Disbanding cohesion team not a solution

By Lukoye Atwoli
Sunday Nation 20 October 2013

Kenya is a relatively young member of the community of nations, having become an independent republic about half a century ago. Fifty years, in the normal lifespan of a nation, is not enough time to accomplish earthshaking things by any stretch of the imagination. Survival is often the only preoccupation of such an infant republic.

Although socio-political commentators, including this column, routinely criticise the leadership and citizenry of this country harshly, we must acknowledge that Kenya has done a pretty good job at surviving turmoil over the past 50 years.

We survived the intrigues and political murders of the Kenyatta years, the coup attempt against President Moi in 1982, and the subsequent crackdown on dissenters and intellectuals. We survived the transition from a single party dictatorship to a multi-party system, and the handover of power from President Moi to President Kibaki.

We survived the laissez-faire years of the Kibaki administration, culminating in the defining moment of our nationhood, the 2007 elections and the ensuing civil strife. We survived the dysfunctional coalition government of Kibaki and Raila Odinga, and this year’s General Election and subsequent installation of Uhuru Kenyatta’s government.

It is important to note that we did not survive all these events and periods because of any conscious effort on the part of the State to ensure that we did. We survived only because of our multiplicity of talent, our resilience in the face of adversity, our ability to ignore our differences when our needs coincide. Perhaps we even survived because of our ability to, at least superficially, accept whatever happens to us and move on.

ESTABLISHED COMMISSION

After the 2008 violence, those involved in resolving the crisis agreed to take measures to ensure that such violence never visits our country again. They identified poor ethnic relations to be one of the driving factors behind periodic ethno-political violence in our country, and in order to deal with this once and for all, they established the National Cohesion and Integration Commission.

Its mandate was broad, and included ensuring that national resources are distributed in a manner that minimises discrimination and promotes integration. The commission was also required to promote ethnic and racial harmony in the country, spearheading legislation outlawing hate speech and encouraging more cohesive communication in the public sphere.

An audit of the commission’s performance would obviously return mixed results.

The fact that it lasted as long as it did is itself a success in this brutally individualistic society whose members are known to bend the law past its elastic limit just to see how much they can get away with. Of course Kenya remains hugely segmented on ethnic lines, but one could not have expected the commission to reverse this phenomenon single-handedly in a few short years.

My view is that if Kenya remains fractured on ethnic grounds, it is their own fault, their leaders included. We cannot use the commission as a scapegoat and hope that our terrible ethnic relations will right themselves somehow. (READ: MPs plan to disband ‘failed’ cohesion team)

The best option is to do a better job at selecting the commissioners and staff and to clarify their mandate to ensure that we build on past gains and learn from our mistakes. Disbanding the commission is the equivalent of throwing out the baby with the bathwater! 

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

Why ‘miraa’ debate is purely political

By Lukoye Atwoli
Sunday Nation 13 October 2013

Kenya is a very interesting country. Most citizens will argue about almost anything, which is a healthy and good thing, especially if the arguments are backed by evidence that follows the precepts of logic. Unfortunately, we tend to hold opinions and defend them strongly without much independent evidence. We mistake strong feelings for strong evidence, and dismiss any piece of information that contradicts our already formed positions.

Sadly, this is the case with the ongoing arguments about khat, or miraa. Misleadingly, the argument has been framed as an attempt to answer the very straight-forward question: Is miraa (or does miraa contain) a drug? Subsequent arguments have laid bare the real question being answered, which is: Should miraa be considered a dangerous drug, and be restricted or banned? (READ: Kenyan leaders and farmers challenge miraa ban in UK)

These are obviously two different questions, and attempting to answer them as though they were one and the same thing is bound to lead to confusion. Usually, the first step towards finding a solution to a problem is finding out its source. In this case, the source of the problem is the decision by some countries to ban or restrict the consumption of miraa on the basis that the disadvantages of use far outweigh any benefits.

Let us try and answer these two questions, and perhaps frame the question for argument correctly.

Firstly, is miraa a drug? The simple answer to this question is an unqualified yes! The World Health Organisation defines a drug as “a chemical agent that alters the biochemical or physiological processes of tissues or organisms”. In other words, a drug changes the structure and function of the body.

Since early in the last century, scientists have described the main active ingredients in khat to be cathine and cathinone, which are known psychostimulants that affect the structure and function of the nervous system. Khat ingestion has been shown clinically to result in symptoms similar to those induced by other stimulants, such as restlessness, garrulousness, sleep and mood changes and even psychotic symptoms. 

'KHAT PSYCHOSIS'

Indeed, doctors who have worked in areas where miraa use is widespread have numerous anecdotes of “khat psychosis”. To “treat” this condition, relatives often lock up the “sick” individual for a few days and, after the stimulant has worked its way out of the system, they are considered “healed” and resume normal functions.

