Expanding My Perception on Vulnerability

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What is in Your Head?

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Expanding My Perception on Vulnerability
Fat to Fit
10kgs and Counting
Public Sector
Transition Phase
Fat to Fit
Took A Long Time But I am Ready
Disease & Conditions
What is in Your Head?
Public Sector

The end of a crisis

This week the doctors strike in embu was called off following the signing of a return to work formula.

Even though the county government didn’t hire the exact number of doctors we hoped for, we compromised for 10 medical officers and 4 consultants. This will not satisfy the deficit but will assuage the burden that has been on the currently employed doctors.

Going on strike is an onerous burden for doctors because none of us want our patients to suffer. We got into this profession to abate their pain and suffering. So as soon as the strike was over, we were quick to report to work. It was encouraging to see my colleagues in the corridors of the hospital, eager to treat patients.

Our absence caused a long pregnant pause in our facilities and things were generally moving at a sedate pace. However, within a few days things will be back to normal.

In summary, we’re not counting any losses here. We are grateful to the county government for sitting down and reasoning with us.

For our colleagues in other counties, do not be muzzled. Stand up against what is wrong. It is indeed possible to bring about change we need for the power is in your hands.
Aluta continua!

Public Sector

Health and politics

The activities associated with the governance of a country or other
area, especially the debate or conflict among individuals or parties
having or hoping to achieve power.

Whenever anyone has a question regarding health, they’re
advised to ask their doctor or another health professional. The
seriousness of which may determine whether you’ll go to the hospital or your
local miti shamba guy. So with a looming election and campaigns
already getting into gear shouldn’t we ask ourselves, is this healthy

I feel it necessary to put the definition of politics up there so we
all have a point of reference to what we’re discussing. In the next 2
years, we’re meant to pick MCAs, Governors, MPs, Women’s
Representatives, Senators and the President. All representatives of the
people meant to implement various policies that we – the electorate –
supposedly agree with and that’s why we elected them to office.

“We have demeaned our politics to baseless rhetoric and
tribalism” that’s what you’ll hear the pundits on television say; the so-
called progressives who want us to become the ideal democracy that
they’d say might be the American or British models. Are any of them
aware that in the last election all major political parties released a
manifesto that none of them bothered to review?

So because most of us depend on mainstream media to know
what the agendas of our politicians are we all went to the ballot last
election cycle ignorant of what would happen in the next 5 years.
But my focus today is on health.
We as a country devolved health on the basis that being a service
it should be taken closer to the people on the ground. “Pesa
Mashinani” is still the mantra we hear. But i ask you, have you seen a
change in the healthcare being provided to you?

We’re sick as a nation. Battling communicable diseases that are
killing our children by the millions to non communicable diseases that
are now decimating our elderly population with cardiovascular disease
and cancer. But we have a worse disease that our first president, Mzee
Kenyatta said was one of our main challenges at independence,

We don’t make informed decisions. That’s why the Kenyan is the
number one complainer and the number one to forget what he was
complaining about. I suspect it’s because we know we are primarily to blame. You vote without knowing what this guy wants to do with his
time in office.

So is politics healthy? Yes it is! Politics is the life’s blood of any
nation. It’s how we determine our course and future. We must engage
in serious policy discussions throughout. Not spewing nonsense on
political talkshows about the tribal bloc that a politician brings to a
party or how he’ll benefit “his people”.

When we don’t seriously discuss actual politics we devolve
healthcare without any thought on the consequences, we allow thieves
and under qualified people to take over a sector that is meant to save
lives, we watch as patients in hospitals lie on cardboard boxes instead
of mattresses, we hear doctors beg for referral hospitals to be
returned to National Government because they watch patients die
every day, we lament about expensive private doctors fees when
universal high quality healthcare guaranteed in the constitution isn’t

We are sick and we need to make a choice to be healthy. The only
treatment is to be informed. Our fourth estate has to stop allowing lies
to pervade the airwaves in the name of neutrality and sift out
nonsense to report actual news. There’s a billboard on a major
highway that says “your vote, your weapon.” I have a different
opinion, “Your vote, your medicine.” Be healthy my fellow Kenyans,
take your medicine.

Public Sector

The Machakos County doctors took to the streets the other day to protest about the hostile working environment Dr Mutua has subjected them to. After an impromptu visit and suspension of a doctor and other health workers in one of the facilities, Kenya Medical,Pharmacists and Dentist Union (KMPDU) met the doctors to know their problems….they are very many.

