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



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



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


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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?

Legalizing Marijuana: The Pros and Cons

The most abused of the light drugs is marijuana in the United States (U.S.), and even globally (Richardson, 2010; Svrakic, 2012). This paper has sampled out marijuana for the discussion on pros and cons of light drugs being legalized. Several researches have been conducted by scholars that demonstrate that marijuana, as a light drug, has medical benefits to the users (Svrakic, 2012). In view of the debate that marijuana portends some benefits, several states in the United States have legalized marijuana despite objections from the federal attorneys (Garvey & Yeh, 2014).

Grant et. al., (2012) note that considerable progress has been made in understanding the effects and action of marijuana ingredients (such as tetrahydrocannabinol and other cannabinoids). They argue that scientific researches have provided evidence that using marijuana and its related extracts are useful in the management of neuropathic pain and spasticity arising from multiple sclerosis. Thus people with multiple sclerosis have long term problems in muscle coordination and poor sense of feeling. Despite the advantages that marijuana has on the treatment of pain, other researchers argue that marijuna is not superior to the normally administered drugs like codeine in the treatment of pain, furthermore marijuana acts as a depressant on the central nervous system which limits their use in pain treatment (Campbell et. al, 2001; Grant, 2012). According to Grotenhermen & Müller-Vahl (2012) who reviewed more than 100 of cannabinoids-related research findings concluded that they provide evidence of the medical importance of marijuana. This gives some of the justification for its legislation in some States like Ohio.

From a social context, light drugs like marijuana have been shown to offer social facilitation and as a means of overcoming emotional pain. Some light drug abusers use them so that can overcome socially challenging situations (Beck et. al., 2009). It is on this basis that some teenagers smoke marijuana to enhance their sex-seeking behaviors which is detrimental to them, their partners and the society considering the health and negative social implications of marijuana (Beck et. al., 2009; Richardson, 2010). Objections to the medical advantages of marijuana has been voiced by many doctors. The many argue that the social and medical benefits of using marijuana and the derivative products do not justify its use (Richardson, 2010; Svrakic et. al., 2012) and hence, there is no good grounds to legalize it by the States in the U.S. (Garvey & Yeh, 2014).

A survey of available literature review indicates that a majority of little scientific research has been done to ascertain the positive social benefits of marijuana. Furthermore, medical researchers are in conflict on the risk and benefits of the use of marijuana (Grotenhermen & Müller-Vahl, 2012; Richardson, 2010). From the social perspective, some researchers have found out that legalizing it may lead to a reduction in homicide and assault rates (Morris, 2014). Such findings lead to the conclusion that some light drugs will not pose danger to public health and safety in terms of violent crime occurences. What complicates the whole debate is the uncertainty in the direction of contrasting findings. Khamsi (2013) argues that road safety may be in jeopardy with legalization of marijuana, and the safety issues relating to it’s recreational use is still poorly understood because available evidence informs the position that both long-term and short-term use have negative impacts to the health of the individual.

Pro-legalization crusaders argue that legalizing marijuana will lead to increased revenue for both the Federal goverment and the States (Stimson, 2010). This is seen as an economic advantage that will generate revenue and improve social outcomes to citizens. Despite the dangers marijuana poses to the health of individuals and society, 55% of Americans are of the view that marijuana should be legalized while 75% are of the opinion that legalizing marijuana nationally is inevitable (Wang, 2014). Looking at the economic arguments of legalizing marijuana, Wang (2014) elaborates the fact that illegal markets can be eliminated if tax on marijuana is kept low. Secondly through a flexible tax policy, the government can be able to regulate the consumption of marijuana because tax will has an influence on demand and supply of consumables.

A review of selected literature on the subject of legalizing marijuana has one thing. Many of the research findings dealing on the medical, social and economic impacts of marijuana indicate that the economic advantages stand to be very high for governments due to increased tax revenue base. However, the economic benefits tend to be seriously outweighed by the findings that show the medical and social risks of marijuana. Legalizing marijuana will instead increase the number of recreational users, and related problems such mental degeneration and ill health will increase. Stimson (2010) disputes legalization based on the fallacy of its pro crusaders by supporting the argument that legalizing marijuana will compromise public health and safety. Finally, research findings on social, economic and medical outcomes show that uncertainty surrounding safety and health issues justify the continued non-legalization of marijuana.



