WHO:Kenya, top 10 globally in environmental deaths

The Daily Nation has published a story I wrote about the loss of tree cover in Kenya’s Luo Nyanza region. What this link  does not contain is a sidebar I placed on the story about how Kenya is performing globally as far as deaths related to the environment are concerned.

Turns out Kenya ranks among top ten countries in the world with the most deaths and sicknesses that are linked to abuse of the environment, new data released from the global health body shows.

The World’s Health Organisation (WHO) released data from its Global Health Observatory on March 15, 2016 which shows that Kenya lost 46,060 in 2012 alone to infectious, parasitic, neonatal and nutritional diseases directly linked to the management of— or lack thereof— the environment.

If you are not afraid of numbers, you can take a look at the data from WHO here –> GHO 2016. Just a quick analysis on that spreadsheet and you can already deduce that Kenya is  the fifth country in Africa with such a high number of deaths after Democratic Republic of Congo (163,548), Ethiopia (82,032) Angola (53,081) and Tanzania (48,814). That very year, the very data shows, environmentally related non-communicable diseases and injuries claimed 34,663 lives.

The report, “Preventing disease through healthy environments, a global assessment of the burden of disease from environmental risks” (You can download it here),  analysed all the countries covering more than 100 diseases.

Therein, the diseases linked directly to the environment include respiratory, diarrhoeal and zoonotic infections. These are attributed to the public improper manipulation of the ecosystem to encourage breeding sites for disease causing germs and maximise contacts with animals.

The other reasons are sanitation, availability of clean water, improper disposal waste and household pollution. The report comes a few months after the Kenya Demographic Health Survey 2014 revealed that more than half (56 per cent) of households use wood as their main source of cooking fuel and that more than 15 per cent of children in Kenya are affected by diarrhoea.

Other deaths are from non-communicable diseases such as cancers and accidents such as drowning and falls into open holes or collapsing buildings. Some of the top global killers listed in the report –Malaria, cancers, heart and diarrhoeal diseases, lower respiratory disease— as linked to the environment are also top ten in Kenya, bringing its healthcare to its knees, according to deaths registered in Kenya’s Civil Registration Department. The latest data, 2014, ranks Malaria as the leading killer in Kenya claiming 22,948 lives. Cancer (21,640) and Tuberculosis (10,986).

Globally, 12.6 million people died in 2012 as a result of living or working in an unhealthy environment, representing 23 per cent of all deaths. Children are most affected because the genesis of their lifetime problems start when a pregnant are exposed to factors such as radiation, polluted.

Women registered the most musculoskeletal injuries—related to bones, bones and part of the body that coordinate movement— due to travelling far and wide to fetch water for domestic use.

TAKE HOME POINTS HERE?

  1. Living in healthy environments will save lives, and money, as diseases that thrive in unhealthy environments get dehorned.
  2. It is a collaborative effort. The government owes you a sanitation system, but you have to dump your waste properly, minimize on waste. The government owes you water, but its your duty to ensure you take it when its clean.
  3. PREVENTION, PREVENTION. Try as much as you can NOT to get sick. Do not expose your body to harmful stuff when it already has air pollution, stress and all that to deal with. Stay healthy, and that does not need millions of money.

 

John: please don’t let death take me

Dear reader, you know I owe you stories even when they’re typed from a phone like now. So let me tell you what my little brother told me when he asked me for a facial scrub and I responded with “what’s that?”. He said: “Siz, this is the reason you’re still single I swear” The nerve of that little brat. I know. Let me give you the chance to express your disappointment in your miss scribe here. I normally roll my eyes when I am disappointed so you can roll your eyes.

I am those girls. Those ones whose wardrobes have more combat boots than heels. The ones who will show up on a romantic date in jeans. Not because I intended it but because I am that annoyingly informal. Well my friend and baby sister Sandra is a deep contrast of what I am so she had been coming to my rescue. You can go to my Instagram and see how I am putting my best foot forward in make up and dresses thanks to her. 

