Monthly Archives: April 2015

Upombe wa Chuka

Awareness Alcoholic Drinks Control Act

According to the research findings on average 94% of the respondents are aware of the existence of the Alcoholic Drinks Control Act. 98% of the respondents who are aware of the act refer to it as the Mututho Laws. Teachers in rural areas of Chuka exhibited the highest rates of awareness at 96%, Peasant farmers 92%, Traders 95%, and casual laborers at 93%, others 94%. These findings indicate that many of the rural people in Chuka have an idea about the existence of the act and are aware that it is in force. The awareness rate of the Act is very high to the extent that the residents of Chuka actually refer to the act as Mututho laws. Implication of this finding is that the residents may not be accurate in their knowledge of the legislation but the fact that it is in existence and they are privy to that goes a long way in making the foundation of the law be operational to achieve its intentions in control and management of alcoholic consumption.

Respondents Grasp of the Content of the Act

All the 94% respondents who demonstrated that they have knowledge of the existence of the act did not show any concrete indication of having fully grasped the content of the Act. They were aware that the law was aimed at controlling alcohol use in the society but they are not privy to the contents of the Act. For peasant farmers, 55% indicated they had an idea about the content, but only 14% of peasant farmers interviewed showed adequate knowledge about the content of the act.  Traders and merchants were 64% who had a general overview of the content but only 48% were sufficiently privy to the content of the Act. Casual laborers had the highest ignorance rates, with only 30% showing they had a rough idea about the actual content of the law, but those with accurate information about the Act’s content was only at 9%. 75% of the teachers showed that they had an idea of the content of the law. Only 25% demonstrated they had adequate knowledge of the Act and its content.

This shows that more needs to be done in making people in Chuka have a clear understanding of the law by being informed of its content. For the law to be effective, its operationalization requires that awareness of the Act be furthered by ensuring people actually know the basis of the law, its requirements and intentions. To be aware of the law alone is not enough in meeting its objectives. Despite the mantra ignorance is not a defense in law, without a clear understanding of the basic principles embodied in the act will render its full implementation problematic and adherence to it may not be fully realized with the current state of high ignorance of the actual content of the legislation.

Strategies to Curb Drinking as Proposed by the Law

The research study evaluated the responses and determined that all the respondents who were aware of the existence of the act knew that the law intended to curtail excessive drinking. In terms of knowing the objectives of the Act, many respondents could not spell out the strategies that the Act proposes to curb the use of alcohol in the country.

In listing the strategies aimed at control of alcohol consumption, the respondents who knew the contents of the law gave priority to the element of barring minors from accessing alcoholic drinks. They cited the time when alcohol should be sold during the day, the ban on children from being present in Alcohol selling points and from being employed or used in the dispensing of alcohol to consumers. Schools location and alcohol dispensing points was noted as important. It is important to note responses on the other strategies such as display of information on alcoholic drink packages, packaging of alcoholic drinks, license issues were barely touched on by the respondents. One aspect where the respondents showed ignorance of the law was that only 15.5% of all the respondents mentioned the issue of debts being prohibited in the purchase of alcohol. In the research, the element of debts contributes to the nature of gender relations within the family. In this aspect, the Act has failed to achieve its objective

Healthworkers’ Resilience

Many of the developing nations worldwide have similar problems that are a challenge to the success of the efficiency of their healthcare systems (Elkhammas & Singh, 2010, p. 149). With particular concern is Africa has 25% of the global disease burden with only 2% of the total healthcare workers globally work in Africa which has less than 1% of global health funding (World Health Organization (WHO, 2014). That already is a manifestation of struggling healthcare systems in which health workers have work in developing nations

In the USA it has been established that when health personnel are over-worked it results in sub-optimal care being given to patients by healthcare workers (Janicijevik, Seke, & Filipovic, 2013). This problem is made worse by the frequent brain drain that favours the developed countries, making developing countries fail to retain healthcare workers they need resulting in low doctor-patient ratios (Elkhammas & Singh, 2010; Musau, Al-Sadat, & Gerei, 2010). The low doctor-patient ratio in many African countries is worsened by unequal distribution of doctors, more sparsely in the countryside (Elkhammas & Singh, 2010, p. 149). This simply exacerbates the pressure health care facilities and healthcare workers are having in terms of facilities, resources and personnel in Africa .

