Friday, March 30, 2012

Agenda for new Kenya Medical Association team

Sunday Nation 25 March 2012

The Kenya Medical Association (KMA) will hold its Annual General Meeting at which members will install a new team at the helm later next month. The incoming team will face a couple of serious challenges due to the peculiar situation our country is in at the moment.

However, if the team is more proactive and able to recognise the opportunities inherent in these challenges, it shall rise above them and come out stronger than any other team in the history of KMA.

The first challenge the team will face at inception is the relationship with the Kenya Medical Practitioners and Dentists Union (KMPDU). The union, registered in August last year, already counts among its members thousands of doctors from across the country, and continues to recruit aggressively in all health institutions.
Many observers are convinced that the two institutions are in conflict, and that one must prevail while the other necessarily collapses.

Fortunately for Kenya’s health sector, this is simply not true. The two organisations, though drawing membership from the same pool, serve very different functions, and none can take over the roles of the other.

The union was formed primarily to address shortcomings in the terms and conditions of service of doctors.
In this regard, the union is empowered by law to negotiate legally binding collective bargaining agreements setting out new terms that are mutually acceptable.

KMA, on the other hand, has the primary mandate of presenting the professional side of the Kenyan doctor.
It is the only organisation that Kenyans can turn to for professional advice in any field of healthcare service delivery. The association also serves as a guarantor of ethical medical practice in Kenya, and is represented on the Medical Board. Finally, the association organises professional conferences and publishes a journal through which members share ideas on advances in diagnostics, treatments and other interventions in the medical field.

The two institutions, therefore, serve very different functions. For instance, KMA cannot sign a legally binding agreement with government on doctors’ terms and conditions of service, while KMPDU has the legal mandate to do so. Conversely, it would be strange for KMPDU to organise a professional conference discussing research in various areas of medicine, when this is the core function of KMA.

The second challenge the new KMA team will face as soon as they assume office is one that faces all professional associations in the new constitutional dispensation. Implementation of the Constitution requires that professional organisations identify areas that they can get involved in and advise the constitutional implementation authorities accordingly.

KMA will need to get more actively involved in the drafting of legislation for the health sector, including the proposed health Bill that is still under development.

More importantly, however, KMA’s voice needs to be heard loud and clear on the need to create the Health Service Commission. There is already a draft Bill in the report of the Health Reform Task force that was formed in December last year to look into areas requiring urgent attention in the health sector.

The new KMA office will be judged by how well they deal with these twin challenges, and important fruits members will recognise are a harmonious working relationship with the union, and an enabling legislative framework that will drive us all towards a better healthcare system for our country.

Dr Lukoye Atwoli is secretary, Kenya Psychiatric Association, and lecturer at Moi University’s school of medicine

Tuesday, March 20, 2012

The price of ethnic demagoguery is another war

Sunday Nation 18 March 2012

As political temperatures continue to rise in the country, one cannot fail to notice that much of the rhetoric is gradually acquiring dangerously ethnic undertones. As Prime Minister Raila Odinga engages more directly with his opponents, Deputy Prime Minister Uhuru Kenyatta and Eldoret North MP William Ruto, many ordinary Kenyans are being led to think that their spat is a bigger issue between their respective communities.

Last week, after the first statement was issued by the Raila Odinga secretariat, vernacular radio stations were awash with call-in sessions, with everyone eager to give their two cents’ worth on the matter. Predictably, opinions were clearly divided along tribal lines.

Many commentators have already accepted as a given that this coming election will once again be an ethnic contest, with the ultimate prize being the ability to determine the flow of resources in this country. Unfortunately for them, the Constitution did away with most of these powers, and made the prospect of wielding power significantly less attractive than it was at the last General Election.

The most ominous issue, however, is the emergence of cynical and manipulative circuses masterminded by ethnic chieftains in order to taint their opponents and their supporters, resulting in the sort of ethnic animosity that recently erupted into open conflict in several parts of this country.

Building up momentum 

Any observer will not fail to notice that politicians are slowly building up momentum for ethnic alliances ahead of the General Election. Current talk revolves around the emergence of Luhya leadership in the Orange Democratic Movement, instead of talking about the chances of one Luhya, Musalia Mudavadi.

There are steps being taken to form some sort of alliance among the Meru, Embu and allied tribes, as reported last week in the Press. During the funeral of a former leader of a tribal outfit bringing together the Kikuyu, Embu and Meru communities, former President Moi even endorsed Mr Kenyatta as a worthy successor to that particular tribal throne.

