July 1-15, 2011
ISSUE 043
A bimonthly newspaper by the Media Diversity Centre, a project of African Woman and Child Feature Service
Politics of population By ODHIAMBO ORLALE Since 1968 the world has been marking the World Population Day after world leaders came together and proclaimed that individuals had a basic human right to determine freely and responsibly the number and timing of their children. About 40 years later modern contraception remains out of reach for millions of women, men and young people. Like with many other leaders at the time there has been a need for each Government to conduct census to know the population within its borders. This then makes it easy to plan for services and infrastructure.
Since independence the Government of Kenya has religiously conducted national census through the Kenya National Bureau of Statistics on every decade. However, the impact of the results has not been as great as in the past decade when the figures were tied to HIV/Aids as well as devolved development funds kitty like Constituency Devolved Funds and Local Authority Transfer Funds among others. According to the latest census released last year by the Bureau of Statistics, the country’s population stands at 41 million up from 28.7 million in 1999 and 21.4 million in 1989. The 1979 census revealed that the country had a population of 15.3 million, up
from 10.9 million in 1969, when the first census was conducted after independence. In 1962, the census recorded a population at 8.6 million. However, other than the main aim of conducting a census, politics has played into the population figures. Politicians have always led in the fray by poking holes on the results either to complain that the figures had been “doctored” in favour of or against their constituencies and/or communities. The breakdown of the 38.6 million by province was as follows: Rift Valley (9.1); Eastern (5.5); Nyanza (5.2); Western (4.5); Central (3.9); Nairobi (3.2); Coast (3.2) and North Eastern (1.4). Continued on page 2
World Population Day
Clockwise: Kenyans at the Nyayo Stadium, the Kenya Army marching and Ethiopian women entertaining the crowd during the Madaraka Day celebrations. Children playing at Ayany Primary School in Kibera. A distressed woman in Turkana waiting for relief food. Pictures: Reject Correspondent
Read more Reject stories online at www.mediadiversityafrica.org
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
EDITORIAL
Kenya’s 40 million In this special issue of the Reject we look at the state of the world’s population with a special reference to the Kenyan situation. Today the world population is approaching seven billion with a myriad of challenges facing humanity. While global problems are similar, Kenya has its own unique situations that are affecting its populace. The growing population has left the country reeling under a burden of how to make sure that food and other resources such as water and power are available. Currently, the effects of climate change have left certain regions reeling under drought. However, the challenge this poses is that communities are in danger of killing themselves as they fight over the little water and pasture resources that are available. Jobs have become scarce, and men have been disempowered, a situation that has made gender based violence a major issue. Sexual and reproductive health issues remain a challenge as mothers continue to die giving life. As we mark the World Population Day on July 11, the dream of reducing maternal deaths by three quarters by 2015 remains just that, a dream. There is no hope of the target being realised as a dark ominous cloud hangs over the Millennium Development Goal number Five. Yet there is the threat of population explosion as the high growth rate poses planning challenges to Kenya. The rains started beating Kenyans when the issue of population numbers were put on the ethnic foundation and family planning became an instrument of politics that politicians have been using to their advantage. Thirty years since the first case of Aids was reported, stigma and violence abounds. Women remain the face of HIV as they face stigma from their partners and families. They also bear the burden of violence as men use them as the scapegoat. A whole generation seems to have disappeared in Turkana to the effects of the deadly scourge. However, voluntary male circumcision gives a positive face to HIV as communities that never practiced it embrace with more awareness on how to avoid contracting the virus. Looking at populations, communities like the Ogiek and Yaaku remain under threat of extinction as they get absorbed by neighbouring and bigger communities. However, there are some positive things happening around. Emmaculate Musya leads over 4000 women in the slums of Nairobi, showing them that being down does not being out and that they can actually use their situation to catapult to better and more positive lives. In the same slum, a library is helping children who have no access to electricity and tables to manage their school assignments amid challenges. These and many form part of this special issue of Reject that gives a human face to the State of the World Population that should challenge politics and policy. Have yourself a good read.
First intergenerational dialogue on sexual and reproductive rights By Omwa ombara When the young Tewodros Melesse was in high school, he often wondered where the girls in his class would disappear to for a whole year before resuming their classes. He was perplexed why nobody talked about it and why it was such a taboo subject mentioned only in whispers. He later learnt that they actually went to give birth in secret. They had gotten pregnant while in school and this was considered scandalous. The disappearing act became a way of surviving in a society where discussions on sexuality and sexual and reproductive health were never done in public. Today, Melesse has reason to celebrate the fact that dialogue has been given a chance. “Women die due to lack of access to reproductive rights. We talk about how abortion is bad but not how to prevent it,” says Melesse who is today the Regional Director, International Planned Parenthood Federation Africa Region (IPPF).
Abortion
Melesse who has a passion for the subject says there is abortion in every corner of the street yet no one is talking about it. “How do we make it safe? How do we prevent it?” he poses. Melesse recalls the recent outcries in the Kenyan Media about abandoned babies and aborted foetuses, yet he regrets that nobody talks about babies who are alive. “Let us stop mourning the dead and celebrate the life that is here. We want every child born to be an asset to the nation. Let the cry at delivery be a cry for hope. The woman should not be a victim because she gave life,” observes Melesse. Noting that our ancestors were not produced in a factory but through a sexual act, Melesse reiterates that sexuality is not a western
Students from Sambirir Secondary School in Keiyo Marakwet dance during the Madaraka Day celebrations. It is important for sexuality education to be imparted to the youth. Africa Regional Director IPPF Tewodros Melesse during the media briefing on sexual and reproductive rights in Nairobi. Pictures: Correspondent and IPPF website
concept but a universal one. Keynote addresses for the dialogue were made by Prof Fred Sai, a former President of
IPPF, His Excellency Kenneth Kaunda, former Zambian President, Minister of Medical Services Prof Anyang Nyong’o, Deputy Director General UNESCO, Getachew Engida and Her Excellency Joyce Banda, Vice President of Malawi. The dialogue, which took place in Nairobi on June 30th hoped to make recommendations for the development of regional frameworks to guide governments in policy formation around sexuality education for youth and formulation of strategies on the role of IPPF and partners in engaging young people.
Politics of population in planning dilemma
Continued from page 1 Early this year, Planning Minister Wycliffe Oparanya warned that Kenya’s current population growth was too high compared to the growth of the economy and needs to be curbed. Speaking in Nairobi after releasing the Economic Survey 2011, Oparanya maintained that slowing the rate of population growth was one of the measures Government would undertake to keep the economy on a growth path.
Urgent intervention
Said the minister: “We have to come in with interventions to control our population growth. Our population growth is 2.9 per cent almost three per cent (annually). With the current resources that growth is dangerous.” The Economic Survey 2011 showed that Kenya’s economy grew by 5.6 per cent last year but is projected to slow to 4.2 per cent this year. Other bodies like the United Nations have warned that unless controlled, Kenya’s population could become unsustainable. Majority have children they are not able to take care of. James Oluoch, who is a polygamist, says his big family of ten children from his two wives has been a big strain on him economically, but he has survived through hard work and determination. He is a fisherman, mason and businessman. “If I could turn the clock backwards, I would think twice before getting into polygamy and having many children,” Oluoch says. Days when nurses from the City Council dispensaries would walk around estates and speak to families about having the number of children they can cater for are no longer there. Today many
women and men have no access to information on having the right number of children. It is for this reason that unwanted and unplanned for pregnancies abound with partners having children they had not planned for. The National Coordinating Agency for Population and Development is on record for promising to roll out a series of family planning campaigns by end of this year to control the growth. NCAPD’s manager in charge of programme evaluation Karugu Ngatia, says they have drafted a population policy which they would present to Parliament to debate on. According to Ngatia, the proposed policy would entail the family planning campaigns strategies and is expected to go through Parliament as a Sessional Paper. Kenya’s fertility rate should be reduced to 2.1 from the current 4.6 where the women bear four to five children, the official
“We have to come in with interventions to control our population growth. Our population growth is 2.9 per cent almost three per cent (annually). With the current resources that growth is dangerous.” — Wycliffe Oparanya, Planning Minister
maintained. According to Bernard Machio, a freelance journalist, politicians have tried to influence the census reports to their benefit at the expense of the common man because of the devolved funds like Constituency Development Funds and Local Authority Transfer Fund (LATF). “We must accept the reality of the census and live with it instead of trying to politicise them,” Machio says. Politicians have been heard asking their voters not to do any family planning as they need the numbers. People who look to them for advice normally take their word as gospel truth. But even as the census results are released, not very many Kenyans understand the message they are portraying. They find it too hard to have technical terms that make interpreting why a census was conducted in the first place difficult.
Academic
Faith Wafula, who is a house-help, says the statistics released by the Bureau of Statistics sound very academic to her as she never feels the impact. Wafula says she can barely survive on her shoe string budget and this has a bearing on her decision to postpone marriage and start a family. “By the rate of inflation and lack of better job opportunities in the formal and informal sector, some of us will be left with no option but to shy away from starting a family,” Wafula says. Her sentiments are supported by Irene Ndambuki, who is single and a recent graduate from a private university in Nairobi who says her part time job at a leading shopping mall is not able to sustain her.
ISSUE 043, July 1-15, 2011
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Unfiltered, uninhibited…just the gruesome truth
Yaaku: A people on the brink of extinction By MWANGI NDIRANGU As Kenyans wait for the full implementation of the new Constitution and reap the gains of the reforms, one of the smallest communities in the country is feeling its survival threatened. The Yaaku people who live in Mukogodo Forest in Laikipia County feel there is little to gain and a number of ongoing reforms are working against their interests. Between 3,000 and 4,000 Yaaku people call Mukogodo Forest their home and it is here they have been deriving their livelihood for over a century. They are believed to have migrated from Ethiopia and settled in the forest at the beginning of the 20th Century as hunter-gatherers. Their main diet was honey and wild meat though some of them have now started rearing livestock. However, recent happenings are prompting the community to cry for attention. Since their arrival and settlement in the area, they have interacted with the neighbouring Maasai community and have slowly been assimilated into their culture, including language though they are cushites.
Extinct
It was for this reason that Yakunte language was declared extinct by the United Nations Education Scientific and Cultural Organisation (UNESCO) nearly a decade ago. The community’s spokesman Manasseh Rux Matunge says in recent years, they have witnessed various forms of invasion that are putting their identity and source of livelihood in danger. “After turning our forest into grazing fields, they are now claiming possession of our Kuri Kuri Group Ranch, the source of pasture for our livestock,” he says. The matter over the ownership of the disputed 6,230 hectares of land is still pending in court. On invasion of Mukogodo Forest, Matunge is referring to the Forest Act 2005 which now mandates communities residing near government forests to play a bigger role in conservation of the natural resource. Through formation of Community Forest Association (CFAs), communities living near forests are mandated to come up with ways of conserving them. For their conservation efforts, CFAs are allowed to reap the benefits from the forest like harvesting overgrown trees, obtaining honey or even grazing their animals during drought. However, these benefits must be in conformity with Kenya Forest Service (KFS) approved management plan. Matunge points out that with the coming of the Forest Act, the Yaaku have lost the “ownership” of Mukogodo Forest and their representation at the local CFA is only a minority.
Displaced
“The forest no longer belongs to us and it is for this reason that herdsmen from the neighbouring Samburu County have been grazing in our forest without our consent. Our worry is that they have been destroying trees to get foliage for their animals,” explains Matunge. Mukogodo Forest is among the best conserved in East Africa and Kenya Forest Service credits the Yaaku community for this. What worries the Yaaku is that the invading herdsmen are armed and cannot reason out with the locals. They are now left to watch the invasion and destruction of what they have called home for decades. They cannot complain to the authorities because they believe other communities have the right to graze in the forest in line with the reforms in the Forestry Department. “Previously, our main challenge was the dying Yakunte language which we have been trying to revive but of late, we seem to be encountering new problems every other day,” complains Matunge. He faults the Government for failing to
recognise Yaaku as a community and cites the 2009 census where they were classified as “others”. “The Government has totally failed to recognise our existence and when our children apply for national identification cards, they are told to fill on the tribe section that they are either Samburu or Maasai. We are a distinct community struggling to retain their identity in a hostile environment,” he observes. The struggle to retain their identity is an uphill task for the Yaaku and nature seems to be conspiring to thwart their efforts.
The community has From top: Three of the Yaaku elders, Stephen been campaigning for Leriman Leitiko, 86, Johana Saroney,85, and Latero the closure of the school Ngilelengi,78. Leteyion Leitiko ,78, poses in front of and pupils to join other Mukogodo forest. Yaaku elders during a meeting at Currently there are only eight elders who schools if the GovernMukogodo forest. can speak the Yakunte language and they are all ment is not willing to dePictures: Mwangi Ndirangu in their sunset years. ploy more teachers. These are Stephen Leitiko, Johana Saroney, Matunge says failure Latero Ngilelengi, Letaki Leitiko, Kanoru Karfor their children to get In Kenya there are the Ogiek while others uja, Leteyion Leitiko, Sirere Matunge and the quality education means they will not have include the Akiek and Aasax or l’Aramanik only woman who can speak the language Silele leaders to champion their cause at national in Tanzania as well as other small marginal Moile. The elders have been making efforts to level. peoples who try to live off the land, like the teach unwilling youngsters the language of According to an official of Yaaku People AsDahalo in Kenya or the Ik in Uganda. their ancestors. sociation Gabriel Sipuko, the Yaaku have four The Yaaku are worried that with the comMzee Stephen Leitiko, 85, is considered the clans spread in Nandung’oro and Mukogodo ing of the new Constitution, their political rep“professor” of Yakunte language and has been areas in Laikipia North district. resentation within the county government will visiting Kuri Kuri Primary School to teach the The four clans are Orondi, Sihalo, Losos and diminish. Currently they have one civic leader pupils the language. Luno which is the smallest. at Laikipia County Council, Councillor John The 260 pupils enrolled in the school are Sipuko says out of about 4,000 people with Parmashu. from the Yaaku community but according to Yaaku genes, pure Yaaku people are slightly Mzee Leitiko they are not very enthusiastic to over 1,000 in number. learn the language and consider Kimaasai their According to documents compiled by There are fears that with the county govmother tongue. Maarten Mous, linguistic researcher at Leiden ernment setup, various civic wards will be The Maasai people derogatorily refer to University in the Netherlands, Hans Stoks, merged and the likely scenario is that Mukothem as ntorobo, meaning poor people who do pastoral worker with the Maasai in Kenya, and godo would be merged with Momonyot ward not own livestock. The Maasai could ask men Matthijs Blonk, a filmmaker, Maasai have aland Parmashu or any other Yaaku is not likely from the Yaaku to herd their livestock and this ways been viewed superior by the Yaaku. to win in a contest pitting him against the popway, the forest dwellers came to admire the ulous Maasai. language and lifestyle of their neighbours. One of the prominent people from the comAccording to Mzee Leitiko, the young gen“The Maasai were the ones who stated the munity is Jennifer Koinante who was a teacher erations are ashamed of being ntorobo (Doroterms because of their military prowess and before she founded Yaaku People’s Association bo) origin and struggle to hide anything that their feeling of superiority and eventually, the eight years ago. She also vied for a parliamenmight disclose their historical origin. Yaaku people started admiring and copying tary seat in 2007 but lost. Besides lack of interest in Yakunte language, the lifestyles of the pastoralists.” say the reAnother prominent person from the comleaders of Yaaku community are worried with searchers in one of their papers. munity is Peter Matuge who was a district ofdeclining education standards at the school, a A research documented by Mous says the ficer in Kirinyaga before he moved to a state fate they blame on shortage of teachers. Yaaku are not the only Dorobo in East Africa. corporation. Koinante has been articulating the rights of minority groups in international forums and her main concern is preservation of the Yakunte language and Mukogodo forest. A Yaaku Museum has been constructed in Mukugodo forest where the cultural and traditions of the community will be preserved for —Manasseh Rux Matunge, community’s spokesman future generations to learn.
Dying language
Merged wards
Military prowess
“Previously, our main challenge was the dying Yakunte language which we have been trying to revive but lately we seem to be encountering new problems every other day.”
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Let’s call this young Kenyan John. He woke up hungry yesterday in Kaloleni in Kilifi County and went out with his can to search for food. He gazed into the future by the roadside but could not find the solution to his biting hunger. He looked at the can again, it was still empty. John started licking his empty can, in the hope of satisfying his hunger. These scenes describe famine and poverty, which has hit major areas at the Coast. Most affected at the moment are Kinango, Kaloleni, Ganze, MafaraMagarini (Malindi), Hola and Boni land among others. Pictures: Reject Correspondent
Mourning the death of family planning By JANE GODIA Kenya has a high population rate that is worrying planners. Already Planning minister Wycliffe Oparanya has sounded an alarm bell over the high population rate. But when did the rain start beating Kenya, a country that once prided itself as a leader in the region for advocating for family planning? What happened to access to services and information that easily reached men and women on how to have the number of children they can take care of and have them spaced? According to Muraguri Muchira, Director of Programmes at Family Health Options Kenya (FHOK) formerly known as Family Association of Kenya, a lot of investments on family planning had been done in the 1980s to 1994. However after the International Conference on Population and Development held in Cairo Egypt in 1994, priorities changes and many issues related to development that needed to be focused on came up.
Priorities
“After Cairo there were many things that came up and needed more attention. This included HIV, gender empowerment, safe motherhood, sexual rights and sexuality education among others,” explains Muchira. Post Cairo added impetus to issues like migration and refugee populations. “Globally, family planning was lost as donors decided to channel resources to HIV. Global resources to family planning went down,” observes Muchira. The impact of this was great as countries such as Kenya and many others in sub-Saharan Africa who depended on donor resources for family planning programmes suffered. “This is because previously there were no government resources set aside for family planning,” Muchira explains. “Before Cairo in the 1980s there was national commitment to family planning. However, in the 1990s with the emergence of multiparty politics the commitment went,” says Muchira. He adds: Ethnicities of politics and communities went into family planning. Ethnic numbers took centre stage. MPs, who in essence are leaders that communities look up to, spoke against family planning in a way that their voters believed them.
Politics
William Ntimama, a renowned Maasai leader said family planning was not for the Maasai. Prof Ayiecho Olweny, a university lecturer and MP from Nyanza said it was not necessary. Moses Wetangula, then cabinet minister from Bungoma was also quoted in the Press wondering why women in his constituency were not giving birth. Muchira says support for family planning lost political goodwill including that of President Moi who had earlier been a keen advocate of family planning even from the time he was vice-president.
Kenyans walking to work. The country’s economy is not growing sufficiently to meet the rising demand for the growing population. This is putting pressure on social services such as land and health. Picture: Reject Correspondent
International rule also came into play. The gag rule imposed by the Government of President Ronald Reagan made it impossible for US funds to go into organisations pinpointed as supporting abortion. “An embargo was placed on the organisations that were receiving funds from USAID such that FHOK stopped getting funds,” explains Muchira. He adds: “USAID remains the largest donor in the health sector in Kenya supporting about 90 percent of family planning programmes.” FHOK was originally a family planning organisation but was forced to close down most of their sex clinics because they could no longer support the programmes.
“This was the death of family planning in the country as community based distribution services headed by community health workers who were providing family planning services like contraceptives could no longer continue,” Muchira explains. However, because of the embargo, there was an unmet demand for family planning with about 24-25 percent of women and men who would want family planning methods not accessing the services or missing out on the information. “The percentage of men and women using family planning stagnated from 1998-2003. The contraceptive prevalence rate stagnated at 39 percent,” Muchira observes. Based on the Kenya Demographic Health Survey (KDHS) the contraceptive prevalence rate rose to 46 percent between 2003-2009.
