake provision was just a red herring, and the MPs never intended to get it passed in the first place. Some commentators claim that perhaps their key intention was to blind the public to the change in the elections law making it easier for them to defect from their political parties as close as two months to the General Election.

From where I sit, it is difficult to believe this argument given the sneaky manner they passed the amendment. It was not on the order paper, and it was passed without debate at night when very few Kenyans were paying attention. They wanted it badly, and they hoped that Kenyans would not notice.

It is necessary for Kenyans to institute a process by which the legality of the many self-serving laws our MPs have recently been making can be examined.

In any system of government, any combination of judicial, legislative and executive powers in the same person or institution is a recipe for a dangerous plutocracy over which the citizen would have absolutely no control. 

Dr Atwoli is secretary, Kenya Psychiatric Association, and senior lecturer, Moi University School of Medicine.; twitter @LukoyeAtwoli

Wednesday, October 10, 2012

Health care must become interest of every Kenyan

By Lukoye Atwoli
Sunday Nation 07 October 2012

If there is anything events in the health sector in the recent past have demonstrated, the most startling is that health is very far from most of our leaders’ list of priorities. Despite a doctors’ strike continuing for over three weeks, Kenya’s leading political contenders continued with their lives as if nothing was amiss. A few, of course, made token statements about supporting health and health workers, but it is clear to any observer that none of the candidates has a comprehensive campaign strategy on health.

In other countries, health is a make-or-break issue during any campaign. In the United States, for instance, there are major differences between the two presidential candidates on how to handle health care, and many consider these differences to be so fundamental as to influence their voting choices. In Kenya, obviously no one gives too much thought to this issue.

The tragedy is that the public health sector, broken as it is, is the main provider for a majority of citizens. Over 80 per cent of voters visit public health facilities when they fall ill. Almost all our politicians fall outside this group, and are able to afford care in expensive private facilities. It is thus clear that a chasm exists between the experiences of the leaders and the led, and the possibility of this chasm being bridged is remote.

As someone pointed out to me recently, a developed country is one in which, by choice, everyone uses public social services, including health services. 

Cherished property 

In Kenya, people sell their cherished property in order to afford care in private hospitals. The private health sector is thus the greatest beneficiary of the rot in the public health sector. Indeed, it has been observed that private health providers wrote to the Salaries and Remuneration Commission (SRC) prevailing upon it not to increase the pay of public health workers by a big margin since this would have an impact on their profitability.

One hopes that reason will prevail in the SRC, and that their recommendations will go a long way in making public health care services more attractive than private ones.

The time has come for our presidential aspirants and their political parties to have clear proposals on the improvement of our health sector. Kenyans must start demanding substance from their favourite leaders, instead of fawning all over them on account of their ethnic background. In any case, your tribesmate will not save your life at a time of need if he cannot guarantee a hospital with adequate equipment and staffing in your vicinity.

We need to hear political party positions on the formation of a Health Service Commission to manage human resources for health in this country. We need to know where they stand on the implementation of the Abuja Declaration that called for spending 15 per cent of the budget on health. We need to be told how they intend to improve health infrastructure from the community level all the way to the national level.

Indeed, we need to know who they intend to nominate as their Health Cabinet and Principal secretaries, so that we can scrutinise their integrity and abilities, and make our voting decisions accordingly. Health care must be everyone’s priority, not just for health workers.

This is the thrust of the “Peremende Movement” that exploded out of social media this week. 

Lukoye Atwoli is the secretary, Kenya Psychiatric Association, and a senior lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Monday, October 1, 2012

We must not normalise hate speech by inaction

By Lukoye Atwoli
Sunday Nation 30 September 2012

Some time in the last century, a behavioural scientist known as B.F. Skinner observed that random behaviours can be shaped into a desired behaviour by way of reinforcement. In this model, known as operant conditioning, random behaviour is “shaped” as desired through a system that rewards the desired behaviour.

For instance, a child who randomly gives up his seat for an elder and is rewarded with praise or a gift is more likely to engage in similar behaviour than one who does the same thing and is either ignored or punished for it. This is a fundamental principle in learning and is used in homes, schools, prisons and institutions in which certain behaviours are expected and others frowned upon.

This brings us to the matter of hate speech and how we have been handling it in this country. In January 2008, at the height of the post-election violence, I observed in the Daily Nation that: “... use of ethnic stereotypes must be deemed taboo whether in public or in private. Use of insulting language targeting whole communities must be discouraged whether on the campaign platform or in the privacy of our homes.”

These observations were made in the context of preventing future eruptions of a similar nature, in the hope that Kenyans would learn their lesson and adopt behaviour that would minimise the risk of violence and encourage behaviour that promotes peaceful coexistence of all peoples. Unfortunately, it appears that our social behaviour has not changed, probably due to the wrong schedule of operant reinforcement. 

