ALL THAT GLITTERS: NAIROBI’S GLASS SKYSCRAPERS

THIS ARTICLE FIRST APPEARED IN THE DAILY NATION’S DN2 SEGMENT ON 4/16/2015. http://bit.ly/1czmbrw

Glass is the new norm for Nairobi’s highrise offers, but is the cost more than just the extra shillings?

BY ELIZABETH MERAB

elizabeth@gmail.com

GLPX

At 105 metres tall, Kenyatta International Convention Centre dominated Nairobi’s skyline for years.

The building towered over the rest of Nairobi’s architectural offerings, dwarfing such other highrise structures of the time like Teleposta Towers and Nyayo House.

But today, with more than 50 highrise structures jostling for space, Nairobi is rapidly transforming into a proper concrete jungle, in the words of the great reggae musician, Bob Marley.

That growth is angling for a piece of the city’s aesthetic pie, meaning that, even though KICC still remains the most iconic building here, it is surrounded by structures that are more than just concrete edifices. The race for beauty and elegance is attracting all sorts of architectural designs, and the craze now is for all-glass finishes.

In other global capitals, shiny complexes have all but swallowed the gothic and other styles from the early 1900s.

In Dubai, the world’s tallest building, the Burj Khalifa, kisses the skies with astounding beauty, and at night it is lit by hundreds of lights that reflect its glassy modishness over the Emirati skyline.

In London, The Shard, described by Jonathan Jones of The Guardian as a “transparently misconceived and prodigiously cocksure colossus”, towers 87 stories over Southwark. Standing proudly at 309.6 metres, it became the tallest building in the European Union in December 2011, surpassing Germany’s Commerzbank Tower, which pierces the skies at 259 metres.

FUTURE IN GLASS

So, what is the connection between Burj Khalifa and The Shard? The answer is simple; glass, and Nairobi is following suit, although not as extravagantly as these two other capitals.

The city, whose real estate sector has been on a rapid upward trend, has over 10 buildings standing higher than 80 metres. But the skyscraper boom is not all that city residents have to contend with as a myriad of glass façade buildings are also taking over the skies.

From the imposing I&M Building, which glitters in the warm Nairobi sun like a lone star on the width and breadth of Kenyatta Avenue, to the ocean-green panes of the newly constructed Sifa Towers which pour life to the surrounding buildings on the junction of Lenana and Ring roads, Nairobi clearly sees a future in glass.

For architects, just like developers, the outward appearance of a building matters a lot; so much so that it is said to set the tone for the rest of the structure.

For this reason, developers, architects and contractors will strive to put up aesthetically appealing buildings that pass across a muted yet strong statement about their creativity.

Sifa Towers, an all-glass-façade, 12-storey structure that has adopted the architectural concept of a “hyperbolic-parabolic curve”, took three years to build. And when it was finally finished, it attracted rave reviews from the industry.

GLX1

The developers, King’s Properties, call it “a 21st century commercial complex that goes beyond the conventional building”, and which anticipates “the growing needs in Kenya for a modern business environment that delivers growth and prosperity”.

In Upper Hill, construction is ongoing for Britam Tower, a 31-storey building inspired by the shape of a prism, and whose developers say will be a game changer in the battle for Nairobi’s skies.

So developers are no longer just competing for the few additional feet at the top, but also for the most aesthetic construction in town. As Nairobi-based architect Gad Opiyo explains, a building’s aesthetic appeal matters as much to a developer as its structural rigidity.

However, that appeal comes at a price as glass frames are more expensive than other finishes, like paint. “The use of glass as a finishing tool is costing developers up to three times the amount they would spend on concrete walls,” says Mr Opiyo.

As if borrowing a leaf from the glistening capitals of the developed world, foreign and local investors are using an architectural language that is giving more importance to the “transparency” and “lightness” of building spaces, and hence driving Nairobi towards a flattering, glazed environment.

BUILDING CODE

Interestingly, Mr Jeffrey Gitau, a structural engineer, says that most of the developers are local investors who are interested in bringing “the London feel” to Nairobi.

“Glass is a good material and local developers are now going for it since it gives a sense of modernity,” says Mr Gitau, adding that developers are also interested in having much natural light within the building to cut down on the cost of power.

Also, adds Mr Opiyo, it is faster to construct using glass than concrete.

“Technology has evolved from the traditional wall-to-wall brick-and-mortar variety to today’s screen walls and glass facades which are fixed after major constructions are completed. These facades are mounted on aluminium frames, the latest technology in construction,” he says.

A glass wall not only brings light to offices, but also gives developers the leeway to adjust their office space and feel to suit their preferences. For instance, one may decide to have the whole wall as a window, thereby altering the design of the building and creating the illusion of a wide, open space.

“Masonry, compared to glass, is heavier. A developer will go for glass because, although it is costly, it will only use up small-size structural beams and columns, making it a bit cheaper,” says Mr Opiyo.

So, how high can these glassy edifices rise? Should we expect one to dwarf the postcard-dominating KICC?

Mr Opiyo explains that even though there are no skyline bylaws in the country, there is a building code which acts as a guideline on how tall a construction can be. The code guides the contractor based on the plot size and ratio, he adds.

“The building code dictates a construction’s height coverage. For the CBD and Upper Hill areas, it allows for 100 per cent coverage, while in most residential areas, one can only use up to half of the plot’s coverage to control the density of the area,” explains Mr Opiyo.

Mr Jerry Ndong’, an architect and former chair of the Architectural Asssociation of Kenya, advises that during construction, it is crucial for the developer to get the right advice on the type of glass to use.

“For small frames, one should use thinner glass that is up to 3mm thick, while for wide frames one should use glass of up to 20mm thickness to prevent it from easily breaking.”

GREENHOUSE EFFECT

Those who go the glass way say they are saving the planet by ensuring their buildings have natural lighting. The Glass for Europe website (www.glassforeurope.com), for instance, says growth in building products is fuelled by that of construction projects, both of which are magnified by an architectural and engineering trend towards greater use of glass in building facades.

“The environmental protection in this case is exploiting the ability of glass to capture natural heat and light, and thus reducing the carbon output associated with heating and electrical power,” an excerpt from the site reads.

But the United Nations Environmental Programme differs with this explanation, saying that some global architectural trends “such as the use of glass envelopes in high-rise office buildings, may not be appropriate for their climatic conditions, particularly in hot climates”.

