Kenya’s health system on the verge of collapse as doctors’ strike grinds on

The Guardian

Kenya’s hospitals have almost ground to a halt, with millions facing a third month in a row without healthcare as doctors strike over low pay and poor working conditions.

The public healthcare system has long been overburdened and underfunded, but has now virtually stopped functioning after 5,000 doctors walk out in December after attempts to reach a compromise with the health ministry stalled.

“The machines break down frequently, the doctors are overwhelmed. The patients, they are so many that they are lying on the ground,” said Dr Judy Karagania, an ophthalmology resident at Kenyatta National hospital (KNH) in Nairobi, who is taking part in the industrial action.

Karagania and her colleagues are refusing to return to work until the government makes good on a 2013 agreement to dramatically increase salaries, hire thousands of new doctors and address drug and equipment shortages.

As the standoff drags on, Kenyans are suffering from the lack of care.

“The army doctors are turning away patients,” said Karagania, who normally works as a resident medical officer at KNH. “They’re only handling the emergencies of emergencies.”

Read the full article in The Guardian.

In a World of Closed Borders, Deciding Who Deserves Asylum

The Nation & The Nation Institute Investigative Fund

Fenced in: Some refugees at Kakuma are segregated for special protection. /Jake Naughton

At Kakuma refugee camp in Kenya, workers face few humane options

From Turkey to Pakistan, from Iran to Ethiopia, refugee workers are being forced to make painful choices regarding the future of more than 21 million refugees, part of a record 65 million displaced persons around the world. They must choose between political and economic refugees, individuals and families, the healthy and the sick, the elderly and unaccompanied children, gay and straight. They try to move those most in need of help to the front of the line for resettlement somewhere safe.

But when it comes to triaging the world’s humanitarian crises, there are few humane choices.

Read in the February 27, 2017 edition of The Nation Magazine.

In Kenya, doctors’ strike leaves a nation ailing

Al Jazeera

Kenya’s public sector doctors began striking two months ago to protest against the Ministry of Health’s failure to implement a 2013 agreement which included raising salaries /Jacob Kushner

Kijabe, Kenya – At the bottom of a winding, tree-lined road, a crowd of patients spills out of the entrance of a private hospital waiting room on to a patio and a dirt parking lot. It begins to rain, and a man on crutches tries to hobble into the cramped building for cover.

Sitting in a wheelchair outside the door is Dorcas Kiteng’e, a 25-year-old woman suffering from cancerous growths in her ovaries.

“They’re pressing down on the spine, they’re paralysing her,” says Mwende Mutambuki, Kiteng’e’s sister-in-law“She can’t walk. Back pain, leg pain – I’m hoping it hasn’t spread.”

Kijabe is the third hospital they’ve visited since they arrived in the Kenyan capital Nairobi last week, looking for an oncologist who could perform the surgery, only to be turned away.

“They sent us to Agha Khan,” says Mutambuki, referring to the private Nairobi hospital that’s regarded as one of the nation’s finest. “But we know we were not going to be able to afford that.”

She fears time is running out to save her sister-in-law: “It’s a matter of life or death.”

Two months ago Kenya’s public sector doctors walked out on strike, and millions of Kenyans who normally depend on them are beginning to overwhelm the nation’s private hospitals, particularly in rural areas.

Read the full article at Al Jazeera.

In East Africa, empowering passengers to demand a safe ride

U.S. News & World Report
/JACOB KUSHNER

/JACOB KUSHNER

NAIROBI, Kenya — On a sunny afternoon in Nairobi, 37-year-old Francis Raymond Adika climbs into the front seat of a matatu, or public transit van, and slides next to the driver.

“I lost my brother in an accident,” says Adika. On August 15, 2001, a matatu was speeding down the wrong side of a two-lane road in Nairobi trying to pass traffic. When it swerved back into the correct lane it slammed headfirst into a truck. Adika discovered his brother’s body in the Nairobi morgue. He was 19, just days away from his high school graduation.

A Jesuit missionary who travels extensively across Africa, Adika says it isn’t just in Kenya where people lose their lives to reckless driving. “I lived in Tanzania, Zimbabwe, Zambia – the carnage was just the same.”

Each year, 1.24 million people die in road accidents worldwide. By 2030 that number is expected to triple to 3.6 million, making road deaths the fifth-largest cause of death in the developing world – worse than AIDS or even malaria, according to the World Health Organization. Africa is the hardest hit, with 26 road deaths for every 100,000 people – nearly 50 percent above the global average.