Migration of health workers from Africa is costing African countries huge losses (Mills et al., 2011). The reasons healthcare workers migrate from poor developing countries is based on many factors. In the USA it was noted that under-staffing healthcare facilities had a high correlation with inpatient mortality. This supports the view that under-staffing healthcare facilities increases their work load of healthcare givers and the low doctor-patient ratios in Africa are extremely unfavourable for efficient delivery of services. Kenya has 49 nurses, 7 doctors and 8 clinical officers per every 100,000 peopl . This simply means that understaffing hospitals with doctors is a predictor to poor health outcomes in the treatment of patients and leads to high patient turnover (Needleman et al., 2011). From this statistics it implies Kenya has an approximate population of 25,600 healthcare workforce for a population over 42 million people currently. This translates to approximately one healthcare worker (regardless of whether it is a doctor, clinical officer of nurse) for every 1,641 people. This implication means the healthcare workers have a very high workload rate that may impact negatively on their output

This indicates the doctors and nurses who remain in a very large extent work in very challenging environments. Many of them quit government employment for better paying opportunities in the private sector or seek employment abroad. This shows that some of the health workers are stretched beyond their endurance limit to the extent they lose resilience (Rajan-Rankin, 2013) . This loss of resilience is a coping strategy, and an indicator of doctors and nurses feeling frustrated by the work environment they operate. Medical work may lead to psychological, physical and mental stress on a healthcare worker, and this will have a great influence on their productivity in terms of output of quality service (Govender, Mutunzi, & Okonta, 2012)

Healthcare workers need to have good customer relations and very empathetic to effectively deal with patients. More often than not they also operate in a continuous atmosphere of inadequate resources in many African countries. Thus, despite the shortcomings in resource availability, research shows that an empathetic and caring health worker generate more customer satisfaction in the patient (Pollak et al., 2011). Many patients in Kenya have reservations of the customer care attributes healthcare workers especially nurses (Katira, 2014). A patient who rates his /her experience highly with a doctor is likely to make a repeat visit to a health facility they have used before. Patient satisfaction can be an indicator of an effective healthcare workforce despite lacking enough facilities and resources.

The attitude of some healthcare workers has made them be pivotal in attracting patients to the health facilities in which they are situated. The idea of medical professional being a calling can be used to determine how healthcare workers perceive their roles in the community. It should be noted that when one looks at illness, it is a manifestation of two distinct worlds of realities between the doctor and the patient. In this relationship, how the health workers communicate with patients is a marker of the nature of communication they undertake with each other. Therefore the effectiveness of the communication strategies employed by the patient and the healthcare giver shapes their doctor/nurse patient relationship (Jacobson, 2007).

The design and medical resources available in healthcare facilities have been known to motivate workers to greater productivity. Over time scholars have realized that the way the physical environment has been constructed  as work station, it will ultimately end up influencing employee performance (Carr, 2014). In this construction of the physical environment of a healthcare facility, health care workers may be appealed to develop better therapeutic nurse-patient relationship and hence create a good rapport with the each other (Pullen & Mathias, 2010). This is another significant marker that can point at the general attitudes of the healthcare market area and their utilization of the facilities.

However, availability of resources is scarce in many African countries. The World Health Organization notes that Africa accounts for an incredible 25% burden of infectious diseases globally yet it only has less than 2% of the global share of doctors (WHO, 2014). This provides the evidence of the way healthcare workers in Africa have a huge workload.

