Their dream died at independence

By LUKOYE ATWOLI
Daily Nation Friday, December 12, 2008, Page 11

Today, Kenyans are celebrating the day when Kenya officially became independent under majority rule. Prior to this date 45 years ago, the country had been under white minority rule for 69 years.

History tells us that before the 19th century Scramble for Africa, the territory now known as Kenya was populated by various ethnic communities under different forms of rule, from monarchies to councils of elders.

Prior to the advent of independence in 1963, there was a decade and a half of an armed insurrection culminating in the declaration of a state of emergency in 1952. Thousands of freedom fighters were killed in the struggle, and many more were incarcerated in concentration camps all over the country.

Hundreds of thousands were compulsorily ‘‘villagised’’ in an attempt by the colonial government to control movement and crush the rebellion.

Two years ago, we carried out a study that found out that almost a third of the survivors of those concentration camps suffer from post-traumatic stress disorder and a large proportion suffer from other psychological problems, including depression and anxiety disorders.

Many of the veterans interviewed were bitter that the freedom they sacrificed for had been ‘‘grabbed’’ by those that stood by and collaborated with the ‘‘enemy’’.

Many colonial administrators — chiefs, district officers and junior police officers — at independence became senior government officers with power to allocate resources to the burgeoning middle class. Freedom fighters were shunted aside or advised to band together, purchase land, and start their lives afresh.

In Nairobi and other urban centres, one will today find groups of demoralised old men and women with multiple physical and psychological scars of the freedom struggle. They are now grandparents and great grandparents many times over, but they still eke out a living in conditions of near absolute poverty.

Their children have fanned out across the country and try to make a living from hawking and doing other businesses. They in turn started their own families and in the cycle of poverty they live in, shared stories of how their parents lost everything during the ‘‘Mau Mau’’ war and had nothing to show for it under successive governments.

The grandchildren of the freedom veterans, disillusioned with a hopeless existence and condemned to a life that is Hobbesian — solitary, poor, nasty, brutish, and short — were seduced by the hopeful religion of liberation by facing back to the past. Thus, Mungiki was born.

Current urban thuggery can thus, at least partially, be traced to a Government policy that deliberately ignored the past and sought to build a future based on a spineless vision of ‘‘forgive and forget’’.

If this nation is built on the foundations of the freedom-struggle narrative, then it is a shaky foundation indeed, given the sense of betrayal one sees in the tired eyes of these men and women and their offspring.

In developed societies, there are dedicated veterans’ administrations to cater for the needs of the men and women who take up arms in defence of the state.

As part of our acknowledgement of our past errors, we must start thinking of setting up a similar structure to serve, not only the veterans, but all the soldiers who have fought for this country and now live in humble retirement, suffering nightmares due to their war experience.

Dr Atwoli is a consultant psychiatrist and lecturer, Moi University School of Medicine.

Jamhuri Day in Kenya

Jamhuri day refers to the day Kenya became a 'self-governing' 'free' republic, December 12 1964. The country had just attained 'independence' the previous year on the same date after more than a decade of armed struggle mostly in Nairobi, Mount Kenya Region and parts of the Rift Valley.
Every year we pretend to celebrate the 'independence', before packing our travelling bags and making a beeline for Paris, London, New York and Washington DC with our begging bowls in place and our hats in our hands...
Independence indeed! We are unable to feed our population and are now labouring under two prices for the maize meal staple, one for the 'rich' and one for the 'poor'. The government has finally accepted poverty as an ineradicable reality in this country and has moved to institutionalise it.
Soon we should start seeing schools for the rich and poor, segregation in hospitals, public offices, electoral booths, roads and even churches. For there are only two tribes in this country, as the cliche goes: the haves, and the have-nots.
This is just too tiring to think about! And to imagine that 'we' aspire to be a 'middle income' (sort of ) industrialised country by 2030, I have no breath left in me after the bout of laughter....
This is Kenya.

Reality check on the Waki report

By LUKOYE ATWOLI
Sunday Nation, November 30 2008 Page 22

Ongoing debate over the report of the Commission of Inquiry into Post-election Violence (CIPEV) has taken a familiar Kenyan trajectory.

Many commentators are seeing it purely through tribal or partisan lenses, and if this continues, it is inevitable that the International Criminal Court at the Hague will be involved.