Largely ignore

We have set rules to prevent hate speech and incitement, but we largely ignore those that engage in this behaviour that we have determined to be obnoxious and inimical to our national goals. Many leaders in the past who engaged in this sort of behaviour were not even made to feel as if they had done something wrong. Indeed they were often congratulated on their forthrightness and encouraged to keep it up.

After we changed our laws and outlawed certain kinds of speech, we had an episode where senior government officials allegedly engaged in hate speech and were eventually arrested and charged. The tragedy is that nobody was then convicted of these crimes, giving the impression that it was sort of okay to engage in this kind of behaviour.

Recently, another Cabinet minister was charged with a similar offence, but managed to somehow wriggle out of criminal responsibility by delivering a public apology, courtesy of the National Cohesion and Integration Commission.

This may have emboldened another politician to go into a cosmopolitan city constituency and allegedly order the eviction of a section of the population that he accused of being foreigners and killers. This politician then tried to follow in the footsteps of his predecessor, and gave some sort of apology, after which he tried to escape justice by hiding from the police and rushing to court to pre-empt his arrest and prosecution.

It is clear in my mind that how we handle these very public instances of hate speech and incitement will determine the tone of the forthcoming campaigns, and probably the aftermath of the next General Election. All arms of government, therefore, need to be vigilant and initiate a culture of operant conditioning of all citizens if we hope to gradually eliminate this atavistic behaviour. 

Dr Lukoye Atwoli is Secretary, Kenya Psychiatric Association and Senior Lecturer, Moi University School of Medicine; twitter @LukoyeAtwoli

Sunday, September 23, 2012

Talk of an August General Election dangerous

By Lukoye Atwoli
Sunday Nation 23 September 2012

The Constitution of Kenya, promulgated in August 2010, provides for general elections on the second Tuesday of August every five years. Those that read that literally were convinced that the next elections after the 2007 fiasco should have been held last month.

After much argument and counter-argument, the courts sided with the politicians and gave suggestions that led the electoral commission to set a March 2013 date for the elections. During these contestations, some had even suggested that in case August elections were deemed impractical, December 2012 would be a suitable substitute.

However, once the March 2013 date was set, it seemed as though the matter was settled for good. Despite disappointment with this unnecessary breach of the Constitution, many realised the futility of pursuing further legal challenges that would, in any event, be most likely overtaken by events.

Which is why it is very worrying when no less a personage than the Deputy Speaker, supported by government ministers, opines that a March election is either impossible or impractical. The experience in Kenya is that senior politicians usually float outrageous ideas and then gauge the public response to them.
In case there is no public outrage, consensus is assumed and the idea is implemented. This time, however, politicians will be best advised to observe the following facts.

Complete break

Firstly, Kenyans have been yearning for a General Election since at least two years ago when we passed a new Constitution that promised a complete break with the past. The people are ready to turn their backs on the bloody past that forever destroyed our reputation as an island of peace, and made us out as a querulous people that can never agree on anything without external guidance.

Secondly, the people are weary of most of our politicians, and are eager to replace them with new leaders with fresh ideas on how to govern a modern republic. Traditionally, in any case, we are famous for sending home up to two-thirds of incumbents in any General Election. The coming election will definitely be no exception.

Thirdly, the rising tensions in the labour sector demonstrate a general restlessness of the population, and it is at times like this that a small spark can ignite a fire that will be very difficult to extinguish. It is my considered opinion that moves to change the election date yet again may just be that spark, and that the moment indignant Kenyans begin marching on the streets, there is no telling where they will end up.

It is being whispered in dark corners that some master puppeteer is orchestrating all these incidents in order to benefit from the ensuing chaos. Government behaviour is doing little to assuage these fears among wananchi. For instance, at the height of industrial unrest, the Speaker has been reported as having argued that Members of Parliament earn peanuts, when we all know that they are among the best paid legislators in the world. Government moves to raise perks for permanent secretaries, and talk of further postponement of the elections, fall well within such a plan.

If the master puppeteer exists, one would leave him with a vivid lesson from the French Revolution, of the guillotine that did not spare the architects of the revolution. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association, and a senior lecturer at Moi University’s school of medicine; twitter

Sunday, September 16, 2012

We need to turn the page on this coalition

By Lukoye Atwoli
Sunday Nation 16 September 2012

On Thursday this past week doctors launched a nationwide strike, hot on the heels of several other unions.
In all these cases, the government response has been the fairly uniform one of ignoring the strike notice and hoping it will go away, and then wringing their hands helplessly once the strike is on.

In the case of doctors, a number of small strikes preceded the nationwide industrial action. There was a strike to protest non-payment of an agreed stipend to doctors undergoing postgraduate training at the three teaching hospitals, Kenyatta, Moi and Mathari. Despite an Industrial Court order protecting the strike, the minister issued a statement purporting to stop post-graduate training programmes and withdrawing the doctors’ right to practice medicine at the institutions.

