A Kenyan Journalist Writing About Health

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Turkana’s Children Race for Survival

By Maryanne Waweru-Wanyama

Among some mothers in Turkana, a newborn does not start breastfeeding until he responds to his name.

“After she gives birth, different names are called out and only when the newborn responds positively to a name will he begin breastfeeding,” says Nicholas Losike, a community health worker in Loima district, Turkana.

Losike says this traditional naming practice, which is still observed by some adherents, serves as one of the greatest challenges health workers face as they advocate for exclusive breastfeeding where the newborn is fed nothing else but the mother’s breastmilk for the first six months of life.

As a name is called out and the child shows no enthusiasm about it, it means he has rejected it, prompting more names to be called out. But when the child hears a particular name, opens his mouth and reaches out for his mother’s nipple, it means he has accepted the name and only then can his mother begin to breastfeed him.

“On average it takes about two days for the child to ‘respond’ to a name. Sometimes it can take even longer. In the meantime, the baby is fed on boiled goat or camel milk,” says Losike.

PASSIONATE: Nicholas Losike, a community health worker in Turkana. Photo/Maryanne Wanyama

Photo: Nicholas Losike, a community health worker

Even if the mother has delivered in a health facility, she will argue with the nurses about it and if they insist on her breastfeeding the newborn before he responds to a name, she will sneak out of the hospital, he adds.

Yet, the World Health Organization (WHO) recommends that mothers initiate breastfeeding within the first hour of birth. This is because of the immense benefits that breastmilk offers the infant.

According to Terry Wefwafwa, the head of nutrition and dietetics at the Ministry of Health, breast milk contains all the nutrients that an infant needs in the first six months of life. “Mothers should breastfeed as soon as possible after birth. This is because the first thick yellowish milk she produces called colostrum is filled with antibodies that give the newborn immunity from infection. It is actually the baby’s first immunisation,” she says.

Breastfeeding, according to Wefwafwa, is the single most effective prevention intervention for ensuring child survival and healthy development.

So when mothers such as those in Turkana discard this first milk due to long-held traditions, it gives the newborns a disadvantaged start to a healthy life as they miss out on the free and available first immunisation.

It is perhaps such cultural practices that contribute to a high infant mortality rate in Turkana, which stands at 60 in every 1,000. The health status of children in Turkana is wanting, with only 54 per cent of children aged 0-5 years being fully immunised, which is below the national average of 83 per cent.

This is partly attributable to the lack of quick access to health care services, forcing residents to trek long distances in the harsh, arid climate to reach health facilities.

“Many mothers take days to get to a dispensary or hospital, so they only come for services like immunisation when they are coming to seek other treatment services. We have women who bring in children for their first immunisation at 10 months,” says Susan Ilikwel, a 28-year-old mother of three in Namoruputh division.

Turkana has a population of 855,000, with only one doctor for every 52,434 people. This is against the universal recommendation of one doctor for 1,000 people.

The issue of child deaths in Turkana county is further compounded by the high maternal mortality rate, which stands at 1,500 deaths per 100,000 live births — which is three times the national average. Often, a mother’s death leaves devastating consequences for her family.

Findings from the study A Price too High to Bear released in March 2014 by Family Care International (FCI), the International Center for Research on Women (ICRW) and KEMRI/CDC demonstrated the great link between maternal deaths and neonatal mortality. Of the 59 maternal deaths in the study, only 15 babies survived the first 60 days of life. The deaths of mothers, most of who are in their productive years and engaged in different economic activities only deepens the poverty levels in the home. In some households in the study, surviving children had to be withdrawn from school because of economic disruptions. Often, the sudden death of a woman from pregnancy or childbirth-related causes begins a chain of losses that compromises her children’s health, education and future opportunities.

The WHO states that children from the poorest households are nearly twice as likely to die before their fifth birthday than children in the richest households. It is indeed a tough life for poor children as they struggle for food, health, education and other necessities that would enable them enjoy healthy mental, physical, emotional and spiritual lives.

With Turkana County ranked as the poorest county in Kenya, life for a child here is difficult, with the most pressing health problem being malnutrition. Malnutrition is marked by a deficiency of essential proteins, fats, vitamins and minerals in a diet. Without these nutrients, it becomes difficult for a child to achieve optimum health. Assessment reports indicate that the Global Acute Malnutrition level in Turkana is at 28 per cent, which is high considering the WHO threshold is 15 per cent.