 

1.2 Statement of the Problem

It has been noted that Africa has a very high disease burden which is made worse by the high rates of poverty and presence of a “vector-favourable climate” (Denis et al., 2014). Access to treatment is problematic yet it has been observed that the few who manage to access healthcare facilities make return visits. Secondly, while many research studies have focused on efficiency of healthcare workers and the availability of resources, so far no literature surveyed shows of any study being conducted that have demonstrated the significance of health seeking behaviour of patients and how they are influenced to seek healthcare from the same facilities that they deem them inadequately staffed, with non-empathetic and rude medical staff in the perceptions of patients.

Third, with low motivation that healthcare workers get in Kenya, selected literature surveyed clearly shows there is a contradiction that needs to be investigated. While many of the rural healthcare facilities suffer the vagary of insufficient resources, such as medication and poor facilities, it is presumed that the rural poor use the facilities that are understaffed because of poverty. There is need to determine how the doctor-patient relationship in such an environment influences return visits to the same hospitals. This is at variance with consumer buying behaviours theories that posit excellent customer care and positive experience lead to repeat sales (repeat patient visits in the case of utilization of health care facilities)

1.3.1 Hypothesis

Healthcare workers in public health facilities have high workload burden which affects their productivity in terms of service delivery to patients in Kerugoya Subcounty

 

 

1.3.2 Objectives of the Study

1.3.3 General Objectives

Evaluating Workload Burden and influence of healthcare workers in selected public health facilities facilities in Kirinyaga County of Central Kenya Region

1.4.2 Specific Objectives

  1. To determine the number of doctors, clinical officers and nurses in public healthcare facilities in Kirinyaga County
  2. To determine the number of patients they handle per month for a one calendar year period in public healthcare facilities in Kirinyaga County
  • To analyze the workload burden of healthcare workers in terms of number of patients handled and the type of service offered in the one year period in public healthcare facilities in Kirinyaga County
  1. Establish the reasons why healthcare workers get satisfied with their jobs in the face of the challenges they encounter
  2. Establish the coping strategies healthcare workers use in overcoming high workload stress and de-motivation

1.5 Research Questions

  1. What is the total population count of healthcare workers in public health facilities in Kirinyaga County?
  2. What is the total number of patients handled by the healthcare workers per month over a one year period in in public healthcare facilities in Kirinyaga County?
  • What leads to healthcare workers being satisfied with their jobs in the face of challenges they encounter in public healthcare facilities in Kirinyaga County?
  1. Why do healthcare workers get satisfied with their jobs in the face of the challenges they encounter in public healthcare facilities in Kirinyaga County
  2. What are the coping strategies the healthcare workers use to overcome high workload stress and de-motivation in public healthcare facilities in Kirinyaga County

1.6 Assumptions of the Study

  1. The low doctor-patient ratio in Kirinyaga County increases workload and stress for healthcare workers.
  2. There is a monthly variation in terms of workload burden and stress level for healthcare workers in Kirinyaga County in any calendar period
  • There is a monthly variation in terms of workload burden and stress level for healthcare workers in Kirinyaga County in the a one calendar year period
  1. Workload burden and stress level is affected by the number of patients handled and type of service given by healthcare workers in Kirinyaga County
  2. Healthcare workers derive some degree of job satisfaction despite their high workload burdens in Kirinyaga County

            Justification of the Study

The study seeks to establish the underlying reasons why healthcare workers work in poor work environments and poor remuneration and still remain in their work stations and carrying at their duties. The research will provide information that will shape the policy decisions that govern the relationship between healthcare workers and patients.

By doing so, patients are likely to benefit because what compels the healthcare workers to serve them will be understood against the background of their grievances. This will lead to identifying the factors that make healthcare workers work when in extreme variance with their employer lastly, the information gathered will help the County Government of Kirinyaga and the National government to design better policies that actually promote the factors that motivate healthcare workers for the benefit of the general public

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 Theoretical Framework

The theoretical framework that will guide this research is based on Herzberg’s Two Factor which posits that there are many factors in the workplace environment that create job job dissatisfaction in employees. While a lot has been done to study how factors of job dissatisfaction affect employees, available literature indicates nothing has been done to demonstrate the way healthcare workers in developing countries overcome dissatisfiers in their work environment in a situation where the factors that dissatisfy them are ever present yet they do not leave their jobs. This research will make a unique attempt in evaluating the job dissatisfies on non-exit of health workers who are not having hygiene factors of motivation realized in the jobs         