Access
“The percentage of men and women using family planning stagnated from 1998-2003. The contraceptive prevalence rate stagnated at 39 percent.” — Muraguri Muchira, Director of FHOK
“We expect the contraceptive prevalence rate to rise to the 50s. Muchira says since 2008 there has been a call to reposition family planning. “There is need to bring it on board. It is good that the Government for the first time in 2005-2006 national budget allocated KSh500 million for purchase of family planning commodities. In 2006-2007 the money was raised to KSh530 million and this was the same for 2007-2008.” Muchira says the poor performance of family planning, which is being blamed on the high population rate is due to lack of sufficient contraceptives. Commodity insecurity has been experienced such as shortage of condoms and depo provera. Men and women have not been able to access the method of choice. A lot more money needs to be put into family planning by reducing over reliance on donors. This is the only way we will be able to meet the millennium development goals especially goal number five that seeks to reduce maternal mortality by three quarters by 2015.
According to Muchira, the impact of family planning fallout on development has not been positive. “The country is not growing sufficiently to meet the rising demand for the growing population. There is a high population which has in effect put demands on social services such as education and health. However, the Government has not been able to invest sufficiently for the growing demand. Health services are not sufficient to meet the demands. Doctor patient per capita is very low compared to the World Health Organisation recommended rate. There are only 7,000 doctors out of which 3,000 are in public hospitals and the rest in private hospitals. The Government has been faced with challenges and that is why it has not been able to meet its obligations. “For example, in the Abuja Declaration, the Government committed to giving 15 percent of its national budget to health sector. It has so far only been able to commit seven percent. By not investing sufficiently, the Government will not be able to meet the MDGs. “It is missing out on development opportunities on areas of growth,” says Muchira.
Climate change
The high population growth is having consequences on many sectors including the environment. “Consequences of high population are that people are moving into marginal areas with serious environmental repercussions,” observes Muchira. This is why we have had populations moving into areas such as the Mau which is compounding the global climate. Climate change has seen an increased demand on resources, intones Muchira. In North Eastern Province, which currently has the highest average population rate of 5.9 on an average family, drought has had a huge impact on the families. When family planning fails in a bedroom, the snowballing effects into social goods and services are felt at the national level.
ISSUE 043, July 1-15, 2011
Taita Taveta attempts to demystify its low population By ROBBY NGOJHI When 2009 Census figures were released, Taita Taveta County emerged one of the least populated with only 284,657 people. This did not augur well with some local politicians. Area legislators observed that the number of constituents carries a lot of significance to parliamentarians. The MPs argued that the bigger the population they represent the greater the opportunity of being hired in Parliament. “In Parliament, we brush shoulders with other law makers who were voted in by 50,000 votes and I only went there with less than 15,000 votes. How can I successfully push for some bills to benefit my electorate?” posed Thomas Mwadeghu, Wundanyi MP. His sentiments were echoed by his counterparts Dan Mwazo of Voi and Calisto Mwatela of Mwatate.
Remarks
These political remarks later elicited reactions among the residents with some questioning whether same politicians have big families or otherwise. Different groups of people could be found discussing how some of the politicians had strictly adhered to family planning. After thorough scrutiny of the family profiles of the leaders, the residents would dismiss their calls to multiply as sheer politics. “You see these people are rich and most of them have only two or three children. How come they want us to multiply even with the current harsh economic conditions? They only value us in terms of their votes and not as human beings,” said one of the residents. But as the debate went on, questions were raised as to why the Taita population had remained this low. During a leaders meeting convened in Wundanyi to discuss social development, top on the agenda was alcoholism. Women leaders accused the men of indulging too much in alcohol at the expense of their marital responsibilities. Some of them blatantly complained that their men failed to perform their conjugal duties because alcohol had reduced them to zombies and rendered them impotent. “I am not ashamed to say that our men value alcohol than their families because they spend more time with bottles of beer than they do with us. At this rate how is our population going to grow?” posed Mary Mwatabu.
Alcoholism
As the debate went on Nominated Councillor Mary Saleka from Werugha Ward threatened to mobilise women to block all vehicles that transport alcohol to the area in a bid to save the men from alcohol abuse. “This has gone way too far and we need to take stern action because alcohol is ruining our population,” warned Saleka. An unfounded stereotype depicts Taita Community as famous for beautiful girls who apparently refuse to be married by their local peers. To some extent, this is can be underscored by the virtually uncountable drinking dens which have mushroomed in different parts of this region. In the tiny village of Masumbesunyi within Wundanyi town, patrons will be found taking different types of local brews. They start from the crack of dawn to the fall of dusk. In what can be viewed as a clear indication that local men are ruined by alcohol,
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Unfiltered, uninhibited…just the gruesome truth
Raids
Wundanyi OCS Charles Kibett has made frequent raids in Mwatate, Mbale, and Rong’e Juu areas where he has nabbed hundreds of litres of chang’aa. “There are some brands which are only sold in Taita because it appears the region has offered a booming market for the said brands,” observed Kibett. There are also reports that two nursery schools in one of the locations within Wundanyi Constituency have been shut down because the area has no children to join the school. Voi Mayor Anisa Mwakio pointed out poverty in the area as a major cause for the declining population. She observed that due to poverty, most people refrain from having big families and instead prefer smaller and manageable numbers that are easy to manage. She said the introduction of family planning during Moi’s regime had adversely affected the population because Coastal people predominantly the Taita community are serious law abiding citizens and strictly followed family planning considering it law. “Our population could be partly a legacy of family planning which we adhered to so seriously not knowing that it could affect our numbers in the future. Even today some women still cling to contraceptives,” she said.
By JEFF KIRUI There is an upsurge in early pregnancies among girls in Narok South District. According to Narok South District Commissioner Chimwaga Mongo, many cases reported have implicated teachers in the district as the culprits. Although the administrator did not give the exact number of girls impregnated, he said that the number of teachers implicated was high. He accused the parents of protecting teachers and sex pests instead of being in the frontline to curb the vice that is taking a worrying trend adding that this will affect the education standards in the area. “The community has been protecting the culprits once the alarm is raised. The offenders have occasionally been fleeing to neighbouring Tanzania,” said Mongo. Mongo added that the days of the sex pests are numbered as the Government has laid down strategies to bring them to justice. “I have contacted my counterpart in Ngorongoro in Tanzania to ensure these people who are on the run are arrested and repatriated to be prosecuted,” he said. Mongo said that school dropouts, early marriages and Female Genital Mutilation are on rise especially in Osupuko and Mara Divisions and called upon the residents to stop the obsolete traditions that have negative effects on education. He made the remarks during the Narok South District Education Day at Ololulunga Secondary School in Narok South District. He was accompanied by Narok South DEO Obiri Ambolwa, Narok County, KNUT Executive Secretary Denis Rakwa, Narok South District Secondary School Heads Association chairman Paul Chesimet and his primary school counterpart Stephen ole Nakola. On his side, Rakwa said that they were over 20 school girls who have been impregnated in Mosiro Zone in the area. He challenged parents and leaders to unite in order to sensitise the community on the need to educate the girl child saying it is their democratic right. He called upon the provincial administration especially the chiefs to ensure the culprits who impregnated school girls were arrested and prosecuted.
From top: Men and women during a game of tag of war at Wundanyi stadium. Local men imbibe their drinks beside the road in Mbale location. The population in this region is very low and is being blamed on alcoholism. Pictures: Robby Ngojhi
men have on several occasions been outshined by women in a tug of war which is normally held at Dawson Mwanyumba Stadium during public holidays. However, this is only a tip of the iceberg as it represents some other uncountable drinking joints in Mwatate, Taveta and Voi constituencies where alcoholism has been the order of the day.
Teachers blamed for increase in early pregnancies
However, she was quick to add that alcohol is another contributing factor because most Taita men drink too much and blamed the men for leaving family responsibilities to their wives. “Alcoholism is the main cause of this scarcity because first of all, it contributes to poverty in that you’ll find a man rushing to drink whenever he gets a few coins after doing odd jobs. When he goes back home he sleeps either outside or under the bed while the wife sleeps alone on the bed in the cold night,” observed Mwakio. She noted: “Now most family responsibilities are being carried by women and as a result quite a good number of local women are borrowing loans from different microfinance institutions to start their own businesses and care for their families. Definitely we have to do something to stop alcoholism lest our community becomes extinct.”
More children
Minister for Gender and Children’s Affairs, Dr Naomi Shabaan, who is also the Taveta legislator challenged the men to shun drinking and shift the much wasted attention to their families. She said: “Most women have resorted to contraceptives because men are becoming irresponsible.” Shabaan discouraged women from using contraceptives and instead advised them to have more children in a bid to boost their numbers. “Numbers are very important because the equitable distribution and allocation of resources under the new Constitution will go by numbers,” Shabaan observed. Consequently she told women who got children out of wedlock and left them with their fathers outside the county to call them back home and live with them as they will be a positive addition to the population.
Call for youth to engage land administration By JOHN NDIRANGU Parents in Embu County have been challenged to involve the youth in land management as a way of encouraging them to focus more on farming. According to the chairman of Agricultural Society of Kenya Embu branch Joseph Kibathi the initiative will open up opportunities for the youth to benefit with employment. “As farmers embrace modern technology for their farms, the youth must not be left behind,” he said. Kibathi noted that for a long time parents have resisted dividing sections of their land to their children, which has left them desperate and without any engagement where most of them have turned to crime, drugs and illicit brews. He was speaking in Embu during this year’s ASK beauty contest which attracted the youth where more than 20 contestants from various institutions in the region attended the beauty show with the winner walking away with KSh10,000. Kibathi said this year’s ASK show is meant to attract the youth and more than 20 youth organisations have already registered to exhibit their wares and products. He said attention must be given to the youth if the problem of unemployment which is the biggest challenge facing youths in the area and other parts of the country is to be solved. Jepta Rono, chairman Nakuru show said the Kenyan education system is flawed in that it prepares youths for white-collar jobs which are almost non-existent. “It is the wish of the ASK show to instil farming practices to the youth of this country as any other business they would wish to venture into to develop their lives,” Rono said.
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
School hosts largest pupil population
By MACHARIA MWANGI It is a school grappling with a huge population. Located near the sprawling Karagita Estate mostly inhabited by low cadre flower farm workers, Mirera Primary School is touted to be one of the institutions with the largest populace in East and Central Africa. A visit to the school is an eye opener. Like swarming bees, thousands of pupils play in the dust filled playground during break time. Some teasing their mates while others make a sprint across the field all in the name of pastime activity. At the water point, its survival for the fittest as the pupils jostle and push for a vantage position to take a gulp of water occasioned by sweltering afternoon heat to quench their thirst. Conspicuously, teachers on duty have a hectic time trying to bring sanity during the children’s free time to ensure high level of discipline. The script is replicated inside the classroom as four pupils share a desk meant for three in order to accommodate the bulging pupil population. And it comes with a cost. Some mischievous lads seated at the back row pull all sorts of stunts as a teacher takes the attentive ones through the day’s lesson. Bored and disinterested pupils form part of the afternoon class.
Discipline
Clearly, managing the densely populated classroom is a Herculean task even for the strictest teachers aptly referred to as “disciplinarians”. Some of the teachers have now become accustomed to dealing with the large population and the work load they have to endure to meet the target. With this workload comes a myriad of challenges including infrastructure and overworked teaching personnel who are trying to strike a balance between offering the best to match schools with a lesser population and with modern infrastructure. According to the school’s head teacher, Peter Ndegwa, the population now stands at 3,550 pupils. “It is a fairly challenging task but we are equal to the assignment,” says the head teacher during the interview. Shedding the light on the dynamics that give the school the large population, Ndegwa attributes it to the swelling number to low income earners plying their trade in the flower farms scattered in the vast South Lake area. “It is the natural school of choice for the underprivileged bereft of other options,” he asserts. The 2008 skirmishes that rocked the lakeside town also contributed immensely to the high
Mr Peter Wangai, head teacher Mirera Primary School, addressing pupils during parade session. The school has the highest population in East Africa. Pictures: Macharia Mwangi number of enrolment in the far flung school. A number of those displaced settled in the low cost housing estate leading to population upsurge. The school has a total of 65 streams with Standard One to Six having four streams each, Standard Seven, five stream while class eight six streams. But due to lack of enough classrooms, the pupils have been squeezed into only 35 streams making it a phenomenal task to give the pupil a
personal touch or attention. With the figures, the school has a shortfall of almost 20 classrooms giving the Government food for thought and a nightmare for the parents. Against the backdrop of the swelling population, the school has 42 teachers employed by the Teachers Service Commission, making it understaffed with more than 20 tutorial staff. However, alive to the challenges posed by the runaway population, the Lake Naivasha Growers Group (LNNG) has helped employ 16 teachers to mitigate the shortfall.
Runaway population
“It’s a preconceived idea that Maths is hard and it becomes more challenging when one is teaching a populated class.” – Joyce Munyi, mathematics teacher
According to the group’s executive director, Joseph Kariuki, they decided to chip in addressing the challenges as it was pinpointed as an ‘emergency’. “We found it noble to support the school by employing teachers as majority of the parents hail from the flower farms that form the umbrella body,” observed Kariuki. To ensure the smooth running of the institution, the head teacher is aptly assisted by two deputy head teachers, three senior teachers and an administrator. “Apart from these ones, the teacher’s body and the prefect caucus have greatly helped to ease the administration problem,” said Ndegwa. To cope with other administrative challenges, the head teacher delegates some of the duties and only deals with the most urgent task that requires his personal input. With a teacher student ration at 1:70, giv-
ing personal consideration to each pupil in the class in an uphill task as some of the teachers attested. “We try our best to give attention especially to weak pupils but it’s not easy,” said teacher Joyce Munyi. Just like many of her ilk, the affable teacher has to manage her time well to handle the workload. “Am an early riser and I leave the school late just to ensure that am able to mark more than 90 books,” reveals the mathematics teacher. Munyi who doubles up as the Swahili teacher says the most challenging subject to teach is Mathematics due to the attitude among the pupils. “It’s a preconceived idea that Maths is hard and it becomes more challenging when one is teaching a populated class,” she explained. Despite the limitations, the school was able to place three pupils, two girls and one boy in national schools. Among the gems of the populated school included Stephen Maina who secured a place at the prestigious Lenana School with 391 marks. Rahab Wambui Kariuki joined Mary Hill School with 381 marks while Christine Mbithe was admitted to Limuru Girls with 377 marks. A total of 351 candidates registered for the examination with 342 sitting the examination. But despite the brave attempt, it is clear to all and sundry that a lot needs to be done in addressing the huge pupil population if the school is to march schools that post impressive academic results.
ISSUE 043, July 1-15, 2011
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Unfiltered, uninhibited…just the gruesome truth
Kenya leads region in voluntary male circumcision By FLORENCE SIPALLA The voluntary medical male circumcision (VVMC) programme is being aggressively implemented in Kenya. The programme targets communities that culturally do not carry out the cut. Kenya has taken the lead in the uptake of male circumcision in efforts to prevent HIV infections in 13 countries within East and Southern Africa. So far, Kenya is reported to have reached 66 percent of the uncircumcised men targeted for the programme. The voluntary medical male circumcision programme is aggressively being implemented in Nyanza Province which has a high HIV prevalence compared to the rest of the country. While prevalence in the rest of the country stands at 15.3 per cent, it is 40 per cent in Nyanza. This can partly be attributed to the fact that the Luo community resident in the area does not traditionally circumcise men. According to Dr Zebedee Mwandi from the Centre for Disease Control in Kenya, HIV prevalence in men from Kuria and Kisii, both communities in Nyanza Province is at about five per cent, while among the uncircumcised Luo men it is 17.5 percent.
Priorities
The VVMC programme was mooted in 13 countries namely: Botswana, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. These countries were
prioritised for intervention as they have a high HIV prevalence, low levels of male circumcision and generalised heterosexual epidemics. Male circumcision should not be taken as the only mode of prevention but as part of a package geared towards stemming the spread of HIV. During a recent launch of a film, In It To Save Lives, it emerged that different approaches are required to achieve the targets. The film documents VVMC work in Kenya and Swaziland with additional resources on medical male circumcision. “One foreskin is much like another, but one mind is not like another and one community is not like another,” observed Dr Jason Reed, from the Centre for Disease Control in Atlanta.
Approaches
Much as Kenya has registered positive results in VVMC in Nyanza, it was not an easy feat to achieve. First, health practitioners had to jump over cultural barriers that had the community members reluctant to go for male circumcision. This is because male circumcision in Kenya has been a sensitive topic. “It has been a very sensitive and emotive topic,” observed Dr Kwango Agot of Impact Research and Development Organisation. She said male circumcision has been used to deride members of the Luo community and even undermine their political leadership. Getting the community members to accept
A Swazi man awaits circumcision. The traditionally non-circumcising country with the highest HIV prevalence has embarked on a nationwide male circumcision campaign to reduce the spread of HIV. Picture: AFP/Getty Images VVMC was like charting through stormy waters. In the initial stages of the programme, Apondi Akatch from the Nyanza Reproductive Health Society was tasked with the responsibility of bringing the Luo Council of Elders on board. “It was important to go through them as they are the custodians of culture,” said Akatch. She shared findings of the preliminary research which indicated that male circumcision reduced the chances of HIV acquisition in heterosexual males by about 60 percent. However, it was not easy as she initially faced opposition at first.
Woman mobilises men to get circumcised By ODHIAMBO ODHIAMBO
In Usenge township, in Nyanza Province, Maurine Auma, 23, speaks with ease to a group of young men about the benefits of voluntary medical male circumcision. She never thought this would be possible two years ago when she first volunteered as a community mobilisation officer. “I thought to myself how a woman like me would convince men to go for circumcision,” she says. “I thought many of them would just mock me and dismiss my efforts.” Today Auma looks back with pride on what she says has been an enriching and rewarding experience. In the past two years she has encouraged 250 men to go for the ‘cut’. Many of them have appreciated both her efforts and the benefits of voluntary male circumcision as a HIV prevention method.
Volunteering
Auma is one of the hundreds of community mobilisers in Nyanza trained by the Voluntary Medical Male Circumcision Programme to inform communities on the benefits of the procedure and encourage men to go for the ‘cut’. These mobilisers, majority of who are volunteers, have helped the programme reach more than 230,000 men and boys since October 2008. Auma’s day starts at nine in the morning. “I either conduct door-to-door visits or reach out to clients at the Voluntary HIV Counselling and Testing (VCT) clinic, where I get to share with them the benefits of male circumcision,” she explains. Nevertheless, she admits her work as a community mobilization officer has not been without challenges. Perhaps the greatest challenge is addressing men’s fears that male circumcision is painful. Concerns about lost income during the healing period after the procedure and the reluctance of married men to consider circumcision are also a hindrance.
She is quick to add that these challenges are not insurmountable. “I believe with consistency in delivering of positive messages about medical male circumcision, these challenges can be overcome.” Her desire to see reduced HIV infections in the community fires the resolve to continue her work. She comes from a community that has experienced high levels of HIV infection. Auma advises those who have already been circumcised to continue using condoms consistently and be faithful “because male circumcision is not a solution on its own”. She urges those who are not yet cut to consider going for the procedure. Free voluntary medical male circumcision services have been going on since August 2010 in Kibera. They have been expanded to six additional divisions of Nairobi as part of the Government’s efforts to curb the spread of HIV infection. Ministries of medical services and Public Health as well as the City Council of Nairobi are collaborating with development partners to offer the services in Nairobi with support from the US President’s Emergency Plan for Aids Relief (PEPFAR).
Partners
The Nyanza Reproductive Health Society (NRHS) is providing the services at the Kibera and Local health centres, serving clients from Dagoretti, Lang’ata, and Makadara divisions. Eastern Deanery Aids Relief (EDARP), another partner in the programme, serves those seeking voluntary male circumcision at its clinics in Kasarani, Embakasi, and Starehe divisions. There are plans to expand to public health facilities in the future. At all of these sites, voluntary male circumcision is offered as part of a comprehensive package that includes the male circumcision procedure, counselling on HIV prevention, voluntary HIV counselling and testing, condom provision and promotion as well as treatment of sexually transmitted infections.