More studies have described dental and gastrointestinal effects of chronic miraa use, while others have clearly described effects on the reproductive system. In short, there is no doubt in the minds of experts that miraa is a drug!

The only question that needs answering therefore is whether miraa should be considered a dangerous drug and perhaps be restricted or even banned. This is, however, not a medical or scientific question, but a political one.

The scientists must honestly tell the politicians the scientific effects of miraa on the body of the user, which are well established and require no further study. The politicians should then determine whether, in their own opinion, those effects are sufficiently harmful to the physical, psychological, and social well-being of the population to warrant legislative action.

Lawmakers in a number of other countries have made this determination and taken action restricting or banning miraa use. The miraa debate is thus purely political, and has no bearing on whether miraa is a drug or not! 

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

From leaders to the lowly, all love to loot

By Lukoye Atwoli
Sunday Nation 06 October 2013

In the wake of the Westgate terror attack, revelations are being made by shop owners of a massive looting spree that took place during the siege. In one video posted online, a restaurant is shown with empty beer and spirits bottles strewn on all available surfaces. Heavy losses of jewelry, electronics and cash have been reported by proprietors at the mall.

As usual, these revelations have been greeted with indignation and a collective cry of “shame! shame!” Kenyans have even called for the indictment and sacking of those involved in the looting, including officers affiliated to the Kenya Police Service as well as the Kenya Defence Forces. All this is as it should be in a civilised society where stealing is strongly discouraged and all citizens are on the lookout for anti-social louts.

So the more relevant question to ask is this: Is Kenya a place where such behaviour is discouraged? In order to answer this question, one has to examine the behaviour of regular citizens by observing how their heroes behave. It is perhaps pertinent to first interrogate who our national heroes are.

Most of our acknowledged national heroes are politicians, and with very few being private individuals who overcame some sort of adversity to do something for Kenya. Almost none are paragons of virtue, and many have stolen public property, engineered killings of opponents, mismanaged public office, and generally just behaved obnoxiously.

Further, our national story is anchored on the narrative of the pre-independence freedom struggle. Two things stand out in this narrative.

First, it largely ignores the real protagonists in the freedom struggle, and replaces them with politicians whose role was largely to generate more heat than light, to pontificate in the public spaces while the real fighters endured cold nights in the jungle and faced real bullets and machetes. The politicians were the chief beneficiaries of political independence, and a cursory look at who-is-who in our economy clearly demonstrates this.

Secondly, the use of this violent insurgency to anchor the Kenyan story is itself problematic. It has resulted in a society that believes that there are few legitimate means to gain political power and that ultimately, force and subterfuge must be and are often employed in this quest. This has led to a scenario where it is difficult to accept that anyone can win an election legitimately, and of course every election outcome is vehemently disputed, often leading to violent confrontations.

The result is that we end up electing people of questionable behaviour into public office, with the occasional murderers and violent robbers sneaking in as well. These then become our national heroes, the centrepiece of our national narrative. Their first action upon assumption of office is to survey the landscape for anything that can be “liberated”, and the second is to agitate for improved terms and conditions of service for themselves.

Where then do we get the self-righteous indignation to condemn the looters who burst onto the scene of a terrorist attack and happened upon unguarded jewelry, electronics, and money, and decided to “liberate” these goodies? How can we condemn those that chose to partake of free drinks during a lull in the fighting, when our airwaves are full of offers of one free thing or another?

Aren’t we all just a bunch of pathetic hypocrites?

Dr Atwoli is a Consultant Psychiatrist and Senior Lecturer at Moi University's School of Medicine.
lukoye@gmail.com; Twitter @LukoyeAtwoli 

For once, let us learn from this tragedy

By Lukoye Atwoli
Sunday Nation 29 September 2013

The siege at Westgate Mall in Nairobi’s Westlands suburb is over.

As I write this piece there is still no clear picture of how many people died in this terrorist attack. It is also not clear how many attackers were involved, and what happened to them. Towards the end of the siege a section of the mall collapsed, complicating recovery efforts and making it extremely difficult to know the eventual fate of those that were in the building at the time.

During the attack, Kenyans demonstrated their strength in ways that nobody could have expected. Ordinary citizens found ways of contributing to the rescue and recovery, in all sorts of ways. Some prepared food for the responders; others donated blood, while even others volunteered to take care of the immediate needs of the survivors.

Many Kenyans converted their vehicles into ambulances and took the injured to hospitals, while others braved the hail of bullets and grenades and went into the mall to save trapped civilians. This attack has brought us together, and helped us to momentarily forget our political and ethnic differences in the face of attack by a foreign terrorist organisation.

No one paused to ask the tribe or status of the person they were helping. People were not taken only to hospitals run by people who share their political or religious views. For a moment, we were simply Kenyans again. 

