By LUKOYE ATWOLI
Sunday Nation 13 February 2011
This past week I have had real cause to fear for the future of our country. At the referral hospital in Eldoret, we saw several children suffering from a psychological disorder called conversion disorder.
This condition is part of a broad range of mental disorders known as somatoform disorders, and is characterised by symptoms suggesting neurological impairment whose cause cannot be found even by the most sophisticated tests available.
Generally, this condition occurs among people with a lot of psychological distress but who are unable to express it because they lack either the language (as is often the case with children) or the opportunity to express it for one reason or another.
Among our young patients, most of the distress could be traced back to the school environment, and we could not help but conclude that many of our schools had become terrible centres of torture.
One of the primary school children we spoke to indicated that the main focus in her school was punishment. The children would be caned severely for dropping in position or scoring lower marks than in a previous examination.
They would be caned if another school or class performed better than their school or class. Indeed, the young lady informed us that their school had target marks for “important” subjects such as Mathematics, English and Science, and anybody scoring below these targets would be caned.
Lower classes
Even children in lower classes are not spared. At one kindergarten in Eldoret town, the children are given so much “homework” that many often fall asleep while trying to complete it at home.
Many kindergartens do not even have a curriculum, and the babies spend inordinate amounts of time trying to master relatively complex principles, including mathematics and long sentences.
Another parent lamented that her son in Form Three in a public school had just been forced to repeat the class because he had not scored the “minimum grade” to move to Form Four.
She is now wondering how she will finance the extra year in school, given that she is a widow surviving on the goodwill of relatives and friends.
The upshot of this is that we are creating a highly stressed population that will in future spend a lot of resources managing chronic physical and psychological illnesses.
In my opinion, the biggest problem is that we have absolutely no idea why we take our children to school.
Many parents take their children to school so that eventually, they get good jobs and elevate the family from the ever-present threat of poverty. As a country, it is not clear whether we have a philosophy underlying our education policy, and if we do, then it must be a horrible philosophy that should never be proclaimed aloud.
National aspirations
Hopefully, as the education “experts” meet to refine our education system in line with the new Constitution, they will examine the underlying philosophy and ask themselves if it faithfully reflects our national aspirations.
If there is no philosophy, let the education ministry ask scholars to help formulate one and policy that will guide all educational institutions in our country.
Alternatively, let us build and equip more mental health centres, and train more mental health workers in preparation for our children’s bleak future.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday, February 13, 2011
Monday, February 7, 2011
Why Kenya can’t go the Tunisia or Egypt way
By LUKOYE ATWOLI
Sunday Nation 06 February 2011
Events in North Africa and the Middle East have excited comment from all over the world.
Youthful demonstrators have poured into the streets demanding the resignation of their governments, and especially of their despotic rulers.
The demonstrations have been packaged by most press outlets as being spontaneous uprisings as a result of popular frustration with governments that have failed to translate economic growth into tangible benefits for the common mwananchi.
This characterisation is not strictly true. A WikiLeaks memo from as long ago as December 2008 indicated that the US Government was in contact with a leader of the April 6 Movement in Egypt, and had even arranged for him to attend a meeting dubbed the “Alliance of Youth Movements Summit” in Washington DC.
While there, he had managed to hold meetings with government officials, congressmen and members of various American think-tanks.
Among the sentiments expressed by the April 6 Movement were calls for Hosni Mubarak’s ouster and replacement by an interim government pending elections later this year.
The movement was also noted to favour a parliamentary democracy, and was asking for support from the US Government and others to help Egypt on the path to democracy.
Although the US embassy staff in Cairo considered many of the movement’s demands to be unrealistic, after the April 6 movement’s intimate involvement in organising the demonstrations across Egypt in the past few days, it is clear they may have the capacity to influence Egypt’s political future.
It would also be difficult not to see the hand of the US Government in these protests, given the rather close contact they have maintained with the youth movement over the years.