Mr Opiyo agrees, saying glazed buildings “reflect sun rays as they absorb heat”, meaning that if one doesn’t open the windows for aeration, one will need an air conditioner.

“During the cold season, the room will be so cold that  you will need a heater, therefore it is not energy-efficient,” he says, adding that glass façade constructions are also not suitable for tropical areas where there is long duration of sunshine since they will retain a lot of heat.

However, the experts agree that if the structure of the building is done to the required standards, giving it a nice touch by cladding it (covering the skeleton of the structure) with glass should not be a daunting task if the developer is using professionals.

However, there are basic things to bear in mind while going for glass. First, since glass has a greenhouse effect, it is important to use screens on windows. These can be curtains or sun-shading glass.

UV rays from the sun penetrate the glass walls and become infrared rays which are retained in the room. This feature tends to make glass buildings hotter and in need of air conditioners.

To ensure there is free flow of air to maintain the temperatures of the room, use cross ventilation, which reduces the effects of direct sunlight.

Secondly, the movement of the sun determines how the structure will be constructed, and it is important to avoid direct sunlight.

“Each frame and fixing depends on the designs of the desired end product and therefore it is imperative that it be done meticulously to counter any negative aspects,” says Mr Gitau.

Finally, the structural engineer advises that a good glass façade building should be positioned relative to the movement of the sun around the year.

“A general rule is to build the unit in the East-West direction. Also, remember that the higher you construct the unit, the stronger the glass frames should be since at that point, wind becomes a real danger.”

In Summary

  • “Glass is a good material and local developers are now going for it since it gives a sense of modernity,” says Mr Gitau, adding that developers are also interested in having much natural light within the building to cut down on the cost of power. It is faster to construct using glass than concrete.
  • Glazed buildings “reflect sun rays as they absorb heat”, meaning that if one doesn’t open the windows for aeration, one will need an air conditioner.
  • But the United Nations Environmental Programme differs with this explanation, saying that some global architectural trends “such as the use of glass envelopes in high-rise office buildings, may not be appropriate for their climatic conditions, particularly in hot climates”.

Between a rock and a hard place: Kenya’s growing cancer burden

canc-pic

BY ELIZABETH MERAB

Young, graceful and full of hope was the spirit Rose Nasimiyu (fondly known as Princess Nasimiyu) exuded when she graced the media four years ago.

The valiant young girl had hit news headlines after publicly announcing that she had cancer in 2011, and for days she had the nation in apt attention.

Then aged 9, Nasimiyu had just been diagnosed with Hodgkin’s lymphoma, a disease which was slowly squeezing life out of her.

But, although the long, tedious and painful chemotherapy sessions left her frail, her spirit remained sturdy, ever willing to fight for yet another day.

She embarked on a campaign to sensitise the nation on cancer, whose debilitating effects were beginning to be felt across the country, even though rarely reported.

Through media interviews and social events, the term cancer began to sink in people’s minds.

At about the same time, Prof Anyang’ Nyong’o, the then Minister for Medical Services, was diagnosed with — and successfully treated of — prostate cancer.

In an interview back then, Nasimiyu (who is now 13 years old) expressed optimism that she would outlive the deadly disease.

“I will conquer cancer, and not vice versa,” she said.

DECLARED CANCER-FREE

One year after her diagnosis and a myriad of costly chemotherapy sessions, she was declared cancer-free.

Though both Nasimiyu and Nyong’o were battling different types of cancer, they shared a similar predicament: excruciating pain, unending chemotherapy treatments, treatment abroad and a triumphant survival.

Unfortunately, their stories are the exception in a country where cancer is ranked as the third leading cause of death.

As lack of funding and inadequate radiotherapy and chemotherapy machines systematically cost people’s lives, poor data on the burden of the disease to the country and its people is proving a daunting task for medical experts.

In his speech while commissioning the Managed Equipment Service programme recently, the Cabinet Secretary for Health, Dr James Macharia, could only give old statistics on cancer, saying Kenya registers about 27,000 new cases annually even though other, more recent studies put that number at 40,000.

Last year, the Kenya National Cancer Association compiled a report based on data received and processed at the Nairobi Cancer Registry.

The data, which was used to generate national estimates, was drawn from a population-based registry concentrating only on residence within Nairobi and incidences reported between the year 2004 and 2008.

The chair of the association, Ms Anne Korir, acknowledged that getting actual representation of the burden of the disease was challenging to due to lack of resources.

Currently, the cancer association has only two permanent staff, and Ms Korir said that they relied on grants from donors to enable them employ on contract.

“The government… has not employed enough people to assist in data collection yet it is a crucial aspect in realising the burden.

Without it, we are in the dark,” said Ms Korir, adding that the challenge was even greater due to lack of a national registry.

AS FIRST PUBLISHED IN DAILY NATION DN2  http://www.nation.co.ke/lifestyle/DN2/Kenya-growing-cancer-burden/-/957860/2633016/-/1anpy3/-/index.html

Though deaf and diabetic, he still hopes to enjoy a fulfilling life

ismail

By ELIZABETH MERAB

@lisamcleans

He keenly watches as geckos scamper around the nearby hedge. It is a sight that amuses him and his eyes gleam with delight.

But the gleam is replaced with a mirthless smile as Ismael Ibrahim turns his attention towards his peers at play.

He would like to join in and play but instead chooses to sit and watch.

“Ensure that you get your insulin injection before eating anything,” the voice of one of the instructors breaks through the noise.

Ismael, who was diagnosed with diabetes last year, is attending his first diabetes youth camp. About 50 children from six coastal counties have been invited to the camp.

But Ismael is different. Not only does he have diabetes, he is also completely deaf. The 16-year-old can only communicate with his hearing friends through a sign language translator.

“It is a bit difficult to pick up every word he is signing because he is mixing the signs taught professionally with what we refer to as ‘local signing’, which children pick up at home,” explains his Ms Fatuma Ngoto, a sign language expert.

Though it would seem as if Ismael is reserved by nature, he has learnt to be keen and uses his eyes to follow conversations.

His parents only found out Ismael was hearing imapired when he was two-and-a-half months old.

“Since childhood, Ismael was a very quiet, peaceful baby even in his sleep. His mother would leave him sleeping to go fetch water and come back to find him still in the same position. I don’t remember hearing my son cry like normal children do,” recalls Ibrahim Chiko, Ismael’s father.

