Thursday, 25 September 2014

TEN STICKY ISSUES IN THE REFERENDUM DEBATE



1.      Is it the right time for the referendum?
The constitution does not stipulate when to hold a referendum. However, it provides a referendum as the ultimate recourse whenever there are certain constitutional issues that need to be addressed. The right time for a referendum is that dependent on Kenyans. If we decide that this is the right time, then it is the right time. What is required is that the stipulated procedure be followed. I suspect the governors and CORD are following the procedure diligently and there are as many Kenyans who believe the time is right. On a personal note, I wish we were spared the electioneering shenanigans that come with referendum so that leaders focus on delivering their promises to Kenyans.
2.      What are the real issues to be addressed through referendum?
There are a plethora of issues that have been raised both by the Pesa Mashinani and Okoa Kenya initiatives. Key among them is increasing county allocation and enshrining it in the constitution so devolved funds is no longer a carrot to be used by national governments. There are other issues to do with strengthening senate, inequality in Kenya, security, IEBC etc.
Personally, I think most of the issues being raised are valid national concerns but only a limited number are constitutional issues. Issues of Inequality in Kenya have already been addressed by the constitution through stipulations on appointments and resource allocation. Hopefully, the referendum bill will particularly address composition of any state office or committee. One third of cabinet, any committee, office, board, commission or authority benefiting from tax payers contributions ought not to be from same ethnic group.
3.      Aren’t there other avenues for addressing such issues?
There are many avenues for dealing with some issues, especially those raised by the CORD coalition. On some, all that is required is advocacy, on others legislation through parliament and senate and on other legal action in the courts would suffice. However, on some of the issues, only a referendum will settle them once and for all.
For me, an issue like Pesa Mashinani is best handled constitutionally; let the rationalization of functions and corresponding fund allocations be enshrined in the constitution. This will create proper county autonomy. Equally, issues of date of elections, Issues of 50+1 in election of president, number of elected and nominated legislators, separation of powers and protocol between national assembly and senate ought to be resolved once and for all through the referendum.
4.      Are there enough funds for the referendum exercise?
I think treasury has not indicated that Kenya is nearly bankrupt. We seem to be doing well going by our spending on projects like lap top for children (that are not a priority according to education sector players). Recent generous donations to West African countries shows that we might be having some more to spare! IEBC says it is ready for the referendum, an indicator that funding is not an issue.
5.      Will counties absorb the extra cash?
The counties have key functions like health, agriculture and roads just as national government has education and security. The funds go to the counties with the functions. The counties have to account for the money. As long as they are disbursed on time, counties will definitely absorb the money albeit with the usual challenges that national government agencies have often experienced. When the funds are taken to the grassroots, absorption rates will improve with time and even surpass normal national absorption rates.
6.      Do the counties have the structures?
Most counties are now fully constituted. Additionally, the national structures are being absorbed by counties on devolution. For instant, the health sector does not need much restructuring to absorb funds. Just as agricultural ministry used to disburse funds to grassroots offices, the grassroots offices will now be under counties; these are structures that exist and restructuring is an ongoing process.
7.      Do the counties have legal and policy frameworks?
If the functions have already been implemented, money does not follow policy, money should follow functions. The counties have national policy frameworks to customize to county setting. Hopefully, the strategic plans and integrated plans at the county level have provided meaningful policy directions. If not, to develop such structures and capacity funds are necessary. Asking whether counties have necessary policies and frameworks is applying double standards. The national government does not stop collecting taxes till when it revises or puts in place legal and policy frameworks. Development of policy and legal frameworks is a going concern.
8.      How about accountability in our counties?
There are clear accountability mechanisms for money sent to counties. Accountability issues do not affect counties only; even national government has its own accountability challenges. Mega scandals have happened at national level. Existence of accountability measures is not the criteria for devolving funds. What matters is, have the functions been devolved? Then debate should be on how much funds should we send to counties if we have devolved roads, agriculture and health care functions? Moreover, citizen responsibility in holding leaders accountable is what we should focus on. How are we as citizens participating in processes that would ensure accountable and transparent service delivery at the grassroots?
9.      Will the referendum lead to higher taxes?
The funds are going with the functions, thus we do not need to collect any more funds to devolve more funds. Taxes will only be raised if national government hoards money for corrupt purposes.
10.  Is the referendum about Raila?
Raila is at the centre of the OKOA KENYA referendum push. As a political process, Raila is engaging in the referendum push to gain some political mileage. However, are there genuine issues that warranty a referendum? There are quite a number of issues that many would love to see ironed out. Is it wrong that Raila is taking advantage and riding on those issues? It is only wrong to the extent we do not want political contestations or competition. But, it is Raila’s political right to use national issues to pursue his political agenda. So to the extent the issues are genuine, those who oppose the referendum are also driven by a political agenda; which is about Raila not having a say in national politics. If his say is valid, then why don’t we let him follow the due process? If majority of Kenyans are not interested in his antics, the referendum push will fail and Raila will be shamed.