Soon after this, another group of doctors – specialists teaching at the various university teaching hospitals – downed their tools protesting against the government’s failure to implement certain allowances that were part of the settlement after the December 2011 doctors’ strike. These allowances were paid selectively, with doctors in public universities, programmes, research institutions and even in parts of the civil service being ignored. Despite agreeing that it was an “oversight” on its part, the government is yet to act to correct this anomaly. 

Agreed formula

A common thread runs through these two strikes and the subsequent nationwide strike. All the issues being canvassed were agreed on in the return to work formula signed between the government and the doctors’ union.

The formula provided for the formation of a taskforce to address longstanding problems in the health sector, the employment of more doctors, payment of fees and a stipend for doctors undergoing specialist training, and payment of new allowances to all doctors in the public service. The formula also provided for the formation of negotiating teams and commencement of collective bargaining within a week of its signing.

The Musyimi Task Force was formed soon after the strike and completed its work, handing in the report to the ministries of Health in February. Among the team’s recommendations were a gradual increase in the health budget to achieve the 15 per cent target set in the Abuja declaration, improvements in health infrastructure and human resources.

Another major recommendation was the formation of a Health Service Commission, and a draft Bill was included as part of the report. Six months down the line, the ministries of Health have made no move to present this Bill to the Commission for the Implementation of the Constitution or other relevant agencies for consideration.

The ministries have similarly ignored most of the other recommendations, including the designation of county referral facilities, establishment of a national ambulance service, and scaling up training of all health service cadres. Indeed, even the allowances agreed on in the return to work formula have been selectively paid out, despite the government’s insistence to the contrary.

An agreement to pay a stipend to medical doctors undergoing specialist training is now being trashed as unworkable, and the government has once again stopped sponsoring its own doctors to undertake specialist training.

In my opinion, the goings-on in the health sector and elsewhere provide ample evidence of a failed government, and it is the opinion of a silent majority that the sooner we see the back of this coalition the better.

Dr Atwoli is the Secretary of the Kenya Psychiatric Association and a Senior Lecturer at Moi University's School of Medicine.; twitter @LukoyeAtwoli

Sunday, September 9, 2012

Industrial unrest due to government’s ineptitude

Sunday Nation 09 September 2012

In the months leading up to a General Election in Kenya, it is not strange to see many unions acting tough with government and calling out their members to strike. This is often because our government is notorious for disregarding agreements reached before polls. Indeed, this appears to be the case with the teachers and doctors who went on strike demanding that the government implements agreements it had signed a long time ago.

This year is even more special because after the next General Election, the country will literally start on a fresh slate, with a new structure of government and probably new faces as well. The probability of agreements signed by the current regime being disregarded is very high. This is the reason most workers are restive and just itching to have a go at the government.

The government, on the other hand, appears to enjoy the circus. At some point they refused to listen to or negotiate with workers citing nonexistent clauses in the new Constitution that allegedly placed this responsibility on the Salaries and Remuneration Commission. Unfortunately for government, union leaders had correctly read the law and pointed out that this commission’s role was advisory as far as remuneration of most state employees was concerned.

Once this became clear, government entered into haphazard negotiations and arrived at agreements that it now claims are difficult to implement. This only serves to expose the government’s ineptitude and lack of co-ordination.

Witnessing this confusion in government one is left wondering what other commitments the government is entering into without adequate preparation, running the risk of mortgaging our future for pointless pursuits. It appears that government is running largely on autopilot, and mushrooming scandals in government seem to suggest this. One would suggest that anyone dealing with government at this point exercises extra caution lest they burn their fingers.

Concerning the teachers’ strike, apparently there was a misunderstanding about what was agreed on, what was implemented and whether there was anything left unimplemented. An honest conversation with the teachers’ union would have provided answers to these questions and prevented the disruption caused by the strike.

The dispute between government and doctors goes to the heart of government’s willingness to fully implement a return-to-work agreement that was signed in December last year after another strike. The government has gone about implementing this agreement and the subsequent taskforce report in piece-meal fashion, picking and choosing who would benefit from it and who would not.

Agreements on healthcare financing, human resource development and expansion, and formation of a Health Service Commission have been ignored. Agreements on payment of fees and allowances for health workers have been selectively implemented. Apparently the government was unaware that the term “doctors in public service” meant doctors in the civil service, parastatals including the referral hospitals, and in the universities and research institutions.

This ignorance and ineptitude are going to be very expensive for government, but the bitter pill must be swallowed and all agreements implemented fully. If any officer was negligent in advising the government, there are channels to deal with that.

Ignoring agreements and contracts will not promote industrial peace, but will only serve to strengthen the resolve of workers to “speak to the government in the only language it understands”.; twitter @LukoyeAtwoli

Sunday, September 2, 2012

Lessons we must draw from Mombasa riots

Sunday Nation 02 September 2012
This past week, an Islamic preacher was shot dead in broad daylight in a Mombasa street.
He had previously been charged with terrorism-related crimes, and was on American and United Nations terror watchlists. His killing resulted in an outbreak of violence in the streets of Mombasa, with youths accusing the government of having carried out the shooting and attacking churches and government property.