Chiko says that they decided to test their son’s hearing as soon as they suspected something was amiss. They stamped their feet near him. Struck metal rods and played loud music but still got no reaction from him.

“When my wife hinted that our son could be deaf, I did not want to believe it, we decided to try traditional methods first before taking him to hospital for a second and authoritative opinion,” says Chiko.

The diagnosis from Kilifi General Hospital indicated a change of lifestyle for Chiko’s family. Each member of the family had to take care of Ismael due to his disability.

As if this was not enough for the cash-strapped family, rumours that Chiko had used his son in witchcraft spread in the small village.

“Our relatives began to keep off and our neighbours would not even borrow salt from us. Playing with other children became difficult because they believed that our son’s condition was as a result of witchcraft,” explained Chiko.

To avoid dealing with the stigma, Chiko and his wife confined Ismael to their Makuti-thatched house. Eventually, he got admitted to Kilifi School for The Deaf after living at home for 14 years.

“The allegations were were quite hard to deal with. When one doctor suggested the boarding school, we took it up immediately,” he recalls.

A year after his admission to school, Ismael was diagnosed with Type 1 diabetes, a condition that is currently on the rise among children and young people in country.

“One afternoon, his teacher called to say that my son’s health had deteriorated and he needed quick attention. When I went to pick him from school, I could not believe what I saw. He was so thin and weak that even food supplements could not help him gain weight,” says Chiko, adding:

“For a moment I thought he was HIV positive and even tried to probe him so he could tell me if he had shared any sharp objects with other pupils.”

What Chiko did not immediately realise, was that his son was a diabetic. A diagnosis that came a shock to him.

It is this diagnosis that saw him attend last year’s Diabetes Youth Camp organised by Safaricom Foundation. Through it, Chiko was able to come to terms with the condition.

“All this time I was convinced that my son was the only one with diabetes, it is still uncommon to hear that somebody has such a condition. However, today I can breathe easily after seeing all these children, some younger than my son deal with the same,” He says.

According to statistics, at 16 years of age, Ismael’s diabetic case is not unique. Together with the 49 other children who attended the camp, they are just but a fraction of the ominously escalating cases of diabetes in children and teenagers.

A person is said to be a diabetic when their body cannot properly store and use glucose broken down from foods like bread, rice, potatoes and other carbohydrates.

Such patients will present symptoms of frequent urination, increased thirst and hunger, symptoms which Ismael first presented before he was diagnosed.

The International Diabetes Federation Africa (IDF-A) in 2013 documented that 387 million people in the world are living with diabetes. Last year, Kenya recorded 775,200 cases, a marked rise from the previous year.

The sharp increase of diabetes among children and young adults of between 8-18 years has rised concern from the Kenya Diabetes Management and Information Centre (DMI), a registered medical charity.

Mrs Eva Muchemi, the Executive Director of the Centre says that the number of young people being diagnosed with the non-communicable diseases is on the rise with the youngest patient diagnosed with diabetes at their institution being four months old.

“The number of people coming to the centre for diabetes management is quite high. Many of our patients are young people who have been diagnosed with Type II diabetes, which is more common in adults,” says Mrs Muchemi.

Type 1 diabetes occurs when the body of an individual fails to produce enough insulin while Type 2 begins with insulin resistance, where cells fail to respond to insulin properly.

As the disease progresses a lack of insulin may also develop. Insulin is a hormone produced in the pancreas to regulate the amount of glucose in the blood.

Mrs Muchemi explains that when a child is diagnosed with diabetes, their survival rate is usually between seven months and one year due to lack of appropriate medication and avenues for monitoring and information.

“Many medical practitioners tend to overlook this important aspect when carrying out a diagnosis and therefore, these children end up not being managed early enough,” she says.

However, the director’s major concern is the increase of diabetes Type 2 among children.

“Type 2 diabetes is mainly caused by sedentary lifestyle and we are seeing a sharp increase of the condition in young people, which is a worrying trend,” she says.

Mrs Muchemi points out that medical records only reflect those who have gone to hospital for diagnosis and therefore, may not clearly indicate the situation on the ground.

“When many people are diagnosed with a disease, there is always a high chance that the number of those undiagnosed is even higher. For every one person diagnosed, there are two others undiagnosed. This means that a third of people living in the developing countries will be diagnosed after their death,” she explains.

She adds that early diagnosis is the key to survival and a healthier life. However, Mrs Muchemi acknowledges that the treatment comes at a price.

“Insulin and the testing kits are not cheap and many cannot afford it yet diabetes affects patients of all social classes nowadays. The cost therefore stands in the way of these patients well-being.”

Poor families, for example, may be unable to raise the Sh1,800 required for a pack of insulin testing strips needed per month.

She concludes by advising that anybody above 25 years should have a blood sugar test.

“Diabetes is manageable and not a death sentence. You only need to get tested to know whether you have it or not. There is need for more awareness especially among the young since it is a group that is usually neglected.”

As he takes the syringe to draw insulin, Ismael can breathe with ease knowing that he is not alone in his predicament.

“Does he know how to go about his medication and meals?” I ask. With the help of Ms Ngoto, he quickly responds:

“The doctor wrote down how and when I should take my insulin. He also said that I can only have ugali that is equal to the size of my two fists, eat a lot of vegetables and drink enough water. He cautioned me against staying hungry for too long and this is advice I follow keenly.”

His new friends beckon him to join them in playing beach football and he happily obliges.

Early start in American football linked to brain problems

A new study of NFL retirees found that those who began playing tackle football when they were younger than 12 years old had a higher risk of developing memory and thinking problems later in life.

The study, published in the medical journal Neurology by researchers at the Boston University School of Medicine, was based on tests given to 42 former NFL players ages 41 to 65 who had experienced cognitive problems for at least six months.

Half the players started playing tackle football before age 12 and the other half began at 12 or older.

Those former NFL players who started playing before 12 years old performed “significantly worse” on every test measure after accounting for the total number of years played and the age of the players when they took the tests.

Those players recalled fewer words from a list they had learned 15 minutes earlier, and their mental flexibility was diminished compared with players who began playing tackle football at 12 or older.

While both groups scored below average on many tests, there was a roughly 20 per cent difference between the two groups on several measures.

The age of 12 was chosen as a benchmark because it is roughly the point by which brains in young boys are thought to have already undergone key periods of development.