BOTTOM OF THIS

Despite the show of unity, however, questions about how the attack was handled abound. One expects that investigations will be diligently carried out to get to the bottom of this atrocity. Initial indications were disconcerting.

For instance, there seemed to be no overall co-ordination of the government response to the attack.
Information was being provided by different government agencies and officials and sometimes they contradicted each other.

During a disaster, the first and most important need is information. There ought to be an authority to inform the public regularly of the progress being made to deal with the crisis. Involved citizens often only want an assurance that everything is under control and that they are safe from further attacks. They want regular updates on the progress of rescue and recovery, from a source they trust has the correct information.

In our case, the government was initially too quiet for too long, and when they started talking to Kenyans, they gave information that often contradicted the actual situation on the ground. In a disaster, it is often better to say that it is not clear what is going on, than to make up stories that will later be revealed to have been untrue.

Despite the fact that we have had many such disasters in the past, it seems that we are incapable of learning simple lessons from such events. Due to the high profile of the Westgate attack, one hopes that we will, for once, learn a few lessons that will make it more difficult for similar attacks to happen, and improve our response should they happen.

We must also begin to implement the many disaster management strategies and plans that are gathering dust on the shelves of various government offices after lots of resources were expended in producing them. 

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

PEV psychological wounds far from healed; And now #WestgateAttack

Friends, I wrote this article for the Sunday Nation before the Saturday attacks at Westgate Mall in the Westlands surburb of Nairobi. It was subsequently published on Sunday, in the paper that contained the relatively insensitive cover picture that elicited an apology from the Nation Media Group after a social media uproar.
I upload it here for two reasons.
Firstly, I use this space to share my 'Barometer' column with my readers who may not have access to the paper for one reason or another, or prefer using social media links to get it.
Secondly, and perhaps more importantly, I think it is particularly instructive, insofar as it stipulates some of the prerequisites for healing of psychological wounds such as those inflicted on our countrymen and women before and in 2008, and again, now in September 2013.
I wish to express my deepest condolences to all families that have lost loved ones in this tragedy, and hope that what we take away from here is the resolve to take measures to ensure that it becomes exceedingly difficult for anyone to plot and carry out attacks on Kenyan soil ever again.
May you find support and healing in these difficult times. As we say in these parts, 'Tuko pamoja', or #WeAreOne
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By Lukoye Atwoli
Sunday Nation 22 September 2013

The opening of the trials of Kenyans accused of crimes against humanity at the International Criminal Court (ICC) at The Hague has rekindled painful memories among many survivors of the 2008 post-election violence. While many Kenyans are watching the trials with different motives depending on their political leanings, for the survivors this was the last recourse in their search for justice.

The media has highlighted reactions of segments of our society and in my view, provided a window into the soul of our nation. There are those that hold that some of the atrocities being mentioned at the ICC never occurred, and that the trials are a political attempt at humiliating Kenyan leaders.

Obviously, everyone is entitled to their own opinion. But, as an American leader once said, nobody is entitled to their own facts. The reality is that in 2008 Kenyans went on an orgy of violence that left over a thousand dead, and thousands displaced from their homes. We all saw the burning buildings, the machete-wielding militia, the bow-and-arrow brigades, policemen shooting at protestors and politicians shouting epithets at each other.

As medical doctors, we personally attended to dozens of survivors with physical and psychological wounds, and organised a mental health and psychosocial response that reached tens of thousands. We escorted bereaved relatives to mortuaries and helped them identify their kin, providing psychological support to those that needed it.

It was a tough time. At some point we thought that the country had finally jumped off the cliff, and that recovery would take more effort than we were capable of marshalling as a country. Luckily for us, international mediators took it upon themselves to break the impasse, resulting in the grand coalition mongrel that ruled us for five years before the elections early this year.

It is therefore disturbing to hear some Kenyans argue that we have since reconciled, and that we should simply move on because all is well in the political sphere. In my opinion, it is only those that are far removed from the actual victims that are capable of making such callous statements.

Healing psychological wounds cannot be legislated or ordered by the powers that be. It is a process that takes time, and depends heavily on a secure enabling environment. Just like with physical wounds, an enabling environment for psychological healing has certain indispensable elements.

Firstly, it is pervaded by a sense that something wrong was done, accompanied by true, deep remorse on the part of the perpetrators. Secondly, there is a sense that justice has been done, and that some attempt at restitution has been carried out. Thirdly, there is a collective agreement that the atrocities must never be allowed to happen again, and tangible early intervention measures have been put in place to deal with them should they recur. Finally, provision of long-term care to those survivors who need it is a sine qua non of a healing society.

From where I sit, I cannot honestly say Kenya provides such a secure enabling healing environment for survivors of past atrocities. We are still at a place where a slight misunderstanding could spark an all-out conflagration that will make 2008 look like New Year’s Day fireworks.

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