Auma talks to a client about the benefits of the male cut. Picture: Odhiambo Odhiambo The Nyanza Reproductive Health Society is one of the partners that have been instrumental in expanding the services within Nyanza Province where more than 230,000 men have been circumcised in the past two-and-a-half years. In Nairobi, as in Nyanza, NRHS trains its own staff and those of its partners to provide the services. It also gives the Nairobi Provincial Male Circumcision Task Force technical support in supervising staff to help maintain the safety of the services. The task force coordinates the activities of the various partners in the Nairobi programme to ensure that the population has access to the services and that those services are integrated with other HIV prevention and care services. “The coordination is done through quarterly supervisions conducted to all sites offering voluntary medical male circumcision in the province,” says Dr Sam Ochola, Provincial Director of Public Health and Sanitation for Nairobi.
VVMC had to be popularised as a public health intervention and not a cultural practice. A member of the Luo Council of Elders Owiny Nyady concurs that circumcision was never part of Luo culture but health practitioners explained it was going to be a voluntary process that had medical benefits. Eventually, through a lot of awareness creation they got a buy in from the community. Arguably, the fact that VVMC was endorsed by Prime Minister Raila Odinga also helped to get more men going to be circumcised. The Prime Minister in indicating support for the process, indicated to the community, that while it did not protect them from contracting HIV, it reduced the chances of catching the virus.
Enrolling men
The programme in Kenya is enrolling men who have undergone circumcision to help mobilise their uncut peers to go for the service. According to Mwandi, they are using noncoercive incentives as well as compensating the mobilisers for their time. If a circumcised man recruits young men between the age of 15 and 18 for circumcision, he gets KSh50 for each one of them and KSh100 for recruits aged between 19 and 20 years. The mobilisers also get mementos such as Tee-shirts and reflector jackets for their boda boda (motorcycle) taxis. “But the men coming for circumcision do not get incentives,” reiterates Dr Carolyne Ryan from the PEPFAR Office of the Global AIDS Coordinator. Just like Kenya, Swaziland, the country with the highest HIV prevalence at 26 per cent has had its challenges in kick starting the voluntary medical male circumcision programme. “Swaziland is a non-circumcising nation,” said Ayanda Nqeketo, National Male Circumcision Coordinator in Swaziland. He indicated that perhaps Kenya has a higher success rate with VVMC because most communities in the country already practise it.
Swaziland
However, Nqeketo is optimistic that Swaziland will have more numbers to report in the near future. “You are going to see a big change,” he promised, adding that Swaziland has adopted a sector based approach. For example, through a campaign targeted at school children, they are getting young boys to go for male circumcision. As school going children would need parental consent to undergo the cut, “parents are sensitized through school committees by both Ministry of Education and Ministry of Health but the consent is by the individual parent,” said Nqeketo. Nqeketo said women in Swaziland are increasingly becoming interested in the male cut and are going to health centres to get information on circumcision for their children. Health practitioners agree that VVMC offers them a rare opportunity to interact with men and offer them additional health services.
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Violence in the face of HIV By PATRICK MUTISYA
Have you ever been sick and denied your rights by your own family? That is, you cook food and then after serving your family, yours is thrown into the dustbin including the medicine? This is the situation that has befallen many HIV positive women in Kenya. They are mistreated for their status. Stella Akinyi who is HIV positive is one of the many mothers undergoing such hostility within the confines of their homes. The mother of five who is now breast feeding her one and half year third born has been struggling to overcome the pain of stigma and discrimination posed by her husband. Before she discovered her status, Akinyi had two children who were tested and found to be HIV negative. After the revelation, she delivered three more who have also tested negative. Akinyi has been very adamant in her quest to continue using protection although the idea is usually received with a lot of hostility by the husband.
Dejected
Akinyi has been disgraced and rejected, at times with beatings by her husband ever since she turned HIV positive in 2004. He blames her for the situation. Akinyi has received intensive counselling regarding her status and ways in which to keep her family healthy but her husband would have none of it. “After disclosing my status to my husband, he accused me of lying,” says Akinyi. “He said I am energetic and I am the only one who knows where I got the virus from and the news about my status is all lies.” Akinyi’s husband argued that the doctors lied to her since he does not believe in the existence of HIV/Aids and has never accepted the situation. Akinyi has, therefore, faced a lot of hostility as a result of her HIV status. Her husband denies her food which she has prepared and even throws away her ARVs. Diet is the most important thing for any HIV positive person. Experts recommend those with the virus to eat a balanced diet before taking
medication. “My husband always eats when I cook food but he says I should not be eating because my death is imminent. He eats his portion and then throws away my share into the dustbin to make sure I don’t eat,” says Akinyi.
Time to die
Adherence to medication has become extremely difficult for Akinyi because of the difficulties she is facing. She is worried that after several tests, her CD4 count is on the decline. The 26 year old mother is very weak and cries bitterly for lack of employment that can help her cater for her daily needs. She tries to hold her tears back as she narrates the story but all in vain. Her child on seeing her cry joins in. Akinyi’s husband has interfered with her efforts to come into terms with her status. His drunkenness has tarnished her reputation in the plot they live in. “My husband announced my status to my neighbours saying that I am rotten because I have HIV and that I am not supposed to be talking with them. Other times when I walk out to bask in the sun they laugh loudly and start backbiting me in my presence,” says Akinyi. Akinyi’s husband, Amolo Otiende, is among the many men who have been causing a lot of suffering to their HIV positive wives. Although he also tested positive, Otiende who works as a casual worker has never come to terms with his status. Since his testing during the wife’s third pregnancy, he has refused to accept the results. He was introduced to ARVs of which he took the first dose for some days before throwing the rest into the dustbin. She has given up on her angry husband and prays to God to intervene and transform him. “At times I even think of taking him to the police to be beaten or that I should end the marriage. But all that cannot solve my problems. I
have now decided to wait upon God to transform him,” she says. According to the Ministry of Medical Services, there are 1.4 million people living with HIV in Kenya. The epidemic affects Kenyan women more severely than men. Young women aged 15-24 years are 5.5 times more likely to become infected with HIV than of the same age group. Among those already infected three out of every five infected Kenyans are female. There is an alarming number of women facing stigma and discrimination within their families. Women play a very big role in the family. They not only have to look after their own health but also the health of their children. About 102,000 children were infected with HIV through mother to child transmission 2008.
Stigma
Hence with all the roles burdened on women they face the highest stigma rate. A clinician in HIV care and treatment at the Liverpool VCT, Mr Duncan Berkebo, says stigma, discrimination and misperception have created major barriers in Kenya’s fight against HIV and Aids. “Most people infected by the virus constantly deal with issues of discrimination and hatred because those living with HIV and Aids are viewed as morally corrupt because of the ways in which it is transmitted,” says Berkebo. He adds: “Another reason could be that people are being linked to behaviours that are improper and because HIV is associated with sex, people assume that a person who has HIV has acquired it through sex and the sexual aspect of it is immoral,” he says. Berkebo says HIV positive persons go through a lot of distress from their relatives, friends and even care givers at the disclosure of their status. Some even end up losing their marriages. Stigma remains the single most important
He was introduced to ARVs of which he took the first dose for some days before throwing the rest into the dustbin.
Stella Akinyi outside their home with her last born. She has faced violence fro her husband because of her HIV status. Picture: Patrick Mutisya barrier to public action. It is the main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so. “It makes Aids the silent killer disease because people fear the social disgrace of speaking about it or taking easily available precautions. Stigma is a chief reason why the Aids epidemic continues to devastate societies around the world,” says Ban Ki Moon, UN Secretary-General. Moon says stigma not only makes it more difficult for people trying to come to terms with HIV and manage their illness on a personal level, but it also interferes with attempts to fight the Aids epidemic as a whole. “On a national level, the stigma associated with HIV can deter governments from taking fast, effective action against the epidemic, whilst on a personal level it can make individuals reluctant to access HIV testing, treatment and care,” he explains. Berkebo says awareness should be created on the modes of transmission to stop stigmatising and discriminating those infected.
More women affected by cardiovascular diseases By Mary Nyamongo The verdict is out! Kenya, like other low and middle-income countries, is seeing increasing levels of cardiovascular diseases, commonly referred to in medical lingua as CVDs. As the world prepares to attend a high level United Nations Summit on non-communicable diseases (NCDs), health practitioners and decision makers are beginning to be inward looking. We are beginning to consider the risk factors locally and what can be done to change the tide. NCDs are diseases grouped together because of their common behavioral risk factors such as lack of physical activity, poor diet, smoking and excessive alcohol use as opposed to those caused by infective agents such as viruses, bacteria and fungi. Common NCDs include cardiovascular diseases, diabetes, cancer, chronic lung diseases, amongst many others.
Risk factors
The World Health Organisation (WHO), which is leading activities around the UN summit, is proposing a focus on the four main NCDs — cardiovascular diseases, cancer, diabetes and chronic lung diseases. These diseases account for 60 percent of the burden on NCDs. What is important to note is that these diseases have four common risk factors, which are behavioral and largely preventable: poor diets; tobacco use; lack of physical activity; and harmful use of alcohol. Health promotion and prevention are seen as key strategies towards the prevention and control of these conditions. For those already affected by these conditions, appropriate treatment and rehabilitation are also proposed. Some key questions are: what is the situation
of NCDs among women in Kenya and globally? What can women do to support the prevention activities? This article focuses on CVDs and the Kenyan women: as significant players in the society who determine health and socio-economic well being of children and the community at large. Prof Gerald Yonga of Aga Khan University (pictured), East Africa who provided insightful comments on this issue. Question: What is the situation with cardiovascular diseases in Kenya? Answer: Hypertension is a key risk factor of CVD. The risk factors for hypertension include poor diets (high salt) and lack of physical activity. There is evidence that women experience higher levels of CVDs compared to men. Indeed, evidence from other countries shows that women account for almost 60 percent of CVD mortality compared to men. This could be due to under-diagnosis and inadequate treatment of CVD in women. Question: Why are women at higher risk? Answer: In the Western countries, more than 80 percent of midlife women have one or more traditional cardiovascular risk factors. Women have, on average, greater blood cholesterol levels than men after their fifth decade of life and exhibit mild decreases in the “good cholesterol” after menopause. Obesity is prevalent in one-third of women and seven percent have a body mass index ≥40 kg/m2which is associated with increased mortality. High blood triglyceride levels — a fat commonly found in meat — is a more potent independent risk factor for women as compared with men. Diabetic women have significantly higher death rates from coronary heart disease compared with diabetic men and an elevated 3.3-fold
coronary heart disease risk compared with non-diabetic women. Importantly, 30-year trends reveal marked cardiovascular disease mortality reduction for diabetic men but not for diabetic women. Clustering together of risk factors is common after menopause, notably the combination of obesity, hypertension and abnormal blood lipids. This is thought to be related to hormone changes at menopause. In view of human rights concerns and international commitments, deliberate action is required to address inequalities. Only if public policy is transformed in ways that empower women, will they be able to reach their full health potential.
Women displaying their wares in Arusha Market. Women are increasingly being affected by non-communicable diseases such as diabetes, cancer and lung disease. Bottom: Prof. Gerald Yonga of Aga Khan University. Pictures: Correspondent and Courtesy
ISSUE 043, July 1-15, 2011
9
Unfiltered, uninhibited…just the gruesome truth
Ambassadors of hope break the thread of stigma By Abjata Khalif Cultural beliefs and lack of information on transmission and prevention of HIV/Aids in Northern Kenya continue to fuel beliefs that the disease is transmitted through sexual immorality. The belief is that sexual acts outside marriage are to blame for the infections and that those who get infected are prostitutes. This fact reinforces high level stigma and abuse. Such scenario of high stigma and lack of information on transmission, prevention, testing and living positively with the scourge has left many people living with Aids to be in denial, hiding their status and claiming they are suffering from other diseases like TB or Cancer. According to administration at the Garissa General Hospital, this has contributed to the rise in HIV/Aids prevalence from zero in 2003 to 1.5 percent in 2009. However, the current prevalence is what has made the community come to terms with the scourge. According to Ms Asha Mulki of Frontier Indigenous Network, a community based organisation, communities have been living in denial and sometimes hide family members who are infected with the virus so that other family or clan members do not come to know of their status. “Most families felt it was a curse, shame and bad omen and once news got out that
one of them is infected then that family will be ostracised by clan members,” explained Mulki. This has also contributed to psychological trauma to those who are infected as well as their families and has denied them an opportunity to access to medical attention. Instead majority have turned to traditional rituals and herbs which have not been effective. Constant pilgrimage to traditional medicine men for herbs or to have them chase away the bad omen or curse has cost many families thousands of shillings with no reprieve. Most families only take the sick relatives to hospital as a last resort and when they are in very bad shape.
Breaking silence
However, the scenario of shrouding HIV/ Aids with silence has been broken by massive campaigns and community education by various initiatives that include one being conducted by the USAID funded Aids Population Health Integrated Assistance (APHIA) 2 programme. The intervention and awareness campaigns has targeted the pastoralist communities in villages, market centres and places of worship using religious leaders in changing perception and attitudes towards HIV/ Aids. The APHIA 2 campaign has produced courageous pastoralist women living with
HIV/Aids who have come open on their status. They are also now creating awareness to the community on the scourge and urging those living with the virus to come out on their status. The women are the ambassadors of change and role models in fighting stigma and lack of information on the disease. One such woman is, Ms Habiba Hassan, who is living with Aids. Once her status was revealed to her at the Garissa General Hospital, Habiba’s family rejected her. They called her living dead. However, her two children tested negative. “It was painful to be ex-communicated by family and be called names. What kept me going is the support I got from my in-laws who stood by me through the rough times,” says Habiba. After she was rejected by her family, she took the opportunity to create awareness on the scourge. Habiba and other patients with support of APHIA 2 formed an organisation of people living with HIV/Aids in northern Kenya known as OPAHA (Organisation for People Affected by HIV/Aids). The organisation has undertaken a series of campaigns in educating the pastoralist society on the scourge and especially in fighting stigma. The OPAHA activities have led to more people going for voluntary testing while those infected are seeking treatment in hospital.
Habiba Hassan with her son outside the Aphia II offices in Garissa. She was excommunicated by her family when she tested HIV positive. Picture: Abjata Khalif
World population to reach 10 billion by 2100 By Correspondent According to the official United Nations population projections prepared by the Population Division of the Department of Economic and Social Affairs launched two months ago, the current world population of close to 7 billion is projected to reach 10.1 billion in the next 90 years, reaching 9.3 billion by the middle of this century, according to the medium variant of the 2010 Revision of World Population Prospects. Much of this increase is projected to come from the high-fertility countries, which comprise 39 countries in Africa, nine in Asia, six in Oceania and four in Latin America. The low variant, whose fertility remains half a child below that of the medium, produces a population that reaches 8.1 billion in 2050 and declines towards the second half of this century to reach 6.2 billion in 2100. For long-term trends the medium variant is taken as reference.
Projections
The medium-variant projection of 10.6 billion for 2050 is more certain than 15.8 billion for 2100 because people who will be 40 years and older in 2050 are already born. According to the medium variant, it will take 13 years to add the eighth billion, 18 years to add the ninth billion and 40 years to reach the tenth billion. According to the high variant, an additional billion would be added every 10 or 11 years for the rest of this century. Current fertility levels vary markedly among countries. Today, 42 per cent of the world’s population lives in low-fertility countries, that is, countries where women are not having enough children to ensure that, on average, each woman is replaced by a daughter who survives to the age of procreation. Another 40 per cent lives in intermediatefertility countries where each woman is having, on average, between 1 and 1.5 daughters, and the remaining 18 per cent lives in high-fertility countries where the average woman has more
than 1.5 daughters. High-fertility countries are mostly concentrated in Africa (39 out of the 55 countries in the continent have high fertility), but there are also nine in Asia, six in Oceania and four in Latin America. Low-fertility countries include all countries in Europe except Iceland Ireland, 19 out of the 51 in Asia, 14 out of the 39 in the Americas, two in Africa (Mauritius and Tunisia) and one in Oceania (Australia). Countries as varied as China, Brazil, Russia, Japan, Vietnam, Germany, Iran, Thailand and France, in order of population size, account for 75 per cent of the population living in lowfertility countries. Three-quarters of the population living in the intermediate-fertility countries is located in India, the United States of America, Indonesia,
ity countries are projected to peak before the end of the century, that of the high-fertility countries would continue to increase during the whole period. By the turn of the century, only the population of high-fertility countries would still be increasing. According to the medium variant, in 2095-2100, the populations of both the low-fertility countries and the intermediatefertility countries would be declining at a rate of approximately 0.3 per cent per year. In sharp contrast, the population of the high-fertility countries would still be increasing at a rate of 0.5 per cent per year. Despite this increase, average fertility in the low-fertility countries remains below replacement level over the whole projection period. Small differences in fertility levels sustained
However, because fertility is projected to increase over the projection period, by 2100 the proportion under 25 increases to 27 per cent and that of those aged 65 or over rises minimally to 28 per cent. Bangladesh, Mexico and Egypt, in order of population size; and Pakistan, Nigeria, the Philippines, Ethiopia, the Democratic Republic of the Congo, the United Republic of Tanzania, Sudan, Kenya, Uganda, Iraq, Afghanistan, Ghana, Yemen, Mozambique and Madagascar, in order of population size, account for 75 per cent of the population of high-fertility countries. The highest potential for future population growth is reported to be in high-fertility countries. Between 2011 and 2100, the medium variant projects that the population of the high-fertility countries would more than triple, passing from 1.2 billion to 4.2 billion. Whereas the populations of both the lowfertility countries and the intermediate-fertil-
over long periods have a major impact on the future population. Although the fertility of the intermediatefertility countries has dropped markedly since the late 1960s (from 5.3 children per woman to 2.6 children per woman in 2005-2010), there is considerable uncertainty about whether all of them will continue to reduce their fertility to below-replacement level. If fertility for this group of countries remains above replacement level, they might still experience a doubling of their population by 2100. The reduction of population would result from very deep reductions of fertility, to well below 1.5 children per woman. The values projected by the high variant
would be reached if fertility rose above replacement level while remaining generally below 2.5 children per woman. The values projected by the low variant would result from maintaining fertility well below 1.6 children per woman from 2010 to 2100. The persistence of very low levels of fertility in this group of countries would speed up population decline and population ageing, outcomes that may not be beyond the realm of possibility.
Aging
In 2005-2010, average life expectancy at birth was lowest among the high-fertility countries, at 56 years, mainly because many of them have generalized HIV/AIDS epidemics. Nevertheless, given the advances made in reducing the spread of the disease and the expansion of antiretroviral treatment, the projections assume a continued decline in mortality rates from HIV/AIDS as well as from other major causes of death. Therefore, the expectation of life among high-fertility countries rises to 69 years in 2045-2050 and to 77 in 2095-2100. Because declining fertility and increasing longevity lead to population ageing, population ageing is fastest in the low-fertility countries. Today, 11 per cent of the population of low-fertility countries is aged 65 years or over and just 34 per cent is under age 25. By 2050, according to the medium variant, 26 per cent of their population will be aged 65 or over and just 24 per cent will be below age 25. However, because fertility is projected to increase over the projection period, by 2100 the proportion under 25 increases to 27 per cent and that of those aged 65 or over rises minimally to 28 per cent. Population ageing is slower among the intermediate-fertility countries, but results in a 2100 population similar in age structure as that of the low-fertility countries. It is slowest among the high-fertility countries, which have still a very young population Courtesy: United Nations News Service
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Village recoups after generation is wiped out By HUSSEIN DIDO Their village is known as Manyatta Turkana because it is mainly inhabited by the Turkana community that bore the brunt of the Aids scourge leading to what health authorities said was decimation in numbers of the entire population. Within a spun of a few years hundreds of parents had died and many others were succumbing to the disease every day in their homes. As at now an age set is currently missing with only the aged occupying the entire village. The age set from 20-45 years old. It is believed this age set were active and overindulged in changaa drinking and unprotected sex. This happened from 1998 to 2009. The population of the age set had completely gone down with the old left behind to bring up their children. Isiolo district Aids surveillance and control officer, Mr Stephen Kirigia says the village had a population of about 2,500 people but by the time the initial impact of the disease was felt only a few hundred adults remained.
