By LUKOYE ATWOLI
Sunday Nation 03 April 2011
In northern Tanzania, at a place called Loliondo, a retired priest has allegedly been churning out a ‘‘miracle cure’’ for all chronic illnesses known to man.
The sick, gawkers and tourists have been flocking to the site to see and drink the greenish concoction touted as a panacea.
In my opinion, the concoction he is dispensing would more accurately be described as a “miracle killer”, given that the only miracle in this case is that fewer people are dying after ingesting the poisonous soup.
In Kenyan, and African medical practice, the Loliondo phenomenon is not unique. Claims of ‘‘miracle cure’’ are found all over the continent, with ardent followers swearing by some concoction or other as a cure for diabetes, HIV, cancer, hypertension and mental illness.
Religious leaders have not been left behind, either. They promise exorcism of the “demons” responsible for these illnesses, and all they ask for in return is a small “contribution” to support the “ministry”.
Some get prime airtime on national TV, parading people they claim have terminal illnesses and then performing some religious rituals for them in order to effect “cure”.
Most of these people, believing they are cured, stop taking regular medications and end up dead or suffering from complications soon thereafter.
A walkabout in any urban area in Kenya will leave one in no doubt whatsoever of the clout these “waganga kutoka Tanzania” (Tanzanian healers) wield over the Kenyan psyche.
Even in areas with clear “No Posters” signs, these “waganga” have plastered posters on lampposts and walls, proclaiming their powers to heal all problems of mankind, including problems with relationships, school or work.
Any thinking person knows that no such cure exists, but the practice has no shortage of clients.
Everyone shares a level of responsibility for this. Despite numerous warnings from the medical fraternity about the dangers of ingesting untested substances in the hope of cure, many people continue to queue outside the hovels housing these “waganga”.
Health professionals, on the other hand, have perpetuated this business by developing a false dichotomy between “conventional” and “traditional” medicine.
Human illnesses do not recognise cures as being “traditional” or “conventional”. They only respond to cures that work.
Insisting that we must respect “traditional” practitioners just because we do not understand what they do is in fact harmful in a majority of the cases.
Since nobody has tested whatever they dispense with any scientific rigour, no self-respecting health worker would refer a client to them, or even work side-by-side with them in a formal setting.
Regulatory bodies must also accept that they have neglected their responsibility as far as protecting the health of citizens is concerned. Ideally, any substance that is marketed as a cure for any ailment must undergo rigorous testing to ensure that it is safe, and that it actually cures.
Asking people to take it on “faith” that the substance works results in far more harm than any postulated good. In Loliondo, dozens of people had to die before the Tanzanian government intervened.
And the intervention was really just an endorsement of the priest’s cure, asking him to help deal with the humanitarian crisis his popularity was causing.
Meanwhile, the sad affair continues apace, and dozens more are sure to die before any meaningful action is taken.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday, April 3, 2011
Sunday, March 27, 2011
Citizens at risk as government dithers
By LUKOYE ATWOLI
Sunday Nation 27 March 2011
Three recent reports on the presence of contaminated maize in Kenya should have all of us worried.
The first report, published in January this year, showed that maize samples from markets and farms across the country contained very high levels of aflatoxin; a chemical by-product of fungi that colonise maize and other food crops.
This chemical has the potential to cause liver problems, including cancer, in anyone who consumes contaminated food regularly. This particular report suggested that between one and two thirds of maize produced and sold across the country had dangerous aflatoxin levels, rendering a large percentage of the cereal unfit for human consumption.
The second report was equally significant, but definitely more worrying. Researchers sampled maize flour from several major millers across the country, and concluded that up to 65 per cent of the sampled flour was contaminated with aflatoxin.
The scientists indicated that they would embark on a national survey to determine the true extent of the problem in Kenya, although they cited reports indicating that children were already suffering malnutrition due to aflatoxin poisoning.