In Kenya, the US Government continues to fund multiple youth groups with objectives similar to those of the April 6 Movement in Egypt as far as democratisation is concerned.
Our politicians, many of them in the same age-group as Mubarak and other African despots, have raised the alarm and asked the US ambassador to stop funding and organising youth groups in the country.
Many have even suggested that the US Government is attempting a “regime change” through these youth groups. After studying a lot of evidence available in the public domain, one would be left in no doubt that one of the US Government’s goals in our country is to effect a leadership change to a genuine democracy where ideas sell more than individual attributes such as tribe and age.
As to whether these efforts will bear the same fruit as they did in the North is, however, debatable. One could argue that those efforts are doomed to fail in Kenya for a variety of reasons, the most obvious of these being the question of tribe in our politics.
It is virtually impossible to galvanise Kenyans behind an idea, no matter how noble, without taking tribe into consideration.
Anarchic coalition
For instance, if one were to organise a popular uprising against the Kibaki-Raila anarchic coalition, we would start hearing exhortations about protecting “our sons” in government and tribal alliances would quickly emerge to prevent widespread expressions of discontent.
Of course we see this kind of tribal balkanisation every time the government feels threatened, so it would not be anything new.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer, Moi University School of Medicine www.lukoyeatwoli.com
Sunday Nation 06 February 2011
Events in North Africa and the Middle East have excited comment from all over the world.
Youthful demonstrators have poured into the streets demanding the resignation of their governments, and especially of their despotic rulers.
The demonstrations have been packaged by most press outlets as being spontaneous uprisings as a result of popular frustration with governments that have failed to translate economic growth into tangible benefits for the common mwananchi.
This characterisation is not strictly true. A WikiLeaks memo from as long ago as December 2008 indicated that the US Government was in contact with a leader of the April 6 Movement in Egypt, and had even arranged for him to attend a meeting dubbed the “Alliance of Youth Movements Summit” in Washington DC.
While there, he had managed to hold meetings with government officials, congressmen and members of various American think-tanks.
Among the sentiments expressed by the April 6 Movement were calls for Hosni Mubarak’s ouster and replacement by an interim government pending elections later this year.
The movement was also noted to favour a parliamentary democracy, and was asking for support from the US Government and others to help Egypt on the path to democracy.
Although the US embassy staff in Cairo considered many of the movement’s demands to be unrealistic, after the April 6 movement’s intimate involvement in organising the demonstrations across Egypt in the past few days, it is clear they may have the capacity to influence Egypt’s political future.
It would also be difficult not to see the hand of the US Government in these protests, given the rather close contact they have maintained with the youth movement over the years.
In Kenya, the US Government continues to fund multiple youth groups with objectives similar to those of the April 6 Movement in Egypt as far as democratisation is concerned.
Our politicians, many of them in the same age-group as Mubarak and other African despots, have raised the alarm and asked the US ambassador to stop funding and organising youth groups in the country.
Many have even suggested that the US Government is attempting a “regime change” through these youth groups. After studying a lot of evidence available in the public domain, one would be left in no doubt that one of the US Government’s goals in our country is to effect a leadership change to a genuine democracy where ideas sell more than individual attributes such as tribe and age.
As to whether these efforts will bear the same fruit as they did in the North is, however, debatable. One could argue that those efforts are doomed to fail in Kenya for a variety of reasons, the most obvious of these being the question of tribe in our politics.
It is virtually impossible to galvanise Kenyans behind an idea, no matter how noble, without taking tribe into consideration.
Anarchic coalition
For instance, if one were to organise a popular uprising against the Kibaki-Raila anarchic coalition, we would start hearing exhortations about protecting “our sons” in government and tribal alliances would quickly emerge to prevent widespread expressions of discontent.
