Friday, October 24, 2008


50 things you should know about Barack Obama-corrected

1. Barack Obama's father was a Kenyan. Period. (there is no such thing as “a black Kenyan”in Kenya! For those who are unaware) and his mother was a Kansas native. The two met while attending the University of Hawaii.

2. Barack Obama Sr. (Obama’s father) must have fluently spoken Luo as his mother tongue, Kiswahili and English among other languages.

3. Now Kiswahili is not Creole as some people are suggesting online, rather-Swahili language- Is the native language of various groups traditionally inhabiting about 1,500 miles of the East African coastline. About 35% of the Swahili vocabulary derives from the Arabic language, resulting from the fact that the language evolved through centuries of contact between Arabic-speaking traders and many different Bantu/and or others-speaking peoples inhabiting Africa's Indian Ocean coast. It also has incorporated Persian, German, Portuguese, Indian and English words into its vocabulary due to contact with these different groups of people. Swahili has become a second language spoken by tens of millions in three countries, Tanzania, Kenya, and Congo (DRC), where it is an official or national language. The neighboring nation of Uganda made Swahili a required subject in primary schools in 1992 – although this mandate has not been well implemented – and declared it an official language in 2005. Swahili, or other closely related languages, is also used by relatively small numbers of people in Burundi, Rwanda, Mozambique, Somalia, and Zambia, and nearly the entire population of the Comoros.

Dialects of Swahili:

.Kiunguja-Spoken in Zanzibar City and environs on Unguja (a Zanzibar Island). Other dialects occupy the bulk of the island.

.Kitumbatu and Kimakunduchi- The countryside dialects of the island of Zanzibar.
Kimakunduchi is a recent renaming of "Kihadimu"; the old name means "serf", hence it is considered pejorative.

.Kimrima-Spoken around Pangani, Vanga, Der-es Salaam, Rufiji and Mafia Island.

.Kimgao-Formerly spoken around Kilwa and to the south.

.Kipemba-Local dialect of the island of Pemba.

.Kimvita-the major dialect of Mombasa (also known as "Mvita", which means "war", in reference to the many wars which were fought over it), the other major dialect alongside Kiunguja.

.Kingare-subdialect of the Mombasa area, Kenya.

.Chijomvu-subdialect of the Mombasa area, Kenya.

.Chi-Chifundi-dialect of the southern Kenya coast.

.Kivumba-dialect of the southern Kenya coast.

.Kiamu-spoken in and around the island of Lamu (Amu).

4. Mr. Obama grew up in Hawaii and lived in Indonesia for a few years. From age 10 on, he lived with his maternal grandparents in a Honolulu apartment.

5. He admits that as a teenager, he used drugs such as marijuana and cocaine to cope with questions of racial identity.

6. Mr. Obama played forward on his high school basketball team and was known as "Barry O'Bomber" for his left-handed double pump shot.

7. He wasn't the first in his family to attend Harvard. His father, Barack Obama Sr, also attended the university earning a post-graduate degree.

8. Barack Obama Jr. was the first African –American to be elected president of the Harvard Law Review.

9. He stopped going by the nickname "Barry" in college after reading The Autobiography of Malcolm X.

10. Mr. Obama is only the third African-American U.S. senator since Reconstruction.

11. His wife, Michelle, agreed to allow him to run for president only if he agreed to quit smoking. But he recently admitted that he still has an occasional cigarette.

12. Mr. Obama uses "Renegade" as a code name for his Secret Service detail.

13. He has never faced significant opposition from a Republican opponent before this year’s presidential election.

14. His desk in the Senate once belonged to Robert Kennedy. Mr. Obama was only 6 when Mr. Kennedy, who was running for president, was assassinated in 1968.

15. If elected, he will be the third president in a row without sons. Mr. Obama has two daughters: Sasha, 7, and Malia, 10.

16. Mr. Obama says his daughters made him promise that, as a condition for running for president, they can get a dog after the election, win or lose.

17. He was elected to the Illinois Senate in 1996. He initially had a hard time fitting in because the chamber was controlled by Republicans, and some of his fellow Chicago Democrats thought he was pretentious and "a white man in blackface."

18. As a state senator, he was selected to give his now-famous keynote speech at the Democratic convention in 2004 after presidential nominee John Kerry heard him speak in Chicago.

19. He is 6 feet 2 inches tall, and his wife is almost 6 feet in heels.

20. Barack Obama was referred to as “THAT ONE” by his opponent, the republican Presidential candidate Sen. John McCain during their 2nd presidential debate.