As if these two reports are not frightening enough, the chairman of the Parliamentary Committee on Agriculture made a sensational claim that an “influential family” had imported millions of bags of aflatoxin-contaminated maize into the country.
He further alleged that the maize was already in the market, suggesting that Kenyans were already using it to make their staple, ugali.
Despite these shocking revelations, nothing concrete has been heard from responsible government agencies. There are no publicised visits to “affected” areas by Public Health personnel from Afya House, or public statements by the relevant ministers.
In a civilised society in which government exists to serve its people, a number of responses would be expected.
First, the minister responsible for agriculture would have tendered her resignation for doing little to save the lives of Kenyans who will surely die in the near future from liver failure and cancers.
The reports of aflatoxin-induced malnutrition have actually emanated from the current minister’s own county.
Second, the politician who made claims that poisoned maize has been imported into the country would have been compelled to provide this information to the relevant authorities, and the culprits would be cooling their heels in prison.
Third, the government would prioritise efforts to deal with this threat to the health of its people, and health authorities would spare no effort in ensuring that the poison is eliminated from the food chain.
Unfortunately, we are not a civilised society by any stretch of the imagination, and we do not have a government that cares about the health of its people.
Politicians use the death of their electors to make political points, and use the living ones as pawns in a wider political chess game.
In any case, if we were a truly civilised society, we would not have people sleeping in tents away from their farms while being called “fake IDPs”.
We would not be saddled with parliamentarians who, to this day, continue to defy the Constitution and refuse to pay taxes on their incomes like other Kenyans.
Finally, if we were truly civilised, we would not today be labouring under a coalition government forced upon us to stop us from killing each other purportedly over an electoral dispute.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday Nation 27 March 2011
Three recent reports on the presence of contaminated maize in Kenya should have all of us worried.
The first report, published in January this year, showed that maize samples from markets and farms across the country contained very high levels of aflatoxin; a chemical by-product of fungi that colonise maize and other food crops.
This chemical has the potential to cause liver problems, including cancer, in anyone who consumes contaminated food regularly. This particular report suggested that between one and two thirds of maize produced and sold across the country had dangerous aflatoxin levels, rendering a large percentage of the cereal unfit for human consumption.
The second report was equally significant, but definitely more worrying. Researchers sampled maize flour from several major millers across the country, and concluded that up to 65 per cent of the sampled flour was contaminated with aflatoxin.
The scientists indicated that they would embark on a national survey to determine the true extent of the problem in Kenya, although they cited reports indicating that children were already suffering malnutrition due to aflatoxin poisoning.
As if these two reports are not frightening enough, the chairman of the Parliamentary Committee on Agriculture made a sensational claim that an “influential family” had imported millions of bags of aflatoxin-contaminated maize into the country.
He further alleged that the maize was already in the market, suggesting that Kenyans were already using it to make their staple, ugali.
Despite these shocking revelations, nothing concrete has been heard from responsible government agencies. There are no publicised visits to “affected” areas by Public Health personnel from Afya House, or public statements by the relevant ministers.
In a civilised society in which government exists to serve its people, a number of responses would be expected.
First, the minister responsible for agriculture would have tendered her resignation for doing little to save the lives of Kenyans who will surely die in the near future from liver failure and cancers.
The reports of aflatoxin-induced malnutrition have actually emanated from the current minister’s own county.
Second, the politician who made claims that poisoned maize has been imported into the country would have been compelled to provide this information to the relevant authorities, and the culprits would be cooling their heels in prison.
Third, the government would prioritise efforts to deal with this threat to the health of its people, and health authorities would spare no effort in ensuring that the poison is eliminated from the food chain.
Unfortunately, we are not a civilised society by any stretch of the imagination, and we do not have a government that cares about the health of its people.
Politicians use the death of their electors to make political points, and use the living ones as pawns in a wider political chess game.
In any case, if we were a truly civilised society, we would not have people sleeping in tents away from their farms while being called “fake IDPs”.
We would not be saddled with parliamentarians who, to this day, continue to defy the Constitution and refuse to pay taxes on their incomes like other Kenyans.