At the beginning of this year, I spent several days at the Moi Teaching and Referral Hospital Mortuary, organising mental health and psychosocial services for the mourners coming to identify the bodies of loved ones killed during the violence.

At the peak of the violence, 50 to 100 bodies were arriving each day with bizarre injuries that tested even veteran morticians at the mortuary.

Bodies burnt beyond recognition, torsos without heads, dismembered limbs and bodies were the order of the day.

Bodies picked up several days after being killed and dumped in farms and trenches were brought in badly decomposed. Some are still awaiting identification through DNA technology.

Underestimated

According to the Waki report, 1,133 people were killed between December 27, 2007 and February 29, 2008. I think the deaths are being considerably underestimated.

Many people died during flight and were buried in mass graves or abandoned at roadsides, and these could not have been counted as victims identified by the police or public hospitals.

It is important that anyone deigning to comment on the Waki report reflects on these facts before cheapening the lives of those that were killed during this dark period of our history.

It is important also to remember that both government and civilians hold responsibility for the deaths. About a third of the recorded deaths are attributed to the police while the rest are attributed to civilians.

For those insisting on seeing things through ethnic prisms or in orange and blue, the following statistics in the Waki report should help clarify things somewhat.

Roughly equal numbers of Kikuyu (268) and Luo (278) were killed, and significant numbers of Luhya (163) and Kalenjin (158) lost their lives, among others.

It is macabre for politicians to harp about how “their” people were the only victims, while minimising the losses purportedly suffered by “others”.

Weeps and prays

Every time someone denigrates the contents of the Waki report, a Kenyan somewhere weeps and prays for strength to face the next day without a loved one.

It must be understood that the deepest and most painful scars suffered by the vast majority of Kenyans as a result of the violence were not physical.

Most people underwent some degree of psychological anguish, and indeed the bitter fruits of that experience are only just beginning to be felt.

Many Kenyans are seeking help in health facilities for problems to do with sleep, forgetfulness, poor concentration, nightmares and being easily startled.

These symptoms are often accompanied by chronic bodily aches and pains that are difficult to treat with pills. These are actually some of the symptoms of the psychological effects of traumatic experiences many were exposed to earlier this year.

Long after physical wounds have healed, many Kenyans will continue suffering mental anguish, and it will be difficult to mobilise them politically towards any national goal.

Unless this psychological suffering is addressed enduringly, this country should brace itself for major challenges in its quest to achieve the Millennium Development Goals or Vision 2030.

First step

The first step in addressing this problem will have to involve some form of closure. This will be in the form of a sense that justice has been done one way or the other, and that some degree of restitution has been achieved.

Whether through a local tribunal or at the Hague, this need for a just outcome will just not be wished away, and the sooner our politicians understand this, the better for all of us.

This should be followed by a process of reconciliation, involving our coming together as a nation and re-examining our national values vis a vis the violent activities characterising our history since independence.

The Truth, Justice and Reconciliation process may not go far enough in achieving this goal. We must embark on a national project of healing that goes beyond cyclical political upheaval.

The end-product must include a national vision that is coherent and shared by all who identify themselves as Kenyan.

Political and constitutional reforms not anchored in a national morality and vision will only serve as a template for the next generation’s conflict.

The Waki report offers us the opportunity to finally exorcise the ghosts of our bloody past, and failure to do so will leave us exposed to the harsh judgment of history.

Dr Atwoli is a consultant psychiatrist and a lecturer at the Moi University School of Medicine. lukoye@gmail.com

Mushrooming campuses alarming

By LUKOYE ATWOLI

Daily Nation Tuesday, November 25 2008 Page 11

EXPANDING UNIVERSITY EDUCATION and taking higher education closer to the people in need of it is an important prerequisite for any country aspiring for industrial development.

It seems clear that our local universities have taken on this role with gusto, and are engaged in voracious expansion and creation of satellite campuses, colleges and collaborations with private institutions.

Over the past decade, there has been apparent competition between the universities on which one will have the largest number of satellite campuses in the most far-flung corners of our republic.

However, this has been done with the same degree of preparation as goes into an improvised kindergartners’ dance. University bigwigs just declare that we shall have a campus in such and such an area and voila! The deed is done.

In many cases, no thought is given to the staffing and infrastructure necessary to make the campus an ideal learning environment, and often students are called to these campuses before the teaching staff are identified.