Be that as I may, there is something you cannot resist about me. It will pull you people to me like a magnet. It will make you overlook every other flaw and make you want to know who this woman is. That is…drum rolls… My dreadlocks! I knoooow right? Come on. Do not be mean. Look at those pictures on my Instagram and tell me you don’t feel excited by those locks. Is there anything sexier than a dark skinned woman with a heavy Luo accent in dreadlocks? It is irresistible! Ask Bob Collynmore what he saw in Wambui. I swear it could have played a part in Wangari Maathai’s Nobel peace prize. But you know something? I wouldn’t even tell you how old my dreadlocks are. John would. Yes John. Readers, please wave to my friend and stylist (yeah I have one too) John Mmata.

_20160403_214032
Stylist John. Picture/John’s Facebook page

He works at D’s salon based at Uganda House in Nairobi’s Central Business District. I met John in 2014 when I saw another lady whose hair he had styled and gathered courage ask for referral. When I called him up,the courteous way in which he talked to me pulled me to his salon an I have never left. John is polite, professional and most of all very attentive.

I cannot remember when I made deliberate decision to go to the salon. John reminds me. He knows I am a professional woman and needs to look like one even though the gene of spending time before the mirror is unobtrusively present within me. He would call me saying “Verah I know your hair is shaggy, and you’re walking into interviews and in the office looking weird, and you’re spoiling my work because when you will be asked you will say that shaggy hair was styled by me. I have been counting. You were here two months ago so can you please come now I am free and that is an order”. Then it would hit me oh by the way I heard my male colleague remark about the shaggy hair this morning. I’d walk to D’s Salon and start sleeping while seated. He would wake me up an hour later to ask me to take the juice he served. I’d chugallug it and sleep again and wake up an hour later with a washed, treated, conditioned and styled hair. I swear to you if you asked me what wax he uses on it, I wouldn’t know. What spray, oil… I don’t know. John knows what hair products are good for my scalp,how tight my hair should be pulled and what style would hide the forehead the good lord blessed me with.

Now my hair is shaggy now but I can’t have it done because John is incapacitated. For a year I have watched him move from one hospital to another. One time they said it was ulcers. Then it was some jaw-breaking name pancrese. There was diet to be changed. He obeyed all that as he was being directed. He just lost weight and his stomach ache worsened. Now doctors at Kenyatta National Hospital found a solution to his problems. Gallstones. He is scheduled for surgery next week to save his life. He needs Sh100,000(about 1,000USD) for this operation. He should have saved for a rainy day, right? He did. It got depleted within the year of misdiagnosis.

John has a young family. He has big dreams for his business and the only impediment between him and those ambitions is his health. I would like you to save his life. Whatever little you can spare, Sh100 (a dollar) please send it to John.
Below is his number:
Mpesa 0722614337
If you’re abroad and would like to help please use my PayPal: okeyoverah@gmail.com registered to Veronicah Okeyo.

In the meantime, look at his great work

IMG_20160227_162451
My bohemian self in John’s dreadlocks.

Patriarchy still hurting women with HIV in South Nyanza,Kenya

It has been a while since I published an article here on my blog or the paper that I work for. I’ve been working on a project that has so many sources from whom clarification has to be sought, so many studies to give different views to a cultural issue….I am drained of material and emotional resources. 

Be that as it may, this assignment took me back home to the rural area where I trace my paternity: Kenya’s South Nyanza, a small village called K’anyidoto in Ndhiwa Constituency. By the way I am typing from a phone so forgive some spelling mistakes you may encounter.