Finally, if we were truly civilised, we would not today be labouring under a coalition government forced upon us to stop us from killing each other purportedly over an electoral dispute.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Monday, March 21, 2011
Government statements reveal duplicity
By LUKOYE ATWOLI
Sunday Nation 20 March 2011
Last week, the wing of the Kenya Government allied to the Party of National Unity (PNU) wrote a series of letters and statements addressed to various governments and international organisations, including the United Nations and the International Criminal Court, in an attempt to convince them to help stop the prosecution of prominent Kenyans for crimes against humanity.
The contents of the communications confirm the duplicitous character of our government, given that they appear to have the effect of cancelling each other out.
The letters to the UN sought to influence the Security Council to order a deferral of the cases for one year while the government prepares a local mechanism to try both the top level suspects and the small fry implicated in the actual killings.
As if to completely negate the implications of this process, the letters also indicated that there was a high risk of Kenya sliding back into anarchy should the presidential candidates on Moreno-Ocampo’s list be prosecuted, a tacit admission that the government could not guarantee the safety of Kenyan citizens in the event of widespread violence.
In other words, the government was admitting that the fate of this country lay in the hands of Ocampo’s suspects, specifically the 2012 presidential candidates on the list.
Indeed, a pointer to just what sort of problems we face came in the form of a politician’s statement that there may be “no elections without the Ocampo Six” (or at least two of them) on the presidential ballot.
Deferral proponents
These threats from deferral proponents therefore imply that any prosecution must wait until after the next General Election.
Were the UN and the ICC to accede to these demands, Kenya may soon be faced with a situation in which a sitting president is indicted for crimes against humanity, a situation far more harmful for our international image than the prosecution of presidential candidates.
The government’s International Criminal Court statement, released soon after the court issued summonses for the Ocampo Six, indicated that the Kenya Government intended to challenge the admissibility of the cases before the court.
Ludicrous suggestions have even been made that Ocampo is beholden to local political interests, and is advancing the agenda of one political party.
The implication here is that the suspects have no case to answer as far as crimes against humanity are concerned, and are only being persecuted.
The meaning may be further stretched to imply that no such crimes actually occurred, and the facts before the court are purely a figment of the prosecutor’s imagination.
Three “government” positions therefore emerge from these lines of reasoning. One, that crimes were committed and we are intent on a local prosecution process.
Two, that because of the risk that these trials will almost definitely destroy the country, there can be no ICC or local tribunals. Three, that there were no such crimes and the court should just leave us alone.
A subsequent flurry of letters from opposing wings of government has only managed to further confuse the issues. It is time we took our country back from the hands of selfish politicians, and rejected in totality the three contradictory “government” positions.
Finally, come what may, we shall have elections in August 2012. The Constitution tells us so. Let our politicians try and stop us.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday Nation 20 March 2011
Last week, the wing of the Kenya Government allied to the Party of National Unity (PNU) wrote a series of letters and statements addressed to various governments and international organisations, including the United Nations and the International Criminal Court, in an attempt to convince them to help stop the prosecution of prominent Kenyans for crimes against humanity.
The contents of the communications confirm the duplicitous character of our government, given that they appear to have the effect of cancelling each other out.
The letters to the UN sought to influence the Security Council to order a deferral of the cases for one year while the government prepares a local mechanism to try both the top level suspects and the small fry implicated in the actual killings.
As if to completely negate the implications of this process, the letters also indicated that there was a high risk of Kenya sliding back into anarchy should the presidential candidates on Moreno-Ocampo’s list be prosecuted, a tacit admission that the government could not guarantee the safety of Kenyan citizens in the event of widespread violence.
In other words, the government was admitting that the fate of this country lay in the hands of Ocampo’s suspects, specifically the 2012 presidential candidates on the list.
Indeed, a pointer to just what sort of problems we face came in the form of a politician’s statement that there may be “no elections without the Ocampo Six” (or at least two of them) on the presidential ballot.
