Celebrating World Population Day 2013: Reject 86

ISSUE 086, July 1-15, 2013

Unfiltered, uninhibited…just the gruesome truth

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July 1-15, 2013

ISSUE 086

Celebrating World population DAY A bimonthly newspaper by the Media Diversity Centre, a project of African Woman and Child Feature Service

Deplorable state of affairs for morgue attendants

By WAIKWA MAINA While being a mortuary attendant is regarded as one of the most difficult jobs in the world, actions by the some of those who perform morgue duties leaves a lot to be desired.

Mortuary attendants have been accused of sexually assaulting the dead, stealing from them, arrogance and drugs addiction among many other criminal and de-humanising actions, unaware of how much the wider community and the employer contributes to their status.

The status of morgue attendants is a medical and social issue occasioned by physiological trauma and depression due to the nature of their job which is surrounded by myths and cultural practices leading to behavioural change and excessive consumption of drugs.

Whether accusations against them are true or false, the fact is that morticians are members of the community whose plight can be addressed through participation by all, but mostly through professionalising their op-

erations and making their working conditions conducive.

“I am not aware of any survey conducted on working conditions or on their behaviour change after getting the jobs, but I am optimistic that such a survey can help mitigate the problem and make the job more attractive and respected,” says Wanjau Ndegwa officer-in-charge of Nyeri Provincial General Hospital psychiatric ward.

Affected

His views are shared by Charles Mwangi, Chief Mortician at the Nyeri Funeral Home who has served the dead since 2003.

Mwangi notes that the most affected are morgue attendants who work in public hospitals where they are not only overworked, but also perform their duties under inhuman conditions.

A mortician’s job includes receiving, preserving, cleaning and releasing bodies.

“Their behaviour is due to lack of skills on handling the dead as well as lack of regular counselling and motivation,” notes Ndegwa.

In Eastern region, the Government has em-

ployed only two morticians while all the others are employed by hospital management committees under the supervision of hospital superintendents who rarely visit the mortuary or interact with morticians.

According to Francis Njue, chief mortician at the Embu Provincial General Hospital, the morticians who work as casual labourers are paid KSh200 per day despite the poor working conditions.

Meru District Hospital mortuary, which records the largest number of bodies, is the worst managed in Eastern region with no refrigerator and with bodies scattered all over From top: Nyeri Provincial General Hospital attendant ready to dump a still born the small cold room. child. Nyeri Funeral Home Chief Mortician The refrigerator collapsed more than six months ago and has not been repaired. The Charles Mwangi in the Postmortem room. mortuary has a capacity of 12 bodies but it had Mwangi in his office during the interview.

94 bodies sometimes early last month.

Pictures: Waikwa Maina According to an employee with the Njue, who has worked as a morgue attenMurang’a County Council, errant officers or dant since 1996 says he was never trained on those not in good books with their seniors are this job and relies on the experience gained posted to work in the mortuary as a way of punContinued on page 5 ishing them.

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Unfiltered, uninhibited…just the gruesome truth

Celebrating World population DAY

ISSUE 086, July 1-15, 2013

Vulnerable children benefit from programme

By MAURICE ALAL About 7,800 most vulnerable children living in informal settlements in Kisumu County will benefit from early childhood development programmes.

The list includes children who are at risk of dropping out of school and those not yet in school. The project is designed to complement the Kisumu City Directorate of Education (formerly Kisumu Municipal Education) office’s efforts to achieve the Millennium Development Goal number 2.

The Ksh31.1 million project is being implemented by Kenya Medical and Education Trust, United Nations Children’s Fund (UNICEF) and the Ministry of Education.

According to Sam Owoko, Programmes Manager at the Kenya Medical and Education Trust, so far 30 school communities and over 7,800 most vulnerable children have benefited. That number has risen from the previous 19 schools with 4,900 vulnerable children.

“We are currently implementing an active inclusion of most vulnerable children in the education projects in the city,” Owoko explained adding that they plan to expand to other counties if they receive proper funding.

The project is intended to increase access to early childhood development and education for 3,900 children — 2,730 girls and 1,170 boys — aged between four and five years in the informal settlements within the Kisumu Municipality.

Owoko said the project has three components, early childhood development, primary education and social mobilisation as well as advocacy.

Education

Kisumu Municipal Education Officer, Juma Omwendo, noted that the county education board has a committee that looks into early childhood development, home craft and youth polytechnics. He noted that they will ensure the project runs smoothly.

Omwendo said all primary

schools will have management committees to look further into early childhood development.

“At the city level, there are already 450 early childhood centres and this project is in line with the Constitution’s basic right for a child,” Omwendo explained.

He said that the governor is the superintendent of the early childhood development education and that financial assistance will come though minimal due to the slow transition of governance.

“A child must get better early childhood development and this includes also better health,” said Owoko.

The informal settlements include Nyalenda, Obunga, Manyatta, Bandani and Manyatta Arabs.

Some of the schools that have benefitted from this project include Tido, Manyatta, Kosawo, Kanyamedha and Kodiaga Prison primary schools among others.

Owoko noted that 31 teachers have undergone training on early

childhood development three times and will be able to teach most of the vulnerable children after graduation.

Train

Out of the project, 50 aged women put in two groups have also been trained to run day care services and 40 children are under them.

“Others that have gained from the early childhood development education project are 60 teenage mothers in the informal settlements,” said Owoko.

He added that 50 professional women mentors have been identified and 26 inducted on mentorship skills by Kenya Medical and Education Trust to help in mentoring the girl child to improve their education.

“Children under perform at primary and secondary level if they fail to pass through early childhood development,” noted Owoko. He urged parents to ensure that their children access basic education.

So far, 195 Pupils and 31 patrons

have been trained to facilitate formation of peer education clubs to help in role modelling in schools.

In strengthening sustainability of most vulnerable children basic education, Kenya Medical and Education Trust has also kicked off various interventions through partnerships between target communities and stakeholders in five informal settlements.

Such interventions include community sensitisation and awareness meetings. They are also conducting various trainings to head teachers and quality assurance education officers.

According to Linda Kharemwa, UNICEF Education Officer, more of advocacy on early childhood education development will be beneficial since the devolved government does not have enough funding for the same. “However, both the devolved and national governments should give early childhood development a priority instead of laptops,” she challenged.

Land justice still a long stretch to the limping landless people

By Duncan Mboyah It is 50 years since Kenya gained selfrule from the British colonisers who were widely blamed for irregularly acquiring and allocating fertile land belonging to the native Africans.

Faced with this outcry, the colonial government set up the first Land Commission of Inquiry in 1916 that came up with certain recommendations.

However, these recommendations like is the case in the other various commissions set up after independence has never been implemented.

Save for the Constitution of Kenya 2010 that came up with a permanent National Land Commission with a mandate to look into the land question, previous attempts have not yielded fruit.

However, even the Commission is not safe as forces that are opposed to land reforms have already started rearing their heads by trying to sabotage its effort.

Strategy

“The Commission does not have adequate funds for their operation or for implementation of their strategy,” Odenda Lumumba, national coordinator of Kenya Land Alliance said during a Land Justice Conference in Nairobi. H noted: “The Commission lacks capacity to manage change and there is no baseline data to guide the work of the commissioners.”

Odenda warns that the Land Commission “is still where we were many years back and still struggling to make changes”.

According to Lumumba, the Commission must design its strategy, have national County action plan and

also mobilise political will to remain focussed in its plans.

“There is need to continuously engage the public at devolved levels on land matters besides making policy and the Constitution operational,” noted Lumumba.

The new team must also ensure that relevant regional and international commitments in regard to land are adhered to at times.

Above all, land reform in Kenya requires that a feedback mechanism through report cards are developed to enable the affected note progress made and rest assured that their appeals are fairly being handled.

The commission indeed has an uphill task. With 67 per cent of land in the country still Women weeding vegetables at a farm. The rate of killings in some parts of the country is attributed to not adjudicated and pressure land disputes. Picture: Courtesy AWC from the public, they must prove that they are equal to the task.

However, Tororei observes that cordance to law. billion to implement its objective Top on the agenda of the Com- as spelt in its mandate. A budget of it is upon the citizens to demand for The conference participants noted mission’s plans is to see to it that they KSh241 million that has been allo- their rights and also to demand that the continued allocation of land to change the willing-buyer, willing-sell- cated for the period 2013-2014 is not the Commission gets the much need- foreign investors in the country at er policy that has contributed to land- enough,” says Tororei. ed support from the Government in the expense of the youths who are lessness in this country for decades.

The Commission plans to travel offering service to the population. energetic and could be used in reThe policy that was coined by gov- in some parts of the country to help energising agricultural productivity ernment officials has mainly benefited highlight their mandate to the people in the country. a few people that include top key poli- as well as listen to their grievances.

Tororei is calling on Ministry of They observed that the rate of killticians in allocation of public land that From the look of things, it is com- Lands officials to liaise with the Com- ings in some parts of the country like they have executed mercilessly, some- ing out clearly that the Commission mission before issuing any title deeds Kilifi is related to land inheritance and times leaving land owners landless. is viewed differently by people who to avoid usurping roles that are not called for inclusion of all family memAccording to Dr Sam Tororei, a have liked the status quo to apply in theirs. bers in the title deeds to avoid such commissioner, the Commission al- the lands sector. Given that it is taking The Ministries of Lands at the events. most collapsed soon after it was ga- over the role of the former Ministry of County level needs to protect the They called on County governzetted due to lack of funding and of- Lands, people who have been benefit- County, community and public land ments to allocate land to the youth fice space. ing from the outdated system are not by ensuring that allocations are strict- and also address issues that could of“The Commission requires KSh6 happy and they are fighting back. ly done by the Commission and in ac- fer them help.

Usurping roles

ISSUE 086, July 1-15, 2013

Celebrating World population DAY

Patrick Amuga Nambale’s gifted teenager with huge ambition

Examine

In the recent district mock examination, the he was in the top 10 at position eight in the whole of Nambale District.

However, it is not all a bed of roses for Amuga.

He has a sad side to his life. He was born normal in 1995 but fell ill in 2000 when the right side of the body was partially paralysed.

He fought the illness for 10 years which forced him to drop out of school for that period. ”I gave birth to Amuga in 1995 and he went to nursery in Mumias in 2000 for only one term before he was promoted to Standard One at Matungu Primary School. He only learnt for one term and fell ill on May 23, 2001,” says his mother, Concepta Amuga Masiga, from Manyole village, Nambale township location, Busia County.

Masiga says her son came home complaining of some pain in the right leg, hand and ribs and was taken to St. Victor Hospital in Mumias where they operated on him and removed some boils.

However, the operation did not solve the problem as he continued to feel pain which forced his mother to take him to Kenyatta National Hospital.

“At Kenyatta Hospital there was not much help and we were referred to Alupe Hospital in Teso which also failed to treat him,” explains Masiga.

Schools urged to engage non-corporal punishments

By MARK MWANGI

By LEONARD ACHARRY Everyone in Nambale knows Patrick Amuga for all the right reasons.

The 15-year-old pupil of Manyole Primary School in Busia County has been described by his teachers as “a unique extraordinary and gifted child”.

Amuga has gone into the history books as the first pupil who took the shortest time to advance from one class to another since the school started, having studied from Standard Two to Seven within two years.

