Tuesday, June 24, 2014

When you treat security casually, crime festers

By Lukoye Atwoli
Sunday Nation 22 June 2014
Observing the behaviour of Kenyans and their so-called leaders, there is no doubt we have failed to learn from history. For several months now, we have unnecessarily lost many lives in events that demonstrate a lack of creativity in the running of public affairs. These events have particularly escalated in recent weeks.
One could come to several conclusions based on this observation. Firstly, one could argue that it is all a mere coincidence, and that the road crashes, chang’aa deaths, terrorist attacks, increased crime and political instability have just happened to cluster together purely by chance. That is, of
course, possible but it is highly improbable.
Secondly, one could argue that some malevolent force hell-bent on destroying our country for some obscure reason has planned at least some of these events. This is indeed the line adopted by some in and out of government, especially after the attacks at the coast when the government claimed there was a political angle to it all. 
The President laid the blame for the current troubles squarely at the feet of reckless” politicians who were inciting the people. Unfortunately, all indications are that this is also highly improbable, and that any politicians even remotely associated with these attacks are either opportunists or bystanders in the wrong place at the wrong time.
A more plausible explanation is that these events are an indication of ineptitude in the arms of government responsible for maintaining security, law and order. No matter the source of these atrocious happenings, it falls on the government to neutralise the threats before they materialise instead of waiting for people to be killed and then looking for targets to blame.
Social psychologists have long ago demonstrated a link between disorder and crime. In what is now known as the Broken Window Theory, it has been shown that neighbourhoods and property that is left in a state of disrepair soon attracts vandals and criminals of all shades. Wilson and Kelling, in a seminal paper on this topic, argued that untended behaviour leads to the breakdown of community controls and order. They demonstrated how an abandoned piece of property in a nice neighbourhood can cause changes in the behaviour of residents, and eventually lead to increased crime and general
This theory easily explains what is currently happening in the country, and could even predict what is in store for us. The security docket has not properly exerted itself in a professional manner in dealing with crime in this country. That is not in dispute, no matter where one stands politically. As a result, many “small” crimes have been going unpunished while our police officers get collectively tarred with claims of corruption and bribe taking.
Tolerance for “smallcrimes such as assault, robberies and murders has increased so much that police spokespeople routinely refer to them as “normal” crimes. Consequently the country has slid into a general state of lawlessness, and the government’s brazen assertion that we are now responsible for our own security only worsens this perception.
Because of our tolerance for “Broken Windows” in our country, terrorists and other criminals are having a field day. The sooner the government acknowledges this situation and takes firm action to deal with it the better for all of us. 
Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi Universitys School of Medicine.

Tuesday, June 17, 2014

Want to see how nations burn? Visit social media

By Lukoye Atwoli
Sunday Nation 15 June 2014

Kenyans on social media are a loud and boisterous bunch. Over the past few years they have distinguished themselves as a most combative collection of citizens, and nowadays it is not uncommon to learn of social media wars against other countries or individuals who are perceived to have slighted the motherland. National issues discussed on social media often take on the crimson hues of a violent confrontation, and ethnic organisation is never far from the picture.

Many have argued that the anonymity afforded by social media provides people with the perfect cover to slip into fantasy personae and role-play behaviours they would otherwise not engage in outside of the social media environment. Examples are cited of many otherwise timid people morphing into violent bullies online, driving young people to attempt such harmful acts as suicides and violence.

My view is a little different, though. I would argue that the anonymity of the Internet unmasks one’s real motivations, and allows them to act out their real impulses with little fear of immediate embarrassment or punishment. The result, therefore, is that one feels free to act without the constraints of social conventions and mores, and studying one’s online behaviour can often reveal more about their personality than the traditional assessment methods.

Of course this is a highly generalised view, and it would take a highly experienced analyst to uncover these issues, especially in cases where some people use the Internet to attempt to cover up what they consider to be their real selves. They open multiple proxy accounts and often have social media “conversations” with themselves in order to convince their audience that they are in fact separate individuals.

The long and short of it is that studying the behaviour of Kenyans online may actually be key in unravelling the mystery behind the interesting phenomenon in which most Kenyans openly profess love for their motherland while engaging in the most egregious war-mongering activity online.