21. As a kid, he collected Spider-Man and Conan the Barbarian comics, and as a teen, he listened to jazz saxophonist Grover Washington Jr. and Earth, Wind and Fire among others.

22. He grew up without any particular religious beliefs. His mother, Stanley Ann Dunham, was not religious, and his father was not either. Mr. Obama joined the United Church of Christ as a young man in Chicago, saying he was inspired by the good work of Christians he had met and "felt God's spirit beckoning me."

23. Mr. Obama earned a starting salary of $13,000 a year as a community organizer in Chicago in the 1980s. In 2007, he and his wife made $4.2 million, according to their tax return.

24. He won a Grammy award this year for the audio version of his book The Audacity of Hope.

25. In 2000, he lost by a landslide when he challenged former [Black Panther] Bobby Rush, an Illinois Democrat, for his seat in the U.S. House. Mr. Rush is still in office.

26. Mr. Obama easily won his 2004 U.S. Senate race, defeating Republican Alan Keyes with 70 percent of the vote. Mr. Keyes was a late replacement for primary winner Jack Ryan, who dropped out of the race when after his divorce records revealed sex club allegations from his ex-wife, actress Jeri Ryan.

27. Mr. Obama formally announced his presidential candidacy in February 2007 on the steps of the Old State Capitol in Springfield, Ill., where Abraham Lincoln once declared that "a house divided against itself cannot stand."

28. Throughout 2007, he trailed Hillary Rodham Clinton, whom many pundits characterized as the Democrats' "inevitable" presidential nominee. He found an opening in an October debate, when Mrs. Clinton gave a convoluted answer to the question of whether she supported driver's licenses for illegal immigrants. After that, the race became more competitive.

29. Oprah Winfrey joined Mr. Obama on the campaign trail in December, after endorsing him earlier in the process, for a series of rallies starting in Des Moines, Iowa. Nearly 30,000 people came to see them in Columbia, S.C.

30. Mr. Obama wasn't an overwhelming favorite among “black American” voters early in the campaign. Some didn't think he was "black enough," and others doubted that an African-American could be elected president. But his victory in predominantly white Iowa convinced many black voters that he could win the nomination.

31. Mr. Obama's campaign inspired many music video spin-offs, including "Obama Girl" from the Web site Hip-hop star of the Black Eyed Peas also wrote a song, "Yes, We Can," based on a speech given by Mr. Obama after his loss in the New Hampshire primary and made it into a video for the Web.

32. In February, Mr. Obama racked up 11 straight victories and gained the lead in the number of delegates needed to win the nomination.

33. Mr. Obama lost the Texas primary to Mrs. Clinton but drew big crowds, including an estimated 15,000 at Dallas' Reunion Arena in late February. He ended up winning a majority of delegates in the Lone Star State because his supporters flooded precinct caucuses on election night.

34. During primaries, Mr. Obama did well in states with large numbers of “black” and college-educated voters in general. But he struggled to draw working-class whites, Latinos and rural residents, especially after making comments in San Francisco that some rural voters "cling to their guns and religion."

35. Ms. Obama stirred up controversy after saying that for the first time in her adult life, she was "really proud" of her country. She later said she was misrepresented/and or misinterpreted, and others, including first lady Laura Bush, defended her. The exact comment was this- “For the first time in my adult lifetime, I’m really proud of my country … not just because Barack has done well, but because I think people are hungry for change, I have been desperate to see our country moving in that direction and just not feeling so alone in my frustration and disappointment.”

36. During the primaries, tensions grew between Mr. Obama and former President Bill Clinton over the ex-president's comments that seemed to belittle Mr. Obama's victory in South Carolina.

37. The tension between Mr. Obama and Mrs. Clinton grew as well. The New York senator released a TV ad that questioned whether Mr. Obama would be ready for a "3 a.m." foreign crisis phone call, and Mr. Obama criticized her judgment and derided her as a Washington insider.

38. Mr. Obama's association with longtime pastor Jeremiah Wright proved troublesome during the primary season. Dr. Wright was criticized for racially incendiary sermons and views. Mr. Obama initially tried to defend him and gave a widely praised speech on racial relations in America, but he later renounced Dr. Wright after the pastor made controversial remarks at the National Press Club. The Obama’s left Trinity United Church of Christ soon afterward.