Problems
It was not only married couples who were affected, many young men and women barely out of childhood lost their lives. The result of this catastrophe was orphaned children who had lost one or both parents. The district health board was overwhelmed and could not assist the dying community as the scourge had no known cure and antiretroviral drugs were unheard of in the remote village. Poverty and luck of a livelihood in the near arid conditions was not the only problem they had to contend with, school was out of reach for most of them. All efforts to improve the situation seemed futile for the community as most non governmental organizations (NGOs) and community based organizations (CBOs) did not have enough funds to provide care and support to the ailing nor feed the children whose immediate need was food and shelter. Isiolo town previously not known to have street boys and girls now had a share of their own that littered every corner of the town. The problems faced by children in the manyatta Turkana and surrounding Livestock Marketing Division villages are directly linked to the poverty of their parents and endless abuse of local brews.
Support group
Eboli, Turkana for glittering, is the name of a support group of People Living with HIV/Aids. The group was started after HIV/Aids wiped a whole generation. It was realised then that if people did not come together to talk about the disease and find a way of saving themselves, nobody will be left. By coming together, these people living with Aids found hope and decided to get into activities that would help prolong their lives. The group has since then bought a farm where they have been growing vegetables, onions and tomatoes to ensure a balanced diet. Their biggest challenge has been the drought that hit the region depriving them of their source of livelihood and a balanced diet. “Some of the group members depend on each other for daily meals or skip a meal a day for them to survive. This has been a challenge because they are taking drugs on an empty stomach,” explains Mary Naukot, a widow living with Aids. Naukot has been a role model for women infected by HIV/Aids pandemic in Isiolo because she leads Eboli, a responsibility she took after being sacked from her job at Christian Children fund as a social worker.
The support the group also takes time to visit orphans in other centres. They have travelled as far as six kilometres away from Kulamawe where heart rending stories of misery and triumph experienced by the orphans began in early 1990s when the HIV/Aids epidemic started biting in Isiolo District. Other groups of people found in the area also include the Borana and Somali communities who were not as affected by the scourge compared to their neighbours.
Inhabitants
Most people living in this poverty stricken villages dropped out of the normal pastoralist life because pastoralism is no longer viable as a source of livelihood. Cattle rustling dealt a heavy blow on Women with their children outside their houses in Manyatta Turkana village. A whole them after they lost all their animals to generation in this village was wiped out in the mid 1980s and early 1990s to HIV and their heavily armed neighbours from the Aids. Pictures: Hussein Dido North. However, by the time the Ministry shaving several heads using one blade and maksponsors for the orphans and trying to provide of Health and other organisations realised the ing incisions in traditional body abrasions. to the less fortunate. real trauma affecting Manyatta Turkana within Charcoal burning and alcoholism play maEboli, consists of 26 initial members of the Livestock Marketing Division, the situation had jor roles as sources of income and contribute survivors in the Manyatta Turkana who have gone out of hand. adversely to practices such as alcoholism, convowed to sustain themselves and their famiNaukot is the secretary to the Eboli Women’s tributing to loose morals such as extramarital lies to escape the drudgery of poverty and disGroup. She has single-handedly been finding affairs and prostitution. ease that their village has been associated with. Naukot’s main concern is to sensitise the community to wholly approach issues of their Turkana girls and women are particularly social, economic and cultural concern. vulnerable to male predators from all commuShe wants the community to be empowered nities residing in Isiolo town who solicit sex as socially and economically through seminars, they stroll in hotels, hospitals and residential workshops and theatre just like their Borana and areas where they go to market charcoal. Samburu counterparts where leaders played a Hundreds of soldiers drawn from the armed leading role in the fight against HIV/Aids. forces far from their homes and families are They have been able to access antiretroviral also suspected to solicit sex from the hapless drugs from the district hospital for a few of the girls who are easy to lure because of the excruaffected. ciating poverty. Some materials in support and care for the Many more are employed as casual workorphaned children as well as care for the sick ers and maids in the town looking for sources and finances needed for mobilisation of widows of income for their families thus predisposing and widowers are being given by Population them to the fast spread of sexually transmitSurvey International. ted illnesses and HIV/Aids within the Turkana community. Surprisingly through drama, visits and The organisation provides water jerri cans, counselling members of the group have been mosquito nets and condoms. The support is able to penetrate the community that had hidprovided through the self-help group members den facts about the scourge. who educate and sensitise the community to The data they have collected has helped the respond positively to the challenges posed by Government and other development partners the scourge. to analyse and offer help to the affected as well The predicament facing the community as infected. leading to the high rate of HIV/Aids infec“Previously we relied on relief food from tions and which continue to haunt Naukot’s the Government, Action Aid Kenya and other efforts to educate them include traditional agencies but today we are able to grow our own binding norms and malpractices such as wife food which we are even selling to our neighinheritance, early marriages, teeth removing, bours,” says Naukot. polygamous marriages, funeral celebrations, — Mary Naukot, widow
Vulnerable
“Previously we relied on relief food from the Government, Action Aid Kenya and other agencies but today we are able to grow our own food which we are even selling to our neighbours.”
Harmful practices
ISSUE 043, July 1-15, 2011
11
Unfiltered, uninhibited…just the gruesome truth
Economic disempowerment a catalyst for violence By MARY NYAMONGO Stories abound in Kenya of men who either severely maim or kill their spouses for reasons that are often remain obscure. A study conducted by the World Bank in Kenya in 2005, published under the title “Collapsing Livelihoods and the Crisis of Masculinity in Rural Kenya,” established that as men become increasingly disenfranchised, they become more violent. During a focus group discussion as part of the study, an elderly woman made a profound observation. She noted that although wife beating has been in existence since time immemorial, it has traditionally been done in “‘moderation”. She expressed her shock at the violence that is meted against women today. The brutality had increased tremendously. This she blamed on the breakdown in social sanctions that restrained men from committing heinous crimes against their female partners.
Increased violence
Among the Luhya, for example, if a man caused any form of bleeding as a result of wife beating, he was liable to pay a fine to the wife’s family. Things have since changed. Violence against women has increased so much that many questions abound. When a woman loses life after enduring years of abuse, the main question most of us ask is: “Why did she stay on? Why did she wait for so long? Why didn’t she walk out when she still could?” What we do not realise is that most women persevere abuse in their homes, with the most commonly cited reason being “for the sake of the children”. The World Bank study cited above inversed the question on domestic violence and looked at the other side of gender. It raised the question: “Why do men abuse their female partners?” This article considers three key elements to gender-based violence: the changing context of marriage; changing status of women in society; and failure of male dominated livelihoods as key catalysts of violence.
Context of marriage
There have been significant changes in the form and content of marriage over the last 20 years, which are epitomised by the increasing come-we-stay unions. These unions pose challenges to the old age tradition of marriage. Indeed, as more young people find it difficult or needless to pay bridewealth, which is a common practice in most communities in Kenya, the more prevalent are come-we-stay unions. Furthermore, with increasing exposure and interaction among the youth, inter-marriages are becoming common, providing a basis for downplaying some of the cultural norms. What is becoming clear to social observers is that marriages that are not sanctioned through bridewealth or those of mixed nature may deny men the traditional rights over the women. Under these circumstances, the women are better placed to exercise and demand for their space compared to those for whom bridewealth has been paid.
One of the significant changes that have occurred overtime has been the role and place of women in their households and communities at large. Women have acquired a new sense of awareness, autonomy and feeling of self-worth as they become increasingly responsible for their households’ income or as major contributors to the household income.
Changed status
Indeed, women are beginning to demand their own space, which is an indication of a significant reduction in men’s power. Women are increasingly acquiring status that can no longer be ignored. It is notable that when women A man beats a woman along the Nyalenda Ring Road Street in Kisumu. Nobody seemed to get their own money they become care that the woman was being beaten nor came to her aid. Violence against woman has more assertive because they are been on the rise particularly where the man has no source of income. Inset: Men and women more aware of their pivotal role in demonstrating against gender based violence: Pictures: Reject Correspondent households and society. Women have been found to be more able to form and work and alcoholism. dustry, which are male dominated domains. in groups, which give them access to labour, When a man’s situation in life contradicts The disenfranchisement of men stems from information and credit. Through such groups the moral and social expectations and obligatheir socialisation, expectations of themselves women have been able to gain access to infortions, his identity and the perceptions of self in and of the community regarding what a man mation on family planning, investment, sucrelation to others becomes invalidated. It has should be. Although the main axis of patriarcession and health information that men may been noted that if the self-image does not corchal power is still the dominance of men, manot have access to. respond to the actual social reality an identity terial conditions have seriously undermined However, although women are increasingly crisis occurs. the basis of men to assert themselves. getting involved in generating household inThe KDHS study of 2003 (cited by the Men’s authority has come under threat and, come, men still control or wish to retain conWorld Bank study) showed that women with most importantly, so has their identity and trol of most household decisions on expenhigher status were more likely to report physisense of self-esteem. cal violence.
When a man’s situation in life contradicts the moral and social expectations and obligations, his identity and the perceptions of self in relation to others becomes invalidated. It has been noted that if the self-image does not correspond to the actual social reality an identity crisis occurs. diture. Violence may arise due to a woman’s relative independence and feelings of worthiness that may not augur well with the man’s ego and social value. It is presumed that as women gain more economic independence the levels of domestic violence increase to “put them in their rightful place.” The socio-economic changes that have occurred in the country over the last two decades have largely affected aspects of male domain including cash crop and livestock farming as well as formal and informal employment. For instance, the failure of cooperative societies has affected small-scale farmers pushing some of them to the margins of survival. This is illustrated by the collapse of the pyrethrum industry and the near collapse of the coffee in-
Although the conceptualisation of masculinity has changed, men — whether as husbands or partners to women — still hold onto the breadwinner role and their position as the heads of households. Men’s grip on these positions has much to do with patriarchy that is, the unequal power relationship between them and women. However, this grip is increasingly being challenged as women’s roles in their households expand and as they begin to command respect from their children and other subordinates. Lack of employment contributes to frustrations and desperation; especially among men who have no alternative means of livelihood or whose means of livelihood have collapsed. Psychological explanations exist for depression
Alcohol abuse
Thus, violence could be used to enforce gender hierarchies and particularly when men have a sense of powerlessness because their social position makes them feel ‘unsuccessful’ as men and thus leads to low self-esteem. There are indications that the consumption of alcohol intensifies following the decline in the main source of income for a community. This may be due to the frustration that emanates from a major economic shock and the inability to recoup — for instance, farmers who have not been paid their dues for long periods of time — which is channelled in other activities such as alcohol consumption. Men who find themselves idle after years of economic activity may take time to adjust to such changes. This could also lead to depression. The disempowerment of men seems to be occurring parallel to the empowerment of women. The focus of the Government and development agencies on the girl-child, the empowerment and emancipation of women and affirmative action, have largely sidelined men who are increasingly finding themselves dependent on the women who seem to have more opportunities for generating income. The disempowered man may, therefore, resort to violence to assert his authority in the household, a fact that may partly explain the high levels of physical and emotional violence in our society.
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Power of reading brought closer to the in By RUTH OMUKHANGO It is 10.00 am and on meeting Jack Ouma at the Community Library in Kianda Village in Kibera, one cannot fail to notice the pensive mood regardless of the calmness on his face. For 18-year-old Jack Ouma, a Form Four student at St Michael’s Secondary School within the slum, sitting in the Community Library on this particular morning means a lot. For the past two months, this has been a haven of peace for Ouma as he is not prepared to lose any opportunity to fully prepare for the examinations. He sits for more than five hours studying as well as copying notes from books borrowed from his classmates. Having been sent away from school due to fees arrears of KSh8,500 for both first and second terms, Ouma knows too well that he cannot afford to gamble with his education.
Determined
No matter what, he cannot fail his exams because his dream is to get to the University once he sits for the Kenya Certificate of Secondary Exams (KCSE) at the end of this year. “I am not sure whether I will make it back to school since my father has not been able to raise the money but I am committed to pass my exams by studying on my own,” explains Ouma, the second born in a family of five. The young man lives with his father who is a jua kali artisan within the slum. While Ouma has had to put up with his father, his mother is forced to live upcountry with his siblings due to the high cost of living in the city. Besides, there is not enough space for all of them within the one-roomed shack that his father can barely afford to pay rent for. According to Ouma, being out of school for this long has implications for students like him. First, he has to spend the night copying notes for all the subjects from his friends on a daily basis. He then returns the books to them very early in the morning before they go to school. “During the day, I have to read the notes and struggle to comprehend what my classmates were taught by carefully following what was written though it is not easy,” explains Ouma adding that in the event of any queries, he has to look around for assistance from college students and also borrow textbooks on the relevant subjects. Despite the challenges, he knows only too well that his situation would not have been better were it not for the Global Alliance for Africa Community Library situated next to his house in Kianda Village within the expansive slum.
Reading culture
Ouma represents the day-to-day lives of many children and youth living in the slums for whom this Library has provided a quiet reading place. “Reading from home is hectic because the environment is not conducive for study. I have no control over our neighbours’ activities as well as children playing outside the houses,” he observes. For many of the residents of Kianda Village and the surrounding, this Library whose motto is “knowledge is power” has not only provided space for learning but has promoted a reading culture among residents in the slum. According to Jackline Ombati, a librarian at the centre, the Library has opened its doors to community members who include primary and secondary school children, college students as well as adults at no charge. The Library opens daily from 9.00am to 8.00pm to allow children
coming from school in the evenings as well as college students to complete their homework. This comes as a realisation that some children are unable to do their homework due lack of electricity and lack of reading materials in their homes. The Library, therefore, extends its operation time to cater for them. On average, the Library accommodates about 60 people in a day, especially in the evening but this number almost doubles during the weekends and school holidays. However, Ombati says most of the clients in the evening are boys but the Library is working on a deliberate effort to negotiate with parents to allow the girls to use the facility. For most parents, their daughters’ security and safety is a key concern.
Book donations
She justifies girls’ absence from the Library during this time since they have to manage household chores as their parents are at the peak of their businesses. The time they finish, the Library is closed. “The Library is partitioned into two sections; children’s and general. Books are stocked according to ages to allow easy access,” explains Ombati. While most of the Library is stocked upstairs, the space downstairs is an empty room with chairs and tables to create reading space for many children. The Community Library was started in 2006 but became operational in 2010 with most book donations coming from the United States of America. According to Ombati, there is need to partner with local publishers and donors as well as corporates to support the acquisition of Kenyan books and materials that would benefit a majority of the population. The Library is run in partnership between the Kibera Community and the Global Alliance in Af-
rica, an international non-governmental organisation which partners with local NGOs, religious institutions and community-based organisations to design and implement innovative economic strengthening programmes. This is with the goal of enabling communities and households to provide sustainable care and support for orphans and other vulnerable children affected by HIV/Aids.
Genesis
According to Josephine Alooa, Programme Officer at the Global Alliance for Africa, the Library is purely owned by the community and geared towards benefiting the people of Kibera. It functions as an indigenous catalyst that encourages education, self-reliance and independence for all the orphans and vulnerable children in the area. Alooa says, the genesis of the community Library sprouted from a women’s group in 2000 which initially comprised of 38 women who called themselves St. Vincent-Jikaaze Women’s Group. Its aim was to provide women with microfinance loans to enable them run businesses. However, this group disintegrated due to lack of proper management skills. In 2004, a new group comprising of 18 women was established and required members to pay KSh50 for registration. The group’s mandate was to create a revolving fund that would empower women economically. This time round the group was registered and had the necessary documentation and proper bookkeeping. With the assistance of Global Alliance, who increased their kitty to enable members borrow some substantial amounts, the group was trained on basic management skills for six weeks in business management and basic accounting. Alooa, a founder member of the women’s group and the then secretary of the group recalled that the challenge for many of the women in the group was education for their children. Despite the advent of Free Primary Education,
“Reading from home is hectic because the environment is not conducive for study. I have no control over our neighbours’ activities as well as children playing outside the houses.” — Jack Ouma, a Form Four student at St Michael’s Secondary School
most mothers were still not able to provide the basic needs such as uniform, books as well as provide tuition money for their children. “As a result of this, the group received many book donations which prompted us to start a community Library that would benefit not only the members but the entire slum community,” explains Alooa. With financial support from Global Alliance in Africa, the group was able to identify and purchase as well as construct the community Library. Having been established in the middle of the slum, the group sought approval and received authorisation from the local administration. The Library was inaugurated in 2009 by then District Officer and fully operationalised in September 2010. Since its inception, the Library has embarked on making a difference in the lives of many children in Kibera and discouraged idleness among the young people who suffer from peer pressure.
Improvement
Alooa has received compliments from many parents whose children have done well and whose success is related to their having used the Library. She cites a case in last year’s Kenya Certificate of Secondary Examinations where a candidate from the slums scored a B+. The good result was attributed to her having used the facility. However, there are also challenges faced by this important institution. Currently the Library relies on donations. Most of the books are contributed by well-wishers in the United States. So far they have not received any local donations. It lacks textbooks containing Kenyan Syllabus that can be utilised by the children and students in the community. “If we had local books stocked in this Library, the number of children would be overwhelming, we look forward to receiving donations from the local community to meet the demand,” says Ombati. Since its inception, the Library has relied on donor funds for its operations. It has not been able to sustain itself in terms of paying for both professional and subordinate staff. There are also power surges in the slum area that have continued to interfere with electric-
ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
nformal settlement
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Sex and money determine campus relationships By HENRY KAHARA In the world today both men and women are working extra hard to be noticed. However, resources are limiting and for this reason many are involved in unproductive relationships. Institutions of Higher Learning are the most affected. Now students are warning their parents that they may either receive degrees or ‘PhDs’ (Pregnancy, HIV/Aids and Death). According to their views it is clear that many young men in campus usually target innocent first years, whom they have baptised freshas (fresh men). “Many men target innocent first years especially during the welcoming parties where they give those parties names like ponyoka na fresha, nyakua, kwatua, kwachua while some call the period ‘gold rush’,” says Margaret Wangu, a student at the University of Nairobi.
Stand firm
Wangu maintains that firm principles and advice A section of the Nairobi University main campus. from senior students who Students need to revise their relationships in are well behaved has made campus. Picture: Henry Kahara her stand firm and maintain expected standards. “I have learnt a lot from my friends some of whom her classmates in 2009 after being infected were messed in first year with the deadly virus. “Two years ago we burand after realising that they were lost decided ied one of my classmates who died of Aids to call it a day and have changed,” Wangu exyet she joined this university as a born again plains. Christian.” According to Leaky Kimani, the main reaThis has forced Catherine to develop a son for students to be involved in relationship hate attitude towards men and she says she in campus is money. Kimani speaks of how is not ready to start a relationship in the near female students in campus will always be in future. relationships with rich men. Although some people say it is natural to “You will never see a female student hookbe in a relationship, Dorcas Moraa terms these ing up with a man who does not have money relationships as the highest level of stupidity and if she does, the guy must be very bright in for they are mostly selfish. class,” Kimani explains. He further speaks of how some female students have brought down their boyfriends “Ladies will always be used by these men by double dealing them only to be caught red for less than three months and then they get handed. rid of them and will brag about it, referring “Some girls have sugar daddies. On Friday to some third and fourth year ladies as ‘take a good number of them will say they have gone away’ for they have used them,” explains home to their parents but that is not the case. Moraa, who observes that this has affected They spend better part of their weekends with many of the girls psychologically. those sugar daddies,” he explains. Billy Kuria (real name withheld) also agrees that campus relationships are not serious but based on sex and it all has to do A Fourth Year student who only identified with peer pressure and money. He says any herself as Catherine echoed Kimani’s sentiof the two can break for greener pastures. ments. “I don’t know what can be done for A first year student, Dan Kivuva says stustudents to realise that sex before marriage is dents mostly get involve in relationships so as not only evil but harmful to their bodies,” says to get rid of loneliness. Catherine. Kivuva who has a girlfriend outside camShe gives out a scenario that happened a pus says he too is not comfortable with her year before she joined campus. “A female stuand may get rid of her any time. He is not dent was killed because of love. Another stusure about getting another one in campus redent committed suicide at another University iterating that love issues are never planned. last year after learning that her boyfriend had “You cannot plan about being in a relationinfected her with HIV.” ship, you find yourself in one,” he says. Catherine recalls how they buried one of
Take advantage
From left: The Kibera community library in Kianda village that serves 60 people daily. Form four candidate Jack Ouma at the facility. The librarian Jackline Ombati arranging books. Pictures: Reject Correspondent ity supply in the Library making it impossible for the people to study longer during the night. Even though the Library would wish to extend its services until 10.00pm, many times, they are forced to close before that time due to the low power voltage which usually makes it impossible to operate. However, the management is optimistic about the future. There are plans to expand the Library to increase the reading space and see the estab-
lishment of a resource centre that would attract many people. The management also plans to equip the Library with the latest technology by acquiring computers in order to be able to provide Internet services and computer training services at a fee. The Library also hopes to expand to reach out to empower the youth with different talents by providing them with space to grow and showcase their talent.