According the head teacher, Peter Inganga, Amuga joined the school in Standard Two in 2011, but due to his special ability to grasp class work, he was promoted to the next class within a short period until he got to Standard Seven.

Amuga joined Standard Two in 2011 and excelled in all the tests he sat for. The teachers then decided promote him to Standard Three after one week.

Says Inganga: “While in Standard Three, he passed all his exams and after learning there for only one term we promoted him to Standard Four. He proved that he was beyond it and we moved him to Standard Five after one term.”

Amuga stayed in Standard Five for only one term before he was promoted to Standard Six. “Before administering content in Standard Six, we forced him to learn the whole year in that class before he moved to Standard Seven although he was scoring high marks,” states Inganga. He notes: “Amuga is even supposed to be in Standard Eight because in Standard Seven, where he is now, he scores everything in exams and understands the contents very well.”

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Unfiltered, uninhibited…just the gruesome truth

Physical reprimand in schools is becoming rampant even after it was officially banned by the Government 12 years ago.

Students in some schools in the Central Kenya have been wounded and others psychologically injured by their teachers.

According to the Central Provincial Director of Children Services George Kibuku, corporal punishment in schools is becoming extensive as teachers are brutally assaulting students even for modest misbehaviours which can be corrected without violence.

Kibuku lamented that there have been cases of students being canned by teachers and the victims fear reporting to their parents for fear of further repercussions.

“Teachers are ruthless and brutal as they are nowadays whipping children in an inhumane manner,” noted Kibuku.

Corporal punishment was legalised in 1972 under the Legal Notice No 40 of 1972 (The Education Act 1972) but in 1992 the Ministry of Education issued a circular banning corporal punishment in schools. Teachers deliberately ignored this and in March 2001, the Government through the Ministry of Education issued another circular banning corporal punishment.

Discipline

“We brought him home and took him to a church in Nambale from where they prayed for him until he got healed in 2010.

It is from there that he resumed school in 2011 having stayed out for 10 years.”

“He loves the word of God, he goes to church every Sunday where he is in the praise and worship team and at home we call him pastor because he preaches the word of God to us,” says Masiga.

She notes that her son has a passion for engineering. “He can assemble parts of a radio and make it start working. Even the neighbours are now bringing their radios to him to repair.”

Back at school, Amuga’s class teacher Joseph Magero says: “The boy is among the best in English and leads in all the other subjects.

He is humble and does not talk much.”

Patrick Amuga in class. Below: Patrick with his head teacher Peter Inganga (left) and his class teacher Joseph Magero at Manyole Primary School in Busia County. Pictures: Leonard Acharry

Ability

He was recently elected class prefect due to his ability to coordinate and lead others.

Amuga’s dream is to join Maranda High School in Bondo district, Siaya County and later go to university where he hopes to pursue an engineering course.

However, abject poverty in his family makes him lose hope of ever achieving the dreams.

Amuga is the third-born in a family of seven. The second born is at Alliance High School thanks to support of a donor. His four younger

“Before administering content in Standard Six, we forced him to learn the whole year in that class before he moved to Standard Seven although he was scoring high marks.”

— Peter Inganga, head teacher, Manyole Primary School

sisters are all in Manyole Primary School.

“He is like our son and since he joined the school, he has been learning without paying all the fees. In most cases teachers pay for him and other times we waive some charges,” says Inganga, the head teacher.

He was even allowed to sit for the district mock examinations without paying the exam fees.

The poverty factor has also caused not only his parents sleepless nights but the teachers as well. ”He is a focused boy who has a vision for his future and I am sure with the great potential he has exhibited, he can be a leader and a great person in the society in future if assisted to complete his studies,” Inganga notes.

“We are appealing to the Government and well-wishers to come in and help this boy pursue his studies and fulfill his ambitions in life.”

The head teacher can be reached through phone number 0726829490 and his mother Amuga through 0712185939.

Kibuku said that discipline is allowed in schools but not canning children as there are alternative forms of punishments. He quoted Martin Luther King who said that ‘violence does not beget violence’. One parent, Jane Mwangi, said her son Gitau was suspended for the first time when he went to school late and that is when the sufferings started.

“Gitau came home and told me that he was suspended because of school fees balance. Later on I realised that he was cheating but I believed him. I got KSh3,000 and took it to the principal. The principal was surprised that Gitau lied to me but we later talked and we concluded that he should be punished,” said Mwangi.

“I was beaten by the teacher using a wire which was not coated just because of coming late and yet they had already talked with my mother. He then went ahead and gave me bus fare to go back home,” explained the boy.

“My son is totally desperate and he used to perform well since he was in primary school. I don’t know what to do because I fear that he might be used by other people to achieve their goals,” Mwangi noted. Since then Gitau has been nursing the idea of dropping out of school completely.

Measures

Kibuku noted that there should be other measures that teachers should take when disciplining a student because the child might be worse but if he is not counselled by both parents and teachers because the possibility of repeating the same mistake remains high.

He urged schools to revive counselling sessions which should be used as a source of guidance to the students.

“There are many alternative forms of discipline for example, if a child is to be punished a teacher can make sure that if there is a major event happening and other students are going together, then a child can miss the event so that next time he will learn from his faults,” Kibuku suggested.

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Unfiltered, uninhibited…just the gruesome truth

Celebrating World population DAY

ISSUE 086, July 1-15, 2013

Dead silence Grave working life of morgue attendants

By WAIKWA MAINA Their working in deplorable conditions contravenes several constitutional provisions as enshrined in the Constitution and international labour laws.

However, it appears the inhuman conditions are a deliberate move by crafty hospital management to instil a sense of fear of job insecurity.

The worst crime the victims can commit is talk to strangers about their work place and, when allowed to by their bosses to speak, they all recite the same words spoken by their colleagues hundreds of miles away in a separate facility.

Article 41 of the Constitution of Kenya 2010 states that every person has the right to fair labour practices which include fair remuneration, reasonable working conditions, to form, join or participate in activities and programs of a trade union and to go on strike.

But whether these hundreds of workers are aware of their rights is a story for another day.

They operate as if on a code that dictates that they remain forever mute, never to tell of anything that happens inside and behind the cold rooms.

Indeed, a visit to public mortuaries confirms that “omerta”, the Mafia code for honour that places importance on total silence is the order of the day.

“Whom do you want to see?” is the same question they all ask anyone visiting mortuary facilities.

They have no business with you if you are not there to view a body, their business is strictly to admit and release bodies and if you need anything else, go to the hospital’s medical superintendent (commonly referred to as med-sup). They then go mute, forget or completely ignore you.

However, the medical superintendents, like senior ministry officials, are not comfortable discussing morgue issues. These are guarded secrets often shrouded in silence and are as cold as the cold rooms for preserving bodies.

According to a Ministry of Public Health official, they are also at times denied access to mortuaries. He recalls how during their college years they were denied access to a morgue despite the fact that they were training in a public college under the same hospital.

Silence

The other tactic used to silence the morgue attendants is making them remain casual workers, employed on short-term renewable contracts.

This makes it easy for them to be intimidated, not to talk too much as well as lack an opportunity to join or form any trade union. Most of them have served under such contracts for years.

In Meru, a mortician said he has served in the same capacity for more than 15 years. The mortuary is under the hospital management which employs morticians on three month renewable contracts.

In some morgues, attendants claimed that the facilities are used as conduits for contrabands such as drugs as well as smuggling out some items stolen such as drugs from public hospitals.

“The expensive drugs which patients purchase from selected chemists are normally stolen from hospital wards and sneaked through the mortuary. Always be suspicious when a medic directs you on where to purchase specific medicine,” says a public

Relatives collect the remains of their loved one at Meru District Hospital Mortuary.

Picture: Waikwa Maina health officer, whose sentiments were echoed by a former medical student who came across a case of drugs theft through the morgue during his attachment at a Nyeri hospital.

Hospital management is also engaged in businesses related to the dead such as hearse services or funeral homes where they enjoy monopoly to operate from the hospitals or just a few metres from the mortuary.

Good examples are at the Embu Provincial General Hospital as well as the Meru and Nanyuki district hospital mortuaries where medics or their close associates runs hearse, coffins and other funeral services either within the hospital or at buildings adjacent to the mortuaries.

These are some of guarded secrets behind the cold rooms, and since they must remain so, the attendants who desperately need to retain their jobs, must remain soundless.

One will find that most morticians are under the influence of drugs while at work.

However, according the Embu Provincial General Hospital chief mortician, it is dangerous for the morgue attendants to be drunk while on duty.

“An accident can easily occur in the morgue when one is attending to a body especially when embalming.

We use sharp tools like injections and

knives during post-mortem,” explains Francis Njue. He notes: “Most morticians are under the influence of drugs due to the poor working condition, lack of training on handling the dead, lack of motivation and poor salaries.”

Njue observes that the way society treats them also leads to stigmatisation, they don’t feel part of the wider community.

Dispute

The other key business in mortuaries is when there is a property dispute where the deceased did not leave behind a will, where one party pays either mortuary attendant or anyone with mortuary connections to have the deceased’s fingerprints stamped on a will which is later presented in a court of law as evidence.

The fee on this transaction is based on value of disputed property and on a rainy day, a mortuary attendant can take home up to KSh20,000 from one party of the deceased person intending to fraud the other or have upper hand in legal property dispute to be filed in court.

“Most of the wills with fingerprints, instead of signatures, have everything to do with a mortuary but people do not stop to think why a wealthy man opted to fingerprint and not sign and deposit the will with a bank, a lawyer or any other recognised institution of-

fering such services.”

Crafty lawyers advise such desperate clients, and as you know, dead people have no say but their fingerprints are officially recognised.

“The crafty parties are sure of winning the court battles and can delay the cases for years. In the event of this, they also ensure that the body is properly preserved under the pretext of love for the deceased but in real sense, it is all aimed at protecting their evidence should a court order for a specimen,” says a mortuary attendant. He notes that the shrewd party will do everything to ensure that the body is not buried as decomposition will affect the fingerprints.

Confirm

Eastern Provincial Director of Medical Services Dr Ephantus Maree denied ever coming across the said illicit trades in mortuaries but confirmed that most of the morticians are untrained and lack work contracts.

“We have no training curriculum for mortuary attendants and that is why most of them are untrained,” says Maree. He explains: “Private morgues including private funeral services providers are normally licensed after serious vetting by various bodies including Ministry of Public Health, National Environment Management Authority (NEMA).”

Interaction with dead bodies leaves residents traumatised

By WAIKWA MAINA Most mortuaries and cemeteries are a big threat to environmental and human health with their poor status having a devastating impact on the community living around them.

According to psychiatrists, the most affected are children and women especially who have previously suffered psychological problems or are under stress.

Exposure to dead bodies or unhealthy conditions can have negative effects on child development

Julea Kibathi outside her house in Meru County. She pleads for dead bodies to be handled and transported with respect.

Pictures: Waikwa Maina

which could ruin their future as productive members of the society.

“Susceptible women can develop severe health complications while the child will grow developing emotions,” says Wanjau Ndegwa, officer in-charge of psychiatric department at the Nyeri Provincial General Hospital.

In certain parts of the country, some families living around the morgues and cemeteries have literary been living in a world of the dead.