39. Opponents – most recently the McCain-Palin campaign – have criticized Mr. Obama's association with 1960s radical Bill Ayers, a member of the Weather Underground. Mr. Ayers and Mr. Obama were involved with a Chicago education reform group, and Mr. Ayers hosted a party for Mr. Obama when he announced his Illinois Senate run. Mr. Obama has denounced Mr. Ayers' "detestable acts" but says he was only 8 years old during Mr. Ayers' bombing campaign. THIS GUILT- BY- ASSOCIATION have been all but debunked as their association has been deemed remote at best.

40. Mr. Obama clinched the nomination June 3 and claimed victory in a speech in St. Paul, Minn., later the site of the GOP convention. Four days later, Mrs. Clinton suspended her presidential campaign and endorsed Mr. Obama.

41. A few weeks later, Mr. Obama and Mrs. Clinton campaigned together for the first time in the appropriately named town of Unity, N.H. But he struggled to win over her supporters, including white blue-collar voters.

42. Mr. Obama spoke to a huge crowd in Berlin (estimated – at 200,000 people) this summer, just as former President John F. Kennedy had done decades ago.

43. In a campaign ad, Mr. Obama talked about his mother's death from cancer in 1995 and how, in her final days, she was more worried about paying her medical bills than getting well.

44. Mr. Obama's momentum stalled during the summer when the McCain campaign ran ads –including one with Paris Hilton – accusing him of being a vapid celebrity without substance or a proven record of leadership. But after the debates and the financial crisis, he has managed to assure voters with his cool temperament demeanor and the depth of knowledge he has shown.

45. Mr. Obama selected Delaware Sen. Joe Biden as his running mate to help bolster his foreign-policy credentials, disappointing many Democrats who favored Mrs. Clinton. Early in the presidential campaign, Mr. Biden had questioned Mr. Obama's readiness to be president.

46. Mr. Obama was the first presidential candidate since Kennedy to accept his party's nomination at an outside venue. He gave his acceptance speech at Denver's Invesco Field on Aug. 28, drawing a crowd of about 85,000.

47. Mr. Obama was accused of sexism and disparaging Republican vice presidential nominee Sarah Palin when he referred to Mr. McCain's policies as "lipstick on a pig." His campaign clarified the point he was making, saying he was referring to Mr. McCain's policies as the "pig." Even Mr. McCain himself have used similar phrase before when describing Ms. Clinton’s healthcare plan.

48. Campaigning in Pennsylvania, Mr. Obama tried to connect with blue-collar voters by bowling, but ended up with an embarrassing score of 37. "My economic plan is better than my bowling," he told fellow bowlers. "It has to be," a man called out.

49. Mr. Obama told 60 Minutes earlier this year that every time he played basketball before a key primary, he'd win. He said he plans to play before the general election.

50. If elected, Mr. Obama will be the fifth-youngest president ever at inauguration.

Saturday, October 18, 2008


Unlike the joke that the kriegler commission was and it's below average report-The joker report that - among other things said /or and recommended the ECK commission be ‘radically reformed, or replaced, with a new name, image and ethos, composed of a lean policy making and supervisory board, selected in a transparent and inclusive process.’ JUSTICE WAKI should be the Kenya’s new HERO and deserves a NATION-WIDE STANDING OVATION for a job well done! The 529 page report is as good as it gets-I am elated! He did exceptionally well where others like Kriegler failed us. The South African Pandered to the power of the elites in Kenya. And the fact that one could trace his roots from/through colonialism, it’s no surprise to many.


The WAKI Commission started out with a well- planned out goals and objectives and went through every task diligently. Even though there were some initial setbacks like time constrains among others that are noted in the final report.

The Time Constrains Part-The Commission reported that it concluded early in its tenure that it would not have enough time to visit all areas that had been heavily affected by the post election violence. The life of the Commission, as provided in the Gazette, was only three months and set to expire on 22 August 2008. Hence, the Commission immediately wrote to His Excellency the President of Kenya and to the Panel of Eminent African Personalities asking for a 60 day extension so that it could plan ahead. While the Panel supported the request, the National Dialogue and Reconciliation team, which was the final decision maker, did not. Instead the Commission was granted only a 30 day extension, published in the Gazette Notice no. 7288 Vol. cx – no. 67 dated 12th August 2008. The Commission conducted hearings in public in the following areas: Nairobi between 9 and 25 July 2008 and again from 19 to 27 August 2008, Naivasha on 28 and 29 July, Nakuru from 30 July to 1 August 2008, Eldoret from 5 to 7 August 2008, Kisumu from 11 to 13 August 2008, Borabu on 14 and 15 August and Mombasa on 1 and 2 September 2008. Because of the failure to obtain a 60 day extension of time the Commission abandoned its original plans to conduct public hearings and investigations in Kakamega, Busia, Kericho, Bungoma, Laikipia, Thika and Limuru. Eventually, the Commission received another two week extension for the purpose of preparing this report through Gazette Notice No. 8661 in Vol CX – 74 dated 12th September 2008. The difficulty of receiving limited extensions piecemeal rather than all at once diminished the capacity to engage in forward planning.