Beck, K., Caldeira, K., Vincent, K., O’Grady, K., Wish, E., & Arria, A. (2009). The social     context of cannabis use: Relationship to cannabis use disorders and depressive symptoms           among college students. Addictive Behaviors , Vol. 34 (9): 764-768.

Campbell, F., Tramer, M., Carroll, D., Reynolds, D., Moore, R., & McQuay, H. (2001). Are cannabinoids an effective and safe treatment option in the management of pain? A             qualitative systematic review. BMJ , Volume 323 (7303): 3-6.

Garvey, T., & Yeh, B. T. (2014). State Legalization of Recreational Marijuana: Selected Legal      Issues. Washington, D.C.: Congressional Research Service.

Grant, I., Atkinson, J. H., Gouaux, B., & Wilsey, B. (2012). Medical Marijuna: Clearing away the smoke. Open Neurology Journal , Vol. 6: 18-25.

Grotenhermen, F., & Müller-Vahl, K. (2012). The Therapeutic Potential of Cannabis and          Cannabinoids. Dtsch Arztebl Int , Vol 109 (29-30): 495-501.

Khamsi, R. (2013, May 14). How Safe Is Recreational Marijuana? Scientific American , Vol. 308      (6):

Morris, R. G., TenEyck, M., Barnes, J., & Kovandzic, T. V. (2014). The Effect of Medical      Marijuana Laws on Crime: Evidence from State Panel Data, 1990-2006. PLoS ONE ,       Vol. 9(3): e92816. doi: 10.1371/journal.pone.0092816.

Richardson, T. (2010). Research, Cannabis Use and mental Health: A Review of Recent           Epidemiological. International Journal of Pharmacology , Vol (6): 796-807.

Stimson, C. “. (2010, September 13). Legalizing Marijuana: Why Citizens Should Just Say No.        Retrieved February 20, 2015, from The Heritage Foundation:            should-just-say-no

Svrakic, D. M., Lustman, P. J., Mallya, A., Lynn, T. A., Finney, R., & Svrakic, N. M. (2012).             Legalization, Decriminalization & Medicinal Use of Cannabis:A Scientific and Public Health Perspective. Missouri Medicine , Vol. 109(2): 90-98.

Wang, M. (2014, July 8). Recreational Marijuana Legalization Lights Up Economic Policy            Considerations. Retrieved February 22, 2015, from Yale Economic Review:






The Chinese Translation of My Poems

Translation by Ma Xiaokang

The global community is shrinking into a digital village. The ease of communication is helping us do things with ease, speed and efficiency

Watch the World

I watch the world in helpless consternation
Not from a moral high stool but from a mind hanging
Dangling imaginatively in the emptiness of the skies
From a high cliff in the bare mountains the desert stretches far
Far, far and wide below in the foothills
I witness empty souls of men being dragged
To meet their final destiny in the hands of captors

I sense the desperation of the victims,
Who have been left to roast in the desert sun and sands
While the world is beyond their reach,
A world they live in yet it can’t help them out
I can sense their screams and pain in death
The masked men bring an end to innocent lives
The world helplessly searches for a clue
A clue hidden high up in the beams of the skies

But the world has ears stationed in outer space
These eyes are used only discriminatory to aid the privileged few
Those who pose meaning to the muscled men of the world
And so, the innocent die, branded as dogs
The world fails to help.
And the Merchant of Death have beheaded more
While silence and condemnation does nothing

The cry is unheard by the ear but felt in the heart
The pain does no physical injury but mortally affects the survivors
And yet, the innocent are gathered to work in the frontiers
Where they are left as helpless victims of the merchants of death
Who care not your faith but your submission to them
They attack no mercy even from their kind who question their ways

So the world keeps watching
As the merchants of death take control of Mosul
Burn victims alive from Jordan,
Terminate innocent lives in Kenya,
And wrecking havoc in Maiduguri and Kano in Nigeria
The world must resolve to work with a final push
A have a lasting outcome that protects all.









Or friend I knew
I entrusted you
My secrets I disclosed
That trust you betrayed
You smile at me brother

I did no one wrong
For so long you have sworn
To read my name as good as dead
Why that kind of deed
Why soil my name indeed
What a day from you,
Brother I say,
You make me cry

When my wound oozes puss
Come and be my nurse
You know the contents of my purse
And you go ahead and make me frail,
You set out to see me fail.
Each heart I touch,
Of the lilies I browse,
And the roses I loose,
If you must know,
Then, I ask, must I go?
When all you do
Is pretend to be brother.