Of course we see this kind of tribal balkanisation every time the government feels threatened, so it would not be anything new.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer, Moi University School of Medicine www.lukoyeatwoli.com
Monday, January 31, 2011
Tribe and age are not political statements
By LUKOYE ATWOLI
Sunday Nation 30 January 2011
Our politicians never learn. And it is probably fair to state that the Kenyan voter never learns either.
For the past few weeks, a bunch of politicians has been traversing the country popularising the idea of forming a coalition of tribes to win the next General Election.
No matter how much they protest, several ethnic alliances have been floated, coalescing around prominent politicians purporting to represent their tribes.
At the same time as the formation and reformation of these alliances, some of our politicians began singing the “generation change” song.
They argued that no politician aged over 50 years should be allowed to be president of this republic.
They have vowed to galvanise the youth vote in order to facilitate this “generation change”, ensuring that only “young” people rule the country under the new dispensation.
At the core of these messages is the unspoken declaration of war against anyone who does not meet the criteria being proposed based on age or tribe. For this reason, I feel that we seem to be stuck in a time-warp resembling the thermodynamic law that energy can neither be created nor destroyed, and can only change from one form to another.
In our new “thermo-politics” (hot-air politics), ideas can neither be created nor destroyed. They only change from one form to another, but remain unchanged at the core.
Tribal alliance
Underlying the tribal alliance and generational change talk is the politics of exclusion that has remained at the root of most of our governance problems.
It is a form of politics that sees any opponent as a mortal enemy fit to be eliminated together with all his supporters.
It is the form of politics that culminated in the conflagration three years ago, resulting in the formation of the Grand Coalition. It is the form of politics we sought to change by passing the new Constitution last August.
In the minds of our politicians, tribe and age are sufficient political statements, and one does not need any ideology beyond stating these attributes.
Unfortunately for all of us, our tribe and age are accidents of history and geography, and we had no role in deciding them.
In civilised societies, one must state their political ideology or position before being branded one thing or the other, and personal attributes are never used as the basis for political organisation and the struggle for power.
Using ethnicity as a political manifesto has resulted in bloodbaths all over the world, from Hitler’s Germany to Kibaki and Odinga’s Kenya; from Milosevic’s Serbia to the Rwanda genocide.
Youth, on the other hand, is a truly transient state, and the evidence for this is the penchant for Kenyan politicians to keep shifting the ground on the definition of “youth” for personal reasons.
Our Constitution clearly stipulates that youth are individuals under the age of 35 years, while our “youthful” cabal of politicians have reset this figure to 50 in view of their own rapidly advancing years.
Advancing years
It is time the Kenyan electorate violated this Kenyan law of “thermo-politics” and insisted on real political ideology and manifestos as the basis of political organisation.
Failing this, we must then brace ourselves for another round of ethnic baiting resulting, perhaps, in a bigger conflagration than we saw in 2008.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday Nation 30 January 2011
Our politicians never learn. And it is probably fair to state that the Kenyan voter never learns either.
For the past few weeks, a bunch of politicians has been traversing the country popularising the idea of forming a coalition of tribes to win the next General Election.
No matter how much they protest, several ethnic alliances have been floated, coalescing around prominent politicians purporting to represent their tribes.
At the same time as the formation and reformation of these alliances, some of our politicians began singing the “generation change” song.
They argued that no politician aged over 50 years should be allowed to be president of this republic.
They have vowed to galvanise the youth vote in order to facilitate this “generation change”, ensuring that only “young” people rule the country under the new dispensation.
At the core of these messages is the unspoken declaration of war against anyone who does not meet the criteria being proposed based on age or tribe. For this reason, I feel that we seem to be stuck in a time-warp resembling the thermodynamic law that energy can neither be created nor destroyed, and can only change from one form to another.
In our new “thermo-politics” (hot-air politics), ideas can neither be created nor destroyed. They only change from one form to another, but remain unchanged at the core.
Tribal alliance
Underlying the tribal alliance and generational change talk is the politics of exclusion that has remained at the root of most of our governance problems.