But a series of scientifically rigorous, randomized control studies by Georgetown University may have found a simple way to dramatically reduce deaths on East African roads. By placing stickers inside buses and matatus that encouraged passengers to tell their driver to slow down, researchers discovered that the number of insurance claims fell by half for long-distance vehicles and by one-third overall.

Read the full article at U.S. News & World Report.

KENYA: Two gay brothers and their family are on the run

TakePart

Jake Naughton

“We have a bad, bad story,” begins Gloria Ibara, a refugee from Burundi and the mother of four. Sitting on a mattress in a simple Nairobi apartment, she tells me of her problem: “They want to kill our family.”

Gloria, whose bright smile accents her worn face, was born in rural Gitega province to a family of farmers. As her children grew, Gloria came to realize her son Eric was gay. (The names of the family members have been changed out of concern for their safety.)

At first “I told him to stop, that it’s not good,” Gloria says. But over time she decided that “that’s the way he was, and he couldn’t change it.” So she went on loving and caring for him just the same.

In many parts of East and Central Africa where homophobia is rife, parents react harshly on learning that a child is gay. Parents feel enormous pressure to either “fix” their gay kids or disown them. I’ve met dozens of LGBT refugees who have fled their home countries and escaped to Kenya, and only one—a woman, also from Burundi—wasn’t disowned by her family. So when Gloria learned that her son Eric was gay, it was extraordinary for her not to reject them. Stunned as she was when she later found out that her older son, Claude, then well into his teens, too was gay, she supported him too. It’s for that reason that they are now a family on the run.

Read their story at TakePart.

Can Science Save Development Aid?

Pacific Standard

(Illustration: Chad Hagen)

Randomized controlled trials are the popular centerpiece of an emerging data-driven approach to figuring out precisely the best way to end poverty. Can a return to the scientific method fix the global aid industry?

For too long, “accountability” in the aid industry has meant nothing more than ensuring that a donor’s money was spent the way an agency said it would be. Rarely did organizations examine whether their spending achieved a positive impact (improved access to water, for example), much less one that stood the test of time (meaning the well didn’t dry up).

But recently, many aid organizations, including theInternational Rescue Committee, a New York humanitarian aid group specializing in refugee assistance, have used RCTs to, among other things, evaluate methods for nudging parents in Liberia toward more effective parenting techniques and tocreate highly effective community savings-and-loan programs to combat poverty in Burundi. It’s easy to see why charities are attracted to RCTs: They can make an aid agency’s work more efficient and generate solid evidence of progress to show funders.

As organizations continue to conduct more of them, RCTs are disproving many myths upon which we’ve designed development aid for years, not least of which is our longtime preference for projects over cash. If the data shows, as the RCT of GiveDirectly’s Kenya program did, that it’s most effective to hand a family $1,000 with no strings attached, then that’s precisely what we should do.

Read: July/August print edition of Pacific Standard Magazine 

From human waste to community space

Solutions&Co

Photo / JACOB KUSHNER

On an overcast morning in Nairobi, commuter buses drive down a crumbling road into Kibera, a densely packed slum. A sign at the bus station reads “public toilets,” but the doors are locked.

It’s estimated that Kibera has just one toilet for every 2,500 of its approximately 250,000 residents. Without toilets to relieve themselves, people “use any means, whether it’s a [plastic] bag or a can,” explained Fred Amuok, Community Liaison for a Kenyan rights-based organization called Umande Trust.

The World Health Organization estimates that 1.5 million people die every year from diarrhea, often the result of poor sanitation. There’s also a financial cost: studies show that Kenya loses US$324 million each year in missed work hours due to sickness brought on by poor sanitation. According to the sanitation company Sanergy, four million tonnes of fecal sludge escape into Kenya’s waterways and fields every year.

But Umande Trust has come up with an innovative approach to providing affordable toilets for Kibera’s residents and turning human waste into cooking fuel–one that’s already been working for more than a decade.

Read the full story as it appeared on Impact Journalism Day 2016 at Solutions&Co by SparkNews.

The Secret Lives of Nairobi’s LGBT Refugees

Newsweek

An HIV-positive, gay refugee from Uganda stands outside the house he shared with dozens of other LGBT refugees on the outskirts of Nairobi. JAKE NAUGHTON

For months, nearly two dozen gay, lesbian and transgender Ugandans had been living in a large house on the outskirts of Nairobi in an area called Rongai. Long after a court struck down Uganda’s infamous anti-gay law—dubbed the “Kill the Gays” bill for a death penalty provision in an early draft—LGBT people in Uganda were still being disowned by their families, hunted down by neighbors, jailed by police, even killed. Hundreds fled Uganda—mostly to Kenya, where they are faring little better.