How the commission established a communication strategy

The commission recognized that the public legitimately expected the Commission to work transparently and to keep the public informed. Both to manage public expectations concerning information and to develop a reciprocal relationship with the media, the Commission appointed Ms Mildred Ngesa, an experienced journalist, as media relations officer.

In addition, the Commission designed and established a website to facilitate public access to information about its mandate and its work. The Commission also set up a secure email address, for receiving confidential information and correspondence. Once the Commission began hearings, the verbatim record of public proceedings were posted on the website.

Aside from the above, the Commission conducted periodic media briefings to inform the public of its work. The three Commissioners appeared together on television interviews in the initial phase after which the Chair issued press releases and engaged with the media in other ways.

Consultations with Government Departments and Others

Is this a coincidence that both President Kibaki and former President Moi avoided to be interviewed by the commission?

The WAKI commission stated that the initial meetings with officials were held in private. The officials with whom the Commission met at this stage included the Commissioner of Police, the Commissioner of Prisons, the Commandant of the Administration Police, the Chief of the General Staff, the Attorney General, the Chairman of the Electoral Commission of Kenya (ECK) (represented by members of his Commission), the Director General of the National Security Intelligence Service, the Permanent Secretary to the Ministry of Justice, National Cohesion and Constitutional Affairs, and the Permanent Secretary in the Office of the President in charge of Internal Security and Provincial Administration. This Commission appreciates the level of co-operation received from the various government departments throughout its work.

The Commission also sought audience with the political leadership and managed to interview the Vice-President, the Prime Minister and one Deputy Prime Minister. An appointment sought with the President did not materialize while the former President declined to meet with the Commissioners.

Role of Civil Society in the WAKI report

In the report, the Commission highlighted that it deliberately decided to work closely with Kenyan civil society organizations and seek their assistance with information, contacts, and expertise in areas related to post-election violence. A number of these organizations attended the Commission’s hearings through lawyers who represented victims and communities and provided useful feedback to members of the public on the Commission’s work.

These included Kenyans for Peace with Truth and justice (KPTJ), the Inter-Religious Forum, the Kenyan Section of the International
Commission of Jurists, (ICJ-K), the Kenya Human Rights Commission (KHRC), the Kenya National Commission of Human Rights (KNCHR), different chapters of the Catholic Peace and Justice Commission, and various religious and faith based organizations.
Civil society and human rights organizations greatly contributed to the
Commission’s work by:
•Providing background material and reports concerning the history and patterns of human rights violations in Kenya. This helped the Commission establish a foundation from which to proceed;
•Giving access to their records, often including statements from witnesses they had interviewed and helping map out geographic regions that should be the focus of investigations;
•providing contacts with local community leaders, individual victims, and other key contacts in communities where they had established trust and credibility;
•Assisting and providing victims the Commission interviewed in public and in private with emotional support, based on long established relationships with them; and
•Offering various types of assistance to victims, including medical services, counseling, and various types of community support.

Standing before the Commission

The Commission also addressed the question of legal standing from persons who wished to participate in its proceedings. The following government departments were covered by its mandate and hence were allowed to participate in the hearings: the Kenya Police Service, the Administration Police, the Provincial Administration, the Electoral Commission of Kenya, the National Security Intelligence Service, the Kenya Prisons Service and the Armed Forces.

It also said that-Groups of citizens and civil society organizations also applied to participate in the proceedings. They included victims’ representatives, experts on specific aspects of the Commission’s work, and organizations that had been involved in addressing the post-election violence itself. All had useful information for the Commission.