It is a form of politics that sees any opponent as a mortal enemy fit to be eliminated together with all his supporters.
It is the form of politics that culminated in the conflagration three years ago, resulting in the formation of the Grand Coalition. It is the form of politics we sought to change by passing the new Constitution last August.
In the minds of our politicians, tribe and age are sufficient political statements, and one does not need any ideology beyond stating these attributes.
Unfortunately for all of us, our tribe and age are accidents of history and geography, and we had no role in deciding them.
In civilised societies, one must state their political ideology or position before being branded one thing or the other, and personal attributes are never used as the basis for political organisation and the struggle for power.
Using ethnicity as a political manifesto has resulted in bloodbaths all over the world, from Hitler’s Germany to Kibaki and Odinga’s Kenya; from Milosevic’s Serbia to the Rwanda genocide.
Youth, on the other hand, is a truly transient state, and the evidence for this is the penchant for Kenyan politicians to keep shifting the ground on the definition of “youth” for personal reasons.
Our Constitution clearly stipulates that youth are individuals under the age of 35 years, while our “youthful” cabal of politicians have reset this figure to 50 in view of their own rapidly advancing years.
Advancing years
It is time the Kenyan electorate violated this Kenyan law of “thermo-politics” and insisted on real political ideology and manifestos as the basis of political organisation.
Failing this, we must then brace ourselves for another round of ethnic baiting resulting, perhaps, in a bigger conflagration than we saw in 2008.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Monday, January 24, 2011
Why a doctors’ union is long overdue
By LUKOYE ATWOLI
Sunday Nation 23 January 2011
Just over four months ago, the Ministry of Medical Services threatened to stop funding post-graduate training for young Kenyan doctors.
After much hue and cry, the ministry seems to have quietly backed down and things seemingly returned to “normal”. However, it would be important to heed the saying that still waters run deep.
One of the outcomes of the outcry four months ago was that some junior doctors started organising themselves to agitate for their rights in a more coherent fashion.
Unfortunately, the ministry hierarchy attempted to crack down on the perceived leaders of the “rebellion” and a few of them received interdiction letters.
Instead of silencing dissent once and for all, this action only served to galvanise doctors in employment towards a common cause.
The new Constitution’s progressive Bill of Rights came to the rescue just at the right moment. Unlike the previous document, it guarantees every worker the right “to fair remuneration, to reasonable working conditions, to form, join or participate in the activities and programmes of a trade union and to go on strike”.
In the spirit of the new Constitution, therefore, young doctors have embarked on a process that will very soon see the registration of the Kenya Medical Practitioners, Pharmacists and Dentists’ Union.
Under the framework of this union, medical professionals will be able to enter into collective bargaining agreements with their employers, who will include the Government’s ministries of Health, parastatals and private hospitals.
It is expected that this union will escape the paralysis that has for a very long time stopped the Kenya Medical Association (KMA) from successfully representing doctors as far as remuneration and better working conditions are concerned.
KMA’s main handicap was that it was operating mainly on a gentleman’s agreement with the minister in charge of health. Negotiations were often informal and entirely at the mercy of the minister and Afya House functionaries.
A further handicap was that negotiations often left out doctors employed in parastatals and in the private sector.
With the formation of a union, it is expected that the true worth of a doctor’s service will be revealed, and both the government and the private sector will be compelled to fairly remunerate their doctors or face industrial action.
For a long time, efforts to improve the lot of doctors in employment have been hobbled by the notion that because doctors hold a “special place” in society and provide an essential service, they should not dirty their white-coats by involving themselves in “lowly” union activities.
Indeed, under the previous regime, they were expressly banned from forming or joining unions.
Thanks to this notion of nobility, doctors continue to provide their services to a thankless populace while receiving pay that was average over two decades ago.
Most junior doctors enter the civil service with a net pay of less than KSh50,000, yet they spend days on end attending to all sorts of emergencies with little sleep or rest.