In my opinion, these events bring several disturbing issues to the fore. Firstly, if a Kenyan, no matter his alleged crime, can be gunned down in broad daylight without the killers being apprehended, then we need to be very afraid. 

Police boss

That the police boss came out to say he had no idea who had carried out the killing while absolving the police of any role in the matter is hardly pacifying. If anything, it is a great cause for alarm. This killing happened on a busy public street not far from a police station, and yet the killers got clean away!
How can the police assure other Kenyans of their security if something like this can happen?

Secondly, the reaction of the youths in Mombasa leaves a bitter aftertaste. Several churches were torched and property destroyed, including cars parked on the streets of Kenya’s second largest town. A number of people, including policemen, were killed in the riots, and several more injured.

It is unclear at what point Kenyans decided that the best way of solving their grievances would be through burning property and attacking anyone perceived to be an “other”, whatever that may mean. However, it stands to reason that this is the product of a general decline in civility in our population, which is manifested even in peacetime at our dinner tables, on our roads and even in our institutions of learning.

Thirdly, the difficulties the security agencies had in dealing with the riots may reflect a general lack of policy direction in dealing with situations such as these. Immediately after the cleric’s shooting, police officers arriving at the scene were barred from accessing the site by rowdy youths. Eventually, the preacher was buried without even a perfunctory examination of his body and recording the medical cause of death. 

Murder suspects

One wonders what would happen should the police arrest some suspects and charge them with the killing in court. Due to this disregard for forensic procedures, it is a sure bet that they would walk free on a technicality. In my opinion, the failure of security agencies to take charge, and the refusal by the youths to let the police get anywhere near the body, are symptoms of the rot in our criminal justice system.

The public has systematically lost faith in the system, and the system has given up trying to restore that faith. The officer at the scene was quoted in the press as saying that there was nothing he could do if the youths did not want the police to get involved!

Finally, the ease with which the shooting was framed by some as a religious conflict demonstrates the fissures that characterise our national infrastructure. Elsewhere in Kenya, it might have been branded as ethnic conflict. Unless we deal decisively with these prejudices and skewed perceptions, we are unlikely to be successful in guaranteeing peaceful co-existence, no matter how many “peace conferences” we hold. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association, and lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Sunday, August 26, 2012

Learners should not bear failures of the system

Sunday Nation 26 August 2012

As we continue to debate the merits and demerits of asking children to go to school during “school holidays”, there is a feeling that the debate is lacking in factual content, and is mainly concerned with emotional and financial considerations.
Perhaps the reason teachers and other proponents are unable to provide convincing arguments in favour of holiday tuition is that these reasons do not actually exist.

To recap, the following reasons are cited. First, that they need these extra classes to complete the curriculum. Second, that weak students need the extra classes to catch up with the others. Third, that some schools are less endowed with resources and need extra tuition to catch up with better resourced schools.

A critical examination of these reasons reveals that there is no serious justification for this practice. The first argument about inability to complete the curriculum in the allocated time speaks to a lack of expertise on the part of education planners, managers and implementers. The consequences of this failure should not be loaded on the children.

If the curriculum is overloaded, it should be decongested. If the school managers are unable to plan well enough to complete the curriculum during the school term, they should be retrained or retrenched. The same fate should befall teachers who are unable to complete the curriculum in the time stipulated by education experts.

The “weak student” argument does not justify subjecting whole classes to holiday tuition. It is unlikely that a whole class or school has only weak students, necessitating extra tuition for all of them.
The “under-resourced school” argument similarly does not adequately explain the nationwide craze for holiday tuition. In any case, if a school has no resources to deliver the curriculum during the school term, where do these resources materialise from during the holidays?

In my view, the diagnosis of the problem by the teachers may be correct, but the prescribed treatment (holiday tuition) is not beneficial, and may even be harmful. The truth is that the problems identified cannot be redressed by extra tuition which, as demonstrated below, may be more harmful than beneficial to the children.

Children learn through both didactic and experiential processes. Play and non-academic pursuits are just as important in learning as is classroom instruction and their absence stymies the children’s experiences, interfering with development of critical thinking and problem solving skills.

Further, a proper education system is structured to take into consideration the differential rate of cognitive development in children to avoid loading the mind with concepts that it is as yet unable to comprehend.
Extra tuition messes up with this process of gradual introduction of concepts, interfering with learning and creating a cohort of youth that is relatively rigid in their thinking, unable to appreciate experiences outside of what their teacher said in class.

Finally, inadequate rest causes physical and psychological stress, which is not only detrimental to learning, but also increases the risk of mental disorders such as anxiety, depression and other disorders.