Life is cruel I say
To hear and be told
That you spoil my name
Too many a maiden I loose
Because of your foolishness,
I rest case knowing
I have you forgiven brother







Uhuru Handing Over Power to Ruto Has No Constitutional Merit

I’m really amused by the excitement that is being caused by the supposed handing over of power by Uhuru to Ruto. It really amuses me that the Constitution gave the DP the powers to deputize the president right from 2010 when the new constitution was promulgated. In so far as I am concerned, the handover was pure mediocrity because Uhuru Muigai Kenyatta remains the President of the Republic of Kenya and C-in-C of the Armed Forces.  You can only act as a president when there is a void in that element which must be filled by means so established by the 2010 Constitution of the Republic of Kenya. None of the conditions was fulfilled to qualify that handover as legally binding in defining who an Acting President is. So as of now, Ruto is ‘legally purporting to be the Acting President’ of the Republic of Kenya.

What Kenyans should know is that Uhuru is a smart politician who has studied the art of power in the name of Political Science at Boston University. He is adept at creating impressions which I must say hold sway with the masses and he has chipped away Agwambo’s bedrock of populist politics. What he is waiting for is to count the number of new converts in the name of votes in 2017. This handing over the instruments of power is a sham which is legally irreconcilable but politically palpable and tasty. Constitutionally, it can only happen when he is not able to discharge his duties as the President of the Republic of Kenya. Take note, being under pressure to answer charges of crimes against humanity doesn’t imply incapacitation to discharge his duties as President. He made the promise while campaigning.

Some fellow might question me and challenge me to state if Uhuru can govern the country while he is answering charges of crimes against humanity. My answer is, during campaigns he made that promise, and so far he has made more than 29 official visits to other countries since he came to power. He has spent more than four days away on some of this trips and he never ever handed over power to Ruto to act as an Acting President when he was away. My question is, according to the Constitution, the DP can only become an acting President if he takes the Oath in the presence of the Chief Justice.

If my facts are wrong, I stand to be corrected.

The handing over of the sword was a scam to hoodwink Kenyans that indeed the President was going to The Hague as an individual without the vestiges of the Presidency. It is true he is facing a personal case in the matter distinct from his role as the Head of State and C-in-C of the Armed Forces of Kenya, a critical element that defines the presidency. I laugh at the facebook posts that show Ruto proclaiming his loyalty to the President of the Republic of Kenya. This two play masters know how to get the most out of their ICC troubles. They have turned it into a political asset.

My opinion is that the handover had no constitutional force behind it and it was a mere ceremony of glitter and pomp. I muss and ask myself for the more than twenty something times Uhuru has been out of the Country, I have never witnessed him hand over power, and hand over power to what? Constitutionally that was a case of inconsequent outcomes at law. Baseless by all means in the legal spheres, but fruitful to their political mechanizations. Despite this I think the fellow who moved to Court seeking to determine the constitutionality of the handover is wasting time. Ruto was sworn in to deputize the president in 2013 and that is exactly what he is doing despite the ‘bad manners of handover ceremony.’

What does the constitution say about the inauguration of an Acting or Full time president? For that to satisfy the constitutional threshold, it must be done in a public place such as Kasarani Safaricom or Coke-cola Nyayo Stadia, or Uhuru Gardens, even Uhuru Park can do.  It cannot be in the privacy of Harambee House or State House. For one to act as president the incumbent must have been impeached, dead, mentally incapacitated, or has resigned, or by any other reason at law that makes him forfeit the presidency. So, for Uhuru to be out of the country, it does not mean Ruto can act as a president, he will continue deputizing the president despite being fooled with that Sword.

In his ‘acceptance speech’ purporting to accept the honour  of being president, Ruto made a silly joke of himself, he exhibited sycophancy on facebook that are relics of his Moi era rise to stardom. May be it will work out for him in his bid for State House in 2022, but he must be careful to note Agwambo will not be in that challenge by then, and a new entrant will come into power. He is bound to run for his money. Ruto may be cursed to being the kingpin game changer of the political landscape without ever being the king, just like Agwambo. Only time will tell if he can actually take the presidential oath of office after winning a general election and not just filling a non-existent gap in law when his superior is in court answering allegations of rape, murder, and forced displacement of people.