There is need to understand the push and pull factors which make health workers remain in a public health facility or move to the private sector or even seek greener pastures abroad especially in the developed world. It is estimated that more than 30% of healthcare personnel who were born and trained in sub-Saharan Africa emigrated to the developed countries (Poppe et al., 2014). While global statistics point out to what is happening concerning doctors migrating from sub-Saharan Africa, a survey of selected literature focus on why doctors leave but not what makes them remain behind despite the poor working conditions and de-motivation they encounter.

Kenya has an abject shortage of doctors with only 2,300 doctors serving public health facilities which are a far cry of the WHO recommended standards of 1 doctor for every 1,000 people . The pressure on the doctors who remain in public services is therefore big and employee burnouts are associated with this. It is a matter of conjecture on how healthcare workers manage to discharge their duties and achieve relative high success rates in treating patients regardless of how they handle them. In the doctor-patient relationship, the doctor is usually seen as the one who can help the sick regain good health as the knowledgeable other in the relationship. This exposes a gap in knowledge that needs to be filled

2.2 Workload as a predictor of Job Satisfaction

Based on Herzeberg’s Two Factor theory of motivation, it should be noted  that many Kenyan health care professional have quit from the public sector employment. Using Herzeberg’s Two Factor Theory, one needs to discover the motivationa factors that make healthcare workers remain in the public healthcare facilities Kinfu et al., 2009). Healthcare workers are an important component of the healthcare system . The achievements of workers through motivation needs to be evaluated again to determine to what level are the de-satisfiers that make employees shun the jobs, or exit the profession influence their decisions. Contary to what many researchers do, using Herzeberg’s Two Factor Theory to establish conditions that either motivate employees or make them dissatisfied, this study seeks to use the theory in determining what makes them remain in their jobs and work stations despite being de-motivated. This is a gap in knowledge that begs attention.

2.3 Patient Use of Public Healthcare Facilities

Healthcare facilities are used by patients based on their consumer buying behaviour. The theory of consumer buying behaviour looks at the factors and steps individuals under before they came to a decision to buy a product. The consumer buying behaviour will allow the research to determine when, where, how and what the buyer wants. In the context of this study, consumer buying behaviour should be construed as the way patients and other relevant others in a pateint’s come to the decision to use the hospital facilities in solving their health problems.

The use of healthcare facilities is functionally an outcome of the decision to seek healthcare and being affordable for the patient. The patients who have a bad consumer buying behaviour experience of healthcare facilities in the way they have utilized the facilities will not go back to the centres. However, despite the usual explanation based on poverty and inability to access better healthcare facilities in rural areas, this research looks at what promotes health seeking behaviours of patients to make repeat visits to facilities they consider unhelpful. There is a missing link between customer dissatisfaction and repeat purchase which is exhibited by many rural folks in Kirinyaga County

2.4 Coping Strategies and Motivation of Health Care Workers

            In looking at the situation of healthcare workers in Kenya, the issues that de-motivate them are inherently intertwined with their work environment. Secondly, a social expectation that healthcare workers should live upto a certain standard of life compels them to seek extra employment in other private facilities. The issue that needs to be understood the coping strategies are a predictor that the pay and work conditions are not good. This psychologically affects the way doctors, nurses and clinical officers relate with patients. Based on expectancy, what the healthcare workers wants is at variance with what the patient needs. When the healthcare workers resort to industrial action which contravenes their Hippocratic oath, patients in their health-seeking behaviours have been reported to go even to the healthcare workers homes to seek help. What motivates the healthcare workers to assist the patients extant to the hospital environment still remains unknown. Research studies so far do not provide clue of healthcare workers being highly underpaid, in resource-deficit working environments remaining their and serving patients fully or partially