Research has shown that boys younger than 12 who injure their brains can take longer to recover and have poor cognition in childhood.

The findings are likely to fuel an already fierce debate about when it is safe to allow children to begin playing tackle football and other contact sports.

Youth leagues are under scrutiny for putting children at risk with head injuries.

Pop Warner and many other youth leagues have added training protocols, have limited contact in practice, and have adjusted weight and age limits to try to reduce head injuries and the risks associated with them.

But some leagues continue to allow children as young as 5 to play tackle football.

“Being hit in the head repeatedly through tackle football during a critical time in brain development may be associated with later life cognitive difficulties,” said Robert Stern, the senior author of the study, who teaches at the Boston University School of Medicine. “The take home message is, the earlier you start, the more issues you may have.”

The findings came out of a larger multiyear study financed by the National Institutes of Health with the goal of finding a way to diagnose chronic traumatic encephalopathy in living people.

Stern warned that the results were applicable only to NFL players, and that more studies would be needed to determine the impact on a wider population, like players who stopped playing in college or high school.

The findings also should not be used to dictate rule changes, he said.

But “it makes logical sense that kids during a time of rapid brain development should not be exposed to hit after hit after hit to their head,” Stern said.

“To me, it is logical. The brain is our most important organ. The idea of dropping kids off at a field during a very important period of maturation and fostering hit after hit after hit, it doesn’t make sense to me personally.”

First Published in DN2, A weekly magazine found inside the Daily Nation http://bit.ly/1HQufBQ

Group in quest to shed off street life tag

FIRST PUBLISHED ON SATURDAY NATION, OCTOBER 11, 2014.

http://www.nation.co.ke/news/Madaraka-Estate-Street-Families-Squatters-Nairobi/-/1056/2482452/-/133qf64/-/index.html

By ELIZABETH MERAB

DN+STREET+CHILDREN+g+2306.JPG

Dark clouds hang ominously for Samuel Osir at Lang’ata Police Station, Nairobi.

Passers-by are warmly dressed but not Osir. He is in a Barcelona Football Club jersey and a pair of trousers as he picks discarded clothes from a garbage dump and puts them aside.

Osir settles on a torn brown shirt, a worn-out black skirt and a soiled blue pair of trousers. Soon, he has a pile, which he stuffs in polythene bag as it starts to drizzle.

The clothes, he says, are meant for a group of street children he is rehabilitating at Madaraka Estate near Strathmore University.

This and many other odd jobs have been a source of livelihood for 27-year-old Osir since he left Kwa Ng’ethe Rehabilitation Centre many years ago.

For him, the desire to be part of change among fellow street children makes him go out of his way to assume these duties and more.

“I always want to be the change people can emulate. These boys and girls have nowhere to go and no one to turn to. Therefore, whatever little I get from the police station, I take it to them,” says the former street child.

In 2005, the government, in a sting operation, flushed street families from the streets of Nairobi and hauled them into rehabilitation centres.

The programme was started by retired President Mwai Kibaki’s Narc regime to rehabilitate street children and absorb them into the National Youth Service.

But this was not to be, for a year later the project ran out of funds and the families returned to the streets.

Today, they are all over the city centre and estates. Some beg, others do casual jobs at bus stops and markets, while others survive off the proceeds of crime — mugging, vandalism, pick-pocketing, theft and robbery.

SHAME OF BEGGING

However, for the 22 boys in Madaraka, begging for a Sh10 coin is a shame they do not want to subject themselves to.

They live in plastic-paper shanties erected against the wall of the estate. They are lucky that nobody has evicted them from the backyard of the apartments.

Most do not know their parents or siblings, but their bond is so strong that they have nurtured a family known as Madaraka Farmers Self-help Group.

The group squats on a rectangular plot, where they cultivate food crops.

“Boiling sukuma wiki (collard greens) from our garden for a meal gives us gratification. We don’t need to be begging on the streets,” says Philip Baraza, a father of five.

In their seclusion, they have set rules which each abides by. One of the rules is to stay away from drugs.

“We live by these rules and if anyone breaks them, we throw them out,” says Peter Muchega, the group’s chairman, adding:

“We came here to seclude ourselves from reckless groups. We don’t want drugs or to be called thieves because our homes have no roofs.”

Every Sunday, the group holds a must-attend meeting, where each contributes Sh50 to their ‘sacco’. The money is banked through a friend at a local financial institution.

“We have learnt to depend on ourselves for everything. No one is ready to assist a street child because they are always suspicious of us, but our friend has helped us all through for the last four years,” said Muchega alias Konje.

“I had no one to turn to after my parents passed on. The streets became my home and I found peace there,” he says.

For, Muchega it was a complete change — from a life of drug abuse and crime — when he was introduced to the group.

During our short visit to their turf, it was evident that the group has not only changed the perception of many, but also created a life far from begging.

Though Martha Katonge says she is 21, she looks much younger. “I joined the street life when I dropped out of school many years ago.”

She says that bad company led her to the streets. However, when she talks about her life at home, tears roll down her chin.

“My mother was not capable of taking care of us (she is the first born in a family of two) and at some point we had to drop out of school,” Katonge said.

With a gradual introduction to street life, she thought it was an easier way of forgetting the misery at home. “What do you do if there is no food at home?” she posed.

FEND FOR HIS FAMILY

Like Baraza alias Osama explains, the constant cat-and-mouse games between the county askaris and street families, drove many of them from the city centre. Most sought refuge in other places, one being the Madaraka shanties.

Baraza, 37, says since he joined the Madaraka group, he has been able to fend for his family which he houses and caters for in Kibera slums.

“I was tired of being chased and sleeping in the county cells. I even quit drugs just to join this group and I don’t regret it,” he says.

The county government of Nairobi recently announced an operation that will see almost 1,000 street families pushed out of the central business district into a rehabilitation centre.

Unlike the 2005 project, Christopher Khaemba, the County Executive for Education, says there are stringent measures put in place to ensure that the programme succeeds.

The county government has bought 40 acres in Ruai and is in the process of setting up the rehabilitation centre.

“We are aware that the previous operation did not succeed but this time, it must,” he said, adding that: “No group will be spared because even those who look harmless will sooner or later grow into crime.”

For Osir, the impending crackdown reminds him of the clouds that left him in the cold at Lang’ata Police Station.