I therefore advance my opinion, this handover  is a farce in legal perspectives, but a clever political ploy to create the impression matters at The Hague are so serious that for Uhuru to be out of the country he must ‘handover power’ to Ruto because there will be a power vacuum. I qualify that as pure nonsense. If the DP is not there, the Speaker of the National Assembly can take over, if the Speaker is not there, The Chief Justice, if the Chief Justice is not there, what the hell will the cabinet be doing? Can you Kenyans please revisit your Constitution and read it! This handover is pragmatically legal nonsense, but a serious political mileage for the Two Boys, Uhuru and Ruto, and a dirty scar on perpetual campaigner Agwambo.

Do you see why it is dangerous not to pay your dues? I can’t edit your work and you start bothering me over a few K. Watch this, I edited this statement someplace

The study made the following recommendations;

Parliament to re-evaluate the Alcoholic Drinks Control Act and align it with socio-economic needs, capacities and expectations of the poor.

Undertake civic education and encourage alcoholics to undergo rehabilitation in to lead to a positive change from alcohol taking behaviors rather than use the law enforcement agencies to curb alcoholism

Develop socio-economic policies and strategies for the empowerment of women with alcoholic husbands to make them more economically productive to enhance the provision of quality care to their children and families.

The International Community is Smiling at Doom’s Day Merchant: The Reincarnation of the Bubonic Plague in the Modern World

This may be a letter to the world, but one which is just but an essay that will be ignored. Yet it poses a theme far deadlier than the Islamic State threat to world peace. It a pandemic, the a reincarnation of the deadly bubonic plague of that begun in isolated Far East China in 1330AD, and spread to Europe. In October of 1347, Italian ships sailed into the port of Sicily with a sailors already dying of the deadly disease.
The world was sparsely populated than now, China was far and remote, Bubonic plague had no cure, the disease was finally in Europe, and the deadly scourge ravaged European nations. The disease struck, and from symptoms to death it could be a matter of hours. The Black Death aka Bubonic Plague was in as far away as England by August the following year.
Fast forward to the 21st century, 684 years after the first outbreak of the Black Death, it has a new face, a more lethal reincarnation, the Ebola virus. From West Africa the disease is spreading in the distant populations of West African countries of Sierra Leone, Guinea, and Liberia. Now rural populations are getting infected, whole families destroyed, Ebola has an ancestor, the Bubonic plague. Unlike in the distant past when such diseases took days to spread, with modern technology and efficiency in transport, it won’t take the plague more than a year to reach England, unlike Bubonic plague that took a year to reach England, it will be a matter of an infected person undetected covering 3,000 kilometers in hours to spread the disease to new destinations. The virus will be using international transit points to new destinations such Dubai, Amsterdam, London or Nairobi, the busy air transit hubs in the world. A new nuclear weapon in the reincarnated Ebola Virus is a serious threat to global peace.
The developed c countries are not doing enough to aid the containment of the disease. And it is also fool hardy to praise the efforts African countries are as anything substantial. The worst is in the making. I recently posed a question on facebook ;
“As Ebola rages West Africa, spreading majorly due to cultural practices, has Kenya audited cultural practices that can lead to its spread? What will happen if it happens that Ebola has struck Kibera or Mathare slums? I hope cultural practices and ignorance are factors that can be tackled just in case Ebola strikes Kenya”
What about the slums of New Delhi, the overcrowded streets of Beijing or Shanghai, the ignorant West who think they have enough to combat the epidemic if it occurs in their own countries? Think about the African governments lamenting that U.N is not sending enough resources to help combat the disease? I say, closing down international border points is no solution, the best solution, invests in protecting the areas already affected. The global community must rush to West Africa. There no time to waste.
The Islamic State threat is a shadow thing in the face of Ebola. They can behead their enemies, but Ebola does not behead, beheading is not a contagious disease that wipes entire populations. The Islamic State are selective, Ebola is not, soon they too will be crying for Allah’s mercy because Ebola has gone viral globally, we will then say, if we as a world had united when the world was informed of Ebola pandemic in West Africa, we would not have witnessed the reincarnation of the Bubonic Plague, the Black Death, in the new pathological evil face of Ebola.
What is so difficult for all the countries in the world to start a fund now, and establish 80,000 beds for Ebola victims by end of December in the three countries of West Africa? The scourge is slowly moving towards the Ivorian border, we can stop everyone from leaving the three countries, but how sure you have sealed porous borders?
The freedom of the mind is going to be a daily torture to all global citizens. We wait for disasters to happen, and we move in in the aftermath to undertake mitigation measures. Mitigate now, before this Ebola demon wipes entire populations across many nations. It requires serious political will to allocate serious volumes of resources to surmount Ebola. I have known guys, who down play security issues based on their position within the safety net, and now in Melbourne, Johannesburg, Nairobi, New York, Brasilia, Tokyo, Mumbai, Paris, Moscow, Berlin, Washington D.C., Beijing, and Toronto are watching the Ebola development as a scourge occurring in West Africa as a movie series of a disease outbreak somewhere in Africa. But the time the world realizes it’s not a movie, not a reality show, things will be far from worse, we shall be rotting in hell as a human generation. If China, Japan, USA, Russia, German, South Africa, Kenya, Rwanda, India, Italy, Rome, and all the countries in the world, if the move fast to build fifty facilities with 1,000 bed capacity in West Africa by end of November, then we can reclaim our hope. The CDC figures are real, on the highest side at 1.5millon new infections by end of January based on the current reported figures.
What if they have been grossly under reported?
Then the calamity has started rolling down the hill, it will soon reach a point of no global return, just like the Black Death of Medieval Europe. Africa and the Americas were spared because they were entirely isolated from the rest of Asia and Europe, that luxury is no longer for the rest of the World as Africa is suffering from Ebola.
It is time the World acted unanimously and decisively. Ebola may never give the mankind a second chance.