Deferral proponents
These threats from deferral proponents therefore imply that any prosecution must wait until after the next General Election.
Were the UN and the ICC to accede to these demands, Kenya may soon be faced with a situation in which a sitting president is indicted for crimes against humanity, a situation far more harmful for our international image than the prosecution of presidential candidates.
The government’s International Criminal Court statement, released soon after the court issued summonses for the Ocampo Six, indicated that the Kenya Government intended to challenge the admissibility of the cases before the court.
Ludicrous suggestions have even been made that Ocampo is beholden to local political interests, and is advancing the agenda of one political party.
The implication here is that the suspects have no case to answer as far as crimes against humanity are concerned, and are only being persecuted.
The meaning may be further stretched to imply that no such crimes actually occurred, and the facts before the court are purely a figment of the prosecutor’s imagination.
Three “government” positions therefore emerge from these lines of reasoning. One, that crimes were committed and we are intent on a local prosecution process.
Two, that because of the risk that these trials will almost definitely destroy the country, there can be no ICC or local tribunals. Three, that there were no such crimes and the court should just leave us alone.
A subsequent flurry of letters from opposing wings of government has only managed to further confuse the issues. It is time we took our country back from the hands of selfish politicians, and rejected in totality the three contradictory “government” positions.
Finally, come what may, we shall have elections in August 2012. The Constitution tells us so. Let our politicians try and stop us.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday, March 13, 2011
An open letter to Medical Services minister
By LUKOYE ATWOLI
Sunday Nation 13 March 2011
Dear Sir,
Welcome back to Kenya and to the ministry after a long sojourn abroad.
We are glad you got the treatment for prostate cancer and are back home safely, with the declaration that the cancer that threatened to interfere with your very active schedule has been defeated.
Above all, we are excited at your belated discovery while you were away in the United States of America that cancer is curable.
Hundreds of thousands of Kenyans suffering from this nasty condition will be happy to know this, and that the ministry will soon make arrangements to ensure that these treatments are available locally.
While you were away, several things happened that need your urgent attention if you are to prevent a melt-down in health service in our country.
I will point out only two of those, confident that the mandarins at Afya House will already have briefed you about the rest.
First, for the first time in a long time in this country, newly-graduated junior doctors have not been posted to their stations over four months since they passed their final exams in medical school.
Medical officers who completed internship several weeks back are also waiting to be posted to health facilities all over the country to offer much-needed services to our population.
Indeed, just the other day these young doctors demonstrated in the streets of Nairobi, asking your bureaucrats to post them so that they can start work immediately.
Unfortunately, senior ministry officials decided to come up with a draconian, contradictory contract for the interns.
The contract contains clauses such as one bonding doctors to work for the government for at least three years after internship, and another indicating that post-internship employment would not be guaranteed.
As a result of this, a doctors’ union has now been formed, and I have no doubt that you will be hearing from them in due course.
The second thing that happened just before you came back was the screening of a CNN documentary on the state of mental health services in Kenya.
Titled “Locked up and Forgotten”, it painted a very gloomy picture of mental health attitudes and services in our country.
It depicted ordinary Kenyans and health institutions apparently mistreating mentally ill and mentally disabled citizens and denying them even the most basic of human rights guaranteed in our Constitution.
Before we rush to conclusions, let us all reflect on the sort of investment we have made in mental health care delivery and research.
According to available statistics, the ministries of Health dedicate only a minuscule fraction of their budget to mental health, most of it going to pay salaries at Afya House.
Most of the expenditure on mental health services is incurred out of pocket by the already impoverished patients and it is, therefore, no surprise that even patients with easily managed conditions end up being “locked up and forgotten”.
Mr Minister, as you settle back into your comfortable office at Afya House and begin plans to roll out nationwide cancer services and comprehensive health insurance, please give some thought to improving mental health services in this country.
Please remember these two things, Mr Minister: Take care of your health workers. And, there is no health without mental health.