Parents advocating for holiday tuition partly because they are not ready to spend time with their “troublesome” children must weigh the purported benefits with the risks identified above, and decide if that is the fate they want for their young ones. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Tuesday, August 21, 2012

Regulators should control these religious quacks

By Lukoye Atwoli

Sunday Nation 19 August 2012

A few weeks ago, we were treated to a spectacle in which a famous televangelist was caught on camera tricking his congregation about his healing powers. He allegedly coached a woman to pretend that she had some mouth condition, and then went ahead and claimed to use some divine powers to heal her.

Despite the hullaballoo even in the evangelical Christian community, the noise has now died down, and one should not be surprised if the televangelist has gone back to his regular business.
Distressingly, however, even as the saga raged, national television stations continued to air episodes of other “healing” pastors purportedly treating all kinds of affliction each weekend. Claims are still being made on TV that some of these pastors are curing HIV, cancer and other chronic illnesses using various combinations of prayer and exorcism.
Whenever one first comes across these claims, there is a great temptation to blame the purveyors themselves and, to a lesser extent, the consumers of this sort of tripe. With time, however, one learns that there is a role for the government in all this. Unfortunately, due to fear of the unknown, the occult or religion, those in policy and leadership positions dare not touch these charlatans.
There are government departments responsible for vetting and approving medicines and medical procedures, as well as medical practitioners. They determine who may practise what sort of medicine, the sort of training required, and what substances may be administered as medications or treatments.
On an average day, they keep themselves busy monitoring doctors, hospitals, pharmacies and other health workers. If one were to ask these bodies if they have any role to play in regulating the so-called “religious healers”, they would unanimously respond in the negative.
A closer examination of the facts would, however, prove them wrong. Consider the following actual cases.
A person with HIV/Aids goes to “Bishop” so and so for prayers after “witnessing” his healing abilities on national TV, complete with a parade of emaciated “end-stage HIV patients” who get healed through prayer and exorcism. He goes for these prayers and subsequently stops taking his medications or attending his usual clinic. His condition deteriorates and he dies within a few months.
Another person living with cancer goes through the same routine in the hope for a cure, with the same disastrous results. This is repeated for people with diabetes, hypertension, and even mental illness. One must remember that these “procedures” are not done for free. Beneficiaries are required to make some contribution to the pastor’s kitty.
What would one say these “bishops”, “apostles” and “pastors” are selling? Aren’t they selling medical services, purporting to cure a wide range of chronic diseases? Would the relevant government agencies remain silent if some doctor started advertising her ability to “cure” HIV, cancer or diabetes? Wouldn’t they require her to produce evidence of the efficacy of her methods?
Wouldn’t they subject her purported cures to the most rigorous scientific testing in order to safeguard the health of consumers? Why shouldn’t we require the same standard for these dubious clergymen who traffic in fake miracles?
The Medical Practitioners and Dentists’ Board and other regulatory agencies in the ministries of Health need to get together and control these harmful quacks.
Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association, and a lecturer at the Moi University’s school of medicine; twitter @LukoyeAtwoli

Sunday, August 12, 2012

Why Kibunjia’s team has got it all wrong

Sunday Nation 12 August 2012

The National Cohesion and Integration Commission has an abiding obsession with tribe, which has now led them into uncharted waters, with potentially disastrous results. We must take this early opportunity to set them straight, and help them to avoid creating conditions that will thwart any integration attempts in this country for generations to come.

Some genius at the commission came up with the idea of tribal power-sharing in the so-called “hot-spots” based on patterns of violence after the last General Election. The idea was to select these multi-ethnic cosmopolitan regions and convince the residents to “share” political seats among the various tribes they belong to, to ensure that all tribes feel a sense of inclusion in the county political leadership.

The plan, according to the commission, went swimmingly until cracks started to emerge in some of the counties due to disagreements over who is empowered to make such decisions on behalf of the tribes, and what seats should be “allocated” to which tribe. In my view, this was the inevitable result of this misguided venture by a publicly funded body whose key remit is to ensure peaceful coexistence among the various peoples of this republic.

We have argued before that “tribe” is an artificial social construct, and it has been demonstrated in many instances to be extremely fluid depending on the method one uses to arrive at it.

Matriarchal societies

For instance, in matriarchal societies, ethnicity is conferred through the mother. If that were to be applied across our country it is a sure bet that an overwhelming majority of Kenyans would have to change their tribes many times over. 

Further, even in patriarchal societies, we have now glimpsed the truth in the saying that while maternity is certain, paternity is a matter of conjecture. Many Kenyans proudly defending their tribes on the basis of their presumptive paternity may be shocked to discover that they are not their fathers’ children, and may belong to a totally different lineage. DNA analysis would prove this, but the easiest way to find out would be to ask their mothers.

In my opinion, this misguided obsession with tribe is one of the factors that continue to drag our country deeper into an abyss of under-achievement and perennial strife. The commission would do well to find ways of highlighting the achievements of the “tribeless” entrepreneurs of our country, and demonstrating the futility of using tribe as a means of political or economic organisation.