Finally, as Mr Odinga’s troubles increase in ODM, people are discussing the chances of the Luo ascending to the highest office in the land.

This whole scenario is extremely trying, especially for those of us living side by side with internally displaced persons who are still waiting for resettlement. It is scary to those of us who had to run up and down offering emergency medical services to survivors of the most brutal election-related violence in the history of our republic.

Above all, it is irresponsible for those seeking political leadership to use their tribes as a means of securing victory. Obviously, in this day and age, anyone who needs to be elected on the basis of the language his mother taught him has no business in leadership.

Of course those that elect such a leader fully deserve the consequences, including buffoonery in Parliament in full view of cameras, mindless thievery, and enactment of laws and policies that need amendment as soon as they are signed into law.

The greatest price we shall pay for allowing tribal demagogues to have their say is the inevitable violence after the next General Election. As has been pointed out elsewhere, this time we shall only remember the 2007 elections the same way we think about a Christmas picnic.

However, the decision to go to war remains firmly in our hands.

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

Sunday, March 11, 2012

Health workers’ strike and a tale of heroes

Sunday Nation 11 March 2012

The past couple of weeks have seen the demise of several Kenyans, two of whom received national funeral ceremonies with full honours. Like any good African nation worth its name, we flew our flag at half mast and held magnificent requiem masses for the departed leaders who were hailed as national heroes.

There is a solid global injunction against speaking ill of the dead, and we shall refrain from engaging in such profanity today. Instead, let us contemplate the life of a different man, born and brought up in a poor rural village somewhere in this fair land.

In the village

One in a family of many, he grew up herding goats and sheep in the village. He managed to go to primary school late in life, but performed well enough to be admitted to a national school. The village had to hold a fundraiser to pay his first year fees, and later he got a bursary from a wealthy foreign well-wisher who hoped to help him break the cycle of poverty.

The poor young man did not perform as well as he had hoped in high school and, due to the difficulties in raising fees, he could not attend any tertiary institution. He survived by doing odd jobs in the shopping centre near his village, and managed to save a few shillings in the process.

Shortly after high school, he married his primary school sweetheart, an industrious young lady who could miraculously coax his tiny barely arable piece of land to produce some food. Together, they got three children who had to help in the family’s economic activities as soon as they were old enough.

By scrimping and saving, they managed to send the children to school, paying their fees all the way to university. Today, their three offspring are prominent professionals in their respective fields of medicine, law and engineering. As soon as they became more comfortable economically, the couple got involved in community projects.

They helped mobilise the community to protect one of the few water sources in the village, and introduced innovative farming techniques that helped improve the food yield in the village.

Visiting his son

Recently, coming back from visiting his son who lives in Nairobi, the matatu he was travelling in was involved in a grisly road accident. At a police roadblock at the bottom of an incline, the driver of a lorry lost control and it veered off the road, ramming into the matatu and killing most of the occupants.

The man survived with multiple serious injuries. A Good Samaritan took him to a nearby public hospital and had him admitted to the surgical ward. However, due to the then ongoing health workers’ strike, the only staff on duty got to him when he had bled a lot and urgently needed blood transfusion to save his life.

There was no blood screening kit at the hospital and, in any event, there were no theatre supplies to conduct the emergency surgery he needed. He was also in no condition to travel in case a decision to refer him to another facility was made. He succumbed to his injuries soon after admission.

There was no fanfare during his burial late last week. He was not important enough. He was just a self-made man who had left a positive mark on every life he had touched.

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

Tuesday, March 6, 2012

Ethnic clashes a harbinger of things to come

Sunday Nation 04 March 2012

Kenyans should be very angry at this point in time. Recently, there have been incidents of tribal fighting in Northern Kenya, Rift Valley and more recently in Western Kenya. On the surface, the reasons for the fighting are given as conflict over sharing of resources and livestock theft.

Interestingly, these clashes are occurring soon after some commotion over electoral boundaries erupted with the release of the report by the Independent Electoral and Boundaries Commission. Other fights are erupting in the wake of political disagreements between tribal chieftains masquerading as aspirants for various political posts.

Unfortunately, the people who are dying in these clashes do not often understand the political undercurrents behind the fights, and some are actually innocent citizens whose only crime is bearing the “wrong” name in the “wrong” place.

