Monday, November 25, 2013

Why true reconciliation remains a mirage

By Lukoye Atwoli
Sunday Nation 24 November 2013

Last week at a meeting in Pretoria evaluating peace and reconciliation processes across the continent, I had the opportunity to reflect upon the role of trauma in conflict and reconciliation.

Kenya is a prime example of a country that has recently had major civil upheaval, exposing many citizens to extremely traumatic events. Today, many, especially politicians, are parroting the mantra that people have reconciled and are living together in peace and harmony. The Jubilee political coalition is touted as evidence of this.

In the parlance of conflict studies, one would term the method employed in managing our post-election violence as having succeeded at arriving at a negotiated political settlement. While this was a good outcome, it by no means constituted reconciliation. What happened was a suspension of hostilities while, hopefully, more lasting solutions were sought and implemented.

Research has indicated that trauma management and reconciliation are so intertwined that one cannot realistically hope to succeed in implementing one without the other. Unfortunately, many past efforts at reconciliation in this and other African countries have been similarly focused on settling conflicts by dealing with the competing interests, and convincing the combatants that they cannot do without each other.

Little effort has been focused on true reconciliation, whose aim is to effect a change in how people identify themselves, removing the need to negate the hated “other” as a core part of self-identity. True reconciliation facilitates the development of a positive communal identity independent of the need to demonise others, and the acknowledgment of the others’ humanity and right to exist and have competing narratives about common events.

In my presentation at the Pretoria meeting, I argued that traumatised individuals are at increased risk of getting traumatised again, and of perpetrating traumatic events on others. Unaddressed trauma tends to create a spiral of repeated conflict, making it near-impossible to intervene without addressing the trauma effects. Further, although they are most in need of reconciliation, traumatised individuals are unlikely to openly welcome interventions due to their suspicious nature.

Interestingly, societies or communities that have suffered long-term conflict often behave in the same manner as traumatised individuals. They are more likely to be insular and isolated, suspicious of strangers and ready to react with violence at the slightest provocation. They are also likely to experience internal conflict and upheaval as the members recalibrate their own views on the nature of human interactions.

These communal reactions are often enhanced and magnified by leaders who often have been at the heart of the conflict and have been perhaps more intimately affected by it than those they lead. The result is that the population is afraid to second-guess their “liberation heroes” who, in turn, are afraid to acknowledge their possible psychological frailties.

The obvious outcome is that possibly traumatised leaders make erratic decisions that increase, rather than ameliorate, the risk of conflict. The populace applaud and unquestioningly follow the leader. Reconciliation initiatives cannot thrive in such an environment.

Future conflict interventions must build in principles of reconciliation along these lines, and also deal with the needs of traumatised individuals and populations. 

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

Friday, November 22, 2013

How to resolve crisis in the health sector

A late post on this blog, but...

By Lukoye Atwoli
Sunday Nation, 17 November 2013

A standoff looms due to a disagreement between government agencies on the one hand, and public health officials on the other, over the speed and extent to which health services are to be devolved to the counties.
Since this matter is now in court, I will not discuss the merits of arguments by either side in this standoff in any detail. Instead, I will rehash suggested solutions that we have advised government to implement over and over again to no avail.

First, it is impossible to stop the train of devolution much less in health services which was conceded as the prize catch for counties during constitutional negotiations. However, it is important to ensure that in meeting the constitutional requirements, human life and dignity is safe-guarded, and service is guaranteed no matter who is paying for it.

In this regard, my view is that the writers of the constitution did not intend that health services be hastily handed over to the counties regardless of their state of readiness. This is why they built in transitional arrangements to allow a phased transfer to prevent just such a crisis.

Second, the extent of devolution of health services is open to interpretation. How far does policy guidance by the national government go? Does it include policy on human resource management? Does it include regulation of the health professionals? The answer to these questions is an obvious yes, given that no county can carry out these functions.

This being the case, one may argue that due to the scarcity of the human resources for health, the national government must be involved in its distribution in order to ensure that all Kenyans have equitable access to healthcare all over the country. This function cannot at this time be ceded to the county governments.

For instance, it is currently estimated that there are about 0.14 doctors for every 1,000 Kenyans against a recommendation of one doctor per 1,000. If Nairobi County, with a population of about three million people, were to be free to hire all the doctors it needs, it would hire the entire public complement of about 3,000 doctors, leaving none to be shared by the other counties! The same problem obtains for other cadres of highly skilled health workers.