CHAPTER THREE

3.0 MATERIALS AND METHODS

3.1 Description of Study Site

The study will be conducted in Kirinyaga County in the Central Region of Kenya. The county has a population of xyz people as per the 2009 National census. Kerugoya has xyz healthcare facilities serving a population of xyz number of people, with X, Y and Z numbers of doctors, clinical officers and nurses respectively

3.2 Research Design

The study will use descriptive cross-sectional survey design in collecting quantitative and qualitative data from the sample population

3.3 Targeted Study Population

The target population will be the doctors, nurses, clinicians in addition to the patients who make a repeat visit to the selected facilities within a one year period.

3.4 Sample Determination, Selection and Sampling Design

The sample size will be determined by using the sample size determination table proposed by Glenn Israel which was developed from Cochran’s formula for determine the appropriate sample size in regard to different confidence levels required in a study (Israel, 2013, p. 3)

Sample selection will be done in two ways. For healthcare workers stratified proportionate sampling will be used. Using Israel’s table, the total number of healthcare workers will be determined and each group allotted proportionately in the sample population

The population of patients will be selected on a simple systematic random selection. The total population of the number of patients handled the previous year will be assumed to be equal to the current year and that will guide the sample size determination as given by Glenn Israel (2013).

            3.5 Data Collection Instruments

The data collection instruments will be the questionnaire and the use of the interview schedule. The high literacy levels of healthcare workers will allow them to fill the questionnaires of their own.

For the patients, some are expected to be illiterate and use of the interview schedules will be appropriate. In some cases, use of focused group discussions will be used to collect data

3.6 Data Collection Procedures

The researcher and the research assistants will introduce themselves to the respondents and explain the aim of the research. Those who agree to be respondents based on informed consent will either be included in a Focussed Group Discussion (FGD) or have the interview schedule administered to them.

3.7 Data Analysis

Data will be analysed using statistical procedures of mean, averages, percentile, quartile and simple aggregation. The use of inferential statistical procedures of Pearson’s r-Correlation Coefficient will be used to infer the level of linear correlation between the coping strategies employed at different workload burden and stress level to determine if there is any relationship and the significance of that relationship. Contextual analysis will be used to analyse the qualitative data collected.

The findings will be summarized in a report and presented with charts and tables in a discussion of the findings of the research

3.8 Ethical Considerations

            During the data collection process, the research team will ensure the rights and freedom of the respondents is highly respected by safeguarding their privacy and confidentiality during the data collection process and thereafter in the data analysis and compilation of the report. At no point in time during the research process will this be violated and the respondents will be assured of this in seeking their informed consent to be participants in the study

Informed consent will be obtained from respondents without misrepresentation of facts or use of fraud. Participants will be required to s form indicating the were enlisted only after agreeing to be respondents. Children will not be interviewed due to ethical concerns, instead their parents will be interviewed

References

Carr, F. . (2014). Health Care Facilities. BDG. Retrieved from http://www.wbdg.org/design/health_care.php

Elkhammas, E. ., & Singh, N. (2010). Towards Reforming Health Care Services In Developing Countries: Taking Libya As an Example. Ibnosina Journal of Medicine and Biomedical Sciences, 2(4), 149–151.

Govender, I., Mutunzi, E., & Okonta, H. . (2012). Stress among medical doctors working in public hospitals of the Ngaka Modiri Molema district (Mafikeng health region), North West province, South Africa. The South African Journal of Psychiatry, 18(2), 42–46. http://doi.org/10.7196/sajp.337

Jacobson, P. (2007). Empowering the physician-patient relationshEmpowering the physician-patient relationship: The effect of the Internetip: The effect of the Internet. Canadia Journal of Library and Information Practice and Research, 2(1). Retrieved from https://journal.lib.uoguelph.ca/index.php/perj/article/view/244/374#.VTeTQiGqqko

Janicijevik, I., Seke, K., & Filipovic, T. (2013). Healthcare workers satisfaction and patient satisfaction – where is the linkage? Hippokratia Quarterly Medical Journal, 17(2), 157–162.