Many Kenyans remain quiet, dismissing these clashes as primitive affairs that should not be happening in this day and age. The genteel middle class has graciously spared a few minutes of debate on this matter over drinks in a bar, but they later retire to their barricaded neighbourhoods for a good night’s sleep. Our politicians are scouting the situation to discover how much political mileage can be milked from these conflicts as they prepare for the next General Election.

Meanwhile, people are dying. There is no vacuum in the top echelons of government, the Cabinet still meets regularly, and the defence forces of the republic have not been disbanded. But people are dying across the country in what will in future be branded as the 2012 tribal clashes, in a hallowed tradition dating back to the early 1990s.

Culture and tradition cannot be used as an excuse for people to kill each other. No matter the disagreement, as long as one person can kill another and get away with it, law and order cannot thrive. Under the cover of cultural practices and political activity many more people will be killed this year, and clearly, the government will just stand by and wring its hands hopelessly.

The toughest action Kenyans will expect from the government will be a statement that the government “condemns the clashes in the strongest possible terms, and urges the warring communities to exercise tolerance and engage in dialogue”! Coming from an elected government whose most important brief is to ensure that Kenyans can go about their activities in a peaceful environment, such sentiments must annoy every right-thinking Kenyan.

Let us make this clear. No Kenyan has a right to kill another Kenyan. No Kenyan has a right to deprive another Kenyan of their legally acquired property. No Kenyan has more right to Kenya than another. Whoever makes claims to the contrary is a danger to public safety and order, and must be immediately apprehended and prosecuted to the fullest extent of the law.

Let us not hear of “political violence” before, during and after the next General Election. The government must move with speed to apprehend those that are breaking the law under any pretext, and deal with them accordingly.

Any public servant who shirks their responsibility in this matter should be relieved of their job and, in addition, charged appropriately.

The alternative is a total breakdown in law and order, and a return to the barbaric state we endured in early 2008. Kenyans must not let this happen.

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

Issue-Based Campaigns the Way to Go

In many ways, the Kenyan political scene remains unchanged since the independence days. The party leader's opinion is still the de facto party position. Our political parties are still beholden to the whims of an individual, and the political landscape is littered with corpses of parties that collapsed with the exit of key leaders.

It is, however, refreshing to see a political party leader expressing his opinion in a newspaper commentary, indicating his stand on various issues affecting the country. In the absence of coherent political party manifestoes, this approach is all we currently have in terms of political party policies that are likely to be implemented should the party win the General Election.

In the recent past, the leader of the United Republican Party, William Ruto, has attempted to frame a debate that may potentially serve as a key issue in the coming elections. In one opinion article, he indicated that the constitutional referendum, in which he headed the "No" campaign, was not about being for or against the new Constitution.

In his opinion, everyone agreed that we needed a new Constitution, and that the then draft was an improvement on the Constitution that was then operational. In his view, everyone further agreed that there were flaws in the document that needed to be corrected in order to perfect it.

Only difference

He asserted that the only difference between the "Yes" and "No" camps was on the timing of the improvements, with the former holding the "Pass now, amend later" view while the latter wanted to "Amend first, then pass it".

Although the fundamental assumptions of this argument are open to debate, it is a useful way of encouraging constructive engagement in the run-up to the elections.

Those that disagree with this formulation should be encouraged to come up with their own views about what the referendum was all about, while those that agree with the basic assumptions can go ahead and discuss the aspects of the Constitution that need improvement.

Such a debate will be useful in several ways. First, it will ensure that leaders can be held to account on the basis of concrete statements they make, even after the elections. For instance, if those who think the Constitution was flawed win the election, they will be expected to initiate the necessary amendments to improve it. The expectation is that they will point out these flaws in advance, so that they too can become an election issue.

Second, an issue-based campaign may help the country to avoid focusing on less useful electoral decision-making tools such as tribe, race or gender. It should not matter whether it is one's tribesmate who makes a suggestion on how the Constitution should be treated, as long as one can interrogate the idea dispassionately and make their own decision.

Finally, concentrating on issues will encourage the engagement of professional think-tanks, resulting in a battle of minds rather than of might. No matter how crazy an idea sounds, as long as it is in the public sphere, it will stand or fall on its own merits, and not on the strength of its proposer.

Politics is meant to be a competition of ideas, where the best ideas, at least in the voters' collective imagination, prevail. Such competition will hopefully wean our country off our periodic electoral bloodlust for generations to come.

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and lecturer at Moi University's School of Medicine