The Commission considered that the quality of proceedings would benefit from allowing as many interest groups as possible to participate. In the end, the
Commission gave legal standing to the Federation of Women Lawyers (FIDA) and the Center for the Advancement of Women and Children, both of which were allowed to represent the interests of women in the context of the post election violence. The Commission also granted the Kenyans for Peace with Truth and Justice, the Rift Valley Internally Displaced Persons Association, the Center for Justice and Crimes against Humanity, and the Tegla Lorupe Foundation standing as interveners. Outside Nairobi, the Commission granted regional law societies standing in its proceedings. These included the Rift Valley Law Society in Nakuru, the North Rift Law Society in Eldoret, and the West Kenya Law Society in Kisumu, and the Law Society of Kenya (South Rift Branch) even though the Commission did not hold proceedings in Kericho, where the society is based. The Commission declined requests for standing by Kenya’s two main political parties, the Orange Democratic Movement (ODM) and the Party of National Unity (PNU) because it did not think their participation was necessary. However, each of them testified through their Secretaries General.

All groups participating in the proceedings were asked to furnish the Commission with lists of their witnesses and statements from the witnesses. A significant number of the witnesses who testified before the Commission were identified and processed by lawyers acting on behalf of various civil society organizations. To maintain control over its proceedings the Commission insisted that such witnesses coming in had to be processed with the full participation of Counsel Assisting the Commission. This ensured that relevant and credible evidence was presented. Whenever necessary to avoid grandstanding, the Commission intervened to limit questions from lawyers.

The Commission’s experience was that allowing the diverse interests seeking representation greatly increased the quality of the inquiry. The lawyers for the various parties brought useful perspectives before the Commission that might have been missed altogether, if they had been excluded. In addition, the participation of these same lawyers enabled the Commission to reach out to witnesses who might not otherwise have come forward. This broadened participation and enriched understanding. Furthermore, a number of the lawyers admitted into our proceedings had sharply opposing points of view. This increased the objectivity and the credibility of the testified received.

Saturday, October 11, 2008


McCain’s ever changing campaign themes.

Unlike his democratic presidential candidate opponent Barack Obama, who has consistently stuck with his initial theme of change, McCain-the republican presidential candidate has seen/introduced variations of themes-one after another. For example, since he started running- a little over a year ago, now he has managed to morph into at least 5 different themes. Notably-

1) Straight talk express- as the banner on his bus and campaign plane suggests and his earlier starting theme during the primary contests.

2) Change we can believe in-immediately after the republican convention and a surprise pick of the Alaska gov. Sarah Palin, (- barracuda-pit bull with lipstick-or pig with lipstick, whichever!)

3) maverick- introduced concurrently with change theme immediately after the republican convention with his running mate on/at his side.

4) Reformer? Or this also means maverick? - Also introduced just around the time after the republican convention. It might have been overtaken by the events. Who knows?

5) Country first-the current theme. This might also means “suspensions”-including his campaign during the initial first free fall week of the Wall Street and don’t forget the first presidential debate. And as of late-if the last week is anything to go by, it also might mean getting really negative with your... the opponent.



Clinical manifestations-CONTINUED

Meningitis can be either acute or chronic in the onset and progression of the disease.

1) Acute:-cases of acute meningitis are characterized by –fever, stiff neck, headache, nausea, and vomiting, neurologic abnormalities and change in mental status. With acute bacterial meningitis, CSF usually contains large numbers of inflammatory cells (>1000/mm3), primarily polymorphonuclear neutrophils.

The CSF shows a decreased glucose level relative to serum glucose level (the normal ratio of CSF to serum glucose is approximately 0.6), while there is increased protein concentration is shown (normal protein is 15-50mg/dL in adults and as high as 170mg/dL with an average of 90mg/dL in newborns).

The sequelae of acute bacterial meningitis in children are frequent and serious with seizures occurring in 20%-30% of cases in large urban area hospitals. Other neurologic changes are also common. The acute sequelae include; cerebral edema, hydrocephalus, cerebral herniation, and focal neurologic changes.

Permanent deafness can occur in 10% of the children who recover from bacterial meningitis. And a more subtle physiologic and psychological sequelae may follow an episode of acute bacterial meningitis.
Although the morbidity associated with meningitis is still significant, the Haemophilus influenzae type b conjugate vaccine has played a major role in reducing postmeningitis sequelae.

2) Chronic- chronic meningitis often occurs in patients who are immunocompromised, although this is not always the case. Patients experience and insidious onset of disease, with some or all of the following; - fever, headache, stiff neck, nausea, and vomiting, lethargy, confusion, and mental deterioration.

Symptoms may persist for a month or longer before treatment is sought. The CSF usually manifests an abnormal number of cells (usually lymphocystic), elevated protein and some decreased in glucose content. The pathogenesis of chronic meningitis is similar to that of acute disease.