In Meru, Julea Kibathi explains the agony they have lived with for

decades.

“Bodies to be buried in mass graves are carried naked and openly to the Meru Municipal Council Cemetery. They are carried on a stretcher dropping pieces of human flesh on the way,” Kibathi says.

She urges: “Our plea to the hospital management, public health and the municipal council to have the bodies covered have been in vain, we have been to every office without help.” Kibathi, a mother of four, lives less than 50 metres from Continued on page 6

“We bought this farm in 2007, but now we regret it. Unfortunately, no one is willing to purchase this land even at a throw away price so that we can relocate. There is no difference between living here and living in the mortuary.”

— Agnes Gitau, resident

ISSUE 086, July 1-15, 2013

Celebrating World population DAY

Unfiltered, uninhibited…just the gruesome truth

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Family murders cause for high number of bodies

By WAIKWA MAINA Outdated cultural practices and property inheritance is a key contributor to murder of women and children in Meru County.

Specifically, the cultural practice that children must be left with their father in case of a divorce or separation compounds the situation.

According to mortuary records, murder victims booked by the police accounts for more than 60 per cent of total bodies at the Meru District Hospital mortuary.

The mortuary always has more bodies than all the others in Eastern Province, exceeding even the Embu Provincial Hospital by more than 100 per cent.

Meru mortuary also has the highest number of unclaimed bodies, some of them dumped by relatives and others brought in by the police.

At one time, the mortuary with a capacity of 12 bodies had 94 bodies, and more than 60 of them were unclaimed bodies, while Embu Provincial General Hospital whose capacity is 24 had 42 bodies, with 19 unclaimed bodies 12 of them from Meru region.

Embu Provincial General Hospital mortuary chief mortician, Francis Njue, attributes congestion in the mortuaries to bodies brought in by police, who do not make serious efforts to trace the next of kin.

“Most people do not bury their children, especially those aged below the age of 14 and instead opt to dump them in the mortuary. It is obvious that relatives lose property when their relatives’ bodies are disposed by the hospital,” a mortuary source says.

He also claims that police book the bodies into the morgue but do not indicate other details as booked at the Occurrence Book which makes it impossible for social workers to trace the relatives. They also fail to take fingerprints to assist in identifying the body.

To ease the congestion, the mortuary disposes unclaimed bodies every three months.

The rising number of bodies of single mothers and orphaned children is attributed to the murders, as women

opt to get children out of marriage, which guarantees them and their children safety.

“The culture that children are left with their father when marriage dissolves is leading to the murders. Newly wedded wives or relatives conspire to eliminate the children. If the woman got married again or got children out of the marriage, they also become victims for fear that children from the previous marriage may take her and other siblings back to her original matrimonial home,” says Grace Makena*, a mother of two, who vows never to be married According to Makena everyone knows what is happening and the reasons behind the murders, but no one can dare talk for fear of being eliminated.

“Women now opt to get children out of wedlock to safeguard themselves and their children while others leave the area as soon as they learn they are pregnant to keep the secret from the man responsible,” Makena explains.

Report

Relatives at the Meru District Hospital Mortuary load their loved one atop a vehicle for burial. People who are murdered end up decomposing and unclaimed in the mortuaries forcing them to be disposed off.

Picture: Waikwa Maina

The media always reports most of the murder cases which include victims’ bodies being dumped away to be discovered days later when decomposing.

Among the latest murders was in the month of March when a man eliminated all of his uncle’s family members over a land dispute.

The incident occurred at Lunyari village where four family members were butchered.

Julius Gatopi was also killed in a mysterious manner in a night where several other people were brutally murdered. His wife Stella Gatopi described how she made frantic efforts to alert him about the terror in the village in vain and warn him not to be careless as he walked back home from a nearby church where he had attended an evening church service.

"I called the pastor to tell him to pass a message to my husband that all was not well in the village. The pastor told

me that he had already left for home,” Gatopi narrated.

Another victim is Jacob Mithinji whose dismembered body was found near Kambitini River.

In Imenti South at Kigane village, four men among them two brothers were murdered and their bodies dumped by the roadside.

They include Jacob Mutual a primary school teacher, his brother Julius Gatobu, Lawrence Kirimi and James Muthomi all businessmen at Nkubu town all murdered on their way home.

That same night at Kiria village, Imenti Central four men were attacked.

Joseph Bundi, Geoffrey Muchui, Boniface Koome, and one unidentified man, all middle aged were stabbed on the chest and their throats slit.

The four were small traders at Kariene market. According to Sylvester Githongu, Officer Commanding Police Division, due to similarity of the injuries in the two districts, the attack might

have been carried out by the same suspects.

He said the community was silent on the attack and wondered how nobody in the village heard any commotion.

Manage

In Meru town, a young man was killed by his brothers soon after he killed their father on what was termed as a domestic quarrel involving property.

Sixty-year old Stephen Mwenda was stabbed several times by his 34-year old son Jacob Gitonga after they allegedly quarrelled bitterly over a family house.

After the quarrel, Mwenda and his son left for Makutano Shopping Centre from their Kaaga home, and the old man’s body was discovered a few hours later with multiple injuries.

In one of the incidents, three men and a woman were arrested after police managed to track a mobile phone of

one of the slain victims and the matter is pending in court.

In the same County, a man surrendered to the police after killing his brother, wife and two children following family differences in Tigania.

Area District Commissioner Mwangi Meru said the suspect sustained serious injuries on the head during the confrontation.

The bodies of the victims: Kitati Itimui, his wife Susan Kathure, their sons Jamleck and Francis Itimui were taken to the Meru District Hospital mortuary.

To curb the incidents of people dumping their relatives at the Meru mortuary, the management has introduced a policy where those who bring in the bodies must identify themselves, pay a fee and leave their details.

The policy on the other hand seems not to be working as lately bodies are dumped only to be discovered when they are already decomposing.

Deplorable state of affairs for morgue attendants Continued from page 1 over years.

“I wanted to go train at Chiromo Mortuary but I could not afford the fees. The three months training costs KSh40,000 while what I earn can hardly sustain my family,” says Njue.

Even with his vast experience, Njue says communication barrier between him and the pathologist is still a major challenge.

“Pathologists use medical terms which we do not understand, responsibility to explain to relatives the cause of the death of their kin is mostly left to us yet we do not understand the medical language,” he says.

Njue notes that training for morgue attendants needs to be attend to urgently and they should be treated just as nurses are trained to assist doctors.

He says morgue attendants should also be placed under the same job group as nurses since they do the same job though in different departments.

Njue’s sentiments are echoed

by Mwangi of the Nyeri Funeral

Home who says that morticians assist pathologists and attend to the dead just as theatre technicians and assistants assist the surgeon. However, he notes that his situation is better as there is no discrimination at the Nyeri Funeral Home where other members of staff including medics attend to bodies.

Conditions

Apart from lacking training, the worst part in public mortuaries is morticians’ working conditions.

They lack protective gear exposing them to contagious diseases such as Tuberculosis and Hepatitis B from unchecked bodies brought in by police or from the wards, as most of the time they are not informed of the cause of death.

“We use normal gloves instead of industrial gloves when washing cold rooms or attending to the dead. We use poor quality gloves in receiving decomposing bodies brought in by police as well as for cleaning the floors that are filled with maggots when the refrigerators fail to work,” explains Njue.

Other basic requirements are

facemasks to protect them from breathing the foul smell as well as contaminated air when the refrigerator malfunctions.

Attendants in other morgues including those at Nyeri Provincial Hospital as well as Meru, Runyenjes and Isiolo district hospitals’ mortuaries share similar sentiments.

During the post-mortem, the attendants use outdated equipment.

For example, when opening the skull, they use chisel and saw instead of a modern power-saw, which is safer and efficient.

In cases where post-mortem results are to be taken for further analysis to the Government Chemist, the results are never revealed to the attendants who are more accessible to the relatives.

Abandon

Njue says most relatives have had to abandon the mission of seeking to know what caused the death of their kin due to the cumbersome process, thus frustrating their quest for justice in cases where cause of death was related to crime, adding that congestion at Government

Chemists is also a major challenge.

“Some specimen especially where police are involved is never even taken for analysis and we have a number of them in the mortuary.

The police refuse to take them and advise us to get transport from deceased’s relatives,” notes Njue.

According to Ndegwa, stress which leads to psychological trauma to the morgue attendants can be reduced through standardised modern preservation of bodies.

Cultural and religious beliefs about the dead can also lead to haunting of the attendants or anyone exposed to dead human bodies. Ndegwa says most morticians are not trained on preservation and handling of dead bodies which are associated with many things.

“The morticians are adults who understand that the bodies they are handling had some life and this must haunt them. It is out of these fears they engage in drugs,” observes Ndegwa.

“We use normal gloves instead of industrial gloves when washing cold rooms or attending to the dead. We use poor quality gloves in receiving decomposing bodies brought in by police as well as for cleaning the floors that are filled with maggots when the refrigerators fail to work.”

— Francis Njue, Chief Mortician, Embu Provincial Hosipital

6

Unfiltered, uninhibited…just the gruesome truth

Celebrating World population DAY

ISSUE 086, July 1-15, 2013

Genital mutilation cause of rise in fistula cases

By BEN OROKO Harmful traditional practices, particularly Female Genital Mutilation (FGM) are being cited as some of the causes for obstructed and prolonged labour during childbirth, contributing to obstetric fistula.

The World Health Organisation (WHO) defines FGM as a procedure involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons.

According to the WHO statistics, FGM, which has been outlawed in Kenya, is a common practice in the world with about 130million women and girls estimated to have undergone the cut.

Despite making efforts to meet the Millennium Development Goals (MDGs) Four and Five, which deal with infant mortality and maternal health respectively, maternal mortality remains one of the biggest challenges facing the continent and particularly the sub-Saharan Africa.

Records show that the majority of the 500,000 women worldwide who die during childbirth or due to birth related complications are African women.

Female genital mutilation is one of the major causes for complications reported during childbirth in the sub-Saharan Africa as the risk of dying during childbirth increases greatly if the mother has undergone the cut.

Women who have been mutilated face a much higher risk of serious complications and death during childbirth due to obstructed and prolonged labour linked to female genital mutilation than women who have not been cut.

Practice

In communities where FGM is practiced, it is seen as a transition into womanhood. One of its biggest setbacks is having underage girls pushed into early and forced marriages as well as pregnancies when their pelvic bones have not developed to accommodate pregnancies and child-

birth. This exposes them to obstetric fistula, which is described as obstructed labour during childbirth.

One such woman is Vane Ong’ayo, 25, a fistula survivor who has benefited from the African Medical Research Foundation’s (AMREF) Freedom From Fistula (F3) free correctional and surgery operations in partnership with the Kisii Level 5 Hospital.

Ong’ayo says the situation subjected her to social stigma from relatives and friends due to the odour from the leaking urine that wreaked her body.

Ong’ayo developed the complication in 2007 while delivering her firstborn child at Kisii Hospital but the child died at birth.

Suffer

“I first sought medical treatment to obstetric fistula in 2009 but it was not successful. I tried again in 2011 but it failed yet again until last year when I was able to access AMREF’s free corrective repair surgery at the Kisii Hospital,” she says.