Time and again we have demonstrated how gullible Kenyans are being exploited by politicians who only use tribal affiliation to get advantages in political and economic deals, advantages that they do not later share with their presumed “tribesmates”. For a tax-funded agency to fall into this trap is indeed regrettable and, on this basis, one would hope that when their term ends later this year, none of the commissioners should be allowed to continue in office.

They have misused their time in office, and have squandered public funds on hare-brained schemes whose net effect has been to emphasise our ethnic differences instead of improving the environment for integration.

We must therefore look out for a new crop of Kenyans who understand the reality of the new Kenyan “tribe” whose only interest is in building a Kenya future generations will be proud of.

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Monday, August 6, 2012

Dangers posed by a bungling electoral team


Sunday Nation 05 August 2012

In the recent past, controversy has flared over tendering for biometric voter registration equipment by the Independent Electoral and Boundaries Commission. Due to missteps within the commission itself as well as overwhelming pressure from politicians and other vested interests, the tender was eventually cancelled, and we are now set to have another manual election next year.
This controversy leaves certain questions unanswered. Firstly, what was the commission’s rationale for trying out biometric voter registration and electronic voting? Has this rationale now been relegated to irrelevance through bureaucratic incompetence?

If the decision was informed by the inept way Mr Samuel Kivuitu’s Electoral Commission mishandled voter registration and vote counting in the 2007 election, then it seems clear that reverting to a manual system will necessarily result in apprehensions about possible fraud next year. If the commission realised that a manual system is easier to rig through vote stuffing and ballot box destruction, how will abandoning an electronic system assuage our fears of a repeat?

Second, are there divisions within the commission that are resulting in this haphazard decision-making and poor communication? Do these perceived divisions have anything to do with the political affiliations of commissioners and employees of the commission?

The goings-on do not inspire confidence. On the day the biometric voter registration tenders were allegedly cancelled, there were reports that some individuals within the commission had tried to sabotage the decision by interfering with publication of the cancellation. Instead, the next day a small advert appeared in the press extending the deadline for application of registration clerks.

If indeed it is true that there are divisions within the commission, it is imperative that they are investigated and eliminated to maintain the confidence of voters. Anything short of this will increase the risk of loss of public confidence in the voting, resulting in reactions most Kenyans would rather not see after the elections.

Thirdly, what are the implications of these controversies as far as the delivery of a free and fair election is concerned? Given the progressively worsening poisoned political environment that we find ourselves in, might it be too late to forestall an inevitable conflagration based on rigging claims as happened after the last General Election?

One would hope that all Kenyans of goodwill will identify this crisis at the commission as a more pressing threat to national stability than even the date of the next General Election itself. We cannot allow our politicians to get away with literal murder this time. If we mess up the next elections, it is almost certain that there will be no Kenya to speak of afterwards, and the cruel finger of history will forever point in our direction as the chief culprits in the destruction of this beautiful country.

We must remember that Justice Kriegler’s report uncovered evidence of rigging in the strongholds of the major political parties competing for power in 2007. Due to manual voter registration and voting, it was possible to enrol dead and non-existent voters.

We must find a safer, less emotive solution to this problem this time, or risk losing all the fragile gains we have made since 2008. 

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a lecturer at Moi University’s school of medicine; twitter @LukoyeAtwoli

Monday, July 30, 2012

Invest more in mental health research

Sunday Nation 29 July 2012

Over the past two weeks, I participated in two mental health conferences that are of particular relevance to our situation in Kenya. The first was the Kenya Psychiatric Association’s Annual Scientific Conference in Kisumu.

Mental health workers from all over the country interrogated the place of mental health in national development, specifically its impact on Vision 2030. The meagre budgetary allocation to health (amounting to 5.8 per cent of national expenditure) and the practically non-existent mental health vote were some of the key concerns raised at that meeting.

Participants urged the government to increase health expenditure towards the Abuja target of 15 per cent of national expenditure, and also to raise the mental health expenditure from the current 0.01 per cent of health expenditure. Recommendations were made on improvement of infrastructure, particularly upgrading Mathari Hospital to national referral status.

The state of this hospital is currently deplorable, and those working there pointed out that due to perennial underfunding, patient clothing and linen is scarce, sanitation is difficult to maintain, and food and medications are inadequate. Indeed, the medical superintendent of the facility reportedly resigned in frustration a few days before the conference.

The second meeting I attended last week was a World Health Organisation conference bringing together collaborators in the World Mental Health Survey Initiative, and was held in Brussels, Belgium. Leading mental health researchers met to share current knowledge on the state of mental health in the world. The burden of mental disorders was noted to be rising worldwide, including in developing countries, and it was agreed that global mental health funding needs to increase exponentially to meet this need.

A key finding concerned the role of mental conditions in increasing the risk for physical illnesses. For instance, a clear link was demonstrated between depression and a heart condition that is the commonest cause of death in many Western countries. Causative links between mental disorders and other illnesses such as diabetes mellitus, peptic ulcers and even hypertension suggest that mental illnesses must now be managed as part of a prevention strategy for chronic medical diseases.