His prayer is that the county government spares their skin and shanties for another day, month and year.

Three Kenyans suffering from sickle cell anaemia share their experiences

DNSicklecell2806g
By ELIZABETH MERAB
AND
ANGELA OKETCH

In April last year, Denis Awich’s cousin, Rosemary, died of sickle cell anaemia. It was one of the lowest moments in his life because he, too, had been diagnosed with the condition.

They had battled the disease together for years, and when they were not giving encouraging talks to fellow patients, they found hope in each other.

Now Rosemary was gone, just a few months to her 26th birthday, and Denis wondered whether he would soon follow her to the grave.

Heartbroken and, he admits, a bit shaken, he decided to celebrate Rosemary’s life by starting the Denis Awich Sickle Cell Foundation (Dascaf), through which he spreads awareness about the disease.

“Before the death of Rosemary,” he says, “all I did was explain to my friends, classmates and relatives about the condition. But after she succumbed, I took it upon myself to let the world know about it.”

TAUNTED BY SCHOOLMATES

All his life, Denis has been in and out of hospital so many times that he views the brightly lit wards as his second home.

In the beginning, whenever he was in pain, he would go to various hospitals for consultation, and as sure as the sun rises from the east, the doctors would misdiagnose him.

Denis has thus spent a great deal of his life not only fighting sickle cell anaemia, but also popping drugs for ailments he did not have. Malaria, for instance, seemed the doctors’ easiest excuse to send him to the pharmacy.

His parents, worried that their son was always going down with malaria, decided to seek help further up the medical chain, and that was when Denis was diagnosed with sickle cell.

The good news was that they had finally figured out what was ailing their son, and the bad was that the son would be on medication for the rest of his life.

Sadly for him, pain was not his only headache. He was constantly taunted by his schoolmates and some relatives. The stigma was often worse than the pain, he says, and at one point he was tempted to drop out school.

“While in Standard Seven, a classmate succumbed to the disease. Everyone in school knew that she and I were suffering from the same disease and so when she died, my classmates repeatedly reminded me that I would be next. I could not handle it anymore and had to transfer to another school,” he recalls. But he outlived the taunts to celebrate his 26th birthday earlier this year.

MEN RUN AWAY

Catherine Odongo, another victim of the disease, is looking forward to her 29th birthday next week (October 12). For a person who has lived with the condition all her life, that would be a major milestone because most victims die young.

But, like Denis, Catherine has paid a high price for her condition, not least of all losing a job. “My condition was something my boss could not handle,” she begins.

“During the last Sunday of the month of July, after suffering a painful bout and asking for days off, I received a call from my boss telling me not to report to work anymore.”

Catherine, who was diagnosed with the condition when she was eight years old, reckons that her boss was not the only one who could not stand her being sick as she tells of how difficult it is for women living with sickle cell to interact socially.

“I have had men run away from me the moment I disclose my medical condition,” she says. “I remember an instance where I abruptly started feeling pain and walked into a restaurant to request for some water.

“In my pain, I couldn’t even afford an upright posture and people thought I was drunk. In fact, I heard one heckle ‘Leave that girl alone, she is just drunk’,” she adds.

VARIED DIAGNOSIS

Unlike Denis, she chose not to disclose her condition to anyone in school. Not even her relatives knew about it, save for her grandmother who brought her up and enlightened her about what was ailing her.

“I don’t think I could stand the stigma. And, to avoid it, I chose to hide my condition from everyone, apart from my grandma and brother. For the same reason, I never set foot in a boarding school.”

According to Prof Walter Mwanda, a haematologist at Kenyatta National Hospital and the chairman of the National Blood Safety Committee, diagnosis for sickle cell anaemia varies from one individual to another due to differences in the blood composition of individuals.

“Blood has a lot of elements, one of them being globin which, in simple terms, we refer to as chains,” he explains. “During conception, both parents contribute these chains that form the composition of the haemoglobin (an iron-containing protein in blood that carries oxygen from the lungs to body tissues, also referred to as Hb), an alpha chain and a beta chain.”

However, he says, there is formation of a third chain called the foetal chain, found in infants. A beta chain, responsible for the sickle cell trait at times, is usually suppressed by foetal chains which some children retain years after being born, making it difficult to detect the condition. However, as soon as the foetal chains are lost, the trait begins to manifest itself.

Prof Mwanda adds that when red blood cells are malformed, the person could be either a carrier of the disease or a victim, depending on the degree of the malformation.

PAINFUL EPISODES

“In extreme cases — where the patient is not just a carrier, but a victim — the red blood cells turn crescent shaped, making them stiff and fragile, hence clogging the blood vessels, especially around the joints, and depriving the body of oxygen. This causes pain,” he explains. “A normal red blood cell has a life span of about 120 days while a sickle cell has between 10-20 days,” he continues.

The low lifespan of the cells arises because of their sickle shape. Prof Mwanda says that due to the distortion of the cells, jaundice is likely to occur among patients.

Still, a lot of patients in this century live well beyond the age limit of 18 and, as Prof Mwanda says, not all sicklers suffer from painful crises, arguing that an individual is the sole determinant of how his or her body will react to the condition.

“As an individual, you cannot prevent the blockage in the veins, but you can reduce the number of obstructions by avoiding the causative agents.

“When sickle cells have adequate supply of oxygen, they behave like the other normal cells, hence there is no pain. However, a slight depletion of oxygen leads to formation of the crescent shape which blocks the veins and results in painful episodes.”

The disease is a genetically inherited condition which is transferred to children if both parents are carriers of the sickle cell trait.

SWELLING AT TIPS OF FINGERS

“We are not all the same. Misconceptions, ignorance and misinformation are what ail us. Sicklers are normal people who can lead normal lives and perform normal activities.

“It is stupid to segregate them due to their condition. Early symptoms like jaundice (yellow eyes), pain and swelling at the tips of the fingers and toes (hand and foot syndrome) are related to the condition.”

Despite some advances in recent years, the sickle cell anaemia still takes a deadly toll on patients, according to Dr Donald Kohn, a researcher at the University of California Los Angeles (UCLA). He says that, despite all the improvements with medical care, the average patient only lives into their 40s.

Dr Kohn, however, hopes to change that through a clinical trial where the goal is not to just treat sickle cell disease, but to cure it.

The approach is to basically do a bone marrow transplant using the patient’s own stem cells and introduce a gene that will prevent their red blood cells from sickling and clumping together.