Recurring droughts, increasing populations that have put pressure on the county’s resources, as well as insecurity characterised by clashes over water and grazing pastures as well as frequent cattle raids have compounded food insecurity issues for Turkana’s pastoralist population.

However, it is not all gloom for the county, as both the national and the country governments are putting in place measures aimed at bettering the lives of Turkana’s mothers and children.

In June 2013, the national government introduced free maternity services in all public health facilities. This move has seen an increase in the number of women accessing antenatal care services and subsequent delivery in hospitals.

With the cost barrier eliminated, the Turkana county government has put in place measures to ensure that pregnant women and children have better access to health services. “Because of the long distances women have to walk to access a health facility, we have now ensured that each ward in the county has at least one health centre. There will be additional 30 more health centres by the end of this year. With the assistance of partners, we have put up a model maternity section at the county’s referral hospital that will specifically take care of the health needs of mothers and children,” says Peter Ekai, Turkana’s deputy governor.

According to Ekai, the county has further committed 2.1 billion shillings to the health sector, a move that is expected to increase the positive health outcomes in the county.

“We also acknowledge the strategies that the Kenyan government has established at national and county levels with regard to mothers and children. One is the introduction of free maternity services which has seen more Turkana women access services in hospitals, and second is the introduction of free rotavirus and pneumococcal vaccines in public hospitals which will no doubt see more of our children surviving their childhood.”

Ekai was speaking at Lodwar Mixed Primary School during an event called ‘Race for Survival’ organised by the children’s rights organisation Save the Children on October 17 to mark the UN International Day for the Eradication of Poverty. On this day, children from across the world participated in a symbolic race aimed at highlighting the plight of children from the most difficult places in the world.

DISADVANTAGED: Children run in an event to mark the UN International Day for the Eradication of Poverty in Turkana on October 17. Photo/Maryanne Wanyama

Photo: Turkana children participate in the Race for Survival

In Kenya, the celebrations were marked in Turkana county where the focus was on malnutrition. Kenya loses 108,000 children each year from preventable diseases like diarrhoea, pneumonia, malaria and other neonatal causes. Malnutrition however remains a major threat to the survival, growth and development of children where it contributes to more than 3.5 million preventable deaths annually in Kenya.

Children who participated at the Race for Survival called on both the national and county governments to pay urgent attention to Turkana’s children. “We ask that our health and nutrition needs be given priority. We want our governments to ensure that every child has access to a nutritious diet as this will help us live longer,” said Elizabeth Sakasa, a 12-year-old girl from Lodwar Mixed Primary School.

Article courtesy: The Star.

Lilian Madonye: When Infertility Leads to a Life of Reckless Abandon

By Maryanne Waweru-Wanyama

When 37-year-old Lilian Madonye took her marriage vows 14 years ago, she looked forward to the exciting life that lay ahead of her. In her early twenties, she was marrying the man of her dreams, an athlete whom she had courted for two years.

The wedding marked the beginning of her new life, a life that would be filled with untold happiness from both her husband and the beautiful babies they would raise together.

Lillian, a second born in a family of three, had been raised in a relatively comfortable upbringing in Eldoret town. Her father, a banker, and her nurse mother had provided them with a stable home and good education.

Nurtured in a Christian environment, Lilian was a role model in her school, neighbourhood and church where she served as a worship leader. And her marriage did not disappoint.

Lilian Madonye

Photo: Lillian Madonye during the interview

The first year was full on love, warmth and laughter. However, in the second year, the couple became worried when they were unable to conceive.

After trying for a baby for three years in vain, Lilian decided to seek professional help and saw a doctor who put her on fertility drugs and supplements. However, the desire for a baby became a dominant, crippling thought which consumed her whole being.

“Sex became a laborious task that was no longer enjoyable because of the pressure to conceive. Family, friends, neighbours and church members were already spreading rumours about my barrenness,” she remembers.

Meanwhile, Lilian kept hopping from one doctor to another seeking a miracle treatment, but none helped her conceive.

“The day I would receive my period each month would send me to a very dark place where I would spend the duration of the menses in tears. Helpless, I wondered what worth I was as a woman if I could not bear a child. What justification did I have to call myself a woman if I could not have a child?” she asked herself.

