Sunday, August 25, 2013

Nothing new in religious healing claims

By Lukoye Atwoli
Sunday Nation 25 August 2013

The revelation in the past few days that some evangelists are actually conmen seems to have stung many people who believe that their pastors are “legitimate”. Many Kenyans are feigning surprise that at least some of the pastors peddle fake miracles and promise prosperity in exchange for “seeds” planted in the form of cash transfers to the clerics.

A group of “genuine” evangelists has now emerged to challenge these so-called “fake” pastors, claiming to have a checklist that can separate the wheat from the chaff, as far as miracle healing is concerned. They claim that “genuine” miracle healing can occur, but it is based purely on “faith”, and the healer does not ask for money in exchange for the healing.

Sadly, however, the “genuine” pastors do not provide any evidence of this type of faith healing, and end up only sounding like more conservative versions of the con pastors. By not denouncing the notion of “faith healing”, they keep the unrealistic expectations alive among their flock that chronic medical conditions such as HIV, cancer, diabetes and hypertension can be healed without the active agency of experts trained in the management of such conditions.

In my opinion, the emergence of “faith healers” is just the latest manifestation of a con game that has been going on for ages all over the world. Human desire for the easy life and quick options to deal with complex problems has resulted in a gullible populace that will buy snake oil cures despite clear evidence that they will not work.

A few weeks ago, a famous “faith healer” organised a crusade in Nakuru, during which he hosted multitudes of followers, including government officials. Many sick people were removed from hospitals and taken to the venue, with the expectation of miraculous healing. Despite the multiple claims of healing at the crusade, those that really needed it went home without a cure in spite of their enormous faith.

In fact, newspaper reports indicated that some people actually died during the crusade while waiting for their faith to perform miracles. The evangelist continues to parade discredited medics at his rallies to bolster his unproven claims that prayers have healed many people suffering from HIV and other chronic conditions.

Our national hypocrisy is exposed when we condemn the greedy miracle-promising televangelists while at the same time entertaining “genuine” pastors who claim that they are agents of a higher power that cures all maladies miraculously. We are afraid of interrogating miracle cure claims because their purveyors threaten “doubting Thomases” with fire and brimstone on judgement day.

However, when lives are at risk, all right-thinking Kenyans must question these claims. We have written several times in these columns about conmen hiding behind religion and tradition to peddle dangerous ideas that result in death and disability among our people.

These warnings continue to be ignored, and every weekend all the main television channels air people of cloth making all sorts of medical claims without fear of being challenged. They are able to pay millions of shillings to be given lots of airtime on national TV, suggesting that they are making a lot more money from gullible Kenyans.

Desperate Kenyans must be protected from these people, perhaps through a government agency like the Medical Practitioners and Dentists’ Board, whose mandate is to regulate all those that purport to practise medicine. 

Dr Lukoye Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine; Twitter @LukoyeAtwoli

Tuesday, August 20, 2013

Our habits led to flooding of Thika highway

By Lukoye Atwoli
Sunday Nation 18 August 2013

Kenyans who live in Nairobi and think the capital city is the beginning and end of Kenya were shocked last Wednesday when the flagship project of our “development”, Thika Road, was rendered impassable due to heavy flooding.

Pictures posted online showed roads that seemed to have turned into rivers, complete with submerged vehicles and people wading in knee-deep water. What many did not realise was that this phenomenon was not only restricted to Nairobi and Thika Road. Outside Nairobi, many roads regularly turn into rivers whenever it rains. The difference is that they are already hazardous due to the many craters one has to reckon with even on dry days.

It was, therefore, amusing to see some people pouring vitriol on the Chinese, who they deemed responsible for the allegedly “poorly designed roads” that provided proof of inferior techniques. Unfortunately, the evidence against Chinese builders is very weak to begin with.

First, one only needs to look at the roads built by the Chinese in their own country to understand why their engineering and construction cannot be to blame. Every direction one looks in China, there are roads more complex than any we have in this country. Thika Road would approximate the equivalent of a rural access road in comparison!

Second, the criticism of Chinese architecture loses its sting when one looks at Kenyan roads designed and built by Kenyans. They are pockmarked with potholes within weeks of completion, and the usually thin layer of tarmac is washed away within days of a drizzle. If Chinese road-builders are pathetic, then obviously ours are non-existent!

One is, therefore, justified to ask what went wrong last week leading to the conversion of this architectural masterpiece (in Kenyan terms, of course!) into a raging river.

The obvious answer is that there was a problem with drainage. On Kenyan-built roads, drainage is not an integral consideration during construction. Our builders only think about drainage whenever water pools in the craters that inevitably form a few weeks after “completion”. However, Thika Road was built with adequate drainage channels, at least in the eyes of a road construction layman like me. 


Unfortunately, soon after it was opened for use, those of us enjoying the smoothness of the road continued with our peculiar habits. We buy foodstuffs on our journeys, and when we are done with them, we throw the wrappers and any left-overs out of the windows.

Plastic bags, maize cobs, milk cartons, and banana peels -- nothing is spared in our quest to “clean up” our personal space. We subscribe to the philosophy that once something is out of sight (out of the car window in our case), it no longer exists. And if it does, it is somebody else’s problem.

A second problem is the lack of a maintenance culture in Kenya. Despite our uncouth behaviour of throwing all waste out of car windows, had the responsible authorities been regularly unclogging the drains, the problem of flooded roads would not arise. In Kenya, unfortunately, we build things and then sit back to watch them degenerate. Once this happens, we turn around and look for someone else to blame.