Saturday, 20 September 2014

Devolution of Healthcare Services in Kenya



There have been arguments for and against what the 2010 constitution stipulated i.e. the devolution of health care services in Kenya. Those for devolution argue that counties will ensure equitable distribution of health resources and proper prioritization of health care services; as per the needs of the County. It is assumed that each county will put in place mechanisms to ensure a vibrant health care system and to enhance efficiency in service delivery. 

Those against devolution of healthcare functions have argued that health care resources are limited and devolution only stretches them further. Most critically, they argue that counties lack capacity to manage a vibrant healthcare system. Tribalism and claninism and inefficiency at the county level are likely to lower the health care standards in the country.

What is my opinion?

a.       Not all healthcare functions need to have been devolved.
b.      Procurement of healthcare equipment should be centralized. It is easier and more economical when procurement is centralized
c.       Medical services should have remained a function of the national government; this would ensure a national system of training, equipping, developing and managing personnel and health facilities
d.      Preventive services should have been devolved and made the mainstay focus of the counties. This would mean the counties investing more in community health programs, vaccination, immunization, homecare services and outreach services to prevent diseases
e.        intergovernmental relations and coordination mechanisms are necessary to ensure health services and facilities are properly shared and benefit all in the nation
f.       Each county having an independent health system  is disadvantageous to members of the health fraternity; it limits progression and psychologically consigns to local issues rather than feeling part of a strong and vibrant national health workforce

The Devolution Experience
So far, counties are failing in effectively and efficiently tackling health care issues. This is because, in most counties, they have not appointed individuals who understand health management systems into the county executive committee. Some have gone as far as picking retired teachers to head such a docket. The result is that no system is being worked out; instead reactionary responses are the norm.

The desire for the political class to subdue everyone seems to affect health operations. In some counties, MCAs, some of whom did not see the light of post secondary education want to dominate and dictate terms to health workers. How can we have a health system that is not weighed down by petty chang’aa politics of the village? It requires that in terms of pecking order, on matters health, the health workers be given their due dignity, respect and space to work

Counties have failed in prioritizing health issues. Rather than focus on the system and make choices based on evidence based models, popular programs seem to be the choice. What has become popular is county governments introducing what looks like ambulances and everyone in the county goes gaggers in celebration. What is the priority in our county? Are ambulances a priority? Definitely, means of transport for sick people will always be a priority; however, what is the point of having ambulances if roads to the villages are inaccessible. Do ambulances accurately and adequately address the problem of transport challenges in the county? Can an efficient transport system in our counties serve even the sick more than ambulance provisions?

It would be helpful if counties realized that, in the long run, we would gain more through facilitation than actual implementation. How can counties focus on facilitation? Each County Executive Committee and Assembly needs to have a thorough understanding of issues affecting the health sector in the respective counties. The starting point would be to commission a county health audit where health professionals would evaluate the situation and deliver recommendations. Such recommendations would then have to be transformed into a county health policy inline with the national health policy. The county health policy would then be a guiding reference point for necessary health legislations in the country assembly and health programming by the health ministry of the county.

The legislation and programming should be guided by principle of facilitation; this means that the county government has to be seen as facilitator and provide necessary facilitation. Instead of spending money on capital goods like ambulances, how can the county improve infrastructure and enhance access to health care services even at the village level? How can the county government encourage private sector investment in the county health sector? Would it not be better if instead of ambulances more health care centers, closer to the people, are built, furnished, staffed and equipped?

Ambulances are only feasible as an intervention when we have proper road networks, the ambulances are fitted with proper equipment, there are enough resources to run the ambulances e.g. fueling, the facilities are spacious and efficiency has been achieved in the health sector. In a county like Bungoma, those who manage to get themselves to the hospitals do not receive proper health services. Are we providing ambulances for access to quality healthcare or mediocre healthcare services? In my county, a spot check at the Bungoma District*Hospital will definitely reveal long patient queues, congested rooms, understaffing, unmotivated employees, lack of enough equipment, lack of enough drugs or medicines, poor hygiene standards among other ills.
Maybe such issues should be priority focus rather than spending on vehicles that will not save many.