Katira, N. (2013, March 20). Seeking Aid in Hospitals and being assisted when healthcare workers strike.

Kinfu, Y., Dal, P. M. ., & Evans, D. . (2009). health worker shortage in Africa: are enough physicians and nurses being trained? Bulletin of World Helth Organization, 87(3), 225–300.

Michtalik, H. J. (2013). Excessive Workload Among Doctors Undermines Patient Safety. MTN. Retrieved from http://www.medicalnewstoday.com/articles/255576.php

Mills, E. ., Kanters, S., Hagopin, A., Bansback, N., Nachega, J., Alberton, M., … Ford, N. (2011). The financial costs of doctors emigrating from sub-Saharan Africa: Human Capital Analysis. BMJ, 2011(343:d7031). http://doi.org/10.1136/bmj.d7031

Musau, Y. A., Al-Sadat, N., & Gerei, A. . (2010). Brain-Drain and health care delivery in developing countries. Journal of Public Health in Africa, 1(1). Retrieved from http://www.publichealthinafrica.org/index.php/jphia/article/viewFile/jphia.2010.e6/pdf_4

Mwena, S. . (2012). From a dream to a resounding reality: the inception of doctor’s union in kenya. Pan African Medical Journal.

Needleman, J., Buerhaus, P., Pankratz, S. ., Leibson, C. ., Stevens, S. ., & Harris, M. (2011). Nurse Staffing and Inpatient Hospital Mortality. New England Journal of Medicine, 364, 1037–1045. http://doi.org/0.1056/NEJMsa1001025

Pollak, K., Alexander, S. ., Tulsky, J. ., Lyna, P., Coffman, C. ., Dolor, R. ., … Ostbye, T. (2011). Physician empathy and listening: Associations with patient satisfaction and autonomy. Journal of American Board of Family Medicine. http://doi.org/10.3122/jabfm.2011.06.11

Poppe, A., Jirovsky, E., Blacklock, C., Laxmikanth, P., Moosa, S., de Maeseneer, J., … Peersman, W. (2014). Why sub-Saharan African health workers migrate to European countries that do not actively recruit: a qualitative study post-migration. Global Health Action, 7. http://doi.org/10.3402/gha.v7.24071.

Pullen, R., & Mathias, T. (2010). Fostering therapeutic nurse-patient relationships. Nursing Made Incredibly Easy, 8(3), 4. http://doi.org/10.1097/01.NME.0000371036.87494.11

Rajan-Rankin, S. (2013). Self-Identity, Embodiment and the Development of Emotional Resilience. The British Journal of Social Work, 45(2). http://doi.org/0.1093/bjsw/bct083

Shi, L. (2012). The Impact of Primary Care: A Focused Review. Scientifica, 2012(Article ID 432892). Retrieved from http://www.hindawi.com/journals/scientifica/2012/432892/

 

Herzberg’s Theory of Motivation”

 By Julio Warner Loiseau,

 

 

 

Terrorism and Corruption are intimate romantic lovers in Kenya

In the last few months, I have seen my country succumb yet again to the atrocities of the fanatic murderers ‘abrogating’ the divine role of God, taking away lives which they are utterly 3,000% incompetent to produce. Time has made me check myself. I’m I getting inherently mad at the government of the day for no good reason when the culprit lies elsewhere? Are these terror attacks meted on innocent people when the perpetrator is inadvertently blind? I have been silent for so long, reflecting, and in my mental monologues I have decided to share this with you.