It is, therefore, very dangerous for the national government to leave each county to its own devices, given the resource constraints that preclude making each county attractive to health workers. Further, even if all counties had enough money to hire all the doctors and health workers they need, we would need to import almost 40,000 more doctors and hundreds of thousands of other health workers in order to attain the recommended ratio. The numbers currently in the country would simply be insufficient to supply all needs.

The solution lies in devolving most of the healthcare services to the county, but having a national body to organise registration, recruitment, deployment and remuneration of these scarce human resources for health. Such a body, in the form of a Health Service Commission, has been postulated countless times, and perhaps the time has come for central government to implement this recommendation and end the unnecessary health care crises. 

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

Monday, November 11, 2013

Why Kenyans have reason to be afraid

By Lukoye Atwoli
Sunday Nation 10 November 2013

For the past few weeks, I have been experiencing a nagging feeling that something is just not right in this country. In the beginning, I had no idea what was behind this feeling apart from the fact that our top leadership was saddled with enormous “personal challenges” in a foreign court as they struggled with questions of governance. Then a series of events began unfolding that clarified matters somewhat.

An angry Parliament passed a motion calling on the government to introduce a Bill to repeal the International Crimes Act and pull us out of the Rome Statute that established the International Criminal Court. A time frame was given for this, but this has since lapsed without much indication of progress on this process. But a warning shot had been fired — the ruling coalition would steamroll anyone who stands in the way of their quest to totally control the State.

Then a series of legislative gems followed, with the most evocative one being the VAT Act whose net effect was to raise the prices of basic commodities. After a public uproar and demonstrations, government appeared just at the right moment to save Kenyans from the effects of this legislative misadventure. In the best Machiavellian tradition, some minor functionaries took the flak while the rest of us moved on to the next big thing, as we are wont to do.

Soon after the Westgate mall attack, a chorus of enforced patriotism emerged from among the staunch supporters of the ruling coalition. Anyone who criticises the government is today labelled unpatriotic, negative and even a saboteur of government efforts to develop the country.

As the praise-singers reached a crescendo, Parliament pulled yet another surprise — an amendment to the ICT Bill that set limits to media freedom and threatened huge penalties for infringements. The tribunal created to implement the punitive measures was proposed to be top-heavy with political appointees whose main task would be to ensure that all media toe the government line.

In the resulting commotion with media freedom themes, Parliament once again sneaked in a piece of legislation aimed at reining in non-governmental organisations. A particularly nefarious section of the Bill required that NGOs ensure that no more than 15 per cent of their income comes from foreign sources. The aim, of course, is to completely paralyse this notoriously defiant segment of our population.

Meanwhile, the Inspector-General of Police seems to be acquiring absolute power over the domestic security apparatus, with little or no civilian oversight. Independent commissions have been crippled by the Executive’s failure to replace commissioners whose terms have expired. The Executive has been making extra-legal appointments with the active connivance of Parliament, and recent moves concerning the Lands cabinet secretary amount to little more than window-dressing.

The net effect of all these moves is to concentrate power in the hands of the Executive, emasculate dissenting voices and return the country to the era of Moi’s monolithic monster. This may look like a good thing to those in power but, as sure as rain, it always leads to disaster in the long run.

The Jubilee government must learn from history and remember that entering a sword fight with hands firmly around the sword-blade is a sure ticket to amputation.

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

Friday, November 8, 2013

We must take responsibility for our actions

By Lukoye Atwoli
Sunday Nation 03 November 2013

Last week I came across something on social media that really illustrated the Kenyan thought process with such clarity that it blew my mind. After a road crash involving a public service bus and a train, someone, presumably associated with the ownership of the bus company, posted what passed as an attempt at exonerating the driver and company from any blame.

This individual wrote that the “bus was not driven carelessly” but only “got stuck” on the railway line. In his view, it was wrong to place blame on the bus driver or management of the bus company, and he ended up insinuating that the police and others in authority had slept on the job for not stopping the bus before it got to the railway line.

I got very angry when I read the response but, after some contemplation, I gained an insight into where the writer of the “explanation” was coming from. In Kenya, as in many parts of Africa I have had the privilege of visiting, we seem to have developed a culture in which taking personal responsibility is alien. A psychologist would describe us as individuals with external loci of control whenever it comes to most events.