As a journalist, I have to always make a concious decision not to use my experiences to cloud my judgement and perception when I am discharging my duties. So right now, seated here going through the footage of what I did in the day, I can’t help but compare (at least mentally) what it meant to spend portions of my childhood here and what it is now for the women who live here. I’ve reached one conclusion:Being a woman in this community is difficult. Yes wait for it. Those patriotic Luos are about to ask me to produce a study to back up my claim. As if statistics are supposed to rubbish the experience of one woman. The irrational ones will tell me I’ve lived around the Kikuyu for too long that I compare the Luo to them. If only the prevalence of HIV, and incidence too, weren’t so high in this region! (About 25 per cent in Homabay County, Kenya Aids Indicator Survey)

Regardless of what oppositions I may face about what I am talking about, I have every right to talk about this right here, right now. Contrary to what I look like and talk (all deadlocked, tattooed and cursing sometimes) this community taught me about being a homemaker.

Even now that I came, I did not need to be reminded about where to go get the traditional vegetables, how to slaughter chicken and make a meal for a 12 people in less than an hour on a three-stone stoves. Here meals are served on a huge table, prepared without the luxuries of cooking oil or tomatoes but boy aren’t they sumptuous! There are secret recipes that you would never know unless you grew up here. The women who taught me and any other girl who grew up here may not even appreciate the complex process of the things they’re able to produce in less than an hour…Mo moleny(some edible oil made from milk cream), Chak mopuo(natural yoghurt). Nyuka abagi, (fermented porridge), mok bel arega (wheat flour that you kneel on a traditional mill and make with your hands)… If I were to list the nutritional names for them I’d publish a book.Oh and it’s interesting how the meals are categorised… The one for the breastfeeding woman…the food to give to a man that underperforms in bed…You must also remember the process of serving the food and it’s surprising that today I still let the man wash his hands before me as my culture dictates even though I believe in equality. It also shocks me that I’d keep a man company until he finished his meals, then and only then would I go wash my hands. So I am not relying on studies published in some peer reviewed journal to make my inference.

When I come here they call me Nyar K’onyango (a daughter of Onyango’s clan). And as I begin my conversations with my people, I find reason to justify the confrontational way with which most Luo women have to deal with issues. At a home in Kamenya village, a husband hid his wife’s antiretrovirals. He thought she had become too proud since she joined the Aids support group. At the group, she was told eating cassava is good for their health. She went home to try out a different menu. When the meal was served, he asked why they’re having corn meal made of cassava flour and maize, she had started responding: “ne opuonjwa e chokruok..” (we were taught at the group…) No sooner had she mentioned the group than the man landed on her with blows blaming the group for rearranging the order in his house. It was appalling to me that the husband was a high school teacher with adequate knowledge to know about what good nutrition is. That is when he hid her ARVs.

Knowing what discontinuing her medication meant, she reported to the chief. She’d tried reporting to her parents-in-law the first time this happened last year but the process of reconciliation had taken too long she’d feared for her health. At the chief, she was reminded about the need to “take things slowly” to know what language “soothes her husband’s heart”. A meeting was organised by the elders. A week later. Her husband did not show up. When it finally took place (which happened to have been the day I was here) the woman was warned against “not consulting”. She was cautioned against “taking family matters to strangers”. I listened from behind the room hiding behind the papyrus reed mat that separated the rooms because I wasn’t allowed to come to where elders talked.

Here,a woman needs to “talk nicely” and beg for such basic needs that are rightfully hers and a benefit of the people in that community. Why should a woman beg to be allowed to take drugs for diseases that are a public health concern such as Tuberculosis and HIV? I always questioned the Kenya Demographic Survey 2014 data where women said they couldn’t access healthcare because “they had not been given permission”. I asked Mourine from Ligodho why she hadn’t gone to have her ca checked since she is positive and is well aware of TB being infectious at the first few weeks. She answered: Wuon parwa owacho ni abiro dhi next week (The head of my thoughts said I’d go next week). She could cycle to the facility actually. Remember the knowledge of HIV here is nearly 100 per cent. This society knows what is at stake. 