AMREF has been offering corrective repair surgery to women from poor backgrounds who have been suffering in silence for many years.

“With corrective repair surgery costing about KSh30,000 at Kenyatta National Hospital, the amount is costly for majority of the rural poor women suffering from obstetric fistula to raise,” says Ong’ayo.

She adds: “As a woman and a mother, I am happy and thank AMREF and Kisii Hospital for offering corrective repair surgery for women from Kisii County and the neighbouring regions who have been suffering from obstetric fistula.”

According to Dr Geoffrey Otomu, Medical Superintendent at Kisii Hospital, rampant cases

of obstetric fistula in Gusii region are linked to obstructed labour which is attributed to women giving birth at home under the care of relatives or untrained traditional birth attendants who cannot detect complications.

Otomu regrets that majority of the women continue giving birth at home through the assistance of untrained traditional birth attendants “hiding behind the excuse of high maternity charges in public health facilities”, compromising their health and that of their babies.

“Some women have developed obstetric fistula complications while giving birth at home under the care of relatives or untrained traditional birth attendants only to seek medical atten- From top: The main entrance at the Kisii Level 5 tion at health facilities when it is too Hospital. An AMREF staff attending to a fistula late,” laments Otomu. patient during AMREF’s free from fistula surgery He says that fistula complications at the facility. Pictures: Ben Oroko are preventable if women seek antenatal services and give birth in health of suffering in silence,” says Otomu. facilities under with the help of skilled health The WHO estimates that more than two milpersonnel. lion women around the world have untreated “Women suffering from obstetric fistula fistula, with majority of them coming from the should seek treatment in health facilities that of- poor backgrounds in the sub-Saharan Africa fer the corrective repair surgery services instead where FGM is said to be rampant.

Interaction with dead bodies leaves residents traumatised

Continued from page 4 the Meru District Hospital Mortuary, whose home also neighbours the cemetery.

Kibathi’s children get affected anytime there is mass burial at the cemetery and spend the better part of the night awake or having nightmares.

“They wake up at night shouting but when I ask them why they cannot explain. I have also noted that this happens every time they witness the mass burial or happen to see the naked bodies being transported to the cemetery,” says Kibathi.

She observes that such scenes have affected the children’s performance in school. The situation is no better even when there are no mass burials.

Collapse

“The children, just like us parents cannot concentrate on anything due to the foul smell from the mortuary. It has been stinking for years but nothing has been done to mitigate the problem,” Kibathi notes.

Things are made worse when equipment at the mortuary breaks down like has been the case at the Meru District Hospital Mortuary where devices broke down about seven months ago. But even before this, it had previously collapsed and taken

months before repair.

Mortuary attendants in this facility concede that they also work under very harsh and health threatening situation.

“I think it is a deliberate move by the hospital management not to repair the fridge since some of them directly or indirectly own some funeral homes or trade in related business,” says a mortuary attendant. He adds: “The mortuary earns the hospital an average of KSh600,000 per month while the fridge requires KSh200,000 for repairs.”

Kibathi’s sentiments are echoed by Agnes Gitau another area resident. “We bought this farm in 2007, but now we regret it. Unfortunately, no one is willing to purchase this land even at a throw away price so that we can relocate. There is no difference between living here and living in the mortuary,” says Gitau.

She also recalls that before the cemetery was fenced, they would wake up to find dogs feasting on human flesh just outside their door.

“We complained to the public health officials and the National Environment Management Authority (Nema) which compelled the Municipal Council of Meru to fence the cemetery, we are happy that was done,” explains Gitau. She adds: “However, the stench from the mortuary is even worse. We have moved from one office to the other to have the situation addressed but it has all been in vain.”

The mortuary at Meru District hospital has the capacity to hold 12 bodies, but it had 94 bodies when the media visited the facility.

The bodies were scattered all over the cold room while those that had overstayed or are unclaimed were piled on top of each other to the roof, improperly balanced as they were not arranged according to size. Right at the bottom was a body of a young woman brought in by the police, and on top of her male bodies.

The situation is same at Embu Provincial General Hospital where the

“It is important that we have standardised storage, handling and burial of human bodies.”

— Wanjau Ndegwa

workers complained of regular breakdown of equipment.

“It is normal for public mortuaries to be over congested with poor equipment and tools or lack of them. The government and individual hospital managements do not attach any attention to the morgues, we work in very harsh conditions,” says Francis Njue.

When the fridges collapse or where they do not exist, mortuary use bio-chemical method of preserving bodies commonly known as embalming. They use a chemical known as formalin but this method can only preserve the body between 70-80 per cent while a fridge preserves between 95-98 per cent.

Disposal

This is the same case with the Nyeri Provincial General Hospital where besides the stench, disposal of hospital and mortuary waste is wanting.

“They sometimes dispose or burn the wastes in the open forcing us to close down our businesses or leave our houses for hours. The situation has improved a bit in terms of the smell but we still have an issue with disposal of wastes from the mortuary,” says John Kiama, a trader opposite the Nyeri Provincial General

Hospital mortuary.

His sentiments are echoed by Habiba Nunu from the same area.

“I have lived here for over 40 years, the situation improves for some time when we complain and then degenerates shortly,” says Nunu.

Wanjau Ndegwa, officer in-charge of psychiatric department at the Nyeri Provincial General Hospital says constant exposure of dead bodies to children affects them and could even result in their using drugs as they grow to deal with the emotions.

“That is why children are not allowed in mortuaries. Such exposure can lead to trauma and severe stress.

It may be difficult for a child to adapt to such situations and live with them,” explains Ndegwa. He adds: “Adults are equally affected. Dealing with or getting exposed to corpses is not a normal thing in life. Such constant exposure also affects people due to cultural and religious beliefs which come back haunting the victims.”

According to Ndegwa, adults also get affected due to the fact that they are aware that it is a human body, which had life at some point and they are no more.

“It is important that we have standardised storage, handling and burial of human bodies,” notes Ndegwa.

ISSUE 086, July 1-15, 2013

Celebrating World population DAY

Unfiltered, uninhibited…just the gruesome truth

7

Africa yet to earn potential demographic dividends

. . . . . with the youth representing a significant burden to those in the work force

By Joyce Chimbi In the wake of the Arab uprising where scores of youth engineered a significant paradigm shift in politics, similar concerns have been raised regarding the youth in sub-Saharan Africa.

African delegates from 42 countries attending the International Planned Parenthood Federation, African regional Council (IPPFAR) have drawn attention to the immense opportunities that can accrue from a young population, which no one is tapping.

It is becoming increasingly clear that unless African nations respond to the rising numbers of young people, what could have been a significant resource is slowly becoming a burden.

“Demographic dividends are not just about having a young population. Dividends accrue from the investments you make so that young people have access to proper education, health and job opportunities,” said Dr Yilma Melkamu, Director of Programmes at International Planned Parenthood Federation Africa Region.

He added: “Africa must be prepared for its young population. Currently, young people account for about 42 per cent of the Africa’s population.

There is a large population of dependants under the age of 15 years.”

This is true for Kenya, a young nation with at least 45 per cent of its population being less than 15 years and 19 per cent aged between 15 and 24.

Dependency

Melkamu spoke as the world prepares to mark World Population Day on July 11. He noted this means that the small population of those in the work force is supporting a very large population of dependants.

“Demographic dividends come when the working age group far surpasses dependants who are below 15 years. Those under 15 years are usually in school and someone has to support them,” Melkamu expounded.

He gave an example of countries such as Thailand, South Korea and China who are now enjoying demographic dividends because a majority of their population are working as compared to the dependants under the age of 15 years.

“India is also making positive strides. These are countries with very aggressive family planning programs.

Where women are educated on family planning and people have the number of children that they can comfortably send to school,” Melkamu noted.

“The unmet need for family planning in Africa is significantly high, fertility rate also remains high. African nations must scale up uptake for family planning so that people are able to plan for the size of families that they can afford,” he reiterated.

Although Kenya’s National Coordinating Agency for Population and Development (NCAPD) acknowledges that the “relationship between a nation’s development and the health of its adolescents and young people is of paramount concern,” young people aged 15 and 24 years have been identified as particularly vulnerable to HIV, sexually transmitted infections and related health issues.

If Africa is to reap the benefits of having a young population, “they must prepare for it, by making investments that ensure that young

people contribute to the growth of their economy. It is not just about accessing education, most urban youths have a good education, it is also about job opportunities,” Melkamu expounded.

Young people in Africa still account for the majority of those unemployed, according to the World Bank, “200 million people in Africa fall into this category, making up 20 per cent of the population, 40 per cent of the work force, and 60 per cent of the unemployed on the continent”.

Peter Mwendia, a university student concurs: “Youth remain the most disenfranchised age group, who also happen to bear the brunt of the many challenges that are facing the society today.”

Strategies

According to IPPFAR, the population of young people in Africa is growing faster than in any other part of the world.

This is a challenge that has not escaped the attention of the African Union (AU) which has agreed to prioritise the expansion of the labour market to ensure that more and more youths are employed. This action is expected to promote stability and reduce crime.

While several strategies have been put in place by the African Union to reduce youth unemployment, many young people are still unemployed

Youth enjoying themselves at a popular entertainment spot in Nairobi. Africa must ensure that young people contribute to the growth of the economy by investing in them.

Picture: Reject Correspondent while a significant number of them are working in the informal sector.

According to the United States Agency for International Development (USAID), at least 75 per cent of out-of school youths are unemployed, a scenario that has prompted the Jubilee government to promise to reduce youth unemployment by at least 80 per cent.

However, economic hardships are not the only challenges that are facing young people. According to government statistics, the national HIV prevalence now stands at 7.4 per cent, a situation that has serious implications on the health of young people and their future. According to Kenya Demographic Health Survey 20082009 knowledge of all the key HIV prevention methods is lower among women and men aged 15-19 than among people age 20 years and older.

UNICEF estimates that of the 2.4 million Kenyan children who are orphans, at least 47 per cent of them have lost parents to AIDS related complications. A significant number of young people are taking care of their sick parent.

Consequently, a significant number of these children are spending a better part of their childhood out of school.

“Africa must be prepared for its young population. Currently, young people account for about 42 per cent of the Africa’s population. There is a large population of dependants under the age of 15 years.”

— Dr Yilma Melkamu, Director of Programmes at IPPFAR

Young people also continue to be the recipients of harmful cultural practices and even violence, which according to the Kenya National Bureau of Statistics (KNBS) claim, remain under reported.

It further shows that the HIV prevalence among young women aged 15 to 24 are four times higher than among young men.

In addition, government statistics show that Female Genital Mutilation (FGM) practice rates are at 98 per cent among the Somalis, over 90 per cent among the Pokot and 73 per cent among the Maasai.

Besides pastoralist communities, other tribes practicing FGM according to the Government are the Kisii with a practicing rate of 96 per cent, 73 per cent among the Maasai and 48 per cent among the Kalenjins.

Female Genital Mutilation practicing rate among the Samburu community is still at 100 per cent. The Samburu also has a cultural practice known as ‘beading’

Moran

“A moran (young unmarried man) identifies a girl aged between nine to 15 years old. He talks to the girl’s brother about his interest in his sister, then they speak to the girl’s mother,” explains Jane Meriwas, coordinator of Samburu Women for Education and Environment Development Organisation.