In our world, events always have an external causation or just happen on their own. For instance, when a small child plays with some chinaware and happens to drop the item and break it, she will explain that the “plate fell down and broke”, rather than looking at her own role in the whole affair. This is replicated throughout our public interactions.

Today, we are almost unanimous that the 2007/2008 post-election violence just happened, and we should just bury our heads in the sand and forget about that nasty period in our history. The frequent road crashes (not accidents!) that happen on our roads have no causative agency. They just happen and, unfortunately, result in massive loss of lives annually. 


Poor leadership in this country also seems to be imposed upon us by forces beyond our control, which is why we keep lamenting about it but doing nothing active about it. Periodic famines that predictably follow food gluts are obviously also beyond our capacity to deal with, and a few prayers should do the trick.

It is not unheard of to hear a senior government official in this country blaming “the government” for one thing or other, even for shortcomings in his own docket. This attitude explains our regular “naomba serikali itusaidie” (begging the government to help) attitude, even when the solution is staring us straight in the face.

A combination of this helpless attitude, and the supplication to our respective deities in the face of adversity, has resulted in a society that can never get anything right. Nobody has the motivation to set things right if they don’t feel responsible for them.

However, the moment everyone recognises that they are responsible for events in their environment, and that nothing truly happens by accident or by supernatural agency, they become more proactive in dealing with potential threats.

Unless we change how we explain events for which we are responsible, we are doomed to continue suffering under what we think are forces of nature when, in fact, we have the power and ability to deal with them. 

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

Leaders must speak the truth at all times

Apologies for late posting. I was traveling and I've only just returned to Eldoret!

By Lukoye Atwoli
Sunday Nation 27 October 2013

From the utterances of Kenyans in positions of leadership, it is very clear that we have come to a time when the “uta do?” phenomenon rules. Obviously, our leaders have lost all respect for us, perhaps because we have in the past demonstrated our propensity to shout ourselves hoarse and then go back to our daily routines.

After the Westgate attack, our military chiefs insisted that the soldiers involved in the response did not engage in any acts of looting, despite video evidence to the contrary.  Later, the Chief of the Defence Forces, Julius Karangi, had the temerity to suggest that soldiers caught on camera with paperbags full of loot were actually carrying water to quench their thirst! The insinuation here is that it is okay to loot a supermarket if you happen to be thirsty, no matter what else is going on.

The saga in the Judiciary involving the Judicial Service Commission and its Chief Registrar further illustrates the amount of disrespect Kenyans are being subjected to by those in positions of authority. 


Each of the parties involved in the saga have their own story, which contradicts that of the other. Obviously someone (or both) in this case is not telling the truth, for whatever reason.

Throughout our history, the organs of state have gradually perfected the art of peddling falsehoods, often citing the amorphous justification of “state security” to obfuscate on issues that should be in the public domain. Perceived adversaries of the State have been killed and extrajudicial executions taken place.

Although State operatives may have “good” reasons for the decisions they make, they must consider the fact that among the citizens there are those that will see through the tissue of falsehoods they put out. And once government is caught out telling falsehoods, it becomes difficult for the discerning citizen to believe anything else coming from officialdom.

Sadly, this has now come to pass concerning the Westgate affair, with multiple conspiracy theories being spun all over the country. It would be a sad day when we cannot all come together to deal with national crises of this nature because we do not trust the official version of events. 


The situation is now so bad that we are speculating about a link between recent episodes of insecurity in the country and a wider geopolitical scheme aimed at influencing the outside world one way or the other. Obviously, one must remain sceptical about such theories because, if true, then the Kenyan experiment at statehood would have come a cropper.

Additionally, if it were true that State officials are involved in schemes aimed at causing insecurity and killing unwitting people going about their daily lives, treason trials would be on the cards. And if any of them hold positions in government, they would, at least in a civilised society, not be allowed to continue holding such positions.

It is, therefore, imperative for the survival of our State that we take matters of state more seriously, and maintain honest communication at all times. If State officials are unable to adhere to this standard, it is up to Kenyans to refashion the State in a more desirable image.

Allowing the State to be captured by peddlers of falsehoods would be the greatest mistake we can ever make in our short republican life. 

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