Frustrated and at her wits end, she one day asked her husband to take a fertility test if only to encourage him to be part of their quest for a baby.

“Even though I knew I was the one with the problem because I believed that infertility was a condition only for women, I asked him to get tested anyway.” But the results of the semen analysis test on her husband shocked her.

“My husband had a low sperm count, hence my difficulty in conceiving! The news took me aback because all along I thought I was the one with the problem,” Lilian says.

A low sperm count decreases the odds of a sperm fertilising an egg which results in pregnancy. Lilian’s husband was then put on fertility treatment aimed at boosting his sperm count.

At the same time, out of curiosity, Lilian decided to take a fertility test as well, and whose results showed that she was perfectly capable of conceiving and bearing a child.

“I stopped all the drugs I was taking. I wished we had both done the tests earlier as it would have saved me all the medicines I had taken for three years!”

For the next two years, the couple continued trying for a baby, but were unsuccessful. During this time, their marriage began undergoing turmoil.

“We would constantly engage in verbal confrontations about anything and everything. We were both frustrated and very desperate about wanting a baby. At some point, the fights became physical. Our marriage became filled with extreme tension and anger. We both became very unhappy in our marriage. There were infidelity issues and I was constantly rebuking women with whom my husband was having dalliances with. We stopped talking and even slept in separate rooms. I felt there was nothing left to hold on to and I eventually walked out of my marriage,” she remembers.

Lilian then moved to Nairobi where she landed a job as a sales representative in a bank. Older, wiser and with her newfound freedom — her faith in God long gone, Lilian took to alcohol and drugs. A short while later, she got a transfer to Mombasa.

“As soon as I landed in the beautiful Coastal city, I met up with people who introduced me to a wide variety of hard drugs which were easily accessible unlike in Nairobi. Soon, I began engaging in prostitution to finance my new lifestyle as my salary could obviously not cater for my needs. I would have multiple affairs with married men who would take care of my different financial needs.

Lilian Madonye

Despite being aware of the dangers, I would have unprotected sex with my partners. I didn’t care about HIV, venereal diseases or drug overdoses because I had nothing to live for. With no husband and no children, my life had no meaning,” she confesses.

Lilian says she was on a constant high because when sober, the reality of her empty life would hit her, something she did not want to face. One morning after a night out, she began feeling sick.

“I knew that Aids had finally caught up with me,” she remembers. Lilian went to the hospital, but the doctor’s diagnosis shocked her. She recalls his words:

“Lilian, your HIV test is negative. But there is another test that has yielded positive results. Congratulations, you are pregnant!” She did not believe it.

“I was living a very evil life, engaging in all the abominable acts mentioned in the Bible, but yet God remembered me? I wondered why, yet when I was a good Christian, faithful in my marriage and with enviable morals, he ignored me. But now, when I was fully immersed in sin, he remembered me?”

Shocked to the bone, Lilian decided to sober up for the sake of her unborn baby. She packed all her belongings and moved back to Nairobi to start a new life.

She got back her old sales job at the bank, and began piecing her life together, which was not easy. “I was used to men taking care of all my bills, but now I had to support myself and my unborn baby. It became very difficult to make ends meet, but I did not despair. My baby motivated me and kept me going,” she says.

One day, in her seventh month of pregnancy, she noticed some blood stains. She rushed to hospital, and by the time she got there, her clothes were soaked in blood and she was writhing in pain.

An ultrasound done on the foetus revealed that Lilian’s baby was already dead. Lilian had faced high blood pressure issues during the pregnancy, which led to her having pre-eclampsia, a condition characterised by a high level of protein the urine and which can be fatal.

But she had to deliver the baby anyway, and after six agonising days, she finally gave birth. “It was a baby girl. Even though I wanted to see her and hold her in my arms, the doctors refused and only showed me her legs. They said that because she had been dead for more than a week, she was already decomposed and in a bad state. I called her Zawadi, because she was my special gift,” she says, struggling to contain the tears welling up in her eyes.

As she walked out of the hospital on that day in May 2012, Lilian left with a new resolve. To completely turn her life around and find her purpose in life again.

“I don’t blame anyone for the path I took in life. I am responsible for all the decisions I made. I could have made better choices, but I did not. I have forgiven myself and I am embracing my new life.”