The moran then buys about 10 kilogrammes of beads which are made into necklaces. Upon wearing the necklace, the girl is considered ‘beaded’ and belonging to the moran.

“The mother builds a small hut in her homestead. This is where the moran will come to visit the girl and he has the right to do whatever he pleases

including beating her up and no one will raise a finger,” she explains.

Meriwas, speaks about the effects of beading “since sex between the young girl and the moran is usually unprotected. If the girl gets pregnant at some point before marriage, the pregnancy must be terminated at all cost”.

According to Meriwas, an activist in the war against female genital mutilation and other harmful cultural practices in Samburu, it is better that the girl dies than have the pregnancy grow to full term.

“Sex between the moran (young warrior) and the girl, though permitted by culture, is considered incestuous because they are both from the same clan. The moran can never marry this girl,” Meriwas explains.

As a result, there are three possible outcomes “the older women lure the girl into the forest once they suspect she is pregnant. They press her stomach until she bleeds and the foetus comes out,” she explains Her sentiments are echoed by Lolonju Lerukati, a Samburu, who notes: “Many deaths have resulted from this exercise but no one in the community will speak about it.”

If this fails, the girl, upon delivery is forced to poison her new born child. If she refuses, then the child is to be left in the forest to be eaten by hyenas or given to a non–Samburu often the neighbouring Turkana community.

In spite of the challenges facing Kenya and Africa as a whole, it is not too late to begin reaping from a young population.

“Governments, policy makers and other stakeholders must work together to turn a young population into a resource,” Melkamu advised.

8

Unfiltered, uninhibited…just the gruesome truth

Celebrating World population DAY

ISSUE 086, July 1-15, 2013

Slum women opt for TBAs for fear of losing their uterus ..….scores of women in Nairobi slums say traditional birth attendants still their best option

By Joyce Chimbi As curtains are set to fall on the Millennium Development Goals, it is clear that Kenya will not have achieved goals four and five that target to reduce child mortality and improve maternal health respectively.

Even as the deaths of mothers and babies during delivery continue to be a major health challenge for the country, women living in Nairobi’s slum areas consider traditional birth attendants (TBAs) as their best chance of escaping the rigours of child birth alive.

This coupled with the fear of losing their uterus during public hospital deliveries, women in the slums have been forced to resort to TBAs. “There are women who when assisting delivery will have the uterus comes out. At the hospital, they either touch the uterus with their hands or they damage it because they don’t know what it is. They assume it is part of what comes out during a delivery,” says Angelas Munani, a retired traditional birth attendant living in Kosovo within the sprawling Mathare slums.

Millicent Awino, a mother of three living in Kianda 42, Kibera concurs with Munani. “My deliveries are strange because the placenta takes long to come out and when I push, the uterus also comes out.”

After her first home delivery, a TBA warned Awino that she may lose her uterus as some women have done, if she even went to deliver in hospital.

“Traditional birth attendants know what to do when the uterus comes out.

They know that it is not to be touched with hands,” explains Awino.

According to information given to Awino by a TBA, the uterus cannot withstand cold water and when a pitch of cold water is thrown at it, it quickly retreats.

“But who is there to give you this attention at public hospitals where a nurse is handling several deliveries at the same time?” poses Munani. She notes: “Further, we have herbal concoctions that we give to the women to help the uterus return to its rightful place.”

Harm

However, a skilled healthcare attendant who is a nurse at Kenyatta National Hospital does not agree. “Women living in the slums have turned to TBAs even though they are of no use if a complication arises during delivery. Most women die due to excessive bleeding, something that TBAs are unable to deal with,” she says.

“Further, if there is need to perform a Caesarean Section, a woman being attended to by a TBA will most likely die even if she is rushed to the hospital because no one will touch her since most probably she lacks the hospital card to show that she has been attending antenatal clinic,” expounds the nurse. She adds: “I have seen women die right at the gates of hospitals because such issues.”

The nurse notes that TBAs often do

more harm than good because they are known to massage the abdomen of pregnant women and this has resulted in babies not turning properly in readiness for delivery.

“We recently had a case of a woman from Kibera who has been coming to our hospital for prenatal care while also being attended to by a TBA.” According to the nurse, “the baby came out legs first causing serious complications. While the mother survived, the baby did not,” the nurse explains.

However, in spite of these serious reservations and allegations regarding the competence of traditional birth attendants, women living in the slum will seek no other medical attention during delivery.

Often, this has been attributed to difficult and painful experiences in the hands of trained health attendants.

Beatrice Wafula is nursing her wounds after a traumatic child birth in the hands of skilled practitioners.

Supervision

“On arrival at the hospital, I was told that there was no available bed space and that I had to wait for another woman to deliver so that she could create room for me,” says Wafula, a first time mother.

“Without a bed to lie on, I was told to keep walking. This was around 6 am in the morning. The nurses and the doctor were not paying attention to me even though I was in serious pain,” she says.

As a result, Wafula did what women are advised not to do, she went to the toilet and almost delivered her baby there. “I quickly left the toilet and went back to the labour ward. I could feel the baby coming so I started pushing,” she explains.

“I must have pushed so hard because everything came out and I heard the nurses saying that I had pushed ‘nyumba ya mtoto’ (uterus) out, I did not think I would survive,” Wafula notes.

Despite this, her woes were far from over.

“They said that the baby was too big and had created a tear on my vagina. I had to be sewn. When the woman who appeared to be the head nurse came to assess me after the sewing, she said I had to be sewn again because it had not been done properly,” Wafula says in tears.

However, Wafula’s case is not an exception. According to women de-

livering in public health facilities particularly those under the City Council it is traumatising. “It is an experience that many vow not to repeat. The kind of treatment women receive at public hospitals is abusive and harsh,” says Munani.

She says that while trained health practitioners working in hospitals tend to dismiss TBAs, they are custodians of indigenous knowledge that has helped save the lives of mothers and babies.

Trained health practitioners lack this indigenous knowledge and end up causing unnecessary complications.

“There are many cases where a woman delivering in hospital is told not to push by the nurses. They misguide the women into thinking that pushing will rapture the vagina but this is dangerous,” Munani observes.

She explains: “It explains why there are so many babies dying in hospital deliveries. When a baby is coming, a mother must push. The delay in pushing can cause fatigue in the baby leading to death.

Munani says a baby can easily drink the water that breaks during delivery and end up with serious health implications, including death.

According to Munani it is not just the health and life of the mothers delivering in public hospitals that is at risk.

“New born babies are neglected at delivery. My baby has a problem with sinuses. When she was delivered, the nurse put her aside as she continued to attend to another mother delivering beside me,” says Jacinta Anyango, a resident of Katwekera in the sprawling Kibera slums.

“This is one of the main reasons why women deliver at home with TBAs. Immediately the baby comes out, a TBA will ask you to hold on to the umbilical cord that has been cut from the baby. You hold the tip so that it does not retreat,” explains Anyango.

As the woman holds on to the umbilical cord, the TBA quickly wraps the baby in a towel and places it in a warm

“There are women who when assisting delivery will have the uterus comes out. At the hospital, they either touch the uterus with their hands or they damage it because they don’t know what it is. They assume it is part of what comes out during a delivery.”

— Angelas Munani, a retired TBA

A section of Kibera slum in Nairobi. Below: Millicent Awino is one of the many women who will not be rushing to the hospital any time soon even after the waiver of maternity fee.

Pictures: Reject Correspondent and George Ngesa place where the baby cannot inhale cold air.

“Once the baby is safely tucked away, and mind you this happens very fast because you have the TBAs undivided attention, she comes back to the mother and finishes the job,” says Awino.

Scores of women still hold on to traditional beliefs “but hospitals do not accommodate these beliefs which TBAs do. So if afraid that your child will be bewitched, or may carry things from the family that are of an evil nature, TBA’s help dispel these fears,” Anyango explains.

Women in Mathare spoke of a TBA famously known as Japolo (person of God).

“She pours holy water on the abdomen before delivery, ties some-

thing around the wrist of the baby, and even blesses the baby’s bed with holy water to dispel evil spirits,” says Anyango.

“But if you take your baby to the hospital with that thing around the wrist, the nurses will really insult you and even refuse to attend to you because they know you have been to Japolo who is a TBA,” Anyango notes.

Solution

According to Ann Ngugi-Wekesa, a nurse in a city hospital, the way forward “is finding a working balance between TBAs and public hospitals. This could involve identifying TBAs in the slums, offering them regular training and equipping them with skills and tools to assist in home delivery”.

Munani concurs: “We used to be trained every now and then. I even had a certificate which was destroyed in a fire during the post-election violence.”

She explains: “Some TBAs understand the rigours of delivering babies but most of the so called traditional birth attendants do not, and this will cause even more avoidable deaths.” According to Munani some TBAs think that since they can cut an umbilical cord, then that is enough yet delivery of a baby involves much more.

ISSUE 086, July 1-15, 2013

UCelebrating n f i l t e r e d , u n i n h iWorld b i t e d … j upopulation s t t h e g r u e s o m eDAY truth

9

Kitui babies put on ARVs by mistake

By ANDREW ELIJAH Residents of Kitui County are yet to come to terms with the shocking news that some babies had been put on antiretroviral therapy (ARVs) for over two years by mistake.

This has put the future of comprehensive care dispensed to those living with HIV positive in the County in a limbo.

After intense investigation, particular cases were identified from Kitui South where some infants were apparently put under the anti-retroviral therapy (ART) for over two years by mistake.

The two children sired by infected parents were put under the same programme as their parents received drugs, food supplements and other benefits from the comprehensive care programme.

These two have been among the over 1,800 active clients put under comprehensive care at the Mutomo Mission Hospital, the leading health facility in Kitui South sponsored by the Sisters of Mercy under the Catholic Diocese of Kitui.

Both cases are attributed to a possible misdiagnosis of the HIV status of the infants after birth where it is believed health officers from the hospital rushed to declare the exposed infants HIV positive, because of their parents’ status.

In one case, a child who had tested

HIV positive after the first Polymerase Chain Reaction (PCR) test done on the DNA two weeks after birth tested negative when similar tests were carried out on him after six, nine and ten months.

It is not clear if further Polymerase Chain Reaction tests were done on the child after the three attempts. A final antibody test that should have been done on the child after 18 months could have determined the future of the child in the programme, which led to the child being retained for two more years before he was finally discharged in February, this year.

Discharge

The child’s mother Monica Mbula* says she continued to give her son the drugs as directed by the health officials at the hospital.

“I continued giving him the drugs since I believed once one tests positive for HIV then they have no choice but to take the medicine,” she says in an audio recording obtained via the assistance of a social health worker who has since left the hospital.

In the other case, a five-year old boy kept under anti-retroviral therapy since his birth in September 2008 was discharged from the programme in March this year.

Paradoxically, the mother of the child reveals that a pharmacist from the institution had once informed her that the child should no longer be kept in the programme promising to

The entrance at the Mutomo Mission Hospital in Kitui County where it is alleged that some babies were put on ARVs for more than two years. Picture: Andrew Elijah follow up the matter.

“One year after my child was put under the programme, a pharmacist said the boy should not be receiving medication for HIV anymore but did not give further explanation as to why,” she reveals.