This is a community that teaches women to put men on a pedestal and still punish them for being so obedient. While growing up, I saw my mother get really physical to defend my sister and I on issues such as the need to consult (for months) on whether my sister would go to the school she was admitted to. Not that they will pay anything for her fees. It’s just that you’re women and you can’t think on your own. This is the community where widows and orphans are robbed of the little they have been left as the society watches in silence.
Hiding of ARVs is one thing but there are rumours that I have heard of acts bordering on criminality that women have to put up with.

While progress has been made on women’s rights, we need to make noise about some of the issues that happen to women in rural south Nyanza as people hold “meetings to reach amicable solutions”. We need not have a discussion about why women shouldn’t be taking their ARVs given to them by the government for free. It’s not pride it’s a public health concern.

Thumbi Mwangi: Disease-causing pathogens talk to each other

Last year, I participated in nominating a professional for the prestigious Aspen Institute New Voices Fellowship. My candidate did not make it. Naturally, I became curious about the Kenyan that had beaten my nominee to the price. That is when and how I met veterinary epidemiologist Thumbi Mwangi. When I read his name, I rolled my eyes and thought “People should consider us Nilotes when they chose names for their children…his name takes a ceremony to pronounce! ”

Yet meeting Thumbi Mwangi was a much needed reminder of an unwritten rule for me as a journalist: That I have to allow myself to flow with what comes in and out of my days; That I have to approach every subject with an open mind; that it is in conversations that the story directs me to what is most important, the silent voices that should be amplified because they have been hushed by the sensationalism that characterise journalism in these parts of the world.

mwangi-samuel
Prof Thumbi Mwangi, veterinary epidemiologist and a member of One Health Initiative. PHOTO/WSU

I emailed him with that “selfish” he-could-be-a-story attitude. Boy didn’t he live up to it. He scared me when he told me that Rabies—gotten from a dog bite… or scratch— is 100 per cent fatal once the clinical signs start manifesting. Quoi! He also drew my attention to a subject so crucial to human health, yet so underreported: Zoonoses, diseases that come to man from animals. I must also mention that it is in the course of this meeting that I learnt about Kenya’s Zoonotic Disease Unit (ZDU),very few of such in Africa or the world by the way. After two weeks, the initial interest about why he made it to the fellowship over my nominee sublimed to the background, and the publication of a detailed piece on Zoonoses in Kenya in the Daily Nation came to the fore.

It could be modesty or shyness, but whatever it is the Professor does not like to be reffered to as “Professor”. His Twitter handle has a handful followers mostly of people pooled from his field. “Social media? Oh that is a great platform for those that have the grace,” he said. He says he likes racket games, though. That should act as a saving grace in a profile that would have fit the perfect “boring scientist” narrative. However, it is incredible that such a travelled person is so rural-bred. He was born in Kieni in Nyeri County. From St Martins Boys Hostel, he went to Njiiri School for hi O-levels and found himself in the University of Nairobi (UoN) pursing bachelors in Veterinary medicine and surgery in 2000. While at UoN, he met Prof Kiama Gitahi who is the current director of UoN’s Wangari Maathai for Peace and Environmental Studies.

Picking from his description of Prof Kiama, I gathered that Thumbi considers him (Kiama) a mentor. With a tinge of poignancy, he said: “He gave us a Continuous Assessment Test, I passed and he asked me to see him”. From that meeting, many opportunities would present themselves to the young ambitious Thumbi. He worked at Kenya Wildlife Service (KWS). Then he pursued interests in small and large animals as well as ranching to as far as Botswana, before getting a scholarship from UoN to pursue a post graduate degree on genetic and animal breeding. Another scholarship would present itself from International Livestock Research Institute (ILRI). Later, he joined Royal School of Veterinary Studies at the University of Edinburgh in the United Kingdom, his interests narrowed to epidemiology. His passion earned him a post-doctoral research opportunity at Washington State University, where he teaches and holds a position as a clinical assistant professor.