Indeed, in many cases, the only consideration is that the location should be near the home of one of the senior university administrators.

This is leading to a situation where our universities are beginning to appear like glorified secondary schools, competing with all sorts of middle-level colleges for students.

Highly educated professors are being dispatched to head up these colleges and campuses and end up being under-employed and playing the same role as headmasters and principals of high schools!

It is time our universities sat back and rethought this whole expansion strategy.

Failure to involve all those affected in siting satellite campuses will result in a situation where it will become increasingly difficult for teaching staff to divide their attention between the main campuses and these satellite campuses.

INDEED, A CRISIS IS LOOMING IN some of the universities as teaching staff are beginning to raise complaints about inadequate remuneration and provision of facilities to make it easier for them to reach these far-flung campuses.

The Privately Sponsored Students’ Programme (PSSP) was initiated as an income-generating activity to enable our public universities to improve their infrastructure and to better remunerate lecturers without compromising the quality of education.

As it is currently, the income-generation objective seems to be the only one being met, and going by the complaints from many dons, it would appear that little is being done to meet the other goals.

Education standards are being compromised in the name of taking higher education to the masses.

Most of these universities have very little to show in terms of infrastructure improvements since the programme was started, and even the little money lecturers have been getting through the program is at risk.

The question must therefore be asked: Where have the funds accruing from this PSSP been going? Can any of our public universities fully account for these funds?

Satisfactory answers to these questions will be the exception rather than the rule. Indeed many university administrators will be hard pressed to show that there has not been any corruption in the use of these funds.

Dr Atwoli is a consultant psychiatrist and lecturer, Moi University School of Medicine, Eldoret.

Mathari: What is in a name

By LUKOYE ATWOLI
Daily Nation, Thursday November 13 2008 Page 11

A few weeks ago, the World Mental Health Day was marked. The event is commemorated on October 10, but in Kenya, this was changed to the last Friday of October due to the Moi Day holiday.

Every year, there are calls for the reduction of stigma against mental illness by changing the name of the premier mental health institution in this region, Mathari Hospital.

A former minister of health once suggested a change from Mathari Hospital to ‘‘New Muthaiga Hospital’’ or some other more glamorous name. Ironically, despite having the power to effect the change of name, the minister never went beyond the suggestion.

This year, the matter was rehashed at the ceremony marking the day at Mathari Hospital on October 31. It is likely that nothing will be done about this since the ceremony was given a wide berth by senior officials at the Health ministries.

There is stigma directed towards the mental health community, not only in Kenya, but all over the world. Those with mental illnesses are often shunned or hidden away from public view.

Many languages contain derogatory references to the mentally ill, all suggesting that the illness fundamentally changes one into something less than fully human.

The stigma is not limited to those with mental illness. Their families are often targets of snide remarks, and people are afraid to associate with them.

Stigma is often a product of ignorance and prejudice. It is then manifested in discriminatory behaviour. Tackling ignorance, prejudice and discrimination would, therefore, be a more comprehensive method of dealing with stigma than seeking to whitewash it with a mere change of name.

A strategy incorporating an increase in the general population’s knowledge on mental illness and mental health would be the beginning of an anti-stigma campaign.

Huge amounts of money have been channelled towards increasing knowledge on HIV and Aids over the last two decades, and today it is estimated that over 95 per cent of the adult population knows all there is to know about it.

If only a fraction of this money were used in a mental health awareness campaign, a huge dent in the stigma directed at the mentally ill would be made.

Prejudice may be tackled by demonstrating the ubiquitous nature of mental problems in our society, and highlighting helpful attitudes towards them. Investment in the facilities for treatment of mental illness would go a long way in improving the quality of life for the mentally ill, and for the general population at large.

Discrimination must be tackled from the very top. The Mental Health Act of 1989 takes the first step by outlawing discrimination in health insurance coverage for mental illnesses. This must be taken further to deal with discrimination at the workplace, in social places, hospitals and other public services.

Failure to fundamentally address the problem of stigma towards mental illness is responsible for many social ills in society.

The violent crises in our politics and in the education sector are an indictment on the mental health of our nation, and unless steps are taken to improve the situation, we can predict with utter certainty the recurrence of worse eruptions in future.

Dr Atwoli is a consultant psychiatrist and lecturer at Moi University School of Medicine, Eldoret. (Lukoye@gmail.com).