Many of these refugees grew up in urban, middle-class families and loathe living in a hot, squalid refugee camp, as Kenyan law requires of all refugees. They are city people, accustomed to partying at secret gay clubs in Kampala.

One afternoon last December, a Kenyan man came to the gate of the Rongai house with a warning: Neighbors were plotting to attack the gay refugees that night and run them out of town. The refugees didn’t wait. They fled, scattering to different apartments across the city.

Read in the June 10, 2016 print edition of Newsweek

In Africa, Covering Business the Bloomberg Way

Columbia Graduate School of Journalism - Covering Business

Downtown Nairobi, Kenya, as viewed from the Africa Nazarene University © dan lundmark

Two years ago, Michael Bloomberg launched Bloomberg Media Initiative Africa, a $10 million fund to “build media capacity, convene international leaders and improve access to information” on the continent. As part of the three-year program, journalists in Kenya, South Africa and Nigeria can apply for training programs and seminars to improve their knowledge about African finance and how to cover it.

Truly independent media outlets remain scarce on the continent. Freedom House lists the press in Kenya, Nigeria and South Africa as only “partially free.” The first and fourth most censored media in the world are in Africa, according to the Committee to Protect Journalists, which last year published a detailed report about how Kenyan officials and partisan media owners are eroding press freedom there.

To learn more about the initiative and its relevance for African business journalism, CoveringBusiness spoke with three veteran Bloomberg editors. Read the interview at Columbia University Graduate School of Journalism’s Covering Business blog. 

In Kenya, residents are coming face to face with the wildlife that preceded them

National Geographic

A Kenya Wildlife Service ranger shoots Mohawk lion after he injured a person. Mohwak left Nairobi National Park and wandered south into the town of Isinya.
PHOTOGRAPH BY AFP/GETTY

First, a lioness ventured into the city as a decoy to draw officials away from her cubs that were lost in an army barracks.

Then, just weeks later, a pride of six lions breeched a fence into a pasture killing as many as 120 goats and sheep. One lion lost his bearings and ended up on a major highway, injuring a man before finding his way back into Nairobi National Park, located adjacent to Kenya’s capital city.

Now, this week, a popular lion named Mohawk ventured some 20 miles (32 kilometers) south of that park only to be surrounded and harassed by onlookers. When he responded by attacking one of them, he was shot and killed by park rangers.

Why are so many lions leaving Nairobi National Park? Read the full story at National Geographic

Nairobi’s immigrant cookbook

Al Jazeera

Sandra Zhao inspects a wooden vat filled with spices at Cedar’s, a Lebanese restaurant in Nairobi [Jacob Kushner/Al Jazeera]

Two foodies team up to explore the Kenyan city’s diverse foreign cuisine, and the entrepreneurs who brought it here.

Nairobi, Kenya – On a drizzly afternoon in Nairobi, Sandra Zhao sits at a hand-crafted wooden table sipping green tea from a ceramic Japanese cup. Across from her, the man who built the table and the restaurant that houses it describes the different Japanese delicacies as they arrive.

First there is pink-coloured tamago, a Japanese appetiser made of egg and dashi, and a light miso soup. Then comes a plate of salmon maki. Next is the main affair: Tantanmen (spicy noodle), a rich brown broth made of fish stock with home-made noodles that the restaurant’s owner, Yuki Kashiwagi, says is a favourite Japanese late-night food. And last, a plate of Japanese pancakes, or Okonomiyaki, topped with flakes of dried tuna that are so thin they wiggle in the afternoon breeze. “I love that!,” Zhao exclaims. “I know – that’s why I ordered it,” says Kashiwagi.

Zhao, after all, has been frequenting Kashiwagi’s restaurant since the day it opened. Creator of the Nairobi specialty cupcake startup SugarPie, she is teaming up with another American foodie – cupcake collaborator and founder of Nairobi’s Open Table Cooking School April Dodd – to publish a cookbook that will feature recipes from 30 Nairobi immigrant restaurant owners and the stories of what brought them here. Called Im/migrant Nairobi: A Cookbook, the project will feature Kashiwagi’s restaurant.