Love
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Power of leading 4,000 slum women
Mama wa Kibera takes the leadership mantle from the grassroots By Omwa Ombara What does it take to lead women in the slums? That is only a question that can be answered by Immaculate Musya, popularly known as Mama Slum or Mama wa Kibera. Like all women in leadership positions Musya has harboured dreams, and they have been big dreams. Once upon a time she dreamt of being a civic leader. She had chosen a party of her choice, and garnered the numerical support that one needs when aiming for a political leadership position. However, her dreams were nipped in the bud by men who felt that it was not right for a woman to lead them in the expansive Kibera slum. “I too would have been a civic leader today had I not been subjected to one of the most painful and humiliating forms of physical violence,” Musya said during an interview in her one roomed house in Kibera’s Laini Saba. The 2007 December incident left her stark naked in public. She sustained injuries from panga cuts from 30 youths she alleged were hired by political rivals to rape and kill her. However, she looks at the incident as being part of the nature within Kenya’s political arena. The intimidating incident left her fearful of vying for a political position. The new Constitution looks at the political landscape by calling for two thirds majority of either gender. If tables were to be turned for Parliament to have two thirds of women and only one-third of men, some of the women in the slums would also qualify to be in the Cabinet.
Women’s front
It saddens Musya that although women have numerical voting strength on the ground, they remain in the oblivion as men go places. Her experience with attempting to get in civic leadership made her conclude that one does not have to be a politician to be a leader or to bring development to a needy lot. Musya’s track record as a leader rings a bell as far as South Africa where she recently visited to advice Soweto women on the strength and force of a united women’s front. “Kibera is a teacher. It teaches you a lot of things. If life has not given you all its lessons then Kibera will do it for you,” she says as we walk past hundreds of businesses. The familiar smell of omena, traditional vegetables like kunde, terere and cigarettes waft through the market giving one nostalgia of being in the rural areas. Notably majority of these traders are women. “This place was never really this busy. We had thousands of youth idling along the railway lines. Most of them were high on drugs, busaa and cannabis sativa and quite a number were up to no good,” Musya explains. She adds: “The young girls were mostly involved in prostitution or early sex and most of the young mothers would sit outside their doors gossiping or looking for trouble.”
Immaculate during a fund raising event for women in Kitui County. She consults the Prime Minister at a fund raising in Kibera. Pictures: Reject Correspondent and Courtesy ried to a mechanic who operated at the Police garage next to the Central Police Station where she lived with a relative. Today with three children and a growing family, Kivuva would leave her with KSh30 for the day’s budget. She would buy sukuma wiki for KSh5, one tomato for Sh2, an onion for KSh2 and cooking fat for KSh5. She would save KSh10 and contribute her share to a group of 20 neighbours. With KSh350 from the chama she bought shoes from Gikomba market and hawked them on her shoulders from door to door. This was the beginning of her fortunes. More and more women pooled together and as she broke them in zones of 50 out of the eight Kibera villages, she found her group had expanded to 4,000 women. However, as soon as the women’s development movement picked pace, politicians in the area developed cold feet and confronted her. “I told them we were not a political but a development group. I consulted my husband and he allowed me to go and meet the area MP,
Self help group
She claims politicians would take advantage of the desperate youth and hire them, for a pittance, to conduct violent campaigns. In 2001, Musya, 38, initiated the Tushauriane Self-Help Group. Now known as Pamoja Tushauriane, a project that has changed the lives of the women in the slums from Makina through Siranga to Soweto and the other four villages. With savings of KSh10 daily, she joined other women in her plot and after only four months held a harambee that raised KSh3 million. This money was divided among the women equally and everybody got about KSh6,000 to set up a business of her own. However, it has not always been smooth sailing for Musya. When aged 18 in 1994 she travelled from her home to look for a job, after her Form Four examinations. She had a B plain in KCSE. As fate would have it, she got mar-
“Today, our women’s business group has 14,800 members. We have several groups among them; The Voice of the Slum Woman funded by the G10 and FIDA Kenya, Lang’ata Orange Democrats. We meet to discuss issues that affect us as women.” — Immaculate Musya
Raila Odinga at his office. I needed to explain to him that we would not interfere with the LDP campaigns,” Musya explains. “For the first time in my life, I stepped on a red carpet. I was close to power. I sweated and shook in fear,” recalls Musya. Raila noticed that she was not comfortable and asked her not to fear him as he was just a human being. “He said he had a guest and needed me to mobilise Kibera women to support the new Constitution. God has plans. I did not know that I could ever greet a minister.” That was the beginning of mixed fortunes for Musya. The rally succeeded and the Orange side emerged the winners over the Banana side during the 2005 Referendum. Soon after the women felt they were a great force and nominated her to stand as a councillor.
Violent youth
The male politicians used some of the female members in the group to trick her into a women’s meeting at one of the salons. “We had just bought two cases of sodas and some biscuits when a group of 30 violent youth ambushed us in the salon and demanded that I remove my clothes and underwear so they could rape me. As my fellow women screamed, they cut us with pangas and tore my clothes,” recalls Musya. She adds: “I removed my underwear and threw it at the man who had cut my forehead. I screamed in pain and told him to go ahead and rape me. I think he got scared because he heard the women say I had cursed him and he would go blind.” Musya says the man apologized and confessed that the group had been hired at KSh20,000 by a rival politician from Kibera. The women reported the matter at the Kilimani Police Station but the case never reached court as the police kept saying investigations were going on. One of the women who was in the group later died in hospital. Musya was demoralised. “I was afraid but still mustered courage to stand for elections. Pushed by thousands of women, we embarked on serious campaigns in 2007. But my party, ODM, let me down. Someone else got the nomination certificate a week before elections! I was instead sent to be the Eastern Province Regional Co-coordinator. I believe this was to appease me,” Musya observes. She adds: “There was a by-election and my husband insisted that I should not vie. I left politics and continued with my business.”
But all that today is water under the bridge. “Today, our women’s business group has 14,800 members. We have several groups among them; The Voice of the Slum Woman funded by the G10 and FIDA Kenya, Lang’ata Orange Democrats. We meet to discuss issues that affect us as women.” Most slum women are single mothers or divorced. Life has not given them an opportunity to fulfil their potential. When they reach Standard Three, they drop out but we have confronted these challenges by getting women to rent two rooms, one for the parents and the other for the children. This controls the rate of sexual activity among the youth and gives them some privacy.
Pride
“I am very proud of being a woman. If it were not for the Kenyan women we could not have had the new Constitution.” She observes: “This time round, we will not rally behind a man. Men always want women to vote for them but they rarely stand behind a woman. The woman is the life-giver, the care taker and must take control of the community through leadership.” She observes: “That is why behind every successful man is a woman but not behind every successful woman is there a man. I cannot be recognised because I live in the slums yet these slum women see me as their role model.” Musya adds: “Women who want to be leaders must come down to our level at the grassroots so that they get serious support.” She believes that women are good for politics because a woman will not torch another woman’s house or run around with a machete. “The secret to halting the violence in 2012 is to vote for women. They hold the key to a peaceful society,” Musya reiterates. She is grateful to her role model and mentor, the late Mrs Njeru, her former headmistress at Mbooni Girls’ Secondary School. Njeru adopted Musya after her father’s death and educated her and her younger sister. Musya hopes to vie as a women’s leader in 2012.
ISSUE 043, July 1-15, 2011
Adverse climate change leaves communities vulnerable to conflict By EKUWAM ADOU Resource based conflicts over dwindling pasture and water looms large, as effects of ravaging debilitating drought continue to be felt across the country. A report by Ministry of Northern Kenya and Other Arid Lands has warned of renewed wave of incessant inter-community conflict as the warring pastoral communities compete for fast diminishing pasture and water. Frequent cattle rustling and raids have been reported in Koom and Duma rangelands where massive livestock from Wajir, Isiolo, Merti and Samburu East are currently concentrated competing for fast depleting pasture and water. According to the May 2011 drought monitoring bulletin prepared by Isiolo Arid Land Resource Management Project (ALRMP), the massive migration of thousands of livestock as far as Marsabit, Moyale and North Eastern has put pressure on grazing land in Merti area in Isiolo, and in the process brewing hostility and suspicion from host communities.
Killings
Tens of people have been killed and hundreds of livestock stolen in recent times in what has been perceived as organised raids to scare away the migrating herdsmen. In the first incident, two herdsmen were shot dead at Loruko area, around Buffalo Springs National Reserves while looking after their livestock. Two days later a middle-aged man was killed at Lesosia area, the border between Samburu East and Isiolo districts, where currently thousands of livestock are concentrated raising suspicion and mistrust among different communities currently co-existing at the vast dry grasslands. Another notable killings was that of a teenager at Kona Mbaya area in the outskirts of Isiolo town. The place currently swarms with hundreds of camels from neighbouring Wajir District. The report notes that livestock concentration remained in the traditional dry season grazing range-land of Hawaye, Koom, Duma, and Urura with high livestock mortality increase in Merti and Sericho divisions. Pasture is completely depleted in this dry season grazing areas, following pressure on land due to massive livestock migration. The pastoral livelihood of Merti, Cherab, Oldonyiro and Sericho are the most affected.
Depleting resources
Access to pasture in terms of average distance covered by herdsmen, worsened from an average of about 30 to 32 kilometres in April to 32 mainly in the dry season rangelands of Duma and Urura of Merti districts. Water availability for both human and livestock consumption remains a challenge as most rivers mainly Ewaso Nyiro, Isiolo and Bisanadi have dried up due to the effects of the ongoing drought. Acute water shortage has extended from the grazing fields to urban areas especially Isiolo town and environs where over 70,000 residents are reeling from chronic water shortages. Isiolo River which is the main source of water has dried up following a combination of factors ranging from the current drought situation to diversion of upstream water by commercial farmers. Boreholes and shallow wells remain major sources of water for herdsmen and their livestock in the grazing fields, although distance, low yields, and increased depth remained a challenge. Water access for livestock was a major problem with the distance covered ranging from as high as 26-30 kilometres one way for cattle and 60 kilometres for camels especially in Duma and Urura rangelands. Distances of access to water for domestic use also increased over the month to an average of
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Unfiltered, uninhibited…just the gruesome truth
More mobile schools to buffer nomadic pupils By HUSSEIN DIDO The current drought situation has forced the Government to put up more mobile schools for nomadic pastoral communities in order to avert further drop outs. The drought situation that is getting worse has greatly affected the learning environment for school going children who move with their parents in search of pasture and water. Some parents have been forced to leave their children with relatives in trading centres while others have been taken out of school completely. In Upper Eastern, most of the mobile schools have recorded high enrolment rates unlike before when the schools remain deserted due to availability of pasture and water.
Samburu morans during a peace meeting held at Ngaremara area in Isiolo. Turkana women from Daaba location follow the proceedings during the meeting. The communities have been fighting over scarce water and pasture. Pictures: Ekuwam Adou 16 kilometres covered in about 10 hours, mostly in Cherab division. “Shallow wells depths increased to an average of 50-60 feet requiring five to 10 persons on average. The highest was Hawaye wells that required 10 persons to draw water,” read part of the report. On livestock trade which is the main economic mainstay, the prices of cattle has adversely been affected dropping to an average of KSh9,000 from KSh15,000 last month, translating to 31 percent depreciation. The price reduction subsequently led to body weight loss.
Pricing
On the contrary, the prices of goats increased during the same period to an average of KSh1,898 (April 2011), to KSh1,837 translating to 3.3 percent increase. The slight price increases was attributed to low supply to the market with most goats having migrated to far grazing fields in search of pasture and water. The highest goat price was recorded in central division at KSh2,400 and the lowest at Sericho Division at KSh1,000. The report paints a gloomy picture of the drought situation in the area exacerbated further by spiralling commodity prices which has eroded consumers’ purchasing power. It offers rafts of recommendations to mitigate the crisis. Top on the table include peace building and conflict resolution interventions mainly in Merti, Kinna and central divisions to forestall imminent inter-community clashes over diminishing resources.
Shallow wells depths increased to an average of 50-60 feet requiring five to 10 persons on average. The highest was Hawaye wells that required 10 persons to draw water.
More schools
Provincial administration and district peace committees should be supported to hold consultative inter-community peace meetings and encourage the herders to establish grazing committees to coordinate grazing patterns. Drilling of boreholes mostly in Ilaat, Dololo, Dakiye and Hawaye to provide water to thousands of pastoralists currently concentrated in this dry season grazing areas. The water situation currently is dire and the authorities need to move in immediately before communities fight over scarce available water. The report recommends increased provisions of emergency supplementary foods to vulnerable groups. Food for assets formerly referred as “food for work” programme should be hastened and expanded to cover vulnerable groups. Recently, killings were reported during a fierce gun battle between warring pastoral communities in what was linked to competition over dwindling pasture and water at Koom grazing field border point between Isiolo and Samburu district.
Gun battles
Among the dead were six suspected raiders and four herders caught between the ensuing gun battle between security forces and suspected cattle rustlers who had unsuccessfully tried to steal livestock. The raiders had earlier attacked the village at koom area at 5am last week killing four on the spot and leaving two injured. Isiolo OCPD Augustine Nthumbi said the six raiders were shot dead by police and Kenya Police reserves some distance away from the village where they engaged other in a fierce fire exchange with the raiders for more than 5 hours. He said four of the herders killed were locals and were trying to repulse armed Samburu raiders at the dawn attack. Nthumbi added that seven of the raiders sustained bullet wound injuries while two of the locals were also injured and admitted at Isiolo district hospital. The Isiolo police boss confirmed that five of the raiders have been arrested at Laisamis area by criminal Investigation department and have been handed over to Marsabit police station.
The current drought situation is a pointer for establishment of more mobile schools in the arid and semi arid areas to ensure that children do not drop out as result of the drought. In the Upper Eastern region, the government has established mobile schools. This is to ensure that children in the region access education as parents migrate from one region to another in search of water and pasture for their livestock. According to Upper Eastern Regional Commissioner, Isaiah Nakoru, the Government has established 11 mobile schools with enrolment of over 1,400 pupils with six nonformal education centres in Marsabit South district. This comes amid influx and mass exodus of herders in search of pasture and water for their livestock as drought continues to worsen in the region. Nakoru cited Kalacha Primary School in Maikona District that has 710 pupils with its first year candidates excelling well in the last year’s KCPE exams. He said out of 35 pupils who sat for their examination in the mobile school, 32 managed to join secondary school. Nakoru was speaking at Kalacha Primary School during a tour of the region when he assessed enrolment rates in mobile schools. He advised: “Students must uphold discipline, dignity and good reputation by desisting from engaging in vices that may deter their performance in education.”
Encourage enrolment
Nakoru called on schools’ management to put more emphasis on enrolment of children to schools adding that education was the only benefit and investment one can be proud of. Isiolo District Education Officer Dominic Opec assured that appropriate measures will be put in place to ensure better results and performance in the KCPE and KCSE examination in the larger Isiolo district. He said: “The district had a mean score of 4.355 in Kenya Certificate of Secondary Education last year slightly above the 4.204 national score.” The enrolment rate in public primary schools went up from 1, 149, 902 in 2002 to 1, 485, 619 this year in the region while in Isiolo it stood at 18,405. In the secondary sub-sector in the province, the enrolment rate stands at 297, 755 while Isiolo has 860 students currently following the opening of more day secondary schools and provision of free secondary education.
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Populations remain threatened by food and water insecurity By KIGONDU NDAVANO Her skin is dry and nearly white in colour, all a sign of tough life and suffering. It is clear that even the tree she is using to shield herself from the unbearable sun is offering little comfort. Struggling to clear her throat to respond to greetings from a team of Kenya Red Cross officials visiting the village in response to the water crisis, Bomea Ibrahim, 70, realises that her throat is too dry to even talk. With great effort she stands up and staggers towards a Manyatta made of grass which she enters and emerges moments later carrying a half empty cup of water. Before Bomea reaches the dry old tree trunk she uses as a seat, one of her grandchildren quickly walks towards stretching her hand, in essence begging for the water in the cup. The frail old woman manages to sip the liquid which she considers to be water, just enough to clear her throat and answer the greetings from the visitors. Back to her trunk again, she lets the grandchild sip the water as another one arrives and joins the queue for the water. In turns she allows the two children sip the water until the cup is empty.
Hopeful
This is clear indication that she is left with no more water to quench her thirst, cook or use for the basics of cleansing required among Muslims before prayers. She goes inside her hut and returns with an empty blue plastic container. Another elderly woman, Sudi Hato, who could be 70 years old on the other hand quietly sits on the doorstep of her structure with three empty plastic containers in front of her. She has been waiting since morning when word came that the Red Cross would be bringing water to the village. Her hope that she will finally get the rare commodity is perhaps the reason she had persevered the long hours. The Red Cross truck has to come from Mombasa, more than 300 kilometres away. It then fetches water from a pipeline at Witu village transports it to Panda Nguo, 30 kilometres inside virgin bushes where the road is rough and fully of huge gullies. For a village where the only type of locomotion seen are the Red Cross vehicles, when the sound of a powerful engine is heard from a distance, women and children break into song and dance. Here in Panda Nguo village, the wells dried almost over a year ago with all what had been stored in the rain fed cement containers having been exhausted. Water has become a very rare commodity which can only be found if one travels 25 kilometres away. Here one will find an open pan where women first throw stones to wild animals such as monkeys and baboons before quickly
fetching the muddy chalk like fluid. Sometimes the women need to use their clothes — mainly kanga waist cloth to filter the water just in case the mud in the water is too much and too heavy to carry home together with the water.
Food supply
But it is not the water alone, the food stores are also running empty and appeals to the Government and to the Red Cross have been received from all over. The story of water and food shortages is not restricted to Witu alone. It is the same in the South Coast in parts of Kwale towards Lunga Lunga. Various Lamu Islands such as Faza, Kiunga, Manda, Pate and Kizingitini have not been spared either. Coast regional coordinator of Kenya Red Cross, Mohammed Mahdi, while releasing a major appeal for food and water in the area produced statistics of the situation on the ground. The report notes that the effects of the La Nina as forecast by the Meteorological Department in Kenya in July 2010 are being experienced in several parts of Coast Province. “There have been reports of livestock deaths, acute food shortage and increased migration by pastoralist communities due to depletion of pasture and water for livestock,” explains Mahdi. As a result of the drought, school dropouts have increased significantly with young men abandoning learning to become migrant herders. The effect on farmers will have a compounded impact as they have not recovered from the effects of the 2009-2010 drought. Indicates the report: “Distance to water sources has increased due to earlier than normal drying of temporary water sources.”