Climbing through the ranks is no consolation either, as the levels of remuneration do not match that of people with less education or skills.
Anyone interested in greater investment in healthcare must therefore support this noble initiative. Remember, if the doctors are not well, no one’s health is guaranteed.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University School of Medicine inbox@lukoyeatwoli.com
Sunday Nation 23 January 2011
Just over four months ago, the Ministry of Medical Services threatened to stop funding post-graduate training for young Kenyan doctors.
After much hue and cry, the ministry seems to have quietly backed down and things seemingly returned to “normal”. However, it would be important to heed the saying that still waters run deep.
One of the outcomes of the outcry four months ago was that some junior doctors started organising themselves to agitate for their rights in a more coherent fashion.
Unfortunately, the ministry hierarchy attempted to crack down on the perceived leaders of the “rebellion” and a few of them received interdiction letters.
Instead of silencing dissent once and for all, this action only served to galvanise doctors in employment towards a common cause.
The new Constitution’s progressive Bill of Rights came to the rescue just at the right moment. Unlike the previous document, it guarantees every worker the right “to fair remuneration, to reasonable working conditions, to form, join or participate in the activities and programmes of a trade union and to go on strike”.
In the spirit of the new Constitution, therefore, young doctors have embarked on a process that will very soon see the registration of the Kenya Medical Practitioners, Pharmacists and Dentists’ Union.
Under the framework of this union, medical professionals will be able to enter into collective bargaining agreements with their employers, who will include the Government’s ministries of Health, parastatals and private hospitals.
It is expected that this union will escape the paralysis that has for a very long time stopped the Kenya Medical Association (KMA) from successfully representing doctors as far as remuneration and better working conditions are concerned.
KMA’s main handicap was that it was operating mainly on a gentleman’s agreement with the minister in charge of health. Negotiations were often informal and entirely at the mercy of the minister and Afya House functionaries.
A further handicap was that negotiations often left out doctors employed in parastatals and in the private sector.
With the formation of a union, it is expected that the true worth of a doctor’s service will be revealed, and both the government and the private sector will be compelled to fairly remunerate their doctors or face industrial action.
For a long time, efforts to improve the lot of doctors in employment have been hobbled by the notion that because doctors hold a “special place” in society and provide an essential service, they should not dirty their white-coats by involving themselves in “lowly” union activities.
Indeed, under the previous regime, they were expressly banned from forming or joining unions.
Thanks to this notion of nobility, doctors continue to provide their services to a thankless populace while receiving pay that was average over two decades ago.
Most junior doctors enter the civil service with a net pay of less than KSh50,000, yet they spend days on end attending to all sorts of emergencies with little sleep or rest.
Climbing through the ranks is no consolation either, as the levels of remuneration do not match that of people with less education or skills.
Anyone interested in greater investment in healthcare must therefore support this noble initiative. Remember, if the doctors are not well, no one’s health is guaranteed.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University School of Medicine inbox@lukoyeatwoli.com
Sunday, January 16, 2011
Secondary school quotas miss the point
By LUKOYE ATWOLI
Sunday Nation 16 January 2011
Every parent wants the very best for their child. If they can afford it, they will buy the best clothes and food for their children and ensure that they live in the best house available to them.
Having taken care of these basic needs, most parents will then want their children to have the best education they can afford.
This is what drives even the poorest parent to skimp and save to take their child to the best school in the neighbourhood, often in the hope that the child will benefit from a good education and help the family get a better life.
With the advent of free primary education, schooling became available to a majority of children who would otherwise have missed out.
This was a commendable achievement by the NARC government and any future administration will be hard pressed to match it.
However, the government did not react early enough to deal with the increased numbers of learners, leading to a gradual decline in the quality of the education being provided for free. Hiring of teachers has not matched the demand and facilities continue to be overstretched.
In many areas, parents who can afford it are now taking their children to private schools in the hope that they will get a better quality education than in the public system.