Sincerely,
Barometer.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday Nation 13 March 2011
Dear Sir,
Welcome back to Kenya and to the ministry after a long sojourn abroad.
We are glad you got the treatment for prostate cancer and are back home safely, with the declaration that the cancer that threatened to interfere with your very active schedule has been defeated.
Above all, we are excited at your belated discovery while you were away in the United States of America that cancer is curable.
Hundreds of thousands of Kenyans suffering from this nasty condition will be happy to know this, and that the ministry will soon make arrangements to ensure that these treatments are available locally.
While you were away, several things happened that need your urgent attention if you are to prevent a melt-down in health service in our country.
I will point out only two of those, confident that the mandarins at Afya House will already have briefed you about the rest.
First, for the first time in a long time in this country, newly-graduated junior doctors have not been posted to their stations over four months since they passed their final exams in medical school.
Medical officers who completed internship several weeks back are also waiting to be posted to health facilities all over the country to offer much-needed services to our population.
Indeed, just the other day these young doctors demonstrated in the streets of Nairobi, asking your bureaucrats to post them so that they can start work immediately.
Unfortunately, senior ministry officials decided to come up with a draconian, contradictory contract for the interns.
The contract contains clauses such as one bonding doctors to work for the government for at least three years after internship, and another indicating that post-internship employment would not be guaranteed.
As a result of this, a doctors’ union has now been formed, and I have no doubt that you will be hearing from them in due course.
The second thing that happened just before you came back was the screening of a CNN documentary on the state of mental health services in Kenya.
Titled “Locked up and Forgotten”, it painted a very gloomy picture of mental health attitudes and services in our country.
It depicted ordinary Kenyans and health institutions apparently mistreating mentally ill and mentally disabled citizens and denying them even the most basic of human rights guaranteed in our Constitution.
Before we rush to conclusions, let us all reflect on the sort of investment we have made in mental health care delivery and research.
According to available statistics, the ministries of Health dedicate only a minuscule fraction of their budget to mental health, most of it going to pay salaries at Afya House.
Most of the expenditure on mental health services is incurred out of pocket by the already impoverished patients and it is, therefore, no surprise that even patients with easily managed conditions end up being “locked up and forgotten”.
Mr Minister, as you settle back into your comfortable office at Afya House and begin plans to roll out nationwide cancer services and comprehensive health insurance, please give some thought to improving mental health services in this country.
Please remember these two things, Mr Minister: Take care of your health workers. And, there is no health without mental health.
Sincerely,
Barometer.
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday, March 6, 2011
Might the grand coalition be illegitimate?
By ATWOLI LUKOYE
Sunday Nation 06 March 2011
The wrangling in Kenya’s divided government leaves one in no doubt about the need for real change in this country.
Clearly, only tangible action will help change this country, and this tangible action does not include congregating on street corners and singing the national anthem for a few minutes and then dispersing as happened last Monday.
Tangible action entails scouting for all possible constitutional means to effect a real regime change in our time.
Thanks to countless research papers and opinion polls, we know that our system of governance and our politicians top the list of our immediate problems.
In August last year, we promulgated a new Constitution in the hope that we would change the system of governance and, with it, usher in a new generation of leaders.
However, all indications are that we will have to contend with the same old kleptocrats, or their offspring and hangers-on.
Since the promulgation of the new Constitution, many have had cause to wonder why the drafters of the Constitution postponed the overhaul of the political system to late next year.
The assumption was that they had some pretty good reasons for doing so, guided by precedents from other jurisdictions and their own legal education.
However, after carefully studying the Constitution, especially the transitional provisions, it appears to some of us that the drafters never intended any such continuation, but were only forced to include these provisions by the political realities of the moment.
Nevertheless, it may be that they left us a very narrow window of opportunity that may be used to truncate the lifespan of the grand wrangling coalition before the expiry of its five-year term.