Long distance
The average distance in the livestock livelihood zone range from 10-15 kilometres but are longer in Bofu area of Langobaya division in Magarini District reaching 25 kilometres. In the mixed farming zones the average distance to water sources range from five to 10 kilometres compared to the normal two to six kilometres. Migration of cattle from Tana River District to Langobaya and the northern part of Marafa Divisions has been noted. Mahdi says that distances to pasture had increased from the normal five to 15 kilometres and the now little available pasture may not last long. “The general water quality has deteriorated and water borne diseases are now commonly being reported. The food insecure people are 19,400 while those who are totally vulnerable are 45,000,” explained Mahdi. In Kilifi, the worst hit areas are Ng’ombeni, Mwarakaya and Pingilikani with a total of 43,335 (13.39 percent) people out of 323,609 facing starvation in the district. Areas like Chonyi Division that had been the grain basket have since seen the
A woman waits for relief water at a dry jabia. A resident uses clothes to filter water at Panda Nguo, the only open water pan that is now drying. Women fetch water from the pan in Tana Delta. Access to clean water for domestic use has been a challenge in this region. Pictures: Kigondu Ndavano situation reversed and are now food insecure. Here the food insecure population is 280,274. Those who are vulnerable are 42,335 while the totally vulnerable 323,609. The problem has been compounded by the government withdrawing the school feeding projects. In Kinango, previously 38 schools had school feeding program. However, due to food insecurity in the district this figure has since increased to 77 resulting in an increase in school attendance by 87 percent. In Tana River North area 41,273 people out of a population of 82,545 people are in need of food and water supplies while 24,000 out of 68,000 in Tana River zones will have to be is-
“The general water quality has deteriorated and water borne diseases are now commonly being reported. The food insecure people are 19,400 while those who are totally vulnerable are 45,000.” — Mohammed Mahdi
Interventions put in place for vulnerable groups By KIGONDU NDAVANO Pregnant and lactating mothers will be targeted in the supplementary feeding programme. Under this section there will be access to high nutritional value foods including Corn Soy Blend/CSB Unimix aimed at not only preventing malnutrition and anaemia in these groups. It is expected that this will enable the lactating mothers to continue with breastfeeding in the face of hunger and starvation that communities are facing.
In the selection of beneficiaries, the Kenya Red Cross has indicated that “even if food is available, chronically food insecure households who do not have sufficient access to food should be assisted in a timely manner”. These are the households that have limited capacity to grow their own food or purchase sufficient food hence the intervention here will include households vulnerable to food security including, but not limited to, households badly affected by HIV/Aids. Also to be included are people caring for
orphans and vulnerable children, the disabled and elderly as well as female and child-headed households. The targeted areas will be thoroughly assessed and beneficiary selection criteria applied. To ensure fairness, verifications will be in public and household levels. In a bid to strengthen the selection criteria of all vulnerable groups, the Kenya Red Cross intends to engage and consult with other humanitarian organisations, stakeholders and the government.
sued with food and water supplies if life has to continue normally. Analysing pastures and animal body condition, the report noted that with the rains bellowing normal during this short rainy season, there is regeneration of annual grass in both marginal mixed and pastoral livelihood zones. With normal or negligible rainfall in all zones, most farmers who planted have seen their crops wilting due to water stress, a clear indication that there will be no crop.
Mitigation
Some of the activities being undertaken to address some of the crisis include support peace building initiatives within the district, water trucking to ensure that operations continue in schools, hospitals and at domestic levels. Plans to supply water purifiers and promote hygiene in education in the various affected communities are already under way and medical supplies have already started for Bura area to enable medical personnel handle cases before referral. Mahdi says due to inadequate water, pasture conflict has been reported in Bura Tana North District between two communities and alert of livestock diseases outbreak given. The biggest crisis in Lamu District is the escalating of conflict between pastoralists and farmers in the area and food shortages on Pate Island as djabia (rain water fed underground reservoirs) reserves are running out fast. Livestock from Somalia have moved towards mangai area creating fear of disease outbreaks due to poor vaccination coverage in the country. There is need for proper water and forage management or supply of supplementary feeding with maize bran and animal off-take programme. The Boni areas are all dry with a few ponds existing far in the bush. The biggest crisis will be food as the communities live from hand to mouth. While the Red Cross has been providing the most vulnerable rural communities with relief food aid under the auspices of the Government and the World Food Programme, more interventions are needed to ensure that the communities not targeted but vulnerable are given a lifeline.
ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
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Borehole brings hope to desperate community By HUSSEIN DIDO For as long as she can remember, every morning 40-year-old Magret Sampale has been walking far in search of water. She has been taking a 30 kilometre walk to and from Kipsing River in Isiolo County to search for the scarce but vital commodity. Sampale’s struggle replicates that of the women in the rural areas in Isiolo and Marsabit County who spend so much of their time fetching water for domestic use. “We always walk tens of kilometres with our donkeys in search of water especially at this time when drought is getting worse,” explains Sampale. However, the walk has been cut short and the women now have a well that has been constructed for them through a water project by the Kenya Red Cross Society.
Water project
According to Sampale construction of the Kawalash Water Project will go a long way in alleviating the suffering that the women in the area have been going through. Sampale was speaking during handing over of Kawalash water catchment project to the communities, a project financed by the International Committee of Red Cross in conjunction with the Kenya Red cross Isiolo branch. The women present said the water project worth KSh6 million will benefit more than 2,000 families living around Kawalash in Oldonyiro Division, Isiolo District. The project comes amid myriad of challenges faced by women in the rural areas especially when the drought is biting hard. The committee chairman James Lempantu says the project is aimed at alleviating suffering among the communities and will cushion them against the ravaging drought. He said unlike before when they fetched
water from contaminated water pans that are located very far from their homes, they will now access clean water easily within the shortest time possible.
Accessibility
Lempantu called upon the communities to abide by the set rules and conserve the environment. “The residents will be contributing KSh2 per jerri can and KSh2 per cow or camels that will be used towards maintenance and other costs,” explained Lempantu. The well has two water tanks with a capacity of holding 200,000 litres that were built on the rock. Gutters were placed 200 meters away with additional water troughs and taps fitted to ensure that both people and livestock get access to clean water. The Kenya Red Cross in partnership with International Committee of Red Cross (ICRC) had carried out an assessment four months ago to determine the use of Kawalash rock to collect rain water and store it for use during dry spell. Area Councillor Peter Lekurtut hailed the Kenya Red Cross for its generous contribution and support towards initiating the project. “The provision of water to the community will go a long way in alleviating suffering among the residents,” he said. The community committees have been trained on how to manage the wells and water rationing should there be persistent drought.
Community support
Kenya Red Cross officials were led by the Upper Eastern regional chairman Tache Bonsa who said the committees will facilitate continuity of the project and ensure sustainability. He said the Kenya Red Cross Society under its water and sanitation department had initiated several water projects in Upper Eastern as well as other parts of arid land to cushion the communi-
Magret Sampile and her daughter fetch water at the newly commissioned water rock. Below: the water project funded by the International Committee of the Red Cross. Pictures: Hussein Dido ties against the drought. “The society has diverted from only intervening in the crisis but is also engaged in supporting the communities in areas of need,” Bonsa said. The Councillor appealed to the Government to assist the community by taking in their remaining livestock as the drought situation was getting worse.
Community initiative to prevent communicable diseases By NZINGA MUASYA It is every household’s dream to have clean and safe drinking water. This dream, however, remains a mirage for many households following widespread contamination of water sources like rivers, boreholes and wells. Due to consumption of contaminated water, majority of people in rural settings suffer from waterborne diseases such as cholera, typhoid, bilharzia and dysentery. Quite often, these preventable diseases claim a lot of lives. Residents of Mutomo District have had to contend with acute water scarcity year in, year out. Water which is fetched in dams and seasonal rivers has its contamination at unprecedented levels. Locals often fetch water that has been turned green by algae for domestic use with devastating consequences.
Cholera outbreak
In 2009 when there was a cholera outbreak in parts of Kitui Central and Mutomo districts, 17 people died while another 1,000 were hospitalised in a period of two weeks. Today, Mutomo residents have a reason to smile after Lifestraw Family Filters recently provided them with portable water filters to prevent water borne diseases. Kenya Red Cross Society, Kitui branch is carrying out the exercise mainly in Mathima and Kanziku locations in Mutomo District. The co-coordinator of KRCS Kitui branch Mr Augustine Kiswii says that the lifestraw water filters are being distributed to school going children and others at household level in a programme dubbed Community Based Water Filter and Hygiene promotion. “We are targeting 3,750 pupils and 6,750
households in both locations,” explains Kiswii, adding that the programme will be going on until April next year. The filters come into two types, a small one that pupils hang on their necks and a bigger one meant for households. The smaller filter has a lifespan of three years and costs KSh600 per piece while the household type has a lifespan of five years and costs KSh2,000 per piece.
Distribution
Kambua Mwania, a Standard Seven pupil said: “We have been trained on how to use them, we were told that it eliminates water borne diseases and I was surprised to learn that the filter even eliminates bad smell in water.” The initiative is a joint partnership between Coca-Cola Company in Denmark and the Danish Red Cross. Coca-Cola is giving out the filters that are distributed to the Kenya Red Cross through their Danish counterparts. Speaking at Mathima Chief ’s camp during the distribution exercise of the water filters, Betty Kramer, a representative of the Danish Red Cross underscored the importance of water filters noting that they reduce waterborne diseases significantly. The household lifestraw can filter at least 1,000 litres of water per day removing 99.9 per cent of waterborne bacteria. It also filters 99.9 per cent of waterborne protozoan cysts and reduces water turbidity by filtering particles and sludge. The filters are a big boost in health promotion as many contend that they cannot trade their gadgets for anything. Josephine Katemi, from Kiviu sub-location has benefited from the training and got herself the household filter. She
Kanziku primary school pupils practise how to use the water filters to drink water. Ms Josephine Katemi explains to the women how the household filter works. Robert Musya with his newly acquired filter. The Danish Red Cross representative Betty Kramer during the distribution exercise. Pictures: Nzinga Muasya is now among the few locals training others on how to use the filters for maximum benefits. “These filters are playing a significant role in our lives, we fetch water from rivers and wells dug along seasonal rivers which mostly is muddy and produces foul odour,” Katemi told Reject. She was among 60 people from Kiviu sub-
location who were trained on how to use the filters. They have now embarked on the process of training others. “We want the gospel to spread far and wide so that we can be safe and healthy,” she says. Mutomo deputy public health officer Stephen Mbeni advised area residents to maintain home and personal hygiene.
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Housing remains a big challenge in the slums By JAMES MBAKA The World Population Day is set for July 11. This is a United Nations event that is marked globally and seeks to increase people’s awareness on various population issues such as the importance of family planning, including gender equality, poverty, maternal health and human rights. It also looks at the issue of housing and settlement. As this day draws to a close, we find Kenya grappling with a myriad of challenges including providing affordable and decent housing to its population. Poor housing, hazardous environmental conditions coupled with lack of meaningful hygiene pose a serious impediment for the Government’s efforts to offer better and healthy housing to its citizens. Year in year out, efforts to eradicate slums through ambitious programmes by the Government and the private sector have been hampered by ignorance among slum dwellers, majority of who live below the poverty line. Most of the dwellers here are casual labourers working at different construction sites around the city. They leave home at dawn and only return with the darkness. Kibera, arguably Kenya and Africa’s largest informal settlement has over 250,000 people according to the 2009 census figures but reportedly houses over 2.5 million people. The slum dwellers have persistently opposed plans by the Government to upgrade it. Those opposed to improved settlement cite high costs of living and increased rent rates as reasons for their objection. Despite the fact that the slum is populated
Goods packaged for low income class By JAMES MBAKA In Kibera just like in many other slums within the city goods are packaged in small quantities which are affordable by the residents in this place. For instance as opposed to other formal settlements, a kilogramme of sugar is repackaged and sold in quarters. Agnes Nyambura who owns a kiosk in the heart of Kibera says most of her customers are low income earners who earn peanuts from construction or manual work around the neighbouring Lang’ata and Upper Hill areas. “Majority cannot afford anything above half a kilo and I have to repackage everything to affordable quantities,” explains Nyambura who has operated the kiosk for a decade. A neighbouring kiosk owner, Muthoni, says goods are not sold on credit here not unless you know somebody well beyond just being a customer. This is because many customers are not on permanent employment and can relocate any time without clearing debts owed. “Others run away with our money when they are sacked from where they work especially without notice,” she explains. Muthoni recalls a time when she lost over KSh500 to a neighbour who was a regular customer. “I did not know when she moved.”
with the dirtiest environmental conditions, residents in the settlement live in de javu. They say they will die defending their habitation. John Obwoge has lived in Kibera since he was born and has no plans of relocating from the slum. He has been married for the last 12 years. He lives in a single room with his four children. “Our houses An aerial view of Kibera slum that are made of mud and they are is neighbouring the new slum very crowded. I live here with upgrading housing project. Below: my family,” he says. Jared Nyamosi making mandazi Obwoge has lived with his at a makeshift kiosk in Kibera. children in this room withHousing remains a challenge for slum out any problems. However, residents. Unemployment is forcing he regrets that such habitamajority of the educated urban tions are a den for moral youth to seek alternative sources of decadency among children. income to make ends meet. Pictures: “The toilets and bathCorrespondent and James Mbaka rooms are far away from the houses and people just bath of the poor where one in the open mainly at night,” Obwoge explains, finds entrenched povadding this poses a security threat. erty and enduring hope. Houses within the slum are small and highly The slums are like congested with vague partitions of bed sheets self-contained cities, but that divide the bed from the living area, leaving they operate with little nothing to the imagination. official recognition or assistance. That is because slums hardly fall under the formal or official city plans. Like the majority of other Kibera residents, There is a key difference between slums in Obwoge and his family have little access to toiAfrica and slums in developed countries. In the lets. They used to make do by sneaking into a United States today, for instance, people use nearby outhouse which belongs to someone the word ‘slum’ to refer to deteriorating inner else. Hell broke loose when the owner put up a city tenements or abandoned row house neighfence to keep intruders at bay leaving this bulk bourhoods. However, in the developing world of residents with no choice of where to empty ‘slums’ are the crowded illegal settlements. their bowels. The wooden door of the privy reeks with almost a pungent smell and the stains evident Squatters or slum lords put up shacks on on it leave no doubt that this is a urinal area. land that no one else wants to develop. The preAnd a muddy swamp of plastic bags obstructs carious locations and poor quality construction the entrance to the ‘latrine’. It is a classic picture make these settlements vulnerable to disasters embodiment of what is preferably referred to as like diseases, natural calamities and insecurity. ‘flying toilets’. However, some slums occupy land that Slums across the world pose serious health is vulnerable leading to the occupants being dangers and in some cases many are just deathevicted, sometimes brutally. beds. Throughout the developing world slums Obwoge notes: “They demolish the shanties, are giant cesspools. Sanitation systems are saying that they want to build better houses nearly absent. Human waste leaches into drinksince the shanties are a source of insecurity. ing water and contaminates the food they eat. It They do not give you notice.” carries typhoid and other diseases that can be Almost always, the residents simply rebuild deadly especially to young children. or relocate and the slums often grow even larger Despite the dangers posed by such habitathan before. tions, residents and the Governments alike are According to a recent UN-HABITAT report lethargic in wiping out such settlements many slums are booming for reasons that many counof which have sprawled within the cities. tries share crises, like poverty and war, which push people from the countryside into cities. “When rural migrants arrive in cities, they While the private sector may be ready to inlack decent and affordable housing and often vest in upgrading such settlements to habitable join the ranks of slum dwellers as most cities human conditions, slum dwellers continually are not preparing for future urban growth,” the oppose such moves as political activism. report reads. Recently a move by the Government to deThe study warns that if nations don’t enmolish all the makeshifts in Kibera and construct ultra-modern housing units was met with overwhelming resistance from not only the residents but political leader as well. While residents claimed that this was a scheme hatched to deny poor urban dwellers an opportunity to live conveniently within the city, some leaders took to the stage arguing the plan was skewed with political underlining. According to the United Nations, for the first time in history, half the earth’s population will live in cities in the next few years. An estimated one billion people in third world countries live in slums. Visiting Kibera slums, gives one the opportunity to go deep inside the burgeoning cities
Sanitation
Illegal developments
Opposition
When rural migrants arrive in cities, they lack decent and affordable housing and often join the ranks of slum dwellers as most cities are not preparing for future urban growth.
sure affordable urban housing and deal with burgeoning urban poverty, social unrest will increase worldwide pointing that most slum dwellers are mainly young people. For many people, slums like these are places of horrible desperation but to the locals they are places with a strong sense of togetherness. “People feel at home when they are in the slums; there is a sense of belonging,” explains Obwoge. Many of them were born there and have nowhere to call home. For them, the slums are their home, and the neighbours their brothers and sisters. Life in such places is simple and easily manageable. Other dwellers say that given the proximity of the slums to the cities, transport costs are minimal as many opt to walk to and from work.
Affordable living
Jamas Oluoch, a resident of Kibera works as a clerk with the Ministry of Education but unlike many of his colleagues he has opted to stay at Kibera. “Life in Nairobi has become unbearable with the rising prices, living in Kibera saves me an extra coin,” he says. Oluoch only pays KSh2,000 as rent for his single room after the landlord hiked the rent, otherwise two years ago it was only KSh800. Perhaps this explains why some slum dwellers have protested plans by the government to upgrade and rebuild Kibera. “We don’t want to be moved. We don’t want the new houses. We feel comfortable here,” says Obwoge. In 2009 about 300 families were moved into the new settlement popularly known as Kibera slum upgrading project where tenants occupying the 632 houses are supposed to pay Sh1,000 monthly, which includes Sh500 for water and electricity, but many simply don’t pay. However, while moving into the new houses looked like a good thing, for others it was like jumping from the frying pan into the fire. With the new houses came costs such as high electricity and water bills. Goods also sold within the upgraded houses were not as cheap as those sold within the slums. In May several families were kicked out of the new houses for nonpayment of rent. Officials say the slum residents are consuming too much power which they are not able to pay for and is costing the tax payer a lot of money.
ISSUE 043, July 1-15, 2011
Inquiry to shed light on reproductive health services By FLORENCE SIPALLA Reproductive health has not always been on the national agenda as a priority issue. More so, public participation in policy formulation has been non-existent. However, this is bound to change as the Kenya National Commission on Human Rights (KNCHR) launched a National Public Inquiry on Sexual and Reproductive Health that will run until end of July. Three KNHCR commissioners and three reproductive health experts will listen to members of the public in Nairobi, Mombasa, Kitale, Kisumu, Embu and Garissa. The inquiry will provide the public with a forum to air their complaints on reproductive health issues touching on the quality of the services, level of access and violations they may have experienced while trying to access them. This forum will produce quantitative and qualitative data that will inform policy as well as highlight the gaps and propose on how they can be eliminated. The culpability of medical staff in contributing to women receiving poor health services will also be gauged through the inquiry. “These include unnecessary medical procedures being performed on women, poor quality medical advice, poor treatment of women with reproductive and/or maternity complications, complicity of doctors and medical staff in cases of medical negligence and detention of women after delivery for nonFlorence Simbiri- payment of delivery fees,” said Florence Jaoko, KNHCR chair Simbiri-Jaoko, KNHCR chair.
Survey
According to the Kenya Service Provision Assessment Survey 2010 that was released last month, only 43 percent of women give birth at health facilities countrywide. In the same study, group discussions with women who had been to health facilities indicated they experienced abuse in the hands of doctors and nurses. This indicates that 57 percent of women deliver at home, probably with the help of a traditional birth attendant. According to the Kenya initiative of Women Deliver, 21 women die daily while giving life. The 57 percent of women stand the risk of losing their lives from maternal related causes as they do not access help from skilled health professionals. Maternity facilities such as Pumwani have often being singled out for offering poor services. According to Elisa Slattery, Regional Director for Africa at the Centre for Reproductive Rights (CRR), there have been four taskforces to look into the services offered at the facility. “None of these reports have been made public,” says Slattery. Upon completion of the inquiry later this year, KNHCR intends to share with the public the emerging recommendations. “The anticipated report will signal a change from the trend of keeping information from the public,” observes Slattery. The new Constitution guarantees freedom to information, a right that Kenyans will want to see realised in the new dispensation.