The Folly of Our Petty Kenyan Mindset: What We Need To Know

Finally, the US woes Africa, and to the naysayers that US has been beaten by China to Africa in pursuit of African goody-goodies, I have some food for thought for you.

I do not in any way profess to know the details of the US investment plan, but the mere mention that it is an attempt to invest in Africa simply tells me a lot. Africa is becoming a strategic region in global economic setup, and the US has been laid back in pushing for an aggressive economic agenda in Africa like China. Despite China’s economic package Kenya is seriously suffering economic woes, and hope is in the U.S (Page 3, The Standard. August, 6 2014: Uhuru’s Presence Expected to End Frosty Relations read paragraph 2, 3, 5 & 6.  Why do we chest thump that we have smitten the U.S. when we are hoping they will save our economy? Did China buy the Eurobond? No, the U.S bought 66% of it, to control a stake in Kenyan economy.)

But, time has come. From whither which Kenya stands to gain?

As I read the Standard newspaper today I find the U.S. plan is more ambitious and in tandem with the global redistribution of resources to spur growth in poor malnourished African countries. As the East-see-bad-in-China fanatics curse the American ranking of Uhuru in Africa as the third best president on the continent, I want to take positive side of Uncle Sam’s move and what it portends for Kenya.

In the first instance Kenya is country whose existence has little effect on the U.S, but the U.S. has a mega effect on every aspect of Kenyan society. From economics, fashion and design, entertainment, military, information technology, we keep using the U.S. as a measure of achievement, apart from middle to long distance athletes we are no comparison even in sports.

This is where I have a born of contention with a friend of mine who recently wrote on his facebook wall insinuating that for the US to rank Uhuru 3, it’s a clear sign of hypocrisy. On that I beg to differ. That ranking was not meant for Kenyans, it was meant for the American public. The U.S. has no business appeasing Kenya, but it has business appeasing American citizens in justifying why they want to redirect investment to Africa and not China. For American leadership is more accountable to the people than Kenya.

Investment is a good form of goody goodies. You do not advance loans with conditions that it is American firms that must build the standard gauge railway. You do not finance the Kenya government through an expensive loan scheme and claim it is the only way out to ensure the loan is returned. What the Americans are doing is for a different goal, redistribution of global wealth and not amassing of gains purely to Washington and New York regardless of how well or bad the projects are. That is my beef with Beijing.

Yet, Beijing’s indulgence is what possibly has made Washington turn to Africa. I’m not the devil who never gives credit to his nemesis.

The US want to expand her global reach, increase her global clout and influence global affairs. That is the negative side, so does China, but the US is my benevolent devil with a better agenda than the self-centered devil of Beijing.