A continental hub for all manner of tech start-ups, NGOs, UN agencies and more, Nairobi is one of the most diverse cities in Africa. Indians, who began immigrating to Kenya’s coast more than a century ago, introduced spices, chai and chapatti that have found their way into mainstream Kenyan fare. Ethiopians who escaped the rule of Haile Selassie operate restaurants that adhere closely to traditional Ethiopian recipes and ceremonies. Recently, Chinese, Korean, Japanese and other Asian immigrants are reigniting the trend. If Kenya is East Africa’s country for foreigners, then Nairobi is the Mecca for their culinary traditions.

Read the full story at Al Jazeera.

Cooking to overcome prejudice in Kenya

Al Jazeera

A Ugandan refugee in Kenya hopes his cooking can help overcome prejudice about his sexuality

Kakuma, Kenya – It’s just past noon on a blistering hot day in this refugee camp in northern Kenya. Inside a small hut, hungry customers sit at a wooden table as the smell of meat and beans wafts in from a back door. The customers take shelter within the cool, mud-walled hut as Junior (not his real name), a 23-year-old refugee from Uganda, cooks up some of his favourite traditional fare.

When he started the restaurant, Junior says he received all sorts of customers – Ugandans, Sudanese, Congolese, Burundians, even Kenyans from outside the camp. He earned enough to save for when camp food rations ran short, he explains. Things were going about as well as one could expect in a refugee camp. Until, that is, word got out that Junior is gay.

Read the full story at Al Jazeera.

This story is part of an ongoing reporting project, Who Will Help Africa’s LGBT Refugees?

In A Kenyan Forest, A World Bank-Backed Project Threatens A Way Of Life

GlobalPost/GroundTruth, Huffington Post, International Consortium of Investigative Journalists (ICIJ)

Elias Kimaiyo says the Kenya Forest Service has burned down his home repeatedly as part of a push to evict him and other members of the Senger, an indigenous tribe, from the forests where they have lived for generations. “Most of the time,” Kimaiyo says, “I just live in fear.” / TONY KARUMBA

Another chapter in the World Bank’s fraught relationship with indigenous peoples who live on or near land targeted for development.

By Jacob Kushner, Anthony Langat, Michael Hudson and Sasha Chavkin

It was a morning routine: Elias Kimaiyo woke up, went outside his family’s mud-and-thatch home and climbed a hill. His goal: see where Kenya Forest Service officers were heading that day as they trudged into the forest from a nearby ranger station. Like thousands of his fellow tribespeople, he spent many of his days worrying about whether his family would be the next to be evicted by gun-toting rangers.

One morning in late 2011, Kimaiyo saw that KFS officers were heading in another direction. He went home and worked with his wife, Janet, harvesting their small corn crop in a clearing in the forest. In the afternoon, he decided to check again.

This time, when he climbed the hill, he could see a group of rangers heading toward his house. Kimaiyo ran home. He and his wife began grabbing their things—blankets, utensils, a mattress—and hiding them in the brush. They could see their neighbors’ homes burning. Kimaiyo’s one-year-old son sat in the dirt, crying, as his mom and dad carried armfuls of their belongings deeper into the forest.

Kimaiyo and his wife fled with their son to the other side of a river. They hoped the KFS officers would somehow miss their house in the dense forest.

They didn’t.

Kimaiyo watched, he says, as flames consumed his house and what was left inside—tables, chairs, the bed frame, even the mattress, which the rangers had discovered poorly hidden in the brush and tossed onto the fire.

It was the fourth time, Kimaiyo claims, that Kenya’s government had destroyed his home since the 2007 launch of a forest conservation project that the World Bank said would “improve the livelihoods of communities participating in the co-management of water and forests.”

Read the full ICIJ investigation.

This is the latest installment of “Evicted and Abandoned,” an examination of the hidden toll of development financed by the World Bank. The project is a collaboration between the ICIJ and The Huffington Post, with contributions from journalists around the globe. The story also appeared at The Huffington Post and PRI’s The World.

When Knowledge Isn’t Power

The Financial Times - This is Africa

“I wanted to be here because Africa is on the move,” US president Barack Obama told an energetic crowd at the Global Entrepreneurship Summit in Nairobi in July.

The president’s visit underscored his support for the idea that investment in technology and innovation can propel African economies forward in ways that agriculture, manufacturing and natural resources have not.

Yet two decades after the OECD began promoting the idea that reorienting Africa’s economies towards knowledge generation could fast-track development, none of the region’s 54 nations are yet able to compete on a global scale.

Read the full article at The Financial Times’ This Is Africa blog.