However, the mother cannot tell what became of the promise since she did not receive any more information concerning the matter.

The parents had to wait three more years when a social worker from the hospital finally brought the news home that their son will no longer receive ARVs. According to the health officer, the child was dropped from the programme since he did not have HIV anymore leaving the parents with the belief that their son had been cured of the virus.

All that time the child was attending clinic for care with further anti-body tests done on him when that should have ended at 18 months after birth.

The child’s father says he received the news with shock when he learnt his son no longer had the virus in a final test done on him by the hospital’s social worker in his presence in March.

The mother of the child who refuted suggestions that the health officers

from the facility could have done their initial HIV tests wrongly claims “It is by the grace of God that my son got healed.”

She, however, reveals that her son had developed health complications towards the period he was finally discharged from the programme frequently complaining of pains in the chest cavity and also vomiting regularly in the mornings.

Outcome

According to a source from the hospital, who is privy in matters of HIV testing and counselling of clients in the Comprehensive Care Centre (CCC), the outcome of this final antibody test at 18 months leads to either a discharge of a client from the programme if the test is negative, or a complete confirmation into comprehensive care if the test is positive.

“For all exposed children (those born to infected mothers) the final test is done at 18 months and the test determines the future of the infant in comprehensive care.”

The hospital management declined to comment on the matter that is likely to throw the whole operations of the institution in jeopardy citing a strict code of ethics over the confidentiality of doctor-client information.

However, Amos Kilunda the Dis-

trict Medical Officer for Health in Mutomo refutes claims that the two cases are of HIV positive patients healed upon treatment saying “no viral disease is treatable in the world so we cannot say these two were healed”.

According to Dr Violet Oramisi, District Medical Officer for Health for Mwingi and Tseikuru Districts, if an exposed child is confirmed HIV positive after the final Polymerase Chain Reaction test done at 18 months, then they are permanently placed in comprehensive care programme.

“There is no possibility that an exposed child will be confirmed HIV negative at a later stage when the tests at 18 months were positive,” Oramisi explains.

All exposed children usually have the first Polymerase Chain Reaction test done on them between two and six weeks after birth. The test is then repeated after six months for either confirmation or rejection.

An antibody test is then done on the child after nine months followed by other confirmatory Polymerase Chain Reaction tests at ten and 16 months.

The final antibody test is then done at 18 months a period when the HIV status of the once exposed child will be clearly defined as reflected in the earlier tests done on their antibodies and DNA.

Three tea factories to shift from firewood to hydropower processing of tea

By KARIUKI MWANGI Three tea factories in Embu County have announced plans to shift from using firewood in processing tea to hydropower.

Kenya Tea Development Agency (KTDA) region three manager Peter Kinyua said the initiative will be achieved through the completion of a KSh430 million mini-hydro power plant at Thuci River expected to produce two megawatts of electricity. Kinyua pointed out that the three factories: Rukuriri, Kathangariri and Mungania consume a lot of energy hence they are looking for a clean source of energy.

The manager said the construction of the mini-hydro station is being done through Thuci River Company.

Speaking when KTDA planted 2000 in-

digenous trees at Nyangwa Primary School in Mbeere South District yesterday, Kinyua said that they in the future plan to use other sources of energy adding that they are also considering the use of wind energy and are doing a study on the same.

Embu governor Martin Wambora who also took part in the event said the county government was in full support of the minihydro station adding that they will support it to achieve proper environmental conservation.

“We agreed on a KSh30 million water dam that will store excess water during rainy season which would then feed the minihydro station with adequate water to provide electricity,” he posed. Wambora said that a feasibility study, alongside a detailed

engineering survey, is being conducted to make the dam a reality thus provide a cleaner source of energy and conserve the environment. The Governor said the Ministry of Energy has done wind mapping in the county to establish where there is plenty of wind urging KTDA to exploit those specific wind spots adding that one such wind dyke can produce more power than a mini-hydro station.

Samuel Ireri, a board member with KTDA said a study established that tea farmers in the county use 150 tonnes of firewood daily in each of the three factories which consume a combined eight tonnes daily. He said they have introduced energy saving jikos able to save 70 per cent of energy that are being distributed to all the farmers through the KTDA foundation. “Each of the 27,000 tea farmers

in the county uses five kilogrammes which totals 50 tonnes against the factories’ eight tonnes. We hope that through giving the Kuni Mbili energy saving jikos, the farmers will save massive number of trees,” he said.

Kinyua said all the three factories have completed a rainforest certification that will ensure that they operate in a sustainable way.

“The certification gave assurance to tea buyers and farmers that the factories are ready to operate even in the long run,” he said, adding that out of the tea produced in the country, five per cent is consumed locally and 95 per cent is exported thus the need to put environmental conservation efforts to sustain it and assure farmers of continued profitability.

Every factory was planting 5000 indigenous trees in their catchment area this season.

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ISSUE 086, July 1-15, 2013

Unfiltered, uninhibited…just the gruesome truth

Why you must choose your barber shop with care

By DAVID KIMANI Since the discovery of HIV and AIDs, many campaigns have been conducted to sensitise people on the dangers of the sexually transmitted diseases and preventive measures.

Government and non-governmental organisations have put in concerted efforts to educate the public on how to prevent and manage the disease.

A variety of conventional safety measures have been preached and emphasised on such as abstinence from sex, using protection during sexual intercourse and refraining from sharing sharp objects.

The above measures have also been associated with the spread of other incurable diseases such as Hepatitis B and others caused by contact of body fluids.

However, there has been one likely avenue of contracting the said diseases that seems to have been overlooked in such campaigns: barber shops.

In an interview with Dr. David Thiong’o, a medical practitioner from Naivasha General District Hospital, says people who visit barbershops could be at the risk of contracting HIV and hepatitis B. According to Thiong’o, the major cause of transmission is what he termed as inappropriate mode of disinfection and sterilisation of the shaving machines after use.

“Sometimes the blades of the

shaving machines get a bit too sharp and can cause accidental bleeding cuts on the skin,” explained Thiong’o.

He added: “If that machine is used to shave another customer who incidentally has open wounds on the head, chances of transmission of whatever virus in the blood of the previous customer is high.”

Safety He said the only safe way is proper sterilisation of shaving machines before they can be used on another customer.

But, isn’t proper disinfection expensive and out of reach for the average barber?

“The procedure is simple and affordable because all that is needed is properly diluted bleach solution such as Jik using the diluting instructions printed on the bottle,” recommended Thiong’o.

The solution is strong enough to kill HIV virus among others. It takes approximately five or so minutes to kill the viruses.

Disinfect

Noting the wide use of methylated spirit by most barbers, Thiong’o dismissed its effectiveness in killing germs and viruses most of which he said have a life span of up to 30 minutes.

To this effect, he advised barbers to be in possession of more than one machine so that when one is under sterilisation, the other one can be used.

Apart from this method of sterilisation and disinfection, another medical practitioner from Nakuru, Samuel Gachie, recommends the use of mini micro-waves and auto-crave machines for disinfecting the machines.

“I have heard people complain of contracting fungal infections from barber shops. The possible cause of such transmissions is improper sterilization of the shaving machines,” said Gachie.

He added: “It is important that barbers observe these measures so that we curb the spread of these diseases most of which are deadly to unsuspecting innocent customers.”

Apart from cuttings and wounds on the skin of the customers, the two medical practitioners said that diseases could also be spread from the barber to the customers or vice versa in case the barber has open wounds on the palm.

He advised barbers to wear gloves or take a break altogether if they have open wounds to curb potential transmission of infections.

The doctors called on all those who visit barbershops for a shave to demand that the machines be well sterilised before they can be shaved.

The same efforts that have been concerted to sensitise people about the dangers of HIV and AIDs should also be used to educate the public about the potential danger in some barber shops.

A barber at work. Poor treatment of the shaving kits after shaving could be a major avenue of transmitting HIV among other diseases.

Picture: David Kimani

Consequences of morning after pill leaves woman traumatised

By VALENTINE ATIENO Using the ‘morning-after-pill’ has been a regular in the life of Margaret Owino ever since she was a teenager.

Owino who lives in the sprawling Obunga slum in Kisumu has used the emergency pill as a method of family planning for four years continuously thereby defeating its purpose in reproductive health.

The fact that she did not want to get pregnant or contract HIV made her take the pills more religiously every day than its prescribed use.

The fear of parental and societal rejection also contributed to her actions.

Owino says she has been sexually active since she was 12 and its at that moment that she started taking morning after pills as a method of family planning.

Looking back, Owino says that this must be the worst mistake she ever made in her life.

“My biggest worry was getting pregnant out of wedlock, so I had to take the pills after every intercourse, which was every weekend because that was the time I would meet with my boyfriend,” explains Owino.

Like all the other youth, she never asked the pharmacist any advice on the pills.

However, when she got married things were not easy as she could not get pregnant immediately as she would have liked. It took the intervention of a gynaecologist to detect where the problem was.

“I was so stressed and did not know what to do because I was so much in need of a child and it was not forthcoming. It took like three

years before ovulation took place,” Owino says.

Within the three years of waiting, Owino went through hell literally as she had marital problems and had bad blood with her mother-in-law who could not understand why she could not conceive.

time soon,” says Owino.

Her ordeal made her have sleepless nights and at one point she thought of packing and leaving “my good house and husband because of the pressure from the society”.

After many years of praying, she was answered on June 4, 1986 when she missed her monthly period and decided to go for a pregnancy test to confirm her curiosity.

It turned out positive that indeed she was expectant. During a recent interview, the jovial mother of one said: “I thank God for the direction my life took. I am going to be so cautious on anything to do with the morning after pills, I urge all the girls who use the morning after pills to get guidelines from the pharmacist or doctors first.”

There is no doubt that the emergency pill also known as the morning after pill is popular especially among youth and there is a big demand for it in most chemists in Kisumu city.

However, most of the women who use the pill hardly ask questions from the pharmacist on it proper use or side effects. The experts are required to find out how often the clients engage in sex, their frequency of using the emergency pill and then counsel them on proper usage. They should then be referred to a family planning clinic to get other contraceptives if necessary.

Disclose

“The biggest problem was how I was going to disclose the whole issue to my husband because he was not in the picture while I was taking the pills. So I had to play it cool and hide that I did not know where the problem was,” Owino says.

However, she could not hide her fears for long because her husband was getting worried and impatient. She just had to develop the courage to disclose the genesis of her problem to him.

“I thank God for the husband he gave me because he is understanding and caring and did not pin me down for anything from the past but instead urged me look for the way forward,” she says.

They made many visits to different gynaecologists and consultants who all assured them that everything was normal and that they should keep on trying to get her pregnant.

However, frustration took its toll on her when the mother-in-law demanded that her first born son must give her a grandchild.

There was so much pressure that Owino decided to seek advice from her own mother, who urged her to stay focused and seek divine intervention.

“We kept on trying for quite some time but our efforts looked like they were not going to be awarded any

Teach

A young woman pondering her next move. Medical practitioners are encouraging women to seek family planning services from skilled health facilities. Picture: Mercy Mumo

“As pharmacists we are in business and if teaching them will make them run away from buying from us then we will do all we can to avoid the conversation and concentrate on our business for better income,” says James Odhiambo, a pharmacist

within Kisumu.