The SAD STATE OF MAENDELEO CHAP CHAP is that you have buildings that are well painted on the outside but with leaking sewage on the inside, a lab that looks beautiful but with no lab reagents, a pharmacy that lacks drugs, a ward without linen, x ray machines that have broken down, a dental clinic that patients spit on a bucket full of blood and an ICU that would actually quicken your death.

Yet the governor and his executive are the ones in control of the resources but the doctor is seen as the enemy in all this. THE HEALTH WORKER IS BLAMED FOR FAILED SYSTEMS. The health worker is not the one with the money they are just service providers.
When you give KSH 100,000 to a medical superintendent to run a hospital for a whole quarter, do they use it to buy food for the patients or do they use it to sink a borehole to ensure clean water to the hospital or do they use it to buy emergency drugs or what should they do with those peanuts you have provided???

By Dr. Jane Mwende
Dental Officer.

Public Sector

One of the legal doctrines we hear about on crime TV shows is AIDING AND ABETTING. To abet is basically to encourage or assist by aid in crime. It allows a court to pronounce someone guilty of aiding and abetting in a crime even if they are not the principal offender. In some countries one can be said to be as guilty in commission of an offense if one does or omits to do anything for the purpose of aiding another to commit it.

Do no harm is technically not a part of the Hippocratic Oath. It is more a paraphrasing or a summarizing of the oath. The oath goes into interesting detail about patient care.

“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”
“I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”

The maxim of “Do no harm” forms one of the principal precepts of bioethics in health care known as Non maleficence. Wikipedia interestingly describes it as given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good.

The people who experience the effects of sidelining healthcare are the workers in hospitals. They live and interact directly with the public that so dearly needs the services. Patients do not go to public hospitals unless they have to. It is a last resort. A daunting experience. Most do not even know that the services they are being offered are at times very substandard. They do not know they deserve better. They do not know they have a right to more. So they do not get more.
For a long time now health care has not been a priority in Kenya and many sub Saharan countries sadly. From health financing to policy to leadership. This mentality was devolved down with dire consequences. Health care has been relegated to a political game of show and tell. This is the only country with an incredible shortage of doctors while at the same time county governments are refusing to employ doctors. They site lack of funds as a reason for not being able to take up doctors into the counties and request the already stretched labor force to hide the deficits.
So who fights for those who cannot fight for themselves? Who stands up for those who cannot stand? The leaders? No. It is you and I. For if we do not defend the helpless logic demands that we are part of those who are oppressing them. If we hide the shame, we are propagating the problem. If we keep silent we are aiding and abetting. When working in poor conditions compromises patient safety, the Oath demands more. How long shall doctors leave the public sector and leave the future generations to face the same problems of past generations.
I salute all the doctors fighting for the rights of the public. I salute the ones who tried to fight and were pushed out. I salute the ones who managed to achieve safe working conditions and dream of a day when the public fight for themselves.

“I swear to fulfill, to the best of my ability and judgment, this covenant:…
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.
I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.”
Louis Lasagna, 1964.

Public Sector

When doctors strike

When doctors strike

Doctors in embu county have gone on strike. The main reason being there is an acute shortage of doctors. The county government did not retain any of the interns who completed their internship training. These jobless doctors have had no choice but to seek employment in private hospitals or abroad. This explains why Kenya is one of the biggest exporters of doctors.
Where then does this leave the common mwananchi?

Some would argue that ours is a noble profession and going on strike is unfair and will lead to loss of lives. However, doctors are HUMAN. Not only is it unfair for 60 doctors to be serving a population of 600,000, it is a risk to patients as well. A frustrated, overworked doctor is more likely to make mistakes and be less efficient. Doctors are developing stress related illnesses due to this high pressure environment. There is a surge of alcoholism and suicide among medics which is directly related to stress in the workplace.

We find ourselves working under duress, county officials breathing down our necks thereby making it extremely difficult to do our already strenous jobs.

When did people who have no medical background become our bosses? Why should non-medics manage health workers? These same people who are busy micromanaging us are not efficient at their own jobs. They are running down our hospitals. They are politicizing health. They are painting buildings and calling that progress. Instead of intimidating doctors, how about you stock our pharmacies?  Upgrade our labs? Perhaps HIRE THE DOCTORS YOU TRAINED?

staying healthy
Staying Healthy

Ask your doctor.