I start by making a simple argument. When the government tried to muzzle the media not to report on security matters, I guess that would have been the ultimate death for the general tranquillity in the country, which for long has been a God given heritage to our nation. Then the terrorists started hitting Kenya hard, pelted the civil population with tirades of invective words and the deadly venom of a gun, bullets, laced with more poisons; grenades, RPGs, landmines and many more

It began with Westgate, and up to date I challenge the President of Kenya to retract his statement that the horrors of Westgate will never happen again. I looked at that statement and cheered as a gallant show of taking command of security in the country. It was on the count of the five fingers on my hand a few days later while bragging about the will of the president to fight terrorism did a reality check knocked me out. Not senseless, but speechless. I remember in that single moment of time when a question thrown at me opened so many things in a flash of a nanosecond. A military friend of mine asked me “Why do you think the Al-Shabaab are attacking civilians and not the military?”

I think I gave a silly answer, the military guy looked at me and said “When two countries declare war, you know whom you are fighting, when a faceless amorphous state that operates on the principles of Jihadism use it to wrongly justify terrorist acts and they are not a tangible state, squarely formless or determinately void less, but with capacity to undertake militant manoeuvres, it is going to a long war. The soldiers by themselves are protected, for they are the hands that hold the sword fighting, civilians are the under-belly of a nation.”

“What do you mean?” I asked

The soldier looked at me and said “If you undertake a short history of radical Muslim groups such as Al-Shabaab, the war is not Holy war per se, but a fight to control resources. Unless you find a way to stabilize Somali permanently, the Lords who make merry will continue to churn out even more radicalized terrorists.”

By then I had no idea about the massive charcoal industry in Somali that was being used to fund terrorist operations. I had made little connection between piracy and terrorism, but that day I realized while corruption fights back, terrorism always erupts back when it appears to be highly in check. It was the day the military man gave the short history of the Taliban, and he made sense to me. If I don’t make sense to you, my apologies to you, expand your horizon. After Westgate, the Nation wept. It was then that instead of closing my mind to the world I opened my intellectual window and let the sea breeze of thinking spur on my reflections. In my silent monologues, I felt the urge to write but mixed emotions of vindicating the soldier or lauding the president always kept me at a loss.

Distant events in Kenya changed my perspective, in my silent monologues; I ruled the soldier correct and the President wrong. The soldier had told me the story of Winston Churchill and the speech he gave British parliament of toil, blood and tears. The hard reality to spur the resilience of a nation to endure the ill-fortunes of war with the prize of peace hard fought for and won at the end of the war. In Africa the Boko Haram were wrecking Northern Nigeria to pieces. Yet President Goodluck Jonathan always assured the Nigerian people. Same like Uhuru, and more menace of terror was spewed forth to innocent civilian populations. Mass murders, rape, maiming and killing of innocent people continued unabated. But there is difference here, Uhuru Kenyatta and Goodluck Jonathan are fighting a Stateless enemy, Winston Churchill engaged a well structured State, German.

In East Africa, the Al-Shabaab has taken the cue. They have shown they have systemic hatred for the Christian population. The aim is to fragment the country on religious lines and sow the seeds of discord, so that once defeated, they can have another footing to erupt back. The Al-Shabaab is hot magma, whose volcanicity will not end in a span of months. They will transfer the volatiles of terrorism from their sleeper cells and continuously attack innocent Kenyans. That is why, read my earlier blogs, Uhuru Kenyatta and William Ruto were fervent fools to go on KBC and promise that Westgate will never happen in Kenya. I hope the apostles of political wisdom have given them a thorough ‘reading’ about making reckless comments and promises in terrorist situations. I feel the shame of when Al-Shabaab release a video showing how they organized and undertook their infamous massacre. Terrorism was entwined with local land issues unfettered. Mpeketoni.

Again it happened. Mpeketoni. That again sends chills down the spines of many, especially the women who were forced to witness the execution of their husbands, brothers, sons, and nephews, some were shot for the crime of being boys, age notwithstanding, and toddlers were shot. The blood spills came in torrents, people had forgotten about Westgate and Al-Shabaab were keen to use that memory lapse to their full advantage. This time, the President was an embarrassment to me from the onset. In this crisis he saw political mileage and rubbished terrorism. It was a way of covering up for his failure to deliver the promise, never again will this happen, so why did happen again? The blame was directed to the opposition alliance. I have mentioned the video evidence linking Al-Shabaab to the massacre, do not shame me again like that Mr. President

Next was the Mandera bus attack. The merchants of terror need not haggle with anybody about the essence of human life. 28 teachers and other people were discriminated on the basis of religion and shot. Only one survived by the fate of the brain tissue of his wife, if God purposes you live, say your prayers and give Him thanks always. I shudder to think of my trauma after such an escape. Will I ever learn to trust the very own life I live? Thirty-six quarry workers were massacred a few days later. In between this major attacks small ‘inuendo’attacks were sustained at churches, hotels, businesses, private homes ceaselessly.

