Health

Malkia#1: Elizabeth Merab,on being an award-winning science reporter in Africa

One time, enjoying the cool breeze of Toledo, Spain, Irene Tato who is the Director of Mundo Sano—an organisation championing science around neglected tropical diseases— was telling me how she loves mentoring young women to live to their potential. As I listened to her, I realised that it takes a special kind of strength and calculation for women to excel in whatever parts of the world they are in. Women have come far— thanks to the Harriet Tubmans and Wangari Maathais of this world— but we MUST appreciate that sisters still have to claw their way up, with blood, sweat and tears. So I decided to use my own little space to create a platform for us to have these conversations about “phenomenal womanism”, chats with women who have made a name for themselves in any field in the world, no matter how grand or little. I named it Malkia, Swahili for Queen.

These thoughts were running through my head as I was eating cake bought for my colleague Elizabeth Merab Mcleans, for her international science reporting award (read the winning story here). I was pouting a little as I ate the cake because she had been travelling a lot – to Germany, South Africa etcetera— and I was there, bored in Nairobi. A few days after that, she was nominated for Thomson Foundation young journalist award (read the nominated story here). Then there was that prestigious Falling Walls Fellowship in Berlin. At Just mid-20s, Merab has moved up the ladder in a niche reporting, and been in the newsroom myself, I could not help but pay homage to her success.

Merab chatting with Nobel laureate Klaus von Klitzing, a German physicist, known for the discovery of the integer quantum Hall effect, for which he was awarded the 1985 Nobel Prize in Physics. This was in a meeting in Landau, Germany for the annual Nobel meetings. PHOTO/Source

 

With no training in media—that kind of tells you ‘the media is a man-eat-man society, be ready’— Elizabeth learnt in the job to act in that space. A Kenyatta University graduate in Education, specializing in English and literature— you know now I get why Merab is not critical of teachers’ strikes— she did not become a health reporter from the first day in the newsroom. So how did a trained teacher, end up in the newsroom?

“I started out by writing about agribusiness for the Seeds of Gold, then moved to writing feature stories about the real estate industry,” she told me, adding that she kept eyeing health and science since this is what she enjoyed. Having suffered a series of health issues herself, Merab drew from her own experiences to excel in her job of amplifying the public’s voice in health care that is always trampled on in Africa by the ruling class. “Health and science reporting goes way deep. It is personal. I always say that I am first a patient before I am a journalist. This is because I have spent a lot of my years (and still do) in the corridors of hospitals in search of personal health services”

Now more than ever, Africa needs journalists like Merab more than ever. The continent is experiencing a shift in the diseases’ profile but its sons and daughters are also excelling in research. Who will link those two? Journalists with a keen eye on health. To rise to the task, Elizabeth built her knowledge on the area she is reporting on, her strategy to achieve that was by enrolling for a Masters’ degree in Medical Sociology at the University of Nairobi.

“The health industry is the backbone of any economy. When you talk of life expectancy, total fertility rate, Years of life lost (YLLs) due to premature mortality etcetera, then you begin to notice the huge role health plays in any country. Health, and by large science journalism, bridges the gap between what scientists know and discover and what the general populace knows and believes”

These subjects get her to the office at 9 a.m. and then screen the “docket assignments”— that is newsroom lingo for a big book on which the editors allocate stories to reporters— or go through social media, other news sites and papers to see what’s in the current affairs pages for a daily story. Merab, along with me and my colleague Eunice Kilonzo who joined corporate communication, was the first reporter in the newly converged science desk at Nation Media Group. That weekly pull out needs perusing through scientific journals such as Nature, the Lancet, as well get ideas on a chat on “what is cooking now in science?”

Merab receiving her certificate from Rhodes University South Africa for science journalism

So networks, with people whose name means something in that area really matter. Excellence, therefore, required a certain degree of sacrifice. “While a typical day should end at 6:30 p.m, I often find myself going home past 8p.m. after classes and sometimes, depending on how the day looks, I may end up missing class to finish up office work”, she said. Any journalist is just as good as her contacts. Creating and maintaining those is no joke especially with people who have not been open to the media before.

But Merab, a lover of fashion, also creates time to look after herself and her wellbeing. She told Verah Okeyo: “I love listening to music, so I must also note that I extremely love dancing—I am almost always the show stopper whenever I go out with friends—I also love fashion, I am yet to push the boundaries of fashion but I love being trendy”. She also loves to watch movies and …. wait for it… going to the shooting range learning how to fire and handle guns!