The morning after pill is an emergency drug to be taken only when one has had unprotected sex and have fears that they could get pregnant. Health workers are urging women to embrace the use of long term contraceptives in family planning against the short term methods such as the morning after pill.

According to Barnabas Abok, a quality assurance officer in health, the use of long term contraceptives has declined in the recent past due to misconceptions and myths.

Abok says it is urgent that health workers to improve on the quality of services provided to encourage more women to take up long term methods to prevent unplanned pregnancies.

According to the Kenya Demographic Health Survey, , about 42 per cent of Kenya’s population is under 15 years of age. However the youth aged between 18 and 35 years for 35 per cent of the population and these are in the reproductive age, which puts a heavy demand on reproductive health services.

According to Kenya Demographic Health Survey the proportion of teenage mothers declined from 19 per cent in 2003 to 15 per cent in 2008-2009. The levels of teenage childbearing are highest in Nyanza (27 per cent) and Coast (26 per cent) provinces and lowest in Central province (10 per cent).

Meanwhile, health providers are encouraging women to get family planning services from health facilities where there is skilled medical attendance instead of going to back street clinics.

ISSUE 086, July 1-15, 2013

11

Unfiltered, uninhibited…just the gruesome truth

Loise Wambui Female mechanic beats all odds in the male dominated field

By JOSEPH MUKUBWA She has dared to tread where few women risk to go by being a jua kali mechanic in Nyeri town. In this she has made a name for herself in the past year by challenging sexual stereotypes and venturing into what has been perceived as man’s preserve.

When Loise Wambui dropped out of school three years ago due to lack of school fees, such a job was the last thing in her mind.

Then Wambui had reached the end of the road. She spent several months doing casual jobs at Ihithe area in Tetu District, Nyeri County before she finally decided to venture into working as a mechanic in line with her desire to repair vehicles.

With no money to join a local youth polytechnic due to her poor family background, Wambui was directed by a friend to the Upper Stage Garage where she requested for an opportunity to be trained on how to repair vehicles.

Experience

It has been a year now and Wambui has gained enough experience in the male dominated profession.

“I enjoy my work despite the many challenges around me. This was my childhood dream of venturing on vehicle repairs from primary school to Ihithe Secondary where I was unable to continue with my education,” she says.

Her male counterparts are very friendly at work and she interacts freely with them.

“It does not matter how oily, greasy or dirty it is but life has to go

on. I am very determined in my work. I am lucky that the men treat me like one of them,” she says.

Wambui, who is not married, says that she is determined to continue with the work so that she can raise enough school fees to join a youth polytechnic and acquire more knowledge and skills on the profession.

She shifted from the rural area of Tetu District to Nyeri town so as to be able to sustain herself instead of relying on her parents who have the burden of bringing up other children.

Loise Wambui who is a mechanic in Nyeri town at her work place. She is urging women who are jobless to “I am not ready for white delve into the Jua Kali sector. Pictures: Joseph Wambugu collar jobs. There are many other jobs which women can do instead of sitting down and Wambui’s customers are happy been doing a tremendous job and have seen many changes. There has waiting for their parents or husbands and appreciate her work and many many drivers have been thronging been an increase in the number of to bring food home. There is no need have no doubt that she will excel in the garage for services. customers which demands more laof staying smart with no money in future.

“Whenever she repairs my ve- bour. I wish she could stay here formy bank account. I better stay dirty Joaz King’ori, who is a driver of hicle, I have no doubt that it will be ever,” says Ndarathi. with money,” she argues.

4NT matatu Sacco says Wambui has on the road for a while and in propHowever, Wambui still faces many er condition,” says Isaac challenges as she works in an open Wang’ombe, a business- air garage which is muddy during the man who has been bring- rainy season and very hot during the ing his vehicle to Wambui dry season. in the past year.

“Sometimes we work late in the evening since the car owner would like to go home with his vehicle. At The owner of the garage that time some customers take advanDuncan Ndarathi alias Ka- tage to start approaching me for some bunda says that Wambui personal interests but I’m always carehas been very determined ful,” she says. and devoted to her work Wambui urges women who are which has even attracted jobless to move out of their comfort more customers to the zones and join the jua kali sector — Loise Wambui, Mechanic in Nyeri workshop. instead of waiting for office-based “Since she joined us, I jobs.

“It does not matter how oily, greasy or dirty it is but life has to go on. I am very determined in my work.

I am lucky that the men treat me like one of them.”

Devotion

Abuse of children rife in Trans-Nzoia

By JOY MONDAY Naomi Nasimiyu* is not in school. The former pupil of Kapok Primary School is at home committed in a different occupation.

Nasimiyu, 13, dropped out of school at Standard Six due to lack of uniform and being unable to bear the pangs of hunger that deterred her from concentrating in class.

Nasimiyu’s family lives in a rental room at Kapkoi Trading Centre in Kwanza at the border of Trans-Nzoia and West Pokot counties.

Her parents are not in gainful employment but eke a living as casual labourers in local maize fields and homesteads.

After she dropped out of school, Nasimiyu joined her parents in cheap labour engagements to supplement the family income.

“Life was hard. My parents were unable to support me in my education. I lacked uniform and most of the time I reported to school on an empty stomach,” she explains.

Though she is determined to pursue her education in a bid to help tackle economic hardships affecting the family, there is little hope.

“I was determined to complete my studies but poverty in my family will not allow me to realise my dream,” Nasimiyu explains.

“It was not a relief either when the Government introduced free primary education.

We are in the same dilemma since most of the children from vulnerable families are at home because their parents cannot afford to buy them uniform and other requirements,” she says.

Nasimiyu says her friends from poor families are also out of school after encountering similar predicament.

“I know five schoolmates who are out of school due to financial constraints. They work as labourers on farms and support their families to put food on the table,” she says.

Nasimiyu is among about 3,000 children who are not in school in Trans-Nzoia County and offer cheap labour in the large farms. Most of the affected children are from poor and landless families in the county and some have become young mothers.

These families live in road reserves and open markets. They can hardly afford two meals a day forcing girls and women to sell their bodies to buy food.

“Some girls are sexual abused while weeding on the farms. Unwanted pregnancies are common in the county especially in Kwanza where poverty levels are high,” notes Immaculate Shamalla, Gender and Governance officer at the Kitale Justice and Peace Commission (JPC).

Assault

According to Shamalla some people from wealthy families take advantage of poverty to sexually assault girls and women who are vulnerable.

“Even the rich target girls from poor families and defile them. They then compromise parents when caught in the act thus defeating justice,” explains Shamalla. A report by Kitale District Hospital Rescue Centre revealed that

over 106 cases of defilement were recorded between January and March this year.

During the launch of Ubuntu Kitale project, a programme initiated by Handicap International to confront the increasing cases of sexual and gender based violence in the TransNzoia County was unveiled.

Statistics by the Gender Recovery Centre at Kitale District Hospital indicate that Trans-Nzoia County recorded 106 cases of defilement between the month of January and March this year.

Community Gender representative chairperson David Rono made the revelation during the launch of a project initiated by Handicap International to confront sexual and gender based violence in the area.

Trans-Nzoia County is one of the areas mapped by the Peace Initiative Kenya project that seeks to prevent violence against women and girls as well as protecting them. The other regions are Bungoma, Uasin Gishu and the larger north Rift, Narok and the larger south rift, Migori, Kisii, Kisumu, the Coast and the informal settlements within Nairobi. These areas have been marked as hotspots when it comes to the issue of violence against women and girls.

According to Rono, 48 rape cases and 20 domestic violence cases were reported during the same period.

“The figure could be more because many others go unreported and concerted efforts were required to tame the trend,” Rono told the gathering at Kitale Club. The programme was unveiled by Edith Van Wjingaarden

Country Programme Director Handicap International and it targets saving children and people with disabilities.

Tame

“This is a milestone towards taming sexual and gender based violence and we urge relevant bodies to take active roles in this noble mission,” said Wjingaarden. According to Evelia Anthony Children Protection Officer at Handicap International, those with disabilities are vulnerable to sex pests who expose them to health hazards and unwanted pregnancies.

The local County administrative officer Joash Abong’o blamed poverty and neglect on the vice saying the Government had directed chiefs to monitor child labour in their respective areas.

A research by the Haki Resources Centre, a Kitale based organization reported that TransNzoia and Bungoma counties had the highest cases of child labour.

Investigations show that a child employed as a casual worker takes home between KSh50 and KSh100 per day.

Trans Nzoia County Director of Education Joseph Wamwoto admits that child labour is common in the region and urgent measures are required to check on the vice.

“It is true child labour is a challenge to education. It is compromising education of many children and we are working closely with the provincial administration to curb the problem in remote areas,” he said.

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ISSUE 086, July 1-15, 2013

U nCelebrating f i l t e r e d , u n i n h i bWorld i t e d … j u s tpopulation t h e g r u e s o m e DAY truth

Medics raise red flag over rise in diabetic cases

By HENRY OWINO A five month-old baby is on treatment for diabetes at the Kenya Diabetes Management and Information Centre at the Kenyatta National Hospital.

This baby is not alone. Indications are that children are no longer spared from non-communicable diseases such as diabetes which were previously associated with the elderly.

Diabetes health condition is the number one killer disease in the world and in Kenya it is rated second to cancer. Approximately 380 million people are infected by diabetes globally.

Kenya is among the top six countries with the highest number of diabetics in Africa. The others are Ghana, Nigeria, Democratic Republic of Congo, Zimbabwe and Ethiopia.

In Kenya, 5.2 per cent of the population, about 1.8 million people, are known to be living with diabetes which can be controlled by monitoring one’s sugar intake, weight and nutrition.

The number may be bigger than the estimate since some people have never been diagnosed. It is believed that for every one person diagnosed with diabetes, two more are diabetic but are not aware of their condition.

Genetically many people are predisposed to diabetes. However, poor eating habits and sedentary lifestyle exposes many to diabetes at an early age.

Promote

According to Eva Muchemi, Executive Director, Kenya Diabetes Management and Information (KDMI) Centre, promoting testing for diabetes is critical to ensure that the public are aware of their status.

She says this will help people have a better understanding of the diseases and how to control it.

According to Muchemi, preventing the condition is more important than managing it since once attacked, one has to live with it. She encourages members of the public to purchase

gluco-meters that will enable them test their sugar levels with ease and for better control.

A gluco-meter costs approximately KSh1,200, and this price tag is expensive for the common man to afford. “At Kenyatta National Hospital 60 per cent of bed occupancy are people with noncommunicable diseases and more than half of them are diabetic patients,” says Muchemi.

She is urging the authorities to declare diabetes a national disaster to ensure proper management.

“I would urge the Government to make diabetes a national disaster so that patients suffering from it can be provided with free medical services” Muchemi notes. She explains: “These include free insulin boosters and other tablets taken daily to regulate the sugar level and high blood pressure. Managing diabetes is really expensive considering that one has to buy these tablets daily for life.”

By creating awareness on early testing, costs can be managed as 60 per cent of diabetes expenses are complications related to late diagnosis.

According to Reuben Magoko, chairman Kenya Defeat Diabetes Association (KDDA), there are diabetes support groups in 24 counties across the country.