After the stem cells are removed, it takes three days to modify them in the laboratory. During that period, the patient will undergo chemotherapy to kill the remaining affected bone marrow cells.

POOR BLOOD SUPPLY

The hope is that when the modified stem cells are transplanted back into the patient, they will multiply and quite quickly create a new, sickle cell-free blood supply.

Using the patient’s own bone marrow stem cells means they no longer have to find a donor who is a perfect match, and that they do not have to take powerful anti-rejection medications that most transplant patients need to stop their body attacking the donor cells.

Dr Grace Kaguthi, a Centres for Disease control (CDC) research officer and co-investigator in the trial study, says patients with sickle cell suffer pain due to poor blood supply to different organs in their body, “which damages organs such as the brain, limbs and spleen”.

“With the damage of the organs, it reduces their life span as well as their quality of life.

“But with better health care, the patient’s life span can be increased to 45 years or more,” explains Dr Kaguthi, adding that the goals of treating the disease are to relieve pain and to prevent infections.

—————————————————

THE BATTLE HAS LEFT ME BRUISED, BUT I SOLDIER ON

My name is George Obiero, and, at 53, I may be one of the oldest Africans living with sicke cell disease. As a teacher, I must admit that living with the condition is an everyday fight, but so far I seem to be winning the battle.

That is not to say that I am not bruised, though, because my body is living testimony to how fierce this battle had been. I do my best to fight the pain, but at times the bouts are so strong that they knock me out.

Now, at this age, I do not have the energy of youth, and so I call upon those close to me to help me when the disease attacks. It is a burden they have learnt to live with, and I am grateful to have a family that supports me in this tumultuous journey.

I inherited the disease from my father, who was a carrier. He was unaware that, by marrying my mother — who was not a carrier — and agreeing to have children without medical advice, the possibility of having sickler children was as high as 50 per cent, and I am living proof of that. My two elder siblings, however, came out unscathed.

I learnt I was unwell at the age of 12, when my parents took me to Kenyatta National Hospital to check what was wrong with me as I was always down with some ailment or the other.

In most cases, whenever I went to hospital I had to do an haemoglobin blood test to determine how healthy my blood was.

Doctors opine that when the blood level is above 4, the patient is safe, unless he or she exhibits signs of malaria that need treatment. However, when it’s below 4, then blood transfusion is recommended.

In most cases, my blood level was always 2.9, a sign that all was not well. And most times when I visited the doctors, the results showed I was suffering from anaemia and received four to six units of blood every month.

I had to discontinue my education at Ng’iya Mixed Primary School in Siaya to join my father in Nairobi to be near Kenyatta National Hospital for the frequent check-ups.

In Nairobi, I joined Heshima Road Primary School. I passed my primary exams and was admitted to Starehe Boys’ Centre. I was denied admission, however, because I was 15 when I sat my primary exams in 1978, yet Starehe was admitting boys aged no more than 13. As a result, I joined St Mary’s Yala instead.

In 1980, I had a serious attack that left me in a coma for three months. My father died while I was still in hospital, and when I came to, I had no one to continue paying my school fees at St Mary’s.

I sank into depression, but a local church came to my rescue and sponsored me through secondary school. Just as I was about to write my final exams in 1986, however, I had a serious attack that forced me to be hospitalised, and as a result I wrote the papers from a hospital bed.

I did not score enough points for university admission, and instead joined Kilimambogo Teachers’ Training College for a Diploma Course.

After graduation I was posted to Rambo Primary School in Siaya County, where I have been the head teacher for the past 10 years. In some countries, sicklers are discouraged to marry because they do not want the disease to spread to their children, but I had girlfriends who were very close to my heart, and I knew I would get married to either of them. But all of them refused to marry me when I asked them to.

In 1994, I met a woman named Joyce, and with whom I eloped and later got married despite my situation. She loved me unconditionally and never listened to what people said. We are now blessed with two daughters who are, unfortunately, carriers of the disease, and whose children will most probably have sickle cell.

AS PUBLISHED ON DAILY NATION’S DN2 SEGMENT.

http://www.nation.co.ke/lifestyle/DN2/sickle-cell-anaemia/-/957860/2476612/-/ghk6a5/-/index.html

Hire-limousine-for-baby father does not consider himself rich

BY ELIZABETH MERAB

@lisamcleans

emerab@ke.nationmedia.com

dn+MACA+DG.JPG

Eric Macakiage would not, by any measure, describe himself as a rich man.

Yes, he lives in a Sh90,000-a-month house in Kileleshwa. Yes, he drives a Toyota Prado and, yes, he spent about Sh3 million on a wedding last year.

But to Mr Macakiage, spending quite a bit on a limousine — he is still waiting for the invoice — to take home his days-old first-born son Jayden Cole Otieno from the Nairobi Hospital is not proof that he is a rich man.

The only thing it proves, he told the Sunday Nation on Friday, is that he loves his family and focuses all his energy and his wallet, no doubt, on doing whatever it takes to make his family comfortable.

“It’s not that I have money. I’m a giver. So, when my friends hear that I have an event, they are always willing to chip in,” he said.

CAUSED SENSATION

He caused quite a sensation on social media when he decided to pick up his newborn son and the new mother in style.

He is the chief operating officer at Smoothtel, an information technology firm. With the salary he earns, and the friends — connections — he has made, he says that he can afford to live life the way he wants to.

“I have a responsibility to take care of people who are directly connected to me. And if it means splurging money just to see them comfortable, I will do it,” he says.

Unlike many men, Macakiage stayed in the labour ward with his wife, Irene, as she laboured all Friday night until she delivered on Saturday.

The only role he had, as he put it, was to gift his wife a serious ride and escort back home to ease the pain and welcome their bundle of joy.

“All I did since my dear wife went into labour was to foot the bills. I had no role in the maternity and delivery room. After I saw what my wife went through, I wanted a transition from pain to joy,” he said, smiling.

Like the African man he is, Macakiage does not believe in words without actions. So, to him, he will not just sing the “I love you” song to his wife but will top it up with “a little” surprise here and there, courtesy of his friends.

“My friends planned the entourage, which had some very serious cars. All I did was consult the Royal Limo guy for the Chrysler limo; 15 of my friends came in the others,” he said.