Dr Kim Mangoa
20 June 2016

Knowledge is power

So there I am about to clock out of work after another tedious 8
hour shift. Over 50 patients seen, endless pages of notes, drugs,
treatment strategies etc gone through and my eyes are aching and
fingers cramping from all the writing. The nurse approaches me and
says, “Daktari we have a relative anatusumbua. She wants to know about
her patient.

I sigh deep within but extend a hand for the file.
It falls to the doctor to do this, day in and day out. Passing
information has become such a crucial part of our job that after years
of neglect it’s now a core part of the curriculum in all medical
schools. How to talk to patients and their relatives about diagnoses,
treatment, prognosis and sometimes the worst that may have
happened. It’s been finally realised how fraught with error these
interactions have been in the past being avenues of information and
the need for accuracy, clarity, honesty and satisfaction for both parties.

So in this situation the daughter of the patient is the one
anasumbua the nurses asking about her mother. “Daktari why are you
keeping me here in the ward nikingoja like we are in Kenyatta?” she
approaches me saying. Now which of us would like to be approached
like this, honestly? I smile off her remark and i begin to find out her

But this article is not to highlight relative’s harassment of
doctors but the lack of harassment by the majority of our patients to
demand information from us the practitioners.
Too often a patient will come to me to ask for something as simple
as a refill of prescription say for their high blood pressure medication
and when I ask which drugs they are on a common answer will be
something like, “Moja ni round ya white, nameza moja. Nyingine ni ya
orange.” Now despite years of study and a library of medications in my
mind, I do not know every brand, appearance, dosage and formula of
drugs. But it is my duty to help this patient.

You must ask more of your doctor. What is he treating you for?
Why that? What’s his evidence, and if not that why his suspicion?
What will he treat you with? What should you expect? How much can
that medication be expected to do? How long for, a week, a month, a
lifetime? Are there alternatives?
All these are YOUR RIGHT TO KNOW! Sometimes we may
not cover all of them without being prompted so please ask away.
Demand to know more, demand to know as much as we do about
yourself. Healthcare is a partnership and partners in principle are
equal. We both have a responsibility of knowledge, equal knowledge
of you.

Medicine has changed remarkably. Although I don’t encourage it
due to the large amount of disinformation out there, Google has
created an information centre never imagined and accessible to all.
Problem is information without context is sometimes dangerous. It’s
good to have an idea of what’s happening through your own research
but asking lessens no one. Together we can achieve so much more. It has been proven time and again a knowledgeable patient is an easier
to treat patient. Outcomes are better universally. We must strive to do
more for our patients and our patients must strive to demand more of
us and themselves by trying to be partners with us.

However as a quick caveat we must also remember our roles in
this partnership. Please do not become your estate medicine man after a
few interactions with the doctor. Drugs are being misused and abused
in this country so unknowingly and patients are becoming sicker by
treating themselves poorly due to little knowledge. The saying “A little
knowledge is a dangerous thing” ring ever true here and its original “a
little learning is a dangerous thing” rings louder!


Expanding My Perception on Vulnerability

It has taken me a long time to post since Afyapress failed to snag the blog awards we were nominated for. I hate to admit this but I am overly competitive and I don’t take losing well. On a scale of 1 to Kanye, I’m an 8. I really do believe in myself almost to a fault. However, I don’t think I’m better than the other bloggers and I won’t discredit their win with an ‘I deserved to win’. All I can do is accept, learn from it and move on.Continue reading

Fat to Fit

Week 8 – Check In

It is well past my check point and I apologize for not updating on my progress. No, I did not quit. I am still on the program. The last few weeks have been hectic nonetheless here goes my progress report for week 8. Today is actually week 10 but I have been sitting on this post for a while now. My super power is definitely procrastination!Continue reading

Women's Health

The Hushed C word (Part 2)

**** Please make sure you have read Part 1 before reading this: The Hushed C word (Part 1) ****

However, things go from zero to a hundred real quick and it happens. She panics so much and he assures her that she can take the emergency. She will be fine, he says. After two weeks she gets her period but just for a day then at the end of the month, she is late. She thinks that maybe it’s because she bled in middle of the month. She starts getting moody, tired and nauseated. Second month still, no period! She now decides to take the test which is positive! She tells her ‘boyfriend’. He says that it’s not his and tells her to figure herself out!Continue reading

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