Many ‘‘academies’’ have sprouted all over the place to fill this quality gap and, even in rural hamlets, one finds private schools in the vicinity.
The result is that private schools and ‘‘academies’’ are now producing the ‘‘best’’ overall students and scoring better mean grades than public primary schools.
The Education ministry’s reaction has been very predictable. In a knee-jerk response to the outcry over the poor performance by public schools, the ministry decided to restrict the number of pupils from private schools who will join national secondary schools.
Given that many middle and low-income earners deny themselves a lot of necessities in order to see their children receive a quality education, it beats logic for the ministry to use criteria other than academic merit in selecting pupils to join national schools.
This mentality perpetuates the disdain for meritocracy that had come to characterise the Moi kleptocracy and no one should be surprised if, in future, a leader from this generation maintains that merit counts for nothing.
The bigger problem with this decision, however, is that it glosses over the reasons why learners are performing so poorly in public schools.
If these schools were well equipped and staffed with well-trained teachers, would they still perform as dismally? If teachers in public schools were highly motivated by commensurate pay and a good working environment, would their pupils still lag behind those in private schools?
It has been said that parents who can afford private primary schools can also afford private secondary schools. Are we now advocating the creation of a parallel private education system? Soon learners from private secondary schools will be denied places in public universities.
Eventually, graduates from private universities will not be eligible for jobs in the public sector.
Maybe we should just go ahead and create a private government to run affairs for private citizens whose only craving is a better life for themselves and their offspring!
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University School of Medicine. www.lukoyeatwoli.com
Sunday Nation 16 January 2011
Every parent wants the very best for their child. If they can afford it, they will buy the best clothes and food for their children and ensure that they live in the best house available to them.
Having taken care of these basic needs, most parents will then want their children to have the best education they can afford.
This is what drives even the poorest parent to skimp and save to take their child to the best school in the neighbourhood, often in the hope that the child will benefit from a good education and help the family get a better life.
With the advent of free primary education, schooling became available to a majority of children who would otherwise have missed out.
This was a commendable achievement by the NARC government and any future administration will be hard pressed to match it.
However, the government did not react early enough to deal with the increased numbers of learners, leading to a gradual decline in the quality of the education being provided for free. Hiring of teachers has not matched the demand and facilities continue to be overstretched.
In many areas, parents who can afford it are now taking their children to private schools in the hope that they will get a better quality education than in the public system.
Many ‘‘academies’’ have sprouted all over the place to fill this quality gap and, even in rural hamlets, one finds private schools in the vicinity.
The result is that private schools and ‘‘academies’’ are now producing the ‘‘best’’ overall students and scoring better mean grades than public primary schools.
The Education ministry’s reaction has been very predictable. In a knee-jerk response to the outcry over the poor performance by public schools, the ministry decided to restrict the number of pupils from private schools who will join national secondary schools.
Given that many middle and low-income earners deny themselves a lot of necessities in order to see their children receive a quality education, it beats logic for the ministry to use criteria other than academic merit in selecting pupils to join national schools.
This mentality perpetuates the disdain for meritocracy that had come to characterise the Moi kleptocracy and no one should be surprised if, in future, a leader from this generation maintains that merit counts for nothing.
The bigger problem with this decision, however, is that it glosses over the reasons why learners are performing so poorly in public schools.
If these schools were well equipped and staffed with well-trained teachers, would they still perform as dismally? If teachers in public schools were highly motivated by commensurate pay and a good working environment, would their pupils still lag behind those in private schools?
It has been said that parents who can afford private primary schools can also afford private secondary schools. Are we now advocating the creation of a parallel private education system? Soon learners from private secondary schools will be denied places in public universities.
Eventually, graduates from private universities will not be eligible for jobs in the public sector.
Maybe we should just go ahead and create a private government to run affairs for private citizens whose only craving is a better life for themselves and their offspring!
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University School of Medicine. www.lukoyeatwoli.com
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