Beliefs
The women who access reproductive health services at facilities that are faith based may also fail to access comprehensive health care services. This is because offering information on contraceptives, for example, might be against their beliefs. According to a woman cited in the CRR report Failure to Deliver the personal beliefs of health care professionals in some institutions could form a barrier to access. She said that some health care workers are anti-condoms even though they have a VCT within their facilities. “They didn’t suggest different kinds of contraception there. The nurse said a person with a coil (IUD) would conceive every month and every month would be aborting.” With the new Constitution, international instruments such as the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa which enshrines reproductive rights for women will become Kenyan law. Popularly known as the Maputo Protocol, the Charter pushes for the right of women to control their fertility, choose contraception methods and get education on family planning methods. It also advocates for safe abortion where the law of the land sanctions. The KNHCR plans to publicly issue a report on the inquiry at the end of the process. This should translate to better health services which in turn would lead to less maternal deaths. This would have a concomitant effect on improving the quality of life for children who thrive under the care of their mothers and contribute to the nation living up to the promises in the health pillar of Vision 2030 as well as working towards achieving Millennium Development Goals Four and Five.
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An ignorant population reels in HIV infections
By DIANA WANYONYI Lack of education and knowledge in some parts of Coastal Kenya has contributed to the spread of HIV/Aids among women. Despite efforts by the Government to introduce free education to primary schools and within the adults education sector (elimu ya ngumbaru), the degree of illiteracy and ignorance among adults in Kimbunga Location, Mwakirunge Constituency is high and alarming. This ignorance and lack of awareness is leading to high levels of infections with the disease spreading from mother to child to midwives as well as husbands or wives or any relative who attends to the sick without being protected. Mwakirunge is 17 kilometres from Mombasa town, an area that is characterised by low rainfall that is characteristic of Kisauni County.
HIV status
Majority of the residents of Kimbunga are living in poverty and they lack access to social amenities such as hospitals, schools and infrastructure. The situation has forced some of the women to engage as traditional midwives. Most of the men are also jobless. A midwife of over 20 years, Kachimbi Kazungu is willing to know her HIV status after being sensitised by doctors from Baobab Trust and Haller Foundation, a mobile clinic that visits Kimbunga once a week to offer medical services. “I was not aware of this disease and how it spreads. I have been attending to clients bare handed. I do not know if I am infected but my health is deteriorating with each passing day as I also keep coughing with bouts of malaria”. Though Kahindi is not a trained midwife, she decided to be a traditional birth attendant after seeing most women over bleeding and others die as they wait to deliver yet the area lacks hospitals. “I think I inherited this gift from my grandmother when I was a girl. I am not perfect but many women rely on me. In a day I attend to between six to eight mothers. I do not get much as some pay me as little as KSh50 while others do not pay at all,” she explains. Another midwife, Mishi Hassan, who has been a TBA for six years and is a mother of three, tested HIV positive
last month. Mish fears she may have contracted the virus from the women she was helping give birth. “I was shocked when the doctor told me that I was HIV/AIDS positive. I thought it is not treatable but I have now learnt to take life positively,” says Mishi. She adds: “To save other TBAs who are illiterate, I want to start a campaign to sensitise them on the dangers of the scourge as a way of reducing the Midwives: Mishi Hassan (left), Kachimbi Kazungu spread of HIV/AIDS.” and Sidi Ngolo. Many of the traditional birth Another TBA who has attendants have been helping women deliver been on the job for five without taking precaution to chances of being years, Sidi Ngolo is also infected with HIV. Below: A patient is assisted to living with the virus. She hospital on a bicycle. Pictures: Diana Wanyonyi knew of her status a month ago after she was tested by a doctor from the Baobab Survey (KAIS) 7.4 percent of Kenyan Clinic when they visited the area. adults aged 15-64 are infected with HIV, “After being educated by the doctors the virus that causes Aids. In 2007, a reabout the disease, I realised that I con- search by KAIS indicates that a higher tracted the virus when I was attending proportion being women between the to mothers who were giving birth,” ex- ages 15-64 (8.7 percent) than men (5.6 plains Ngolo, clenching and unclench- percent) are infected with HIV. ing her fingers. “I was not aware of it. I have been faithful to my husband and he Women are most affected than men has also been faithful to me,” she said. with six percent compared to two percent consecutively until age 35 after which the “I have now started a campaign to ratio of male to female infections starts stop my fellow traditional midwives in to approach 1 to 1. A higher proportion aiding mothers who want to give birth of Kenyans aged between 30-34 are curas a way of reducing the spread of HIV/ rently infected with HIV than in any Aids in the community,” Ngolo reveals other age category. her agenda. “I know most of them live According to Dr Lennox Mbaga of in poverty but they should go to hospital Baobab Trust and Haller Foundation, even if it is far.” almost five percent in Mwakirunge locaLife in Kimbunga area is not easy for tion is infected with the virus. The most the women with lack of access to skilled affected are women. health care and facilities. “As an organisation we need to do “We are facing a lot of challenges due massive campaign on the spread of HIV/ to lack of hospitals as scores of people Aids to the residents in order to reduce have been infected by HIV. I don’t know infections,” said Mbaga. how many are in danger of being infectEffort to get comments from Kisauni ed. Some TBAs have come for advice MP, Mr Ali Hassan Joho were fruitless as on what to do with the scourge,” says he was said to be out of the country. Katana. He adds: “We urged the docThe Government and policy maktors to educate us more on HIV/Aids ers have been urged to step in to make so as to avoid stigmatization of infected sure the area has a fully-fledged hospital people.” and forums on HIV/Aids to educate the According to Kenya Aids Indicator residents.
Affected
Safety campaigns
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Unfiltered, uninhibited…just the gruesome truth
ISSUE 043, July 1-15, 2011
Men must be involved in reproductive health issues By KEN NDAMBU The Ministry of Medical Services is planning to come up with comprehensive programmes to bring men on board on reproductive health and family planning issues as a way of curbing population increase. According to the Minister, Professor Anyang Nyong’o although the country’s total fertility rate has declined between 2003 and 2008, the decline was more significant among women in the urban areas showing 12 percent decline than in rural areas which had only four percent decline. “This is an indicator that knowledge of family planning is nearly universal with 95 percent of all women and 97 percent of all men aged between 14 and 49 knowing at least only one method of family planning — condom” observed Nyong’o.
Mortality
The Minister was speaking in Kitui during the launch of the Centre of Excellence for Reproductive Health and Family Planning, a facility of United States Agency for International (USAID) in partnership with Kenya Medical Training Centre (KMTC). He said despite efforts to curb population increase, statistics show that high maternal morbidity and mortality still persist particularly those associated with obstetric emergencies
and related diseases. “Reproductive health and family planning services play a big role for health improvement of women and the Centre of Excellence will fill the gaps in the current unmet needs over the next ten years,” said Nyongo’. He reiterated that the Centre will strive to help meet estimated 3.9 million fewer unintended pregnancies, 1.2 million fewer abortions and approximately 14,000 maternal deaths would be averted and over 430,000 child deaths.
More facilities
Nyong’o who was accompanied by Water and Irrigation Minister, Ms Charity Ngilu said 15,000 applicants who applied for admission in Kenya Medical Training Colleges last year were left out due to inadequate facilities. Out of 20,000 applicants who qualified for training for various courses, only 5,000 will get admission as the facilities cannot cater for the high number of students seeking admission in the institutions. “Unless we look forward and increase the training institutions and facilities to transform with the modern technology, the country will continue to experience shortage of medical personnel,” Nyong’o reiterated. He said the pilot Centre of Excellence unit will support the Kenya Medical Training Centre (KMTC) in the identification, development, and application of innovative teaching
methodologies in areas of reproductive health and family planning service delivery. “The Centre will enable the KMTC to support and enhance the training of nurses and clinical medicine students in public, private and faith-based organizations,” Nyong’o observed. He added that through the Centre, the only one of its type in the country will partner with KMTC to revise its reproductive health Medical Services Minister Professor Anyang Nyongo’ and family planning curopens the Centre of Excellence for Reproductive Health riculum to transform to a and Family Planning at Kitui Medical Training Centre as format appropriate for eWater and Irrigation Minister Charity Ngilu and USAID learning module. Representative Maria Flascisco look on. Ngilu, on the other Picture: Ken Ndambu hand said there was need clinic will help carry out capacity building of to strengthen reproductive health and family planning services to protect the KMTC faculty to use-learning methodologies in the delivery of reproductive health and the lives of women. “Many expectant mothers die at home in family planning modules. She said the project is being implemented the hands of traditional birth attendants hence there is need to take reproductive health ser- by IntraHealth International with partners including African Medical and Research Foundavices to rural areas,” said Ngilu. USAID Representative Maria Flascisco said tion (AMREF), Deloitte, Management Sciences the reproductive health and family planning for Health and Training Resources Group.
Siamese twins leave Coast residents baffled By ELIZABETH AWUOR It is a happening that is leaving many tongues wagging and equally many mouths tongue tied. The birth of many sets of conjoined twins, otherwise known as Siamese twins in Coast Province is bringing in more questions than answers. A few months after a 20-year-old mother from Tiwi in South Coast gave birth to male triplets with two being conjoined, most residents of the area are still yearning for a clear explanation as to what might be triggering the birth of such twins. Even after doctors had been quoted in the media speculating that the births could be attributed to nutrition deficiency during pregnancy, almost every one has his/her own explanation. The resident’s explanations range from blessings, curses, misuse of contraceptives, biological disorders, witchcraft and failure by expectant mothers to pray to God for healthy children.
Survival
Nyota Phunga Mrema, the father of conjoined twins born in April says the children are a gift from God. “I did not expect conjoined children but I look at the twins as a gift from God,” explains Mrema. Just like Mrema’s Siamese twins, the other set of conjoined twins Aziza and Amina (also from South Coast) who were joined from the chest to the abdomen did not survive a surgery aimed at separating them. In February 2004 another set of conjoined twins who were joined from the chest to the hips died at the Coast General Hospital’s Intensive Care Unit. While many cultural and religious explanations are being given as reasons to the many twins at the Coast, doctors equally remain baffled. A paediatrician at the Coast General Hospital, Dr Twahir Hemed, attributes prevalence of Siamese twins in the area to a biological phenomenon related to nutrition and environmen-
tal changes. “Nobody is sure of what could be catalysing the birth of conjoined twins in the area but it is assumed that just like other abnormalities it could be driven by poor nutrition,” observes Hemed. He is of the opinion that there are medical specialists who would want to establish the birth of many Siamese twins in the region but says no research is being undertaken at Coast General Hospital.
Prayers
Ibrahim Hassan, a tutor in Mombasa also links the births of conjoined twins to biological disorders but is quick to add that expectant mothers should pray every now and then for God to help them go through the pregnancy successfully that they may give birth to normal children. “Any pregnant mother should make it a duty to pray for her unborn child’s good health and good development. This can help avert some complications experienced at birth as well as having children with health complications,” advices Ibrahim. Ibrahim who is a bachelor says he would like to have twins when married but not conjoined. According to Hemed, conjoined twins occur only with genetically identical twins. Genetically identical twins occur when a single fertilised egg separates and divides and separates into two foetuses, the children share the same genetic code. A trader in Ukunda, Mohammed Simba, says the repeat birth of conjoined twins within less than one year is a sign that the community is cursed. Simba wonders why the twins are not able to live beyond two days. “We should seek God’s forgiveness for our sins because these are signs that we have wronged him,” he observes. Amina Mwatime shares a different view. She admits the births were not common before but believes it is nature taking its course.
“It is strange to have two sets of conjoined twins born in this area in less than one year but that does not make it a curse,” she asserts. However, the thinking to the reason for conjoined twins are wide and varied. Khamis Ahmed thinks the development of conjoined twins could be as a result of misuse of contraceptives by women. He says some women use contraceptives without seeking advice from health practitioners on what is best for them. Conjoined twins occur in the same way but for some reaThe main entrance of the Coast Provincial Hospital son the embryo starts to divide where a high prevalence of Siamese twins are into identical twins, but fails to reported. Below: a set of Siamese twins in hospital. divide completely. The babies Pictures: Correspondent develop, but share some internal organs and skin. However, there the chest mostly share a heart and cannot easily is no clear explanation as to why the embryo be separated depending on how closely they are fails to divide completely. joined. This type of twins is about 40 percent of According to information posted on the Uniall conjoined cases. versity of Maryland’s website, there are many Omphalopagus is another type of conjoined types of conjoined twins. The most common twins who are connected from the breast bone classification is based on the body parts shared. to the waist. They may share a liver, gastrointesHowever, according to information by the tinal or genitor-urinary function but rarely share University of Maryland Medical Centre, apa heart. They form about 33 percent of all the proximately 35 percent of the twins born alive conjoined cases. live only one day and of those that do survive 70 The other type of conjoined twins is called percent are girls even though more conjoined craniophagus which are joined from the cranitwins in the womb are males. um or head. This is a rare type and make about For example, Thoracopagus twins, joined by only two per cent of all the conjoined cases.
ISSUE 043, July 1-15, 2011
Unbearable burden as women die to give life
Data
In spite of the significant 1987 conference, according to the Kenya Health and Demographic Health Survey (KDHS 1998) the maternal mortality rates stood at a staggering 590 deaths per 100,000 live births. In the recent KDHS of 2008/2009, the maternal mortality rate still stood at a high of 488 deaths per 100,000 live births. KDHS was designed to provide data to monitor the population and health situation in Kenya as a follow-up of the 1989, 1993, and 1998 Kenya DHS surveys. A study conducted by the World Health Organisation (WHO), UNICEF and the World Bank revealed that Kenya is one of eight countries in the world that failed to lower its maternal mortality rates between 1990 and 2008. Many countries signatory to the 2000 Millennium Declaration that established eight goals famously dubbed the Millennium Development Goals (MDG’s) are rushing to honor their commitment to cut maternal deaths by 75 percent by 2015. Although Asian countries were in an analogous position with many African countries, the Mothers’ Index revealed that the former has made tremendous steps ahead of their counterpart and are now considered success stories. According to Tanya Weinberg Director, Media and Communications, Save the Children “One major difference between Africa and Asia relates to the use of family planning. Contraceptive prevalence rates in West Africa and parts of Southern Africa are very low, while they are growing in South and Southeast Asia.”
Expectancy
Weinberg further adds that “This has huge influence on maternal mortality and lifetime risk. Mothers are too young, their births are too closely spaced, they have more children, which is taxing and risky as many still deliver at home or with less than adequate care.” The state of maternal health in Kenya as is the case in other African countries is as a result of a myriad of issues, part of this is due to lack of access to basic health care. According to Prof Joseph Karanja, a gynaecologist in Nairobi, “More than 56 percent of pregnant women deliver at home. In case of complications as happens in child birth, the mother will most likely die due to lack of immediate medical attention.” The Mothers’ Index report further showed that less than half - 48 percent- of births in Af-
Women opt for home deliveries By Alice Wangechi As the world struggles to meet Millennium Development Goals targets, some women are making it look like a far fetched dream. Goal number five that specifically targets reducing of maternal deaths by three quarters could remain a pipe dream if women who prefer to give birth at home stick to their guns. Reports emerging indicate that 40 percent of women in Murang’a County deliver in their homes even as the Government grapples to realise the Vision 2030 in the health sector. Murang’a District Hospital Medical Superintendent Charles Kigo says that this has consequently raised mortality rates of mothers and infants while also increasing chances of infections among children under five.
By Joyce Chimbi Although it is in Nairobi where the international community begun a major global campaign to reduce maternal mortality, over two decades later the country is still reeling from a staggering maternal mortality rate. In a recent report released by Save the Children, one in every 38 pregnant women will die due to childbirth or pregnancy related complications. Revealed in the report dubbed Mother’s Index, Kenya is one of the most unsafe countries for a mother to deliver. The landmark Safe Motherhood Conference held in 1987 in Nairobi was aimed at raising awareness in regard to the high number of women who were dying every year. According to Dr Patrick Kagurusi of the Regional Centre for Quality Health Care: “Maternal Mortality refers to the death of a woman due to pregnancy and child birth related causes. The rate of maternal mortality is higher in the regions where the population growth rates are highest.” As was revealed by the 2010 population Census, Kenya‘s population is growing by one million every year.
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Unfiltered, uninhibited…just the gruesome truth
Maternity fee
Murang’a East District Chairlady of Maendeleo ya Wanawake Jecintah Ng’ang’a holds a new born child at the maternity ward in Murang’a District General Hospital while chatting with new mothers at the hospital. Pictures: Alice Wangechi rica are attended by skilled health professionals in general. In Asia, two out of three - 66 percent -will give birth in the presence of a skilled health professional. Similarly, only one in five women in Africa - 22 percent- are using some form of modern contraception, compared to three out of five -66 percent- of Asian women. In Kenya, the unmet need for contraceptive has remained at 24 percent since 1998 according to the KDHS reports that have been released since. Ironically, Kenya was the first Sub Saharan Africa country to adopt family planning as a national policy. Voluntary Family planning clinics had been established in Nairobi and Mombasa in as early as 1952. National family planning program established through the National Family Planning Policy (NFPP) of 1967 was such a progressive step that by the late 1980s, this program was heralded as an African success story.
Interventions
Later in 1984, the first population policy Population Policy Guidelines - was developed which involved an update of the NFPP. This was long before another landmark conference held in Cairo 1994 dubbed the International Conference on Population and Development. Initially the Government was more concerned with meeting demographic targets but after the conference, there was an emphasis on improving people’s quality of life. Various interventions shifted from targeting women as a focal point for controlling population, to look into their reproductive health as well as that of their partners. ICPD+5 was therefore flagged off that demanded that all signatories to the Cairo conference introduce male involvement in reproductive health as a strategy to improve the reproductive health of men and more significantly by doing so, improve the reproductive health of women who solely bore the responsibility of men’s sexual behavior. “One would therefore reasonably inquire ‘How is population related to maternal mortality and can maternal mortality be reduced when the population is growing uncontrollably?’” poses Dr Kagurusi.
To which he says: “The two are related and maternal mortality may never be controlled if population growth rates are not checked. SubSaharan Africa is home to the highest maternal mortality rates in the world. The rates range from 500-1500 deaths per 100,000 live births per year.” In addition, Dr Kagurusi explains that although the population of Sub-Saharan Africa is large and exponentially growing, it is also young. More than 50 percent of the population is below 15 years. “Tying all these together implies that the women who give birth are young and give birth frequently which exposes them to death risk factors like excessive bleeding, obstructed (failed labor), hypertensive diseases of pregnancies and infections”. Due to the direct impact that family planning has on improving maternal health, the Government has prepared the Contraceptive Security Strategy 2007-2012 with the aim of ensuring “uninterrupted and affordable supply of contraceptives”.
Measures
Further, the Government launched a Maternal and Newborn Health (MNH) Road Map in August 2010 whose goal is to accelerate the reduction of maternal and newborn morbidity and mortality towards the achievement of MDGs. The National MNH Road Map offers a “new and revitalised dimension of efforts of all stakeholders. It provides a framework for building strategic partnerships for increased investment in maternal and newborn health at both institutional and program levels. Implementation will take a phases approach and the final reporting year will be 2015.” Kenya has a long way to go in the less than four years if the country is to cut maternal mortality by at least 75 percent, nevertheless, the strategies put in place if effectively and efficiently implemented will go a long way in saving lives.