The vehicles may not save many because of the disease burden in the counties. The disease burden is high because basic prevention strategies like community awareness and sensitization programs are non existent. The disease burden is high because apart from ignorance, the people can not afford medical care and hence engage in unhealthy practices like using improper doses and self-medication. Even if the ambulances got the people from the muddy villages into town, do we have mechanisms of ensuring patients who are critically ill can easily be airlifted for specialized care say at KNH despite their economic status? If it were my doing, working on community health insurance schemes, partnering with AMREF and Flying Doctors, Working closely with private investors to enhance access and quality of health care would be a better focus.

In conclusion, issue of health management aside, there is need to build capacity at the county level when it comes to health programming. Professional CECs have to be engaged and evidence driven prioritization of interventions done. Each intervention has to be evaluated against current needs and future needs. An integrated approach that is people driven, where people are the forefront of reducing the disease burden in a county would yield awesome resources. This is the spirit of devolution, that local level participation in health cares is realized for sustainable results.


Friday, 15 August 2014

A Review of the Book "The Spirit of Understanding" by Daniel Oduor



Dear Gideon,
I have taken hours reading and studying your handiwork and I am impressed. Allow me in this message to sincerely congratulate you for such a piece. It sums up most of what life is and not. You dear friend have set the bar too high.
As I was reading on, I appreciated the ease by which your words flow. Your mastery of English language leaves the impression that English is your first language even though I am privy to the fact that it is your third language. The flow of the language is effortless. I would like to encourage you to maintain it at the simple in your subsequent publications.
Sir, the message in the book attempts to answer age old question among human being. You have made contributions into understanding who a human being is as an Individual and part of the whole. It is enlightening. What I mean is that as I read on I observed that you dissected the “person” and forces that enhance as well as delimit his existence. You further delved into metaphysical realms. And like some of the philosophers, anthropologist, sociologists, psychologists and other men and women of high intellectual inquiry into the question of “Being” human, those know to me in person and those I have interacted with through their writings , in comparison you are coming of age.
Having said all that, I would like to give my feedback in relation to the content of the work. Please Sir, allow me in humility discuss some areas that I felt inspired me. Let me begin by saying most of the chapters were spot on and I would not like to dwell on them. these include the chapter on “Concept of Success”, “Anxiety and Desolation”, Standards of Living”, and  ” Entrepreneurship and Financial Freedom”.  The others that I will not comment on because of my deficiency in the subject matter are: “ The Mystery of God’s Presence “ and “ The Spirit of a True Radical”.
Allow me to assert that I found the book pregnant with knowledge yet it did not adequately tackle each area of knowledge in-depth.  I am of subjective opinion that it should have taken a certain perspective and dwelt in it to it minutest detail. I am of the opinion that different aspect of knowledge can adequately address more or less questions bedeviling a person and his here and here after. It could have taken a philosophical or religious or psychological or anthropological or sociological approach and the message would have been driven home either way. Nevertheless all chapters tackle issues that trouble a lot of people and in spite of the means the end has been achieved.
M
y friend,  on “ The African Spirit” you did well in trying to anchor the book on the African philosophy the “Ubuntu” it is indeed important that as African we interrogate our place in the global society to evaluate and re-evaluate our values. To examine our past vis a viz our position in the cosmopolitan world. How our past values interact with the acquired values which are a result of our interaction with other cultures.  I agree with you that our point of engagement with other cultures should not be an inferior one. We ought to interact as equals.“ All things are equal; as concerns being equal than others. We can blame fate or nature or the first mover for the fact that somethings  are more equal than others are. It is clear that some places are more endowed than others- inequality is inevitable and our differences be celebrated. That is why Africa should not be blamed for what it hasn’t done right.” P20 as a matter of fact you have hit the bulls eye. In nature be it plants or animals of the same species differences in ability exists even among siblings and that does not mean one should despise the other. The reality though is that it is nature that dictates that the fittest survive and the dominant triumph over the weak.
 Africa happens to be the least among equals. It does not mean that that will always be the case. Observe a last born among siblings when they are born they are at a vulnerable position although they are equal by right to the older siblings. With exception to those overly protected by their parent, a weakness in Parenting, Most last born develop very fast trying to catch up which eventually they do. “time” is all that Africa requires. It will grow there is no need to panic. Africa will come of age. Most of other continents that look down upon Africa should read through their own history. If it is wars theirs were more barbaric; if it is disease they had their fair share; famine, the worst the world has ever experienced yet were not in Africa.All the negative thing currently associated with Africa already happened elsewhere. Just like the last born Africa is lucky it is protected by the elder brother who intervenes amid protest from African who despite their weakness feel slighted. Africa will soon come of age.
L
iving and life. I will not say much on this because this is a very subjective issue I doubt whether there can be an objective position on the subject. What has been said about life and living you summarize when you say: “ No science or art can explain what life is.” And no person can purport to possess knowledge of what life is. Indeed life is a mystery and whatever one says about life is their own interpretation of life including what you say in this book. Their words are only a motivator to the listener or reader to navigate their own life in a particular direction depending on what they perceive their reality to be.
Allow me therefore to add a few words of my own which emanated from your inspiration on what life is. I can summarize life as “ A HUMAN BEING MUST LIVE” human being are busy, working, sleeping, waking and all action associated with a living being is to make it live. We live in as much as we go through the physical, psychological and spiritual stages that are essential to our nature. The socio-political and economic aspects are just but aid to living. Out of experience I have learnt that whatever men say to me about life and living come to one axiom human being must live. Let men accuse , deride and ridicule you in your actions ; let them complain that you don’t respect or fear them; let them say you don’t earn your living honestly; but they too will sooner or later, will come down to the hard, cold and indisputable fact Man must Live.
“Are we here on earth waiting for death? How can we have life so that we wait for its end?”p.39   We are mortal beings and yet we are immortal too. In body and all the physical attributes we are so mortal.Our form as it is, is mortal. The non- physical attributes of a human being “spirit, Mind, psyche etc are immortal. We should not preoccupy ourselves thinking of death. It is only cessation of our physical being. Don’t ask me what happen to the non- physical attributes. I don’t know. To me it is a mystery.
I have lived long enough though to see a lot of people having died in pursuitof life long before they started to live. You find them in clubs jerking their bodies in funny movements in dance halls to weird noises. Soft people who were not any better for their knowledge of a world of things. Yet if they must live, let them.
On my part, it is true I love life not because i am used to living but because I am used to loving. And to me who love life it seems that butterflies and soap bubbles and whatever is like them among people know most about happiness! I have no reason to fear death. Why should I fear death? when I Daniel am alive death is not here! And when death comes I am not there!