Despite all appearances, it seems that the secret is in the wording of Article 3(2) of the Sixth Schedule of the Constitution, which provides, among other things, that “... the National Accord and Reconciliation Act shall continue to operate until the first General Election held under this Constitution ...”
Many have argued that this provision allows the Grand Coalition to continue in office until some time in 2012, when elections are expected to be held.
However, Article 9(2) of the same Sixth Schedule leaves this open, stating that “Despite subsection (1), if the coalition established under the National Accord is dissolved and general elections are held before 2012 ...”
The clincher actually comes in reading the National Accord and Reconciliation Act that the schedule refers to. Section 8 of this Act reads: “This Act shall cease to apply upon dissolution of the Tenth Parliament, if the coalition is dissolved, or a new Constitution is enacted, whichever is earlier”.
Clearly, the Tenth Parliament is still in session, and the coalition has not yet been dissolved; but we enacted a new Constitution last year.
Our erudite legal brethren need to educate us on a few points – did the new Constitution resurrect an Act of Parliament that died on the day the same Constitution was enacted?
In that case, why did the drafters not simply indicate that section 8 of the National Accord and Reconciliation Act would not apply until the next General Election?
Might it not be possible that the much-vaunted National Accord ceased to operate on or before August 27, 2010?
If this is the case, isn’t this wrangling coalition in office illegal, or illegitimate?
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
Sunday Nation 06 March 2011
The wrangling in Kenya’s divided government leaves one in no doubt about the need for real change in this country.
Clearly, only tangible action will help change this country, and this tangible action does not include congregating on street corners and singing the national anthem for a few minutes and then dispersing as happened last Monday.
Tangible action entails scouting for all possible constitutional means to effect a real regime change in our time.
Thanks to countless research papers and opinion polls, we know that our system of governance and our politicians top the list of our immediate problems.
In August last year, we promulgated a new Constitution in the hope that we would change the system of governance and, with it, usher in a new generation of leaders.
However, all indications are that we will have to contend with the same old kleptocrats, or their offspring and hangers-on.
Since the promulgation of the new Constitution, many have had cause to wonder why the drafters of the Constitution postponed the overhaul of the political system to late next year.
The assumption was that they had some pretty good reasons for doing so, guided by precedents from other jurisdictions and their own legal education.
However, after carefully studying the Constitution, especially the transitional provisions, it appears to some of us that the drafters never intended any such continuation, but were only forced to include these provisions by the political realities of the moment.
Nevertheless, it may be that they left us a very narrow window of opportunity that may be used to truncate the lifespan of the grand wrangling coalition before the expiry of its five-year term.
Despite all appearances, it seems that the secret is in the wording of Article 3(2) of the Sixth Schedule of the Constitution, which provides, among other things, that “... the National Accord and Reconciliation Act shall continue to operate until the first General Election held under this Constitution ...”
Many have argued that this provision allows the Grand Coalition to continue in office until some time in 2012, when elections are expected to be held.
However, Article 9(2) of the same Sixth Schedule leaves this open, stating that “Despite subsection (1), if the coalition established under the National Accord is dissolved and general elections are held before 2012 ...”
The clincher actually comes in reading the National Accord and Reconciliation Act that the schedule refers to. Section 8 of this Act reads: “This Act shall cease to apply upon dissolution of the Tenth Parliament, if the coalition is dissolved, or a new Constitution is enacted, whichever is earlier”.
Clearly, the Tenth Parliament is still in session, and the coalition has not yet been dissolved; but we enacted a new Constitution last year.
Our erudite legal brethren need to educate us on a few points – did the new Constitution resurrect an Act of Parliament that died on the day the same Constitution was enacted?
In that case, why did the drafters not simply indicate that section 8 of the National Accord and Reconciliation Act would not apply until the next General Election?
Might it not be possible that the much-vaunted National Accord ceased to operate on or before August 27, 2010?
If this is the case, isn’t this wrangling coalition in office illegal, or illegitimate?
Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine www.lukoyeatwoli.com
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