The U.S. wants her global multinational corporations to set base in Africa. When it comes to business, Kenya is geopolitically strategic for Washington’s interests. Let those U.S. companies set up base here, create jobs for Africans, increase their profits and fleece Chinese companies from the raw materials they obtain cheaply from Africa. The U.S. will not advance loans to African countries, but more bring investment through global multinationals like Coke-Cola, to Africa. If this is achieved, then as usual, Africa will again be the playing ground for the East-West tug of war between U.S and China. The odds favor Africa to gain, while Chila is slow in setting up investment opportunities within Africa, they are more intent on extracting raw materials and undertaking value addition in Beijing, Shanghai, or may be Guangzhou among others. So before we condemn East, think about the West, and before you condemn the West, think about the East.

It is on this note that I found sense in CORD’s plea that we as country need the West in as much we need the East. But, with our historical records, the East (China) is a new entrant, the irony being they are more capitalistic than the West, yet they profess socialist communism. But credit too to Uhuru, despite the misgivings of people like my former college friend, you go grab the pie first and then think of what to do next. That pie is a great investment we should not miss in the U.S attempts to strangle China of resources by ensuring they invest in value addition in Africa, relocate their companies to Africa for cheap labor and raw materials which are hard to come by in China. Remember U.S. company’s have a huge stake in Chinese companies too.

So, despite being pawns in the East-West tug of war, isn’t the U.S justified in proclaiming Uhuru the 3rd best president in Africa? Cordashians will dispute this, because of the 13 point agenda.  Jubileeans amuse me by being skeptical of Uhuru’s visit to the US. Cord applauds that, it’s what they want, to mend fences with traditional development partners.

Classical Stupidity of All Kenyans as Blind Political Followers

Agwambo followers don’t believe he can be wrong. Uhuruto followers don’t believe they can be wrong. And history is but a record of events of a different time epoch, lessons are the same, players are the same in character but different in body, the setting the same, context is what is different. As Wanjiku what reasons do have to believe that your choice of the man you ascribe to is wrong? Do you believe your opposing camp could be having a point? That is my query to all Cordashians and Jubileeans plus Amanis and Tip tips . I have to include even the unknown or whatever Eagles and elephants in the political climate of Kenya.

One might say, so what the hell was Kalonzo doing for all the years he was within the government? So I question, what the hell was RAO doing? What about Uhuru? Mudavadi? Ruto? My verdict is simple, at that time they did what they thought was good for them or may be, may be to some fortunate extension, the country. They are no different now only that the stadia they used to play the ball games has made them wear different uniforms. The stadia have changed and players transferred to in different teams. Ronaldo will be Ronaldo whether in Real Madrid or Manchester United. Elections being the transfer windows. For the same old causes? History will be the judge.

On the other side Ruto is seen as disaster in waiting. My point is, what we think we know, may not be. What validity do we have to advance our opinions as factual? The answer is, many of you guys are blind to the fact that the positions you take have been doctored and engineered by the leaders, regardless of what side you are. If we could dialogue with supreme reason in our own selves, you will be able to decipher the fallacies Uhuru feeds u to get your unfettered support. On the other side, If we could dialogue with supreme reason in our own selves, you will be able to decipher the fallacies RAO feeds u to get your unfettered support

My opinion, all leaders are the same rotten eggs, we need another sweeping change across the political platform. New players with ideologies of diverse nature but with unity of purpose to the goals of national unity and developmental growth.

So my dear Kenyans, you as the common man who keeps on complaining that leaders are the ones who make you fight at the grassroots as they exchange pleasantries at the top, aren’t you the greater fool? You are stuck with your political demigods. You only abhor to the fullest they that you hate without reason. Or admire them with religious fervent that you love without asking yourselves, “can he/she be dead wrong?”. You are the silly creatures. Let the leaders have their fill as you complain with your brainless minds. Minds? Minds ought to think. reason, explore and discover the truth by itself. You should not be fed de facto truth by the political class and applaud it as heralding Gospel truth. De Facto truth is a potential recipe for outrageous falsehood

Kudos to the political class. What else matters? The fox has had his kill, but the rabbits are congregating. Now the hyenas will come, and by the end of the day, wild dogs are coming in, because they do not know how big the meat size is They think it was enough for two, or a million of them, the rabbits will soon start fighting. The rabbits are the common voters.

Kenyan Wanjikus, Cheronos, Nanjalas, Denas, Fatumas, Adhiambos et cetera, you are the fools. You actually deserve the suffering you undergo as a nation. But if you learn, and use your heads in the correct manner, liberty is all yours.