T
he self, Me, I am as I am.  Let me comment on these since I feel they are the summery of the massage of this book. I must admit though that I am summing up everything as a consequence of my impatience and to a large extend my laziness. Please understand me sir.  You are right, “I am as I am.” I am what I perceive myself to be. I am the sum total of what I have absorbed into I am creating the “Me” me and I are one and the something depending on where I view myself from. And that I am human this I share with other humans. That I see and hear and that I drink and eat is what all animals do likewise but that I am Daniel Oduor is only mine and belongs to nobody else, to no other persons not to angel nor God.  Just as a horse would be as much destroyed if it were changed into a man as if it were changed into an insect. A person would be as much destroyed if he or she becomes an angel or Godas if he becoming a horse!
What to me is the biggest human question is “who am I?” the answer to this question have been disrupted by self-awareness, reason and imagination which have disrupted the “harmony” which characterizes animal existence. Their emergence has made humans into the freak of the universe. He is part of nature, subject to her physical laws and unable to change them yet transcends the rest of nature. He is set apart while being a part; he is homeless, yet chained to the home he shares with all creatures.
My friend I am now tired I would have shared my reflection on happiness but may be some other day.
Let me leave you with the struggles of one of my friend. He claims that he has a conflict within him. That he feels to fulfill his purpose to live he needs help from another free being the female of his species.  He says that he has never thought seriously about marriage. He claims he has once or twice fallen in love but he is naturally girl shy, although he respects women. So the two incidents of falling in love were only incidents of passing nature. And he has always excused excused his girl shyness by telling himself woman is not yet necessary in his life project. He could live quite gaily without partnership with the female species. He does not necessarily deny the importance of physica            `sswl side of such partnership. In fact if he must live this cannot be overlooked.
Please sir, in your next volume make an attempt to address the issue of love and marriage in-depth since your target population are the youth some of whom are grappling with the question of their individuality, freedom and independence on one hand and their lust and crave for intimacy which delimit their individuality(narcissistic tendencies) and perceived freedom. In brief narcissi versus altruism.