MOULD A BIG THINKER

In his life, he adds, money is never the first-topic subject in a discussion; it is an “AOB”.

For that reason, his first-born son will not have sleepless nights thinking of a trip out of Africa by air.

Why? Because, his father says, when he can comprehend, he will be shown the memoirs of his grand exit from the hospital to champion him into becoming a “big thinker”.

“It is upon me as a parent to help my son think big and not be shocked when he sees somebody boarding a limo. And neither do I want him to faint when he sees anybody boarding a plane. These are ordinary things that anyone can get.”

“Everything I do is to appreciate my family, which I do not take for granted,” he added.

His parting shot was that having founded his young family in a strong Christian tradition, they will raise baby Jayden with Christian values. For that reason, they will “vet” schools before enrolling their son to any.

“We will fill questionnaires to know whether the school has the values we want our child to emulate,” he said.

They also plan to give Jayden siblings in the future.

AS PUBLISHED ON SUNDAY NATION ON OCTOBER 5.

Twin births paralyse woman, but therapy helps her regain footing

By EUNICE KILONZO
AND
ELIZABETH MERAB
FAM1

Her eyes darted around with curiosity. “Are they here yet?” she asked, scanning the room and listening to any movement in the hallway. “Are you sure they are coming today?”

At exactly 4.30pm on August 22 this year, visitors were allowed into Ward GF/B of Kenyatta National Hospital, and two very special visitors were among them. A little boy and his sister were about to see their mother — for the first time ever.

The lucky woman, 38-year-old Mercy Muthoni, was beyond herself with excitement, disbelief and relief.

As the pair of babies was handed over to her, she received them with such joy and emotion that it was impossible to control the welling of tears among those gathered around to witness the special moment.

The twins, like the little lovely babies that they were, had decided to take a nap just when they needed to be wide awake, and so Muthoni delicately held the blue and pink bundles of joy before gently placing them on her hospital bed.

She then lifted her head, twisted it to the left, and then to the right. Little bodily movements that we take for granted all the time, but such important, joyous milestones for her. She may have been seeing her one-and-a-half-month-old babies — named Joy Muthoni Mugo and Daniel Muthoni Mugo — for the first time, but she was also making those all-important movements for the first time in 40 days. That was such a sight to behold for the scores gathered by her bedside.

It had all started at 2pm on July 9 this year. The day, as is characteristic of July days in these parts of the world, had been quite chilly.

Muthoni was having lunch, coiled in her couch and enjoying her favourite TV series, when she felt a stabbing pain on her lower back. She did not think much about it at the time because her delivery date was approaching and thought it was the onset of labour.

“Standing up, I noticed blood on the couch. I knew that was a dangerous sign of pregnancy as I had been warned about it at Mama Lucy Kibaki Hospital in Nairobi, where I attended my antenatal clinics. I called my sister about it and asked my househelp to take me to hospital,” Mercy recalls.

She met with the sister in Dandora and went to Pumwani Maternity Hospital. By then, the pain had escalated and, shortly after 4pm, she delivered the twins naturally.

HUSBAND WAS AWAY

It was after bringing forth this pair of lives, however, that hers started to hang on a shaky balance.

Her husband, George Njoroge, was away at the time. He is a truck driver who regularly does the Kenya-Uganda-Rwanda-Burundi run. So Muthoni had only her sister to share this trying yet joyous moment with.

George, however, remembers the call from his wife that he does not think he will forget for a long time.

“At around 3pm, she called to tell me that she had gone into labour. I was elated, but that elation soon turned into worry as the news from Nairobi was not that comforting.

“I kept calling, but my wife was not on phone. I was almost losing my mind when my wife’s niece called, but she had both good and bad news.

The good news was that my wife had delivered two healthy twins. The bad was that she had developed complications in the process. She did not go into details about what exactly these ‘complications’ were, and that made it even harder for me to wrap my mind around what was happening back home.

“I don’t think you can ever understand, but picture this: I had left home just a few hours earlier and my wife had seen me off. She had been in perfect health and high spirits. And then you are told that she is in hospital; that she has complications and you can’t talk to her. I was so frustrated, so confused that, for a few minutes, I couldn’t even drive.”

What had happened was that, despite being expectant with twins, Muthoni had risked her life delivering them naturally rather than the recommended and much safer Caeserian section — almost standard nowadays for multiple births.

She had lost a lot of blood in the process, and a few minutes after birth, she had convulsed, had become paralysed, and had blacked out.

“When I came to,” Muthoni remembers, “I had an oxygen mask on my face and I could not feel anything in my body. I thought it was the drugs I had been given to relieve the pain, but before I could understand what was happening, I blacked out again.”

Her babies were taken to the nursery and the mother wheeled into the Intensive Care Unit. By Friday, July 11 — two days later — her condition had worsened so much that she had been transferred from Pumwani to Kenyatta National Hospital.

‘TWINS DAY’

A week later, DN2 team was in Kenyatta Hospital to mark ‘Twins’ Day’, hosted by the hospital and the Twins Association. It involved a visit to mothers with newborn twins in the maternity ward, and it was here, in Maternity Ward GF/B, that Muthoni gave us her story, telling us how proud a mother she was, and how much she had longed to hold her twin bundles.

“I have twins!” she exclaimed, but you could tell she was straining to breathe. Her face was ashen and swollen, with a conspicuously shiny patch of sweat in thick capsules on her forehead.

She could not turn her head, and when she tried, the sweat would pour down in streams and another would form almost immediately.

“If you are here about twins, I have a baby boy and girl… they are in Pumwani Hospital,” Mercy insisted, trying to move her head to face the crowd that was forming around her bed.

Unknown to her, she had developed preeclampsia in the last trimester, and it was presenting as very high blood pressure. It was that dangerous condition that had almost killed her soon after the delivery.

Preeclampsia is pregnancy-induced hypertension that is characterised by a sudden rise in blood pressure, excessive weight gain, swelling, water retention, severe headache, visual disturbances, and excessive protein in the urine. It can lead to stroke, brain damage, multiple organ failure and death of the mother and/or baby.

According to Dr John Ong’ech, an obstetrician and gynaecologist at KNH, women carrying multiple babies have more complications.

“Minor symptoms such as nausea, heartburn, fatigue and backache are exaggerated due to the mechanical and hormonal effects of multiple pregnancies,” says Dr Ong’ech.