As a story teller (do we even tell stories in science?), I was most intrigued by his work during his doctoral studies. The conversation began with: “We are most interested in pathogens as a harm to people and animals, but rarely do we study how these organisms interact”. There wet my “aha!” moment. My internal dialogue was like “Wait! So protozoans and all those jaw breaking names I read in Binomial nomenclature class in Biology not only cause diseases that kill, but also talk to each other?” I need to listen to that recording again to get the scientific terms right, but I heard of how a cow gets infected with some pathogen which in turn protects it from another harmful pathogen. That is like saying if your child gets malaria, do not treat it because the malaria parasite is going to protect it from some other common disease. I know, right? Then there were organisms that we should just label as hoes. I mean how could they be able to live in so many domestic and wild animals and still be able to reside in a human body so as to make us sick.

You know what journalists lack in knowledge, they make up for with an unhealthy amount of reading. So I scoured the internet, books and outdated magazines about disease patterns. Let us start with the most basic mind-blowing nugget that the literature gave me. Did you know that 60 per cent of the pathogens that cause infectious diseases in human beings come from animals (WHO)? Then there was Thumbi’s paper published at Plos One that drew a direct line from healthy animals to happier, healthier and wealthier farmers and their families. Wouldn’t it be economically sound if farmers were taught these things?

So with all that, it is understandable why Thumbi champions One health Initiative. This is a global program where many scientists and other professionals advance the idea that human, animal and ecological health are intimately linked and need to be studied and managed as a whole unit. I think I should join  it too… to design posters to announce the latest research. So, thanks to technology, I met a scientist to ask him about one thing and I got the opportunity to be pointed to so many possible stories that could be told, all from his research.

Thumbi is a visiting scientist at the Kenya Medical Research Institute (KEMRI), a visiting lecturer at Wangari Maathai Institute for Environmental Studies and Peace where he teaches and supervises graduate students. He also works closely with ZDU.

Medic of the month,Dr Juliana Otieno: I don’t tolerate excuses on health

Last year, my colleagues Eunice Kilonzo, Jacqueline Kubania and I set on out on a journey to audit public healthcare in Kenya especially after devolution. The stories, like a doctor so busy she couldn’t have a minute for a meal and the neglect of mentally ill, broke our hearts. However, in the midst of the dread and gloom, we met medics whose style of management was as much a story as the facilities they were heading. In Jaramogi Oginga Odinga Training and Referral Hospital in Kisumu (famously known as Russia), I met Juliana Otieno, a pediatrician and the medical superintendent of the facility. On a motorbike to see her, I thought about the studies that states that hospitals are better when run by medical doctors. That, to me, was a conflicting piece of information because I had just left other hospitals not so far away from Russia run by medical doctors and the deplorable conditions that they were in were appalling.

Under her care, Russia has improved tremendously especially on matters of hygiene. During my two-day rounds at the facility, I learnt that Dr Juliana—yeah that’s how we call her in the newsroom— had not been spared of the hiccups that came with devolution. Be that as it may, the pediatrician had learnt about the value of “beneficial friendships and contacts”: some of the successful projects in Russian are funded by people she had met in her postgraduate studies or along her career.

dn TR HEALTH 6
Dr Juliana Otieno, medical superintendent at Jaramogi Oginga Odinga Training and Referral Hospital in Kisumu during the interview on May, 24 2015 in her office

Russia’s state of the art Ksh28million (about 274,000 USD) Intensive Care Unit was partly funded by the government and technology company General Electric. The Renal Unit was funded by the Taiwanese and the Kenyan government. The renal unit also has water treatment system from the Kenya Commercial Bank. My favourites were the new maternity, new born unit and Obama Children’s clinic. As a deputy medical superintendent in this very hospital in 2004, Juliana had met the Norwegian queen who visited the facility on matters related to HIV. Juliana, and her colleagues, had sought the royalty’ assistance to construct the maternity and the newborn unit whose value is estimated to be Sh75million. Being a pediatrician, it’s understandable that the Obama Children’s ward in Russia is semi-autonomous well run clinic where children get free treatment with the comfort for both mother and child guaranteed. The Obama clinic was partly built by Americans, the Walter Reed Project. Of the Walter Reed folks, she told me: “They had stayed here for so long researching about malaria and when they were just about to leave we asked them what they would leave in Kenya and they agreed to help with the Obama Children’s hospital”. Obama runs with great assistance from Kenya Medical Research Institute (Kemri).