Tuesday, 12 August 2014

WHY THE CORD REFERENDUM IS POOR STRATEGY



The dance floor is full and cheers from the watching crowd are abundant. Every dancer is pulling his or her best strokes and he or she is sure he or she is attracting the cheers. This dance is colorful, it is exciting and it has sent every tongue wagging either in praise or in jeer.
Please Raila, stop the dance! Stop dancing and watch the dance a little more. No don’t just watch so you may jump back into the dance, but so you may decide if the dance is worthy or we should move to another arena. The dance as currently constituted has many armature players or dancers. For the armature player; the focus is on winning the dance by all means. By hook or crook, in the most Machiavelli way possible they are determined to win the dance.
The armature players have a toddler mentality or what is referred to as the “Me” syndrome. They do not care about the dance, they are not interested in principles, they care not about values or honor. All they want is to win the dance and all focus to be on them. Even when they are in the spotlight, they are so jealous and suspicious of other players, they would not want to allow them a little space. They declare “it is our time”, they are reckless and they imagine no one is entitled to his or her own persuasion. They do not want to see any bystander rocking his or her head to the tune of the music. They have forgotten to dance, they are more focused on who else is also nodding or moving his body to the music and yet it is their time in the spot light. They make all the wrong moves then quickly they cry victims and blame other parties in the dance or bystanders in the arena.
Raila you are an idealist dancer. You have always stood for nationalism and inclusivity in government. However, in your rallying troops to come to the arena and participate in dance, ethnicity became the banner of your strategy and style. Unfortunate as it was, like a wolf that has tasted blood, your time as the prime minister was a poisoned chalice. You drank the cup of power and popularity and now you are of no capacity for real grassroots based strategy. You crave the podium and all your strategies are high podium oriented. You have become the doomed buffalo surrounded by a pack of hyenas. The hyenas laugh with glee as they hang on your popularity and the power symbol you have become.
Please Raila stop the dance; stop arming your opponents. Stop making your moves; let your opponents move first because you are under no obligation to be the first to move. You have the privilege of not being the government and thus you could successfully use the wait and strike strategy. We all know, without your voice the arena is dull. Without the master dancer on the floor, the dance is boring. In your designed strategic absence, the rookies will pull all their moves that lack refined grace and intensity. They will open their naked tactlessness! You know what, all their strategies start and end with you. As long as the master dancer is on the floor, every other rookie moves to the master’s strokes and the imitations may just be taken for mastery.
You have done enough dear Raila, know when enough is enough. If I were you, I would befriend silence and obscurity at this point in time. Stop engaging Jubilee and give them room to blunder. You do not need to continuously engage your constituency, they are loyal and they believe you as their leader. The more you engage them in flexing your muscles, the more you expose your weak points; please embrace invisibility. In the meantime, focus on party disciple and making elected leaders in the coalition deliver to Wananchi. Work with elected CORD MPs, Senators and Governors to deliver on real needs of the people. Stop the dance and let all those politicians around you go back to the grassroots. Instead of running around clutching on your skirt, let the likes of Wetangula go back to Luhya land and work the grassroots. Let it be that these rookies in your coalition are doing right with the people so that the coalition benefits from them as small brands.
Please Raila, Stop the Dance Sir; forget the referendum and engage people in ways that are move livelihood transforming. Your best political strategies remaining is appealing to our sympathy, massive grassroots mobilization in CORD strongholds and outwitting Jubilee by letting them make the mistakes as you use the mistakes to appeal to some Jubilee constituencies. Let them make their mistakes! Take a podium politics sabbatical and engage the grassroots for real. Where is Mama Ida to engage our women in constructive engagements? Visit counties and let us see you fundraising to develop schools, supporting civil society activities. Why don’t you try and do some listening in the meantime. Come to us and let us talk one on one with us on issues that really affect us. Hear us out dear Raila! Please stop the podium politics or exchanging diatribes with Jubilee. Let us see you launching CORD funded youth activities like a national football tournament etc.
 If you do not stop the dance, we are headed back to a very polarized electioneering in 2017. Many may still stand with you but definitely, you will deliver a great political loss again. The state will be against you. Ruto may choose to kill his presidential ambition; nobody should cheat Ruto that he will be elected president after 10 years as incumbent deputy president. If Ruto sticks with the President Uhuru (Of course he is Uhuru’s only life line for a second term in office) then only strong grassroots mobilization and management will deliver an opposition win. Raila should not loose himself in complicated processes like the referendum; which is a two edged sword. The referendum can only work in favor of CORD if Jubilee opposes referendum and CORD wins the referendum. Unfortunately, Jubilee may just ride on CORD efforts and play the referendum to its advantage. Such a strategy is a gamble; it is a wrong dance!