A key observation for me at this meeting was that African countries are grossly under-represented in mental health research. This is due to the meagre allocations to research in most African countries, coupled with the already inadequate health care funding by African governments. It must be appreciated that without health research all that is left is the experience of the clinician, which can be very capricious even with the most experienced doctor.

Health research helps us to discover what the priority problems are in our country, and what proven solutions may work in dealing with these problems. With political will, it is possible to invest in health research and translate research findings into clinical practice, gradually improving the health of our people.

What little research is available in this country indeed suggests that we are facing a huge burden of chronic diseases, many of them related to mental health. According to the emerging evidence, unless mental disorders are addressed, they will continue to complicate efforts to deal with other medical conditions, as well as the concomitant social and economic challenges in developing countries.

Dr Lukoye Atwoli is secretary, Kenya Psychiatric Association, and lecturer, Moi University School of Medicine.; twitter @LukoyeAtwoli

Wednesday, July 25, 2012

Presidential transport hurts the economy


Sunday Nation 22 July 2012

Last week I needed to travel out of the country to attend a meeting of mental health researchers who, under the World Health Organisation, are driving the global research agenda in the field. To get to my destination, I had to get a flight from Eldoret Airport and connect with another flight at the Jomo Kenyatta International Airport scheduled to leave three hours later.

Unfortunately, those of us using airports that day chose the wrong day to travel, for the Head of State was also arriving back home from a meeting in Ethiopia. To further compound matters, there was heavy rain in Nairobi with significantly reduced visibility.

As a result, our departure from Eldoret Airport was delayed due to what the airline described as “operational reasons”, but which an insider confirmed was due to the President’s arrival. Many flights out of JKIA were also subsequently delayed, and it is possible that some people may have missed onward connections in other international airports. Those using Mombasa Road and other roads in any way connected to the airport reported serious traffic congestion, partly for the same reason.

Economists have estimated the cost of traffic congestion to the national economy to run into billions of shillings. Were they to factor in the cost of unnecessary flight delays and the opportunities lost due to presidential interruptions and related issues, the cost would conceivably be much higher than it is at the moment

Creative ways

It therefore follows that this is an important enough issue that the government must have some strategy aimed at addressing it.

In my opinion, the first step must include calculating and finding creative ways of reducing the amounts of money lost due to delays and traffic jams caused by the presidential motorcade and those of other politicians.
It might turn out that the costs to the economy associated with presidential travel could be offset by ensuring that he lands at some separate airport and uses a helicopter to get around the city. A military airport would be ideal for this, and one could think of using the Eastleigh Airbase as the custodian of presidential transport.

Second, the old suggestion that a separate lane be constructed on major roads for the President and other ‘VIP’ travellers may need to be revisited. This may ensure smoother flow of traffic and a more predictable travelling time than is the case presently.

Finally, as has been pointed out numerous times before, Kenyans must learn to obey rules that they have made themselves, including traffic rules. The peculiar “me-first” mentality that permeates all our social interactions is unsustainable, and will eventually bring down our country. In my opinion, this mentality is a bigger threat to our national security than any terrorist threat we have ever faced.

With this in mind, perhaps it is time we apologised to former Safaricom CEO who raised a storm of indignation by suggesting that Kenyans have peculiar calling habits. The peculiarity of Kenyans is obviously not only confined to calling habits, but runs the entire gamut of human behaviour.

And it runs through the entire fabric of our nation, starting at the very top where leaders consider it a privilege to interrupt the national economy in order for them to get from one point to another.

Dr Lukoye Atwoli is secretary, Kenya Psychiatric Association, and lecturer, Moi University School of Medicine.; twitter @LukoyeAtwoli

Devaluing education is a disservice to Kenya

By Lukoye Atwoli
Sunday Nation 15 July 2012

In the wake of the High Court ruling that was featured in this column last week on educational requirements for our leaders, many voices are emerging to offer a rationale for the practically illiterate leader. In arguments that are slowly becoming shouting contests between the educational haves and have-nots, examples are being trotted out to demonstrate that having higher education would not add value to most leaders, and may indeed be a drag on one’s leadership abilities.

We have been harangued about the academic ineptitude of leaders such as Sir Winston Churchill of the United Kingdom, among many other leaders who allegedly thrived without higher education. Numerous examples are given of highly educated leaders with multiple degrees who have been spectacular failures in their government dockets.

The implication here is that higher education, and especially an academic degree, is often a handicap that should not be extolled when it comes to leadership abilities. In sum, going to school is pointless to one who is destined to become a great leader. This argument is not only restricted to the political sphere.

Many leaders and innovators in industry are notably school dropouts, with prime examples being information technology mavericks like Bill Gates and the late Steve Jobs. Entrepreneurs like Sir Richard Branson are further trotted out to buttress the argument that academic achievement is nothing but a hindrance to success in life.
It is time to interrogate the accuracy of these assertions lest they be accepted as gospel truth. Importantly, there is a reason why only the successful “illiterate” politicians are cited.