Kigo attributed this to the high percentage to soaring poverty levels in some areas of the county where women were unable to raise maternity fees to meet their medical bills. He said that the Government was carrying out a sensitisation programme to educate women on the need to give birth in hospitals and the risks involved in home based deliveries. Kigo noted that in collaboration with the Ministry of Gender, Children and Social Development, the hospital waives bills for in patients who are unable to meet their medical bills and encouraged expectant mothers to visit hospitals for ante and post-natal checkups. Area Maendeleo ya Wanawake chairlady Jecintah Ng’ang’a congratulated women who had delivered in the facility for raising population in the area saying it was disheartening to find women in some parts of Central Province women being paid to deliver children. She said that population levels in the region had been dwindling in the recent past due to over-indulgence in alcohol by adults yet women of reproductive age needed to be appreciated and encouraged to deliver more children. Elsewhere in Murang’a South District, about 250 women deliver babies outside hospital every month with a maternal mortality rate of about three in every six months. According to area District Public Health Officer Charles Shighuli, the most affected areas are Kambiti, Kangangu and Makuyu where health facilities are distanced.
Sensitisation
Shighuli said the department has embarked on a sensitisation programme to educate women not to put too much trust in midwives. “A large number of women who give birth at home are rushed to the hospital when it is too late after developing complications that midwives are unable to handle,” observed Shighuli. He said the department was now orienting midwives on how to give motherly advice to expectant mothers and refer them to hospital for delivery. “We are also training community health workers on maternal and child health to counsel mothers on the need to have individual birth plans for adequate delivery preparedness,” said Shighuli. He added: “They are also being trained on danger signs during pregnancy to be able to identify symptoms of complications and miscarriages so that they can refer patients to health facilities. He urged expectant mothers to visit health facilities as soon as they start experiencing labour pains saying that the waiver system is available to those unable to pay their bills. After delivery, mothers are provided with warm showers and hot drinks for more comfort in health facilities at only KSh300. Shighuli challenged area leaders to lobby for construction of more dispensaries in the affected areas to help alleviate cases of home deliveries.
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Unfiltered, uninhibited…just the gruesome truth
ISSUE 043, July 1-15, 2011
Kenya casts a dark future over MDGs By HENRY OWINO A mother lost her infant at Suba Island immediately after delivery due to lack of a health facility. Mrs Rose Anyango, aged 27 had to take a boat ride from Suba to Homa Bay mainland, 50 kilometres away to deliver her second born child who succumbed to breathing complications. Anyango delivered on her way to Homa Bay Hospital inside the boat while sailing. This case is just one of many unique challenges facing mothers and children in accessing health facilities. Situations such as Anyango’s clearly depict that dreams by the Kenyan Government through the Ministry of Health to make available all health facilities efficiently and effectively utilised by 2015 as per the Abuja Declaration on Millennium Development Goals (MDGs) may best be achieved only in paper work. This was said in a workshop between Health and Science Journalists, organised by Rachel Jones, Director of Knight International Journalism Fellowship in Kenya. The one week workshop drew experts from children health care in the country, Kenya Alliance of Health and Science Reporters (KAHSR) and Kenya Medical Research Institute (KEMRI) in conjunction with Wellcome Trust Research Programme at Kenyatta National Hospital.
Understaffed
According to Dr John Wachira, a paediatrician at Gertrude Children’s Hospital, currently Kenya has only 260 trained paediatricians who are qualified to handle children from age zero hours to 18 years. “Out of these doctors, 170 are based in Nairobi while the remaining 90 are scattered across the remaining 46 counties,” Wachira reiterated. He added: “Some of these doctors work in private hospitals making it even more expensive and difficult for the ordinary woman to access and pay for their services. Most of the counties have no doctors and are only served by nurses.” Wachira said at the Intensive Care Unit (ICU), there are four paediatricians for East Africa based at Gertrude Children’s Hospital. “This is evidence of how our public health facilities are under staffed and only a few women can afford private hospital charges since quality is expensive,” said Mrs Winnie Lichuma, a Commissioner of Kenya National Commission on Human Rights (KNCHR). Lichuma reiterated that at the Millennium Summit in September 2000, 189 Member States in the largest gathering of world leaders in history adopted the UN Millennium Declaration. The Millennium Development Goals (MDGs) are the world’s time-bound and quantified targets for addressing extreme poverty in its many dimensions which include income, poverty, hunger, disease, lack of adequate shelter and exclusion while promoting gender equality, education and environmental sustainability. They also address basic human rights to health, education, shelter and security.
She said most aspects that touch on children’s needs and ailments must be managed by good policies and national responses for example — immunisation that has done well.
Abuja Declaration
African governments, Kenya included met in 2001 in Abuja, Nigeria to emphasise on the same and made commitments to honour them in what has since then been known as ‘2001 Abuja Declaration’ of allocating 15 per cent of national budgets towards health spending. When they reviewed it in an eight point draft declaration on maternal and child health, African leaders meeting at the 15th Ordinary Session of the African Union in Kampala committed to strengthening health systems particularly primary health care, training community health workers and waiving user fees for pregnant mothers and children under five years. Now the renewed commitment from African governments towards maternal and child health as Africa’s leading health development organisation and a voice of vulnerable communities across the continent, Kenyans lauded this commitment but today it seems the dreams were just theories on big paperwork documents. Today people specifically women are urging African governments especially to deliver on these promises to ensure no more mothers and newborns die needlessly. It is only 3 years left to the proposed year of action (Health Care-MDG by 2015) but things seem not to be on the right direction. Ten years have now elapsed since this declaration was made and in Kenya very little progress has so far been achieved more so to child health. Although the ‘ring-fencing’ policy on the budget expenditure on health projects has helped improve maternal health to some extent, a lot still needs to be done if the dream is to be realised by 2015.
Ring fencing
Ring fencing is the case where-by the agreed allocations to a particular sector is never reduced no matter what happens to the revenue. While other sectors may experience cuts in budgets, the ‘ring-fencing’ protects the health, education and planning sectors from such cuts. However, this has never been adhered to
Priority
Policy
Lichuma reiterated this was passed in order to commit nations to reduce extreme poverty and setting out a series of time-bound targets with a deadline of 2015 in what is known as the Millennium Development Goals. “In fact the main aim of the Summit was to entrust member states to a new global partnership to help the world’s poorest countries to meet the set goals, otherwise if it could just have been said by word of mouth, no African country would have been involved or taken them seriously,” Lichuma explained. She added that in the new constitution dispensation, health services and facilities are given prominence at the County levels. She added: “It is hoped that this will be child friendly and they will respect all the children’s rights.” However, Lichuma said at the national level, the referral system must give clear indication on how this will be achieved in terms of children since it is not clear at the constitution.
by the previous and current Finance and Planning Ministries in Kenya. The year 20102011 budget expenditure ending next month (early June) allocation to health care was far beyond the required percentage. Kenyans are eagerly waiting for the 2011-2012 Budget to see if the Government is committed to move the country towards the MDGs goalposts. An obstetrician and gynaecologist at KeFrom top: A pediatric nurse attends to an infant in ICU at nyatta National HosGertrude Hospital. Dr John Wachira displays breathing pital, Dr Anne Kihara, says the successful equipment used in saving an infants life. Pictures: Henry Owino implementation of the MDG-based Economic need be.” Recovery Strategy has seen immunisation coverDr Karuga Kimani of Newborn and Child age rise to 72 percent in 2007. About 68 percent Survival Situation in Kenya at Kenyatta Nationof under-five children years are also receiving al Hospital said there should be a five year cambed nets to protect them against mosquitoes that paign to accelerate achievement of the MDG facilitate the spread of malaria. Four and Five. He said his department has a Kihara added that the Government has invision that no child under the age of five years creased the coverage on immunisation to over dies from preventable causes in Kenya. 80 percent and facilities have improved in pubKimani observed: “The campaign challenglic health centres and drugs accessibility. es the business as usual approach and calls for However, children’s health care is a nightbreakthroughs in child survival and have idenmare that needs urgent intervention by both tified five priority change objectives that must health ministries even if it means importing be achieved among them making it everyone more paediatricians into the country. campaign initiative.” “Child health and maternal health is an unbreakable bond. You cannot separate one from the other. We cannot emphasise materKimani added: “Most threats to child surnal health without stressing on neonatal care vival are preventable and amenable to available, as the two go together,” said Kihara. She addsimple, cost effective interventions. A set of ed: “That is why all nurses and midwives rehigh impact preventive and curative intervenquire basic paediatric protocols to avoid more tions has been shown to collectively reduce deaths.” child mortality by up to 63 percent.” According to Dr Fred Were, professor of Most of these interventions are low cost and Newborn Medicine and National Chairman do not require any new technologies beyond of The Kenya Paediatric Association (KPA) in what is already available in Kenya. However Kenya alone, there are 111,000 annual deaths, lack of Government commitment and political 45,000 of them die before the end of the first will is a major hindrance. month of life and 66,000 more will not reach “I wish our politicians were forecast more on their fifth birthday. the MDGs especially the health sector. Mothers Were ascertained that proportion of births could be now delivering babies free of charge in attended by skilled health personnel — as a any public hospital and more funds allocated to proxy indicator for Maternal Mortality Rate health as Abuja Declaration puts it,” reiterated MMR — increased from 42 percent in 2003 to Kimani. 56 percent by 2007. He said this was immediA Senior Research Fellow with the Kemriately two years after the MDGs commitment in Welcome Trust Research Programme, Dr Mike Abuja, Nigeria. English, urged the Government of Kenya to get He expressed his fears that since then the serious with the health care MDGs and look graph has been constant and stagnant showing again at the words of Ban Ki Moon, the United no signs of improvement instead going back to Nations Secretary General that “The 2015 target its worse position. date for the MDGs is a goalpost that cannot be Were said: “Maternal requires skilled attenmoved… the clock is ticking louder every day”. dance at childbirth with emergency obstetric Unless action is taken urgently on child and neonatal care and neonatal resuscitation if health, Kenya future generation is bleak.
“Child health and maternal health is an unbreakable bond. You cannot separate one from the other. We cannot emphasise maternal health without stressing on neonatal care as the two go together.” — Dr Anne Kihara
ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
23
The forgotten elderly in Kenya
Are they ignored or simply a bother? By OMWA OMBARA Mama Gladys Ombara, 82, a retired teacher keeps repeating a folktale that her late grandmother would tell them. She did not understand why the old woman kept repeating the story then. However, today she does. The story is that of an elderly hare who lived with her son on the hills. She was too old to go to go to the farm. She would then take groundnut seeds from her store and give the son to plant. Initially, when harvest time came, her son would bring home a sack full of harvest and they would enjoy the proceeds. However, as she grew older with her eyes failing and teeth falling off, her son told her that the world had changed since she got blind and people no longer planted raw seeds. He would say: “Just fry the groundnuts for me so that I can go and plant them. We will have a bountiful harvest.”
Memory loss
The grandmother knew the son was cheating her but because she entirely dependent on him, she let him get his way with it. That season, no harvest came from the farm because the son had eaten them fried. Mama Ombara’s story can be related to the case of Jane Misala, 70, who effectively voices the elderly people’s problems. “Old age has pulled a fast one on me. It has taken away my eyes as I can no longer see. It has uprooted all my teeth and I can no longer eat meat. It has wiped off my memory as I cannot remember my name.” Misala complains that some of her neighbours sometimes let their animals into her farm and they destroy her crops but she cannot stop them. “When I argue with them they threaten to beat me up. I have no energy left in my ailing body so I can only watch them from a distance.” Misala’s case is a typical story of what is happening to many elderly persons around us. When elderly parents fall ill or become helpless because of their age people start finding them bothersome.
Frustrations
There are those who wish them dead so that they can start inheriting their property. Others become rude and mishandle them. Some children mock the helplessness while some drunkard sons beat up their elderly parents and grandparents. There are also those who check them into homes. Many times the helpless elderly can only watch in frustration as children they had once cared for, educated and loved mistreat them and make their lives miserable.
Today, there are many cases of greedy and reckless children who have sold their parents’ property, land included, at a throw away prices just so they can buy a tin of busaa (local brew). Others steal their parents’ property or fraudulently withdraw money from their accounts. Yet for some family members, it is disturbing to go home only to find that your father or mother cannot recognise you any more. It is frustrating when you find your old mother or father a helpless parent. One can only watch helplessly as a once powerful parent becomes totally dependent on other people even for as simple a task as feeding. Yet such sad incidents need not happen. Sister Mary of Nyumba ya Wazee, (Home for the Old) in Kasarani, Nairobi says that Kenyans are not prepared for the old generation. Elderly swahili men participate in a game of bao in Malindi Normally, one just discovers that they during the cultural festival. Members of Tungutu Women’s are old yet there are lots of preparations Group in Kitui County. Mama Gladys Ombara outside that can be done over the years to enable her home. Pictures: Nzinga Muasya, Kigondu Ndavano and the elderly have their last years in comfort. correspondent “I would recommend that where there is no one to assist, the elderly should be to be sought. If they are reluctant, then the best taken to an old people’s home,” explains Sister option is to get someone to take proper care of Mary. them in a familiar environment, otherwise they She adds: “However, their consent has On September 3, 2010, the ministry signed will be miserable.” an agreement with the Kenya Postal Corporation to disburse KSh590 million to the elderly. The older persons’ cash transfer fund of In the past, there was no Government KSh530 million targets 33,000 poor and vulsupport system for the aged but his has nerable older persons of over 65 years. since changed. The government is now However, the process has been cumbersome doling out a monthly stipend for the eland disorganised, especially in the rural areas derly. where sickly elders who are over 65 years old The Ministry of Gender, Children’s Sercannot access the Postal Corporation pay points vices and Social Development has rolled due to long distances, lack of transport and igout the elderly cash transfer at Ksh1500 per norance. In some families, the aged have been household per month for 102,000 houserobbed of the money by family members, chiefs holds in over 150 districts. and neighbours. The mandate of the ministry was to proPerhaps a much better well thought out vide social protection interventions to the system could really help in ensuring the elderpoor and vulnerable individuals to enable ly live comfortable and dignified lives. them lead dignified lives.
Old age has pulled a fast one on me. It has taken away my eyes as I can no longer see. It has uprooted all my teeth and I can no longer eat meat. It has wiped off my memory as I cannot remember my name.” — Jane Misala
Protection
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ISSUE 043, July 1-15, 2011
Unfiltered, uninhibited…just the gruesome truth
Living the spirit of hunting and gathering
By Godfrey Machuka
mous with the Ogiek who cherish honey. “This place used to be covered with trees. It was not as open and cultivated as it is today,” Kiboi explains as he brings me a chair and a cup of water. I later learn that his complaints about human activities in this area especially farming have somehow affected their honey harvests.
Abused as Dorobo, a word derived from Maasai il torobo to mean poor and miserable people who killed their animals and are thus punished to live on hunting and gathering, the Ogiek are an amazing community deriving their perceived cowardice from a strong belief and attachment with their creator, Tororet. In a vast wetland that once chocked with thick forest that hid a sacred stone, nessuit, I meet an Ogiek elder deep in prayer. He becomes the subject in my trying to unravel my understanding of this humble community. Dressed in animal skin, Mzee Maambuli Kiboi, starts by unfolding the history of the stone that gave rise to Nessuit village. He says that their bountiful creator dropped the huge stone down on earth at this particular place as a sacred site where they would be offering prayers in times of need. “Tororet has always been good to us. He shields us from enemies and provides us with food,” reveals Koboi as his wrinkled face breaks into smile. Proud of the stone, Kiboi claims that during the colonial times, the white people tried to destroy the stone using bullets and explosives but in vain thus explaining the scars and depressions on this river bed stone.
Honey
Kiboi says that bees depended on sweet nectar from indigenous trees that have since been replaced by vast maize, wheat and exotic tree plantations, plants whose chemical additives have lowered the yield of their bees. Interested in exposing his lifestyle, Kiboi offers to demonstrate how they harvest honey traditionally. He emerges from his house with a small animal skin bag whose contents are a piece of wood, a stick and some dry grass-like stuff. These form his equipment for harvesting honey. He starts rubbing the round stick on the piece of wood to light a fire that he later drops on the dry grass-like stuff to produce a strong smoke. He says this will irritate the bees and they will all flee the hive, making honey harvesting easy and harmless. “We get help from the direction of the wind when chasing away the bees so as to save the grass we use since it is not easily found and prepared,” explains Kiboi as he moves close to a bee hive on the edge of his homestead demonstrating the procedure. The honey, according to his wife, was and still is very important in the Ogiek diet. It is used in meals, as an additive to herbs, in brewing traditional liquor, gifts to outstanding people, medium of exchange among other uses. “Lately we have little stock of honey since we cannot access the hives deep in the forest after the government evicted some of us from in there,” laments Taputany, Kiboi’s wife, looking at the direction of the remaining part of Mau Forest. Cooperative as he has been, Kiboi offers to introduce me to some youth with whom we
Ordeal
The Ogiek or Okiek have never gone to war nor do they need warriors since they believe in peace and when they are threatened by an enemy, they retreated deep into the forest. During the prayer, I conjure a repetitive word timda, which means forest and from his interpretation, Kiboi is asking God to spare the forest that is gradually being encroached by human activities. As a result, this scared the game out or deeper into the thicket thus making hunting an ordeal unlike in the past. “Whenever we wake up, child or adult, our prayers to Tororet are that he provides us with food for that particular day,” says the old man who seems to believe in living one day at a time. As a mark of the Ogiek’s humility and hospitality, Maambuli Kiboi invites me to his home, a tiny grass thatched mud house where he lives with his wife and two children. On the trees around his homestead hang bee hives synony-
penetrate the forest in a hunting experience, the Ogiek way. They are armed with bows mostly made of bamboo trees and poisoned arrows with a dog as the lead hunter sniffing the grassland for a meal for its masters.
Hunting
I observe how keen they are in studying the bushes to tell the position of an animal and occasionally looking down to look for fresh foot prints, dung or droppings of a given animal. We hardly find any hint for over an hour, quite a disappointing endeavour for me but their fortitude almost yielded when a dik dik skilfully eschewed their mastery. They resolve to hunt a Colobus monkey, the
“The animals have been scared by human activities and moved to other safer areas thus making it hard to hunt successfully at any time.” — Changeiywo, lead hunter
www.mediadiversityafrica.org
From left: A member of the Ogiek community accessing his skin bag. Extracting honey from a bee hive. A mother prepares a meal for her children. Pictures: Godfrey Machuka
Executive Director: Rosemary Okello-Orlale Editor: Jane Godia Sub-Editors: Florence Sipalla and Mercy Mumo Designer: Noel Lumbama Contributors: Odhiambo Orlale, Omwa Ombara, Mwangi Ndirangu, Robby Ngojhi, Jeff Kirui, John Ndirangu, Macharia Mwangi, Florence Sipalla, Abjatar Khalif, Hussein Dido, Odhiambo Odhiambo, Mary Nyamongo, Ruth Omukhango, Ekuwam Adou, Kigondu Ndavano, Diana Wanyonyi, Nzinga Muasya, James Mbaka, Ken Ndambu, Elizabeth Awuor, Joyce Chimbi, Alice Wangechi, Henry Owino, Henry Kahara and Godfrey Machuka.
only animal we see on our way deep into the forest. This takes hours and I give up and retreat from the cold forest. The young hunters reminisce on earlier days when wild animals graced the forest and hunting was a less than 30 minutes activity. “The animals have been scared by human activities and moved to other safer areas thus making it hard to hunt successfully at any time,” explains Changeiywo, the lead hunter. Maybe such disappointments on a daily basis push the likes of Mzee Maambuli Kiboi back to the sacred stone, nessuit, for a prayer to their God to intervene. That evening, I witness a heavy downpour that Kiboi faithfully attributes to the prayers he offered early in the day. A sense of contentment then takes over his face marking his relief and rewarded faith from a god that is central part of the Ogiek people. It is sad that this people were left out during the last census thus perennially making them an ignored and marginalised community that loosely hangs on strands of extinction! Write to:
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