Is there a woman out there who you want to clap for? Drop me an email at verah@verahokeyo.com 

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Luo Nyanza governments, “waste” money on Aids orphans,not those useless trips

I trace my paternity to Homa Bay, the county with the highest HIV prevalence in Kenya as at 2014 according to data from National Aids Control Council (Nacc). You can check the full report with the statistics for the other 46 counties here for 2015. Expectedly,not much has changed. My work as a journalist has made me relate to Luo Nyanza much more than a daughter of that land. In 2014, my boss and a team of journalists worked on a pull out marking 30 years on AIDS that you can read the 12 pages of the report here. Homa Bay is part of the former Luo Nyanza—Siaya, Migori and Kisumu- which contributes to more than half of the total number of HIV positive people in Kenya.These are boring, albeit heart-breaking, statistics.

However, there is a group that has remained ignored in the conversation on AIDS in Nyanza: the orphans left behind by the virus. Nacc’s 2015 report states that there were 661,119 AIDS orphans. That is a third (31 per cent) of the total 2.1 million orphans in Kenya.Since the aforementioned four counties also lead in prevalence (all people with Aids over the years) as well as incidence (new infections every year), and the deaths it is safe to assume that they may bear the greatest number of AIDS orphans in Kenya.Even global bodies such as UNICEF have conducted studies on the vulnerability that these children face and called for a little more effort in securing their wellbeing and the numbers are rising globally.

Let me put a face to those statistics for you as I tell you about three beautiful children in Rongo, a small town in Migori County. One day my auntie, who is a teacher in a primary school there, packed so much food I asked her whether there was party she was going to. She said she was taking the food to some three young children who never ate and it was exams time. They needed the food to concentrate. On a Saturday, when resting at home and telling stories, these children came home to her to pick flour. I did not need a degree in psychology to notice just how beat up, tired and drained these children—12,6 and 5— were. When I heard their stories, my heart broke. Their parents died in Nairobi in 2014, after which they were brought home to their grandmother. Their granny was too weak and poor to care for them. For that reason, the first born boy has had to grow up so quickly to look after his sisters. My auntie told me that teachers took part in feeding them, but the help was never consistent. Nobody knew what they ate in their home over the weekends, whether they were warm and it never seemed to bother anyone because there are so many of such kinds of stories in Nyanza.

I heard of, and know, these youth who dropped out of school to work as house helps where they were taken advantage of and violated so cruelly even by relatives.Others became pickpockets and sometimes faced the wrath of the public as they stole to survive.I applaud the efforts that have gone into HIV management in Nyanza. Organisation such as Family Aids Care and Education (Faces) headed by my friend Dr Patrick Oyaro have gone out of their way to make the lives of Aids patients bearable. They have provided Antiretroviral therapy, treated and counselled them.However, once the patient dies, the circle ends. This is where the community should step in. It is really annoying that people have watched as these children become pawns in the villages, robbed of their innocence especially when they have no one to stand for them.

Not once, but many times, we have witnessed NGOs and “well-wishers” use these orphans to attract donor funding as these kids live in squalor in homes that even pigs would not be comfortable in. Underfunded and ill equipped children’s departments in counties have not been able to protect them. The only crime they have committed is being born to impoverished communities and losing the only cover that would have kept them safe.

Taking care of Aids orphans is not only an act of compassion or a God given duty for us, but also a public health strategy. These are the children who get sexually active in their early teens, get infected and infect their peers as well, and we all gasp when the statistics for teenage HIV infections are high? Kisumu, Siaya, Homa Bay and Migori have hit the media umbrage for the outrageous things they do with their monies. In the auditor general’s report released in April this year, three of these counties were listed among the 11 that exceeded the Sh124,800 monthly sitting allowance for members of county assemblies(MCAs). Migori(Sh164,729), Homa Bay(Sh148,200), Kisumu(Sh144,089) outdid themselves! Yet, you would be surprised how many families that have survived on as little as Sh3,000 a month.That is enough to feed a child and just ensure that at least they have a roof over their head, and a safe place where they can play and just be children. We spoil our children, work so hard to give them more than they need. Why do we think the other children whose only crime was to be orphaned have needs different from ours? If you can, give them phones as you do your children, but a hungry child just needs some food served to them in love, a warm place where they can sleep. They would be eternally grateful for a shirt to cover their backs they would not care whether it was new or not. They would feel loved too if you asked them how school was and remembered their birthdays. All that which you feel your child needs, is what these orphans desire as well.

Whenever I raise these concerns, Kenyans especially those charged with the duty to take care of these kids drop escapist statements like “Let us fix the system”, “we need a multi-pronged approach for this, money alone will not solve it”. I appreciate the truth in these statements, but should the children wait until the system in Kenya get fixed so that they can get food in their bellies, go to school or be safe from abuse? As we fix the system, shouldn’t we at least keep them healthy physically and emotionally until then? County governments in these four counties need to step up and take care of its future by protecting children who have become casualties in a world adults have created.

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WHO:Kenya, top 10 globally in environmental deaths

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

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

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

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

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

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

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

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

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

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

TAKE HOME POINTS HERE?

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

 

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Thumbi Mwangi: Disease-causing pathogens talk to each other

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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