In this case, we must acknowledge our own responsibility for our flooded roads and leave the Chinese out of it. We cannot live first-class lives without developing first-class habits! 

Dr Lukoye Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine

Tuesday, August 13, 2013

We have made life very cheap in Kenya

By Lukoye Atwoli
Sunday Nation 11 August 2013

Kenya is an interesting place to call home. On paper, we are a nation built on a combination of conservative religious values and African traditional beliefs — a most improbable concoction under any other circumstances. In theory, we value life and would do everything in our power to save and preserve it under the most adverse of situations. Indeed, our constitution even has an injunction that states exactly when life begins!

It is, therefore, difficult to understand our attitude towards the avoidable deaths that have become so commonplace that no editor would use them as headline news.

Sample the following stories.

A senior policeman was killed in the line of duty in Kitui a few days ago. According to newspaper reports, his was only the latest of a series of “mysterious” killings of high-flying policemen in the country. Conspiracy theories abound, linking these deaths to all sorts of nefarious activities by powerful Kenyans, but the only thing we can be sure of is that the truth will never be known.

This policeman, by the way, is said to have been the main executioner of youth alleged to belong to the outlawed Mungiki gang a few years ago. The deaths of those Mungiki adherents have also never been fully explained by the government, and remain the subject of conspiratorial whispers implicating people at high levels of government.

Last week, a man was reported to have stabbed his children and attempted to kill himself after a disagreement with his wife somewhere in Uasin Gishu County in western Kenya. An intriguing item in the newspaper report of the incident was the observation by the neighbours that the man had tried to kill himself several times in the past, and had constant quarrels with his wife over her alleged infidelity.

To my mind, that situation suggests someone in need of assistance from a mental health professional, and early intervention would probably have averted these tragic deaths and injuries. To the villagers, however, this was the work of the devil and, as one of them put it: “It seems the devil had driven him for long. At times he would be heard saying he would some day kill his wife and himself. He also had taken poison about five years ago.”

Elsewhere, some villagers gathered together to think about possible interventions to curb the rising incidents of road crashes that had claimed several lives in the recent past. Having concluded that supernatural forces were at work, they resolved to deal with the situation using prayers and “cleansing” rituals. No mention of what happens to those responsible for those deaths.

Finally, five years ago, more than 1,000 Kenyans perished in what has been christened “post-election violence”. We made noises about how horrible that period was, and how we must do everything possible to ensure it does not recur. We regretted the deaths and vowed to leave no stone unturned until those responsible had been brought to book. We chanted, “Don’t be vague, go to the Hague”, only partly in jest.

Five years on, nobody has been successfully prosecuted for those heinous crimes and, to many Kenyans, those deaths could as well be classified as self-inflicted.

Having reviewed these and many other preventable deaths in this country, one can come to no other conclusion than that life is very cheap in Kenya. 

Dr Lukoye Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine Twitter @LukoyeAtwoli

Monday, August 5, 2013

Retain national control over health workers

By Lukoye Atwoli
Sunday Nation 04 August 2013

The health sector has been in the news once again, for all the wrong reasons. After a delay in payment of salaries for doctors, nurses and other workers in the ministry of Health, doctors threatened to “march to Afya House to look for their salaries”, while nurses have issued a strike notice due to certain shortcomings in their terms of service.

Apart from subpar remuneration, health workers have raised a raft of issues which, if addressed, would not only improve their own working conditions, but would benefit every Kenyan’s health. A key bone of contention is the move by government to operationalise the constitutional injunction to devolve certain functions to the counties.

According to Part 2 of the Fourth Schedule of the Constitution, the functions to be devolved include “County health services, including, in particular, county health facilities and pharmacies, ambulance services, promotion of primary health care …” among others.

Of course it is impossible to devolve a function without ensuring that the resources for implementing the function are available within the county that is supposed to carry it out. In this regard, the national government has indicated that soon, all health workers’ salaries will be paid by county governments, which will also run all the county hospitals and health services.

Therein lies the rub.

Human resources for health are, for the time being at least, scarce. There are not enough doctors in the public or private sector to serve the needs of all Kenyans. Although they are available in larger numbers, other cadres of health workers including nurses, clinical officers, physiotherapists, social workers and clinical psychologists are still too few to effectively address our nation’s health concerns.

It is therefore difficult to envisage a situation where a county with a health worker shortage advertises positions for doctors and gets enough applications to fill its health facilities. This was spectacularly illustrated during a doctors’ strike last year at the Kenyatta National Hospital where an advertisement for dozens of positions elicited almost no response despite the relatively lucrative nature of a Kenyatta National Hospital posting.

It is with this in mind that one would urge caution as far as devolution of health functions is concerned. It is prudent to devolve the management of health facilities, procurement of medications, primary health care functions and promotive health activities to the counties, while retaining some sort of national control over the health workforce.

Registration of health workers, setting and enforcement of standards and ethics, recruitment and deployment on secondment, discipline and even termination of service ought to be a national function, given the nature of the health professions. Due to scarcity of human resources for health, centralised recruitment and deployment would ensure that even the most remote counties benefit from access to qualified health workers and services.

To address the fear of an overbearing national government inequitably distributing this scarce resource, we have recommended a Health Service Commission to manage Kenya’s human resources for health, much in the same way as the Teachers’ Service Commission does for teachers.

A proposed Bill for the Health Service Commission has already been developed and delivered to the Attorney-General’s office.

One hopes this initiative will become a reality for the sake of our national well-being. 

Dr Lukoye Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s school of medicine Twitter @LukoyeAtwoli