In January this year, Lilian formed a group for women struggling with infertility. The group is called Diamonds Women Ministry, and it brings together women struggling with infertility, and teaches them to focus on other areas of their lives even as they try for a baby.

“The reality is that not all women struggling with infertility will have a happy ending where they will get pregnant and have babies. I encourage women not to be consumed by the search for a baby to the extent that other areas of their life suffers. They should also not peg their worth as women solely on the basis of motherhood. I talk to women during bridal showers and talk to newlyweds about marriage expectations. I always use my personal experiences because I know I contributed to the loss of my marriage and advice them not to make the mistakes I made. I am a strong believer in marriage and just because mine did not work, it does not mean that it will not work for another couple,” she concludes.

Article courtesy: The Star

Rugby in Wheels – Sporting Event for Women with and Without Disability

If you have time, do attend this interesting event.


Ashoka Fellow Fred Ouko: I Didn’t Get the Job, But it Changed My Life Forever!

When Fred Ouko once went for an interview at a multinational corporation, he was hopeful that he would get the job for he had all the qualifications needed, and besides, he had passed all prior interviews. But things didn’t turn out as expected for the interview ended as soon as it began. It didn’t even last two minutes!! But something good did eventually come out of this experience.

Here is the full story about Fred that I wrote about, as published in the Daily Nation newspaper.

Fred ouko

Citizen Journalism and Peace in Kenya

What Kenya witnessed in the last general elections held in December 2007 was akin to a nightmare they thought would never happen. For many, it was an unexpected occurrence, a shocking one which left many in tears. Sadly, others found themselves six feet under. Today, many Kenyans still reel from the effects of the violence that erupted from the disputed presidential results. We still bear the pains of this –physically, economically, socially mentally and emotionally. Every Kenyan was affected no doubt, and we all continue to live the consequences of our actions.

Young girls scavenging for food at the Nakuru IDP camp.
Photo: Dolphine Emali


Lucy Njoki, aged 104 years at the Nakuru IDP camp. The violence affected people of all ages.
Photo: Dolphine Emali
















But what happened, and who ‘happened’ it?

Well many players were involved. And I’ll talk about the media because that’s what I know better. What role did the media play in this? A huge role. Both the traditional media and new media played a huge role in the spread of information. Information that led to violence. Information that was inaccurate. Information that was false. Information that was accurate. Information that was true. Information through the television, the radio, the newspaper, text messages, blogs, Facebook, twitter –all had a role to play. Information that led to the flare up of violence.

But the media too contributed to the halt of the violence. Both the traditional media and new media. Both were involved in spreading peace messages and promoting reconciliation.

A journalist asks a question during a media forum. Many journalists were accused of having been partisan as they provided coverage before, during and after the 2007 general elections.

I choose not to dwell on the traditional media, but on the media that you, me and almost every Kenyan has access to. We called radio stations and reported what was going on in our neighborhoods. Community radio stations were on over-drive with eyewitness accounts and reports ‘from the ground’ flowing in fast and furious. We were on our phones nonstop, sharing messages, alerting each other and warning each other to be on the lookout. Some messages went viral. Bloggers, Facebookers and the Twitter community did not let their fingers rest as they typed away furiously, providing updates by the second. We did not mince our thoughts or our word. Everything went. Lots of rumors and inaccurate information was flying left, right and center. Who was controlling us? Nobody.

And when the dust finally settled, when the fires calmed and all we had were ashes, what did we learn? That we are an emotional lot. That many of us are committed to our tribes and will do anything to protect ‘our people’. That information spreads FAST. That we spread this information FAST. And we believe this information without verifying its authenticity.

So what can be done differently next time? Almost five years later, what have we learnt as a nation?

A female blogger/journalist takes photographs during a media event in Nairobi. Many traditional media journalists today also own their own blogs and are increasingly using other online spaces to tell their stories.











That we should use our cell phones to promote peace. That we should use our blogs, our Facebook pages and our Twitter accounts to pass peaceful messages. Individual responsibility here is important. We should self-censor ourselves. We cannot look to the religious sector for help. They failed us. They took sides. Sad.

The government too should come up with a way to regulate the airwaves and the vast and fast-growing online spaces. They should not mute these platforms when the fire is already aflame, but they should prevent such a flare up in the first place. They should develop rules and create awareness on the consequences of breaking these stipulations. Difficult, but possible. It has to be done.

Those are my thoughts.

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