Obama.jpg
Entrance to the pediatric children in Jaramogi Oginga Odinga Training and Referral facility in Kisumu

Before meeting her, I had been told that Dr Juliana does not “suffer fools” especially when the fool is a journalist. So I called her. I informed her that I would like to talk to her. I also told her that I was not coming for the interview tabula rasa as I had gathered information about the inadequacies of the  hospitals that I wanted her to give me a few answers for. To my surprise, and in a matter-of-fact attitude she told me: “I did not expect you to find a palace, it is a hospital but whatever challenges that are there are being worked on, a lot has changed and I have absolutely nothing to hide. Come to my office tomorrow at 10.”

To the office I went. Juliana looked into my eyes and told me I had 45 minutes. She said as she asked the secretary to make me tea: “Here, time is of essence, it always and literally is a matter of life and death, Verah”. Her gaze was imploring yet very attentive, direct yet very inquisitive that I must admit it intimidated me. Her statements were straight and curt. Earlier during my information gathering period, I got a mixture of feelings about her from workers in Russia. Most felt she was too strict, never listening to opinions that differed from hers but peculiarly enough they did not want her replaced. “She gets the job done,” one had told me.

In our conversation, I got the feeling that she is a guarded woman but also very honest in a way that  allows you to connect with her, at least for purposes of a genuine conversation. I understood that deep contrast by the bits and pieces of her life that she dropped in between the chat. A first born of eight, Juliana learnt about being responsible for a large number of people at an early age as she grew up in Muhoroni. “There was milking before school, fetching water and cooking and of course, being asked where you were as an elder sister when your junior siblings were making mistakes,” she said. When she passed her national primary examinations, her father could not raise the Sh4,000 (That is hundreds of thousands right now) needed for her to join Limuru Girls. The community gathered, fundraised and she went to school. “That is why I grew up with the resolution that, for matters such as education and health, I will give back to the community and to a genuine case,” she said.  She went on to take her bachelors degree in medicine at the University of Nairobi (UoN) in 1979, graduating a year later because of the 1982 coup attempt. She took her postgraduate studies at UoN in pediatric medicine. Apart from working in the civil service, Juliana has taken part in research in Europe, America and various countries in Africa.

a mother of three biological children “and so many others that are just mine but I never gave birth to”, she says she raised her children the very same way she was raised and the way she relates to her colleagues. “I just have to let you know I am not the enemy but I do not expect laxity even in that love,” she said.

Her tips for being the professional of her cadre are straight forward. “Do not cheat me. If you feel that tea will take ten minutes to make, say so. Do not make me come asking for it fifteen minutes later.”

“I tell every healthcare worker to do the best they can with what is available regardless of the circumstances. I know there is pressure, and we are understaffed but do not tell me you yelled at a patient because you were under pressure.”

She said she did not understand the job-hopping of younger people who are always  “claiming to be too busy they cannot even mentor one person”.   She said: “Stay at a point and learn. Oh I know my job and my work place intimately. I interned here, have climbed up the ladders in this very hospital so whenever I am told there is mischief, I do not need an investigator because I know this hospital from corner to corner and I will leave my office, walk to this place and unearth those hidden drugs or whatever is missing”

me drinking water
Interviewing Juliana was so tough I drank a whole bottle of water when I was done…the struggle is real ehehehe

Juliana says she enjoys Benga music, walking barefoot in her farm in Seme and farming.

DO YOU HAVE A PROFESSIONAL YOU ADMIRE? LET ME MEET HER (OR HIM) talktoverah@gmail.com or WhatsApp 0732324609