Almost every open Kenyan discussion one comes across on many social media platforms degenerates into ethnic sparring and name-calling whenever the subject veers towards politics or social conduct. People known to be socially progressive and public-spirited often expose their tribal warrior blood when push comes to shove on the blogosphere.

And there is a pattern to these eruptions. In the run-up to the 2007 elections, social media chatter rose to a crescendo with tribal slurs and threats of annihilation, with plenty of mention of ethnic practices that were deemed to disqualify or qualify some candidates for national leadership. As the post-election violence escalated, the buzz on social media reached deafening heights, and it became impossible for any sane Kenyan to get in a word edgewise at any given time.

My engagement on social media today convinces me that we are approaching that point again. False and exaggerated accusations are being made against politicians on each side of the divide, aimed at casting them almost in the same light as wild animals. These accusations are then being transferred wholesale to their ethnic communities, and explanations are made based on tribal stereotypes. Eventually nothing can be heard but war cries and insults.

That is how nations burn. That is how genocides incubate. Social media is the spark that will eventually ignite the restive tinder-box that goes by the name Kenya.

We cannot say we were not warned this time. 

Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com

Sunday, June 8, 2014

It’s time leaders did what they were chosen to do

By Lukoye Atwoli
Sunday Nation 08 June 2014

In the past few weeks I have been travelling in the US on business related to research and collaborations between my institution and some American medical schools. As always, I have been keenly observing events on my trip and juxtaposing them against conditions back home. A useful observation I have made concerns our behaviour when we disagree on ideas.

Just like Kenyans, Americans bicker and quibble about everything from who should get state-supported health care to what should happen to the baby in a woman’s womb. And the arguments can get pretty acrimonious and public, sometimes raising tempers to the level of threats of violence in sections of the population.

But that is as far as the similarity extends.

The greatest difference lies in the reason why they engage in these arguments and conflict. To a large extent, the average American is proud of his country and its heritage. In every city one visits there will be a museum dedicated to the history of the city and the state, and the greater US. There are monuments everywhere you go commemorating the most seemingly innocuous achievements of the city’s inhabitants, and American heroes.

Every national holiday is an opportunity to remember and re-enact important historical moments in America’s journey since its founding. School-children recite that history with pride, and point out national monuments as though they were erected in their lifetimes. On the whole, Americans argue about their respective convictions on what is best for the US.

Contrast this with Kenyans. For the past 12 years or so, we have been poised on an ethno-political knife-edge requiring very delicate balancing to avoid outright civil war. Kenyans are almost equally divided into two factions on any national issue — those that support the government and those that don’t. Some members of these two factions have shifted back and forth, both among politicians and among the voting public, but the proportions have remained mostly undisturbed.

At any point in time, these two factions express the most vehement loathing for each other, and at least once in the past 10 years this has erupted into open armed civil conflict. Political arguments are turned into existential matters for the politicians’ tribesmates, and nobody remembers the greater good of the republic.

We have heard leaders and their followers say that they are ready to let the country burn if they cannot achieve their goals peacefully. We have heard politicians taunting each other about nusu mkate (half-loaf) governments, as if Kenya is bounty to be fought over, and the winner takes it all. Political power has become an end in itself, rather than an opportunity to serve.

The result is that we have elected people into positions of power who often act as if they have absolutely no clue what that office entails. People are coming into power without the slightest idea what they will do for the people who elected them. This is especially surprising given the amount of resources that are spent campaigning for public office.

I remain hopeful that in my lifetime I will see my country transform into a land where we argue about ideas we think are good for Kenya, and not for individual leaders’ fortunes. But it is difficult to sustain this hope given our current political landscape. 

Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com

Wednesday, June 4, 2014

Medical schools should teach, not make money

By Lukoye Atwoli
Sunday Nation 01 June 2014
Recent demonstrations by medical students at one of our local universities exposed just the tip of the iceberg as far as problems in the training of medical personnel are concerned. The students were complaining about lack of facilities and staff to teach critical courses in their curriculum. This shouldn’t surprise anybody knowledgeable about medical education in this country.
Many universities treat medical education as a cash cow rather than as an avenue for increasing the number of critical personnel in the health sector. Several times in the past, medical students have been admitted to “medical schools” only to find themselves idling on campus without teachers or material to learn.
The Medical Practitioners and Dentists’ Board, being responsible for regulating medical training in the country, has tough questions to answer in this regard unless they can demonstrate the problematic institutions are duplicitous in their dealings with the Board.
The Board is certainly aware of the shortage of doctors in this country, and any move to rectify this situation is definitely laudable. Unfortunately this shortage also affects availability of experts to train medical students in the various areas of medicine. Especially in the basic sciences that form the bedrock of medical training, there is an acute shortage of lecturers even in the more established medical schools.
This being the case, it is surprising that there is no sustained policy to focus on training of experts in these fields in order to ensure all medical schools are sufficiently served. The result is that in some cases the same individual is involved in teaching medical students at several universities, obviously to the detriment of quality teaching and all but obliterating any opportunities for research. With the proliferation of medical schools in all corners of this country this situation is sure to worsen.
Further complicating the issue is the involvement of universities in the training of certain paramedical cadres without clear career progression. For a long time in this country, the Kenya Medical Training College has been training a highly qualified cadre of paramedical personnel known as clinical officers.
These officers have helped ensure Kenyans in the most remote parts of the country have access to a clinician who can diagnose and manage common medical conditions. Beginning training at diploma level, they were able to further their training at higher diploma level specialising in one field of medical practice. Those that were so inclined could later join medical school and train to become doctors.
Some of our universities jumped into the fray and initiated the training of this cadre as they prepared medical curricula for future training of doctors. After a while, some bright chaps at these universities came up with the idea that they ought to train the same cadre at degree level, without a thought as to how they would fit in the highly regimented medical fraternity.
Many of the students enrolled in the courses believing they were being trained to become doctors. Unfortunately many of their dreams are ending in frustration when they find that many institutions do not know how to deploy them when they apply for jobs.
It is time we held candid discussions about the direction of medical training in this country because, after all, the arguments and tantrums, the lives and livelihoods of Kenyans are at stake.
Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com

Doctors’ killing signifies a worrying trend

By Lukoye Atwoli
Sunday Nation 25 May 2014
In the past few weeks, this country has lost several doctors due to various causes. The recent killings of doctors in Nakuru and Meru are particularly noteworthy because they poignantly illustrate the state of our nation.
Firstly, outside of medical circles, these killings have gone virtually unremarked and police have, as usual, chalked them down to “normal thuggery”. This reflects the general situation in this country, where we have accepted that we can lose such important members of our society and not be shocked. We are so preoccupied with ethnic sharing of the national cake that we are unable to appreciate the fact that the scarce health worker resource continues to be depleted in preventable ways.
Secondly, these killings demonstrate the difficult working conditions that many health workers are having to contend with as they serve the thankless populace. Many doctors are working extremely hard to save lives, often without anyone to relieve them when they are tired. They work long hours and have little time for their families or friends. 
Unfortunately, when they burn out and decide to take a break, they are often accused of having abandoned their patients to go and “enjoy” themselves. And when they continue working despite their inevitable problems, they become error-prone and are crucified for every small mistake they make. When their luck finally runs out, they find armed thugs waiting for them when they come home after a long night at work. This once-glorified profession has lost its lustre, and now carries the risk of premature mortality and a lifetime of suffering.
Thirdly, the fact that these unfortunate deaths have not triggered talk of a crisis in the health sector clearly demonstrates that both the national and county governments are only paying lip-service to the health of their people. Measures have not been taken to protect health workers and ensure that they operate in a more conducive environment. The national government has all but abandoned health workers, leaving them at the mercy of county administrations that often don’t have the foggiest idea on how to manage a health workforce.
As a result, health workers are continually being threatened with the sack for a variety of ills, real and imagined. Every so often, a governor lashes out at these “thankless officers who are trying to avoid supervision” and promises citizens that he will make them work or fire them if they are lax in their duties. Many have resigned as a direct consequence of this intimidation, while others have, in the past, been “released to the national government” in an undisguised move to eliminate “foreign” professionals from some counties.
A Kiswahili saying aptly captures the current state of affairs: Usiwatukane wakunga na uzazi ungalipo (Do not insult midwives while women still give birth). As things stand, health professionals feel badly treated, insulted and abandoned by the political class while, on the other hand, citizens are demanding more and more from them.
Perhaps if we knew that everyone will at some point need to see a health professional, we would plan differently. Maybe we would allocate more funding to the health ministry, use the funds to train and hire more health workers, and procure equipment and supplies that would make their work more effective, and rewarding?
But maybe nobody cares!
Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com