“In Muthoni’s case, her babies were big. One was 3.3kgs while the other was 2.9kgs. This meant that her placenta was quite extended and the big babies were putting a lot of strain on her body.”

Preeclampsia is one of the major causes of maternal deaths in the country. Currently, it kills 488 mothers out of every 100,000.

“If it is not treated quickly and properly, it can lead to serious complications for the mother, such as liver or renal failure, or future cardiovascular issues,” warns Dr Ong’ech.

NOT SEEN BABIES

Despite the pain she was in, Muthoni struggled to explain to us what she was going through and how it was affecting her.

“I have not seen my babies,” she said. “I cannot feel my hands or legs, and I have headaches and pain in the upper right abdomen. As you can see I am struggling with shortness of breath and I need to rest now.”

She was scheduled for an MRI (Magnetic Resonance Imaging) the next week in order to get detailed images of the organs and tissues within her body to know the extent of her condition. We left, hoping that we would find her feeling better the next time we visited.

That visit happened on August 22, and it was also the first time she saw her babies. She was barely recognisable — smaller, energetic, and sitting upright as she supported her back with the headboard.

“The MRI showed that the blood pressure had stressed my brain, but it is being controlled,” she informed us. “I can now move slightly, except from my knees to the toes.”

When the babies were brought in, we watched as her husband lit up, and then smiled at his wife as she struggled to hold them.

“Seeing her hold the babies has given me hope and joy,” he said soon afterwards. “Our other child, a daughter who is seven, has been prodding me about her mother. I cannot wait to tell her this great news. I was shattered but my wife’s optimism and resilience have encouraged me to be hopeful. However, I am still seeking answers regarding what happened.”

GET MINERAL SUPPLIMENTS

Dr Ong’ech encourages expectant mothers to attend antenatal clinics for early confirmation of the pregnancy status and avert complications in good time.

“Pregnant women, especially those expecting more than one child, should get mineral supplements, constant blood pressure check-ups, and rest.

“In addition, women should try to get children before they are 30 as their bodies are strong and most suitable for motherhood.”

Back in the ward, Muthoni looked at her babies in awe. She smiled, tried to sit up and hold them but her shaky hands failed her.

A few weeks later, on September 2, she was allowed to go home, from where she would continue with her medication and physiotherapy.

In Summary

  • The twins, like the little lovely babies that they were, had decided to take a nap just when they needed to be wide awake, and so Muthoni delicately held the blue and pink bundles of joy before gently placing them on her hospital bed.
  • Her babies were taken to the nursery and the mother wheeled into the Intensive Care Unit. By Friday, July 11 — two days later — her condition had worsened so much that she had been transferred from Pumwani to Kenyatta National Hospital.
  • Preeclampsia is pregnancy-induced hypertension that is characterised by a sudden rise in blood pressure, excessive weight gain, swelling, water retention, severe headache, visual disturbances, and excessive protein in the urine.         As published on DN2.nationmedia.com on September 8, 2014.          
  • http://www.nation.co.ke/lifestyle/DN2/Twin-births-paralyse-woman-therapy-helps-her/-/957860/2444726/-/hnqelgz/-/index.html

Larry Liza: My mother inspired my talent

By WALTER MENYA
AND
By ELIZABETH MERAB
liza-pic

Growing up in Nyalenda slums, Kisumu, with only his mother to look up to, Larry Liza never imagined he could ever share a platform with some renowned world leaders.

But he has leveraged on his God-given talent, poetry, to mingle with among others, President Jakaya Kikwete of Tanzania, former UK Prime Minister Gordon Brown and his wife Sarah, supermodel Naomi Campbell and Uganda’s First Lady Janet Museveni.

Like him, these are global Goodwill Ambassadors of the White Ribbon Alliance for Safe Motherhood, which focuses on reducing infant deaths and improving maternal healthcare.

http://www.nation.co.ke/lifestyle/Larry-Liza-mother-inspired-talent/-/1190/2435712/-/673mfsz/-/index.html

Bankruptcy, alimony, drugs: It is a wretched life for retired footballers

BY ELIZABETH MERAB
1pic
Football is nice. And entertaining. And unpredictable. And addictive. Very addictive.

In the world of sports, it remains the most popular around the world, and it is easy to see why.

When 22 men — and, nowadays, women — are let loose on a pitch and handed a ball, they lose themselves in the drama.

The players are the stars in their own movies. Young, starry-eyed and athletic, they are the engine of the game. And the fuel too.

Their job is to not only score goals, but also do it in a most entertaining, skilful way. They are soldiers on a battlefield, protected from harm by rules of engagement, and paid a fortune to kick a ball around.

Football, for the hundreds of its fans, is pure bliss and raw, nervy emotion. It is suspense that dwarfs Hollywood, and heartbreak worse than a lover’s jibe.

It is a unifying factor, a militaristic call to defend the pride of an entire nation, and a celebration of the skills and goal-ferreting abilities of the 22 on the pitch.
http://www.nation.co.ke/lifestyle/DN2/Christiano-Ronaldo-Zlatan-Ibrahimovic-Yaya-Toure-Wayne-Rooney/-/957860/2396520/-/3lmu8kz/-/index.html

Land scarcity gives rise to concrete jungles in major towns

By ELIZABETH MERAB

1pic

Picture this: you move to a quiet neighbourhood and put up a nice bungalow.

Every morning you wake up and sit in your small porch as you watch the sun rise in the horizon, and on weekends your children join your neighbours’ to race their bicycles to your common gate and back.

Life is simple, cosy and peaceful. The neighbourhood is sparsely populated, safe and quiet; partly because the zoning laws here dictate that this is a residential area, and partly because this is a new estate that still has one or two undeveloped plots.

Picture, also, waking up one morning to watch the sun rise, only to be confronted with the ghastly sight of cranes and earthmovers massing towards one of the undeveloped 50-by-100s. You rush out to ask what is happening, whether they want to tarmac the dusty road to your fine little abode.

“No, we are not tarmacking any road,” someone breaks the news to you. “We are planting a four-story building here, and it will have 40 one- and two-bedroom units.”

“Hey, this is a residential zone!” you yell, and the contractor informs you: “Sir, your plot is a residential, ours is a commercial one. You can check with City Hall if you doubt it.” http://www.nation.co.ke/lifestyle/DN2/Rise-of-the-concrete-jungle/-/957860/2377632/-/uxhcxfz/-/index.html