When an illiterate leader makes a fool of himself, he is quickly forgotten and no one is surprised at his ineptitude, given his lack of education. Similarly, when an educated leader performs his job to perfection, nobody makes a fuss about it. However, people notice when one bucks this trend and does something unexpected.

For instance, a village buffoon who fortuitously solves a complex problem is instantly elevated to the position of village hero, all his past indiscretions forgotten. A monument is erected in his honour and he is held up as evidence that one does not need an education to solve complex problems.

Similarly, when the neighbourhood “professor” finally meets a problem that stumps him, everybody takes the opportunity to remind all that will listen that intelligence or “book smarts” cannot solve all problems. Indeed some even go as far as suggesting that school learning makes it difficult to solve these problems.

Considering the so-called successful entrepreneurial dropouts, a lot of detail is often glossed over. Many of them dropped out of school because they are clever entrepreneurs, and not because dropping out of school would itself make them successful. Most dropped out to pursue passions they already had, and did not need schooling to develop.
In any population there are persons who do not conform to the norm, and such mavericks cannot be said to be representative of their communities. Encouraging young people to drop out of school or disregard education because some illiterate leaders and entrepreneurs were successful is therefore disingenuous.
Even the societies that spawned the successful “illiterati” currently place a massive premium on education.

Dr Lukoye Atwoli is secretary, Kenya Psychiatric Association, and lecturer, Moi University School of Medicine.; twitter @LukoyeAtwoli

Brief Break

For the past two weeks I have been away attending meetings that brought together mental health teachers, clinicians and researchers in different settings. I will be writing about those in the coming days, and the lessons we can learn from these events.
In the meantime, I will shortly upload my articles from 15th July and 22nd July in the Sunday Nation. Apologies for the delayed posting. I will strive to be more prompt next time!

Monday, July 9, 2012

Court went too far on MPs' education ruling

By Lukoye Atwoli
Sunday Nation 08 July 2012

A few days ago, the High court made a ruling on a controversial issue that had been exercising the minds of Kenyans for quite some time. Judge Mumbi Ngugi ruled that a requirement in the Elections Act requiring parliamentary candidates to have post-secondary education was unconstitutional. In the same ruling, she argued that an even higher educational standard for presidential and gubernatorial candidates was constitutional.

The judge anchored her reasoning on the prevailing socio-economic and political situation in the country and the nature of work required by the positions referred to in this case. On eligibility for office, she pointed out that the right of every adult Kenyan to participate in the political process would be infringed upon by the requirement for a high educational qualification for parliamentary candidates. She therefore ruled that this requirement would be unconstitutional.

Her opinion on presidential and gubernatorial candidates was that due to the limited number of these positions, and the complex nature of the work involved, these candidates could be required to have not only post-secondary education, but university degrees.

To put this whole argument into context, it should be clear that the constitution does not provide for a different set of educational, ethical and moral qualifications for candidates for any office, whether parliamentary, gubernatorial or presidential. In my opinion, therefore, Justice Ngugi’s differentiation of the two categories of aspirants is itself unconstitutional, and may be challenged in a higher court.

The court’s argument that since there are sections of the population that have not been exposed to higher education it would be discriminatory and therefore unconstitutional to require parliamentary aspirants to have such qualifications is similarly flawed. The constitution allows parliament to set the minimum educational, ethical and moral standards for all aspirants. It does not provide any limits to such standards. 

It follows therefore that parliament, as the people’s representative, is empowered to consider what educational, ethical and moral standards are appropriate for the candidates. Enacting such legislation cannot, therefore, be unconstitutional!

It is difficult not to sympathise with the court’s position that in a country where almost half the population live in absolute poverty it would be unfair to require that anyone who wants to be an MP must have post-secondary education. The further assertion that, in a roundabout way, this requirement would discriminate against women and girls is one that merits active measures to address.

In actual fact, then, the court should have argued that the educational requirements for all posts are inherently unfair and potentially discriminatory, and that the government must take urgent measures to ensure that all those interested in higher education have access to it without discrimination. In this regard, Justice Ngugi’s ruling was a damning statement about pervasive poverty and inequalities in the Kenyan education system, rather than on the constitutionality of requiring higher education for aspirants.

In my view, this court overstepped its mandate by delving into socio-economic arguments that are the province of government policy and belong in the sphere of political party manifestoes. This ruling perpetuates the common Kenyan mantra that whatever is wrong or unfair must also be inherently unconstitutional. The assumption is that all constitutional provisions are fair and right, and that one only needs to use their gut feeling such that if something feels wrong or unfair, it is, of course unconstitutional!

Dr Lukoye Atwoli is the Secretary, Kenya Psychiatry Association and a Lecturer at Moi University's School of Medicine; twitter @LukoyeAtwoli