The final straw in the hat was Garissa attack. I call final because it is the most recent and not because no other will ever occur. That is when I realized the Al-Shabaab is not our enemy; the real enemy is within our own failure. I do not want to revisit Garissa attack, like many Kenyans let me hope to forget this and move on in life. Everybody does so in Kenya, even the security machinery. While we fight graft with kuku thieves, we forget grand-corruption is the cause of our systemic failure in the operations of our security organs. KTN has been able to show a documentary that clearly connects graft at all levels of government and the general society to the unfathomable loss of innocent lives in the Garissa attack. Mr. President, while you have not given me any reason to celebrate, I hope you have the audacity to come forward and apologize to Kenyans and tell them to walk knowing it will happen again, with gruesome consequences. Terrorist are not resting, planning and planning more terror attacks. When and where we don’t know, even if we know, who cares about using intelligence reports that have no daughter who will be shot after a terrorist verbally abuses her parents on a phone call conversation? The poor remain unprotected because those with the mandate are too corrupt to make use of intelligence and curb a crime.

As you do fight corruption Mr. President, do the realistic. Get competent people to do jobs competently without recourse on how will it benefit your aspirations for 2017 as a rider for appointment, if that is the case, do change. I know for a fact, Kenyans are happy that you are finally seen to be folding your shirt sleeves spoiling yourself for a fight with grand corruption. Get me right. Do the tough things with the toughness and seriousness they deserve and thereafter don’t talk much. Be like your late dad, he talked tough with the Shifta and acted tough with them. You better act tough in your own way because the constitution was changed.

…before I forget, don’t lie to me Garissa attack will never happen again.  I have a premonition that it may happen, more lives will be lost, but start building resilience in the Kenyan minds to endure, every page in the history of mankind that was filled with atrocities always came to an end, because when you flip to the next page, positive changes always follow the hardest moments in an era. Our sense of security and alertness is becoming sharper in the experience of a nation.

Effects of Warning Messages

 

Apart from teachers expressing their effectiveness of the third message (c.) in the second schedule of the Alcohol Control Act of 2010, it was evident that the residents of Chuka do not see the requirements as effective. The last rule that alcohol should not be sold to minors was rated on average as 28% effective which means that the potential that minors can buy the alcohol is very high. It is only teachers who stated that the third warning set out in the Act’s schedule was effective. Casual laborers and traders gave effective ratings of 40%, 20% and 33% for the warning alcohol role in the impairment of judgment and working using machinery. The possible explanation why teachers gave a low rating of the effectiveness of the law at 19% than the rest is due to the fact that they rarely have to use tools and machinery in the conduct of the work unlike farmers, traders and casual laborers. The contextual analysis indicates that casual laborers are more informed and have experienced to the dangers of alcohol more than the other groups on the inability to operate machines while drunk. This translates to an average of 19% effectiveness for these three groups.

The Booze

Teachers of Chuka
Have the highest rates of awareness at X% on Mututho Laws, Peasant farmers X%, Traders X%, and casual laborers at X%, others X%. These findings…..
many of the rural people in Chuka have an idea about the existence of the act and are aware that it is in force
This is the first marker, the rest are concealed, but why this pombe mingi and kukataa kuhudumu? Each section henceforth has been earmarked for surveillance. Abusers of drugs and alcohol been put on notice

Surely, is it true that they do not have accurate knowledge of the legislation?

When we are clever?