The Association has plans to expand its programmes and to ensure its members easily access health facilities and resources.

“We need to do self-glucose monitoring by purchasing a gluco-meter and having it at home or in schools and work-stations to create awareness, inform and educate people on nutrition,” says Magoko. He adds: “Information is power and knowledge is cheaper compared to buying a viral of insulin at KSh200 and a tablet at KSh2 which many cannot afford daily.”

The Association is working closely with LifeScan and Kenya Diabetes Management and Information Cen-

The Project Embrace campaign team on diabetes signing their commitment on enhancing awareness and promoting accurate testing of diabetes during the launch. Pictures: Henry Owino tre on how to assist patients suffering from diabetes.

This is a major campaign to curb rising numbers of diabetics and diabetes complications with alarming statistics indicating that as many as one out 20 Kenyans is diabetic.

Campaign

The campaign dubbed Project Embrace with the tagline “Simple touches, better life,” targets to reach five million families by 2018 across the continent.

This will be through enhancing awareness, financial and geographical access and promoting accurate testing.

According to Les Klajnscek from LifeScan, the campaign will further encourage diabetics to embrace healthy living through LifeScan’s Lamasat family support program which has been developed around 4Cs: Check blood sugar regularly; Control

the highs and lows of glucose levels; Consume healthy food and Care for yourself by exercising and adopting a healthy lifestyle.

Klajnscek says that the initiative comes in the wake of warnings that the numbers of those suffering from diabetes is likely to double in 20 years unless action is taken by the patients.

“This is a cause for concern with ignorance, awareness and accessibility gaps as major limitations to proper detection, prevention and management of the disease,” said Klajnscek.

He adds: “This is why we have partnered with Kenya Diabetes Management and Information Centre and Kenya Defeat Diabetes Association on this campaign as it recognises the importance of supporting and partnering with others to serve the broad needs of the diabetes community.”

Award winning artiste, Wahu

Kagwi, is among those who have been endorsed to make the campaign reach out to targeted families and members of the public.

She said it was unfortunate that many Kenyans were still unaware of their diabetes status and only seek treatment when the condition has advanced.

In addition, Wahu appealed to the public to get tested so that they could start controlling and managing it early through medication, sugar level, nutrition and healthy living.

Wahu’s mother is diabetic and the celebrity has since then become the diabetes goodwill ambassador.

“Anyone can get diabetes and, therefore, it is advisable that you check your blood sugar levels regularly and save a life today,” Wahu urged.

This campaign is the first ever comprehensive diabetes initiative in Africa and in Kenya.

Relief as user friendly insulin device is launched

By HENRY OWINO Kenyans suffering from diabetes can now acquire a newly developed and modern insulin device that is easy to use, is dependable and durable for their health.

The device dubbed HumaPen Savvio is a reusable insulin gadget to help meet the needs of people living with diabetes.

HumaPen Savvio device is designed in the form of a pen, is attractive, lightweight and modern for diabetics to manage their medication anywhere and anytime.

The device is used with insulin making it very comfortable compared to any other gadgets currently available. It is being introduced in Kenya, the very first African country after nine years of research in laboratories around the world and in collaboration with eminent scientific organisations.

It has been tested in USA, Europe and China among other developed nations. Kenyans are, therefore, the first beneficiaries to access the device before it moves to other parts of Africa after its official launch in Nairobi recently.

The device comes in different colours to cater for colour preferences.

HumaPen Savvio is designed to be used for up to six years after its first use by the diabetic, making it long lasting and economical to users.

This diabetes insulin gadget is invented by Eli Lilly Diabetes Company with its headquarters in Indianapolis, India. (Is this in India or USA> Please confirm.) It provides answers through medicines and information for some of the world’s most urgent medical needs.

Commitment

According to Joachim Becker, senior advisor Diabetes Strategy at Lilly Corporate Centre, the aim of the Eli Lilly Company is to arrest progression and impact of diabetes in the world. He noted Lilly has been a global leader in diabetes care since 1923 when it first introduced the world’s first commercial insulin.

“Today we work to meet the diverse needs of people with diabetes through research and collaboration abroad. We are growing product portfolio and our continued commitment to providing real solutions from medicines to support programs and make lives better,” Becker explained.

Becker noted that they chose to launch the device in Kenya because of its fast development in information

communication technology (ICT), concerns for the non-communicable diseases and for its strategic geographical location in Africa.

He said the device is free for diabetes patients who are registered with Lilly Company unless for replacement, one would be charged KSh7,500 which is the recommended retail price.

According to Ann Marie HosangArcher, Managing Director, Lilly South Africa and sub-Sahara Africa, diabetes is on the rise in Africa generally. Kenya is not spared as it is estimated that some 3.3 per cent of its population is diabetic.

Hosang-Archer said: “Based on our research, we learned that people with diabetes want an insulin delivery device that makes them feel more comfortable and confident managing their insulin.”

Lilly’s HumanPen Savvio was created based on feedback from people with diabetes.

It is available in four colours; grey, red, pink and blue. The device also makes dosing easy and insulin delivery discreet, which helps insulin users feel more at ease when using their medication.

It is hoped that the device will provide personalised solutions for people

Dr. Eva Njenga (left) and Ann-Marie Hosang-Archer the Lilly Managing Director, South Africa & Sub-Saharan Africa displays the latest reusable insulin pen device dubbed; HumaPen SAVVIO. Picture: Henry Owino living with diabetes and even to their care-givers. It is available for use with Lilly’s 3ml insulin cartridges. The pen was available to consumers in the Kenya’s pharmaceutical markets at the end of April 2013.

According to Dr Eva Njenga, Consultant Physician and Endocrinologist majority of diabetics in Kenya are type II, which is mainly caused by lifestyle. She said approximately two million Kenyans are known to be suffering from diabetes while majority

have not been diagnosed.

“Most Kenyan think diabetes is a death sentence, so many would not be brave enough to go for the test. It is always wise to diagnose early than wait until when it is too late to manage it,” Njenga said.

She reiterated that diabetes is a non- communicable disease and could be managed if it was detected early. She added it is a condition one could live with for years as long as one is diagnosed and put under insulin.

ISSUE 086, July 1-15, 2013

Unfiltered, uninhibited…just the gruesome truth

Lawi Otieno Ondieki

13

Kisumu pupil sets his eyes on the environment

By AJANGA KHAYESI When Lawi Otieno joined the Environmental Club at St Vitalis Nanga Primary School in Kisumu town in 2007, little did he know that it would be a turning point in his life.

Otieno enrolled in the club while he was in class four and has never looked back. Today, the 13-year old Standard Eight pupil is a role model to many youth in his County and the country at large after he recently scooped top awards in the Kenya Wildlife Services (KWS) essay writing competition in the primary schools category.

Standing tall among all children in Kisumu County, Otieno also represented his schoolmates at Nanga Primary School who share the same passion and experiences about conserving the environment.

He clinched first position in the Kenya Wildlife Service Partnership for Accountability in Schools Management Around Parks (PASMAP) 2013 Primary School article St.Vitalis Nanga Primary School pupils congratulate Lawi Otieno writing competition on school for winning in the KWS essay writing competition. Below: Otieno governance themed ‘my displays the essay certificate awarded to him during the KWS-Pasmap school my community’. competition. Pictures: Ajanga Khayesi PASMAP, which is a schools based project origidren and adults “comprising second“Children have the right to pronated from an on-going Trust ary and primary school children as tection from all forms of violence, for African Schools (TAS) and Kenya well as members of the community neglect, abuse and mistreatment and Wildlife Service partnership prodrawn from Western, Nyanza and not to be exploited by parents or othgramme. The project was started last parts of the Rift Valley provinces who er guardians.” year at Nanga Primary School. shared ideas on wildlife conservaEssay writing came as a result of Otieno was awarded that certifition and environmental matters,” says Kenya Wildlife Service method of cate and KSh10,000 voucher prize for Ongw’en. fostering community participation the purchase of educational materials.

While on a tour at Saiwa Park, in school management around parks the children were able to see several as a way of improving academic permonkey species, haven swamps with formance and enhancing wildlife He bought an Oxford dictionary, lots of snakes, different species of conservation for prosperity.

Kamusi ya Kiswahili, story books and birds and rain tropical forest with a In his award-winning essay, Otithe Kenya Certificate of Primary Edulot of climbers. eno wrote about pupils’ contribution cation (KCPE) revision books for soBack at the club level, Otieno has in enhancing academic performance cial studies, mathematics and science played a leading role in conservation and service delivery in learning instisubjects. projects such as feeding wild birds, tutions saying discipline was the key “In advance preparations for next tree planting and educating the comto success in any learning individual’s year’s admission in Form One, I munity on environmental awareness. endeavours. bought secondary school books such “Birds eat from trees where we Achieving top scores in Kiswahili, as physics, chemistry, biology, mathput improvised feeding trays made English, Science and Social Studies, ematics, English, Kiswahili, an atlas from used plastic containers. Other Otieno hopes to be a judge in future. and a Casio calculator,” Otieno said children are involved in bringing He admires Kenya’s Chief Justice Wilwith pride recalling how he travelled cereals on a daily basis. The feeding ly Mutunga who he sees as his mentor. to Saiwa National Park in Kitale for system attracted many birds from Situated in the neighbourhood of the award ceremony that was held at Dunga swamp and bushes around,” Kisumu’s Impala Park where Kenya Kokwo Primary School. he said.

Wildlife Service operates programs, Otieno is the last born in a famPASMAP selected Nanga Primary ily of five children to the late Richard School from its vicinity in the wildOndiek and Florence Auma Ondiek.

Otieno does not like seeing othlife inhabited areas.

He was accompanied by Jenipher er children experiencing violence, “Nanga School borders the DunOnyande Nanga Primary School abuse and extreme injustice. ga swamp, the famous Hippo Point deputy head teacher, Millicent He believes the rights of the Beach where different bird types Ongw’en who is an assistant teacher, child apply to all persons below the can be found as well as the Sitatunga and classmate Ricky Eddy. age of 18. antelope, hippopotamus, tortoise, The venue was occupied by chil-

Prepare

Rights

monkeys and pythons can be spotted,” explains Ongw’en.

According to Ongw’en, PASMAP’s agenda includes supporting schools neighbouring wild parks financially as well as buying and equipping them with learning tools.

Ascertain

Showing appreciation to Kenya Wildlife Service for introducing the essay assessment as a measuring stick to ascertain talents in children,

Executive Director: Arthur Okwemba Editor: Jane Godia

Otieno recalls November 20, 1989 when the United Nations adopted the rights of the child. He says: “Every child has the right to express his or her opinion and to be respected by others.”

The 13-year-old is now urging all children in Kenya to be good and always work hard at school. “Do not fall in company with the wrong crowd,” Otieno warns. He adds: “All children are strong in reasoning and they can do anything good.”

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Sub-Editors: Mercy Mumo, Joyce Chimbi and Odhiambo Orlale Designer: Noel Lumbama

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Contributors: Waikwa Maina, Maurice Alal, Duncan Mboyah, Leonard Acharry, Mark Mwangi, Ben Oroko, Andrew Elijah, Kariuki Mwangi, David Kimani, Valentine Atieno, Joseph Mukubwa, Joy Monday, Henry Owino and Ajanga Khayesi.

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