Epidemiology/Etiologic Agents.

The etiology of acute meningitis is very dependent of the age of the patient, with the majority of cases occurring in children younger than age 5. Neonates have the highest prevalence of meningitis, with a concomitant increased mortality rate as high as 20%.
Organisms causing disease in the newborn are different from those that affect other age groups; many of them are acquired by the newborn during the passage through the birth canal. And are likely to be infected with;-group B Strep., E.Coli, other Gram-Negative Bacilli, and Listeria Monocytogenes, in that order. And occasionally other organisms may be involved. For example Flavobacterium meningosepticum has been associated with nursery outbreaks of meningitis. This is usually a normal inhabitant of water in the environment and is presumably acquired nosocomially.

Important causes of meningitis in the adult, in addition to the meningococci in young adults, includes; - Pneumococci, Listeria Monocytogenes, and less commonly, Staph. Aureus and various Gram-Negative bacilli. With meningitis caused by the latter organisms resulting from the hematogenous seeding from various sources, including urinary tract infections.

Aseptic meningitis:-***** TO BE CONTINUED.******

Friday, October 10, 2008


Do Not Cloud the Message!

Following some African countries government’s advice that circumcision lessened chances of contracting HIV/Aids, many young men formed very long lines outside health centers to have their foreskins severed. Innocent “Onyango” had just given the nod to circumcision when he acknowledged that he has been made a ware that, men who are circumcised are 60% more likely to be protected against HIV during sexual intercourse.

The response to the circumcision program has been vigorous, and sometimes spontaneous, that it should get most people worried, instead of exciting them. Until u meet the freshly circumcised young men dressed up in a loose garments –as regular clothing is mostly out of the question at this time of healing.

Young men like “Onyango” point out that, these Aids people(activists) have spoken for long about fighting the disease, but they had never come up with a practical solution as good as this one(circumcision). Don’t have sex, don’t do this, don’t do that. Eh, man, how can a young man such as I forfeit sex, eh? And the condoms – where is the sense in putting on a condom when you are having sex? Sex is about feeling, and so no young person likes them!"
You can view it from young men’s side and be humbled by it, but you should be doubly afraid for the future as far as the hydra known as HIV/AIDS is concerned, and its potential to wreak more havoc against a young population that loves and values fun more than security of life.

There you have it!- whatever sensitization programs that might have been done about ways of protecting oneself against HIV/AIDS infection would be headed to the drain and thrown to the wind, because circumcision would now provide full coverage! NO WORRIES!

It is appalling, to say the least as this explains the long circumcision lines in front of the health centers – young men and women were now going to indulge in all the sex they wanted without any inhibitions, any fears about HIV/AIDS infection.
Anything that will give a person a chance to escape HIV/AIDS infection is gladly welcomed.

The efforts should be to urge the governments, the entire public and in your own communities to step up the campaign against HIV/AIDS. And by taking counseling to another level, who knows that the World Health Organization and Unaids’ statistics might not have taken every single factor into consideration?
It is counseling that will help those young men who are rushing to get circumcised in order to ‘enjoy’ their sex unhindered, to get informed that there are many things to consider before they place their unprotected little friends into the mouth of infected vessels, placing all their faith in their circumcision hype. This is not bashing circumcision per se but rather looking at things in perspective.

Therefore, HIV/AIDS fight should not follow the line of least resistance blindly. Fighting HIV needs discipline, and so an undisciplined person will not manage to walk within the strictures of Abstinence, Faithfulness, Condoms, etc …etc – all of which give high chances, but only when one sticks to them religiously.

And look now; there is another group that has grown into maturity and is infected, but without ever having had sexual contact with any member of the opposite sex – or of the same sex. There are many unfortunate children who were just born with the HIV virus. The level of resistance of these people and many others is quite different from Adults, just as it is different in a general sense. So, it is always a danger to indulge in the kind of sex that the young men want – wild and unprotected – when it is your resistance that is weak and therefore your life is put in uncalled for danger.


Do Not Cloud the Message!

Let’s be realistic and brutally honest about most of the western countries, especially US view towards Africa and other developing countries.

Polygamy and other cultural/[religious-as is the case with Muslim faith] practices such as “wife inheritance- (the way its being put/addressed” without actually trying to understand what at all their deeper meanings are to those communities)- is and has been a cultural practice in many societies including most of African countries.

And as usual, whenever there is a belief system or cultural norms that are at odds with the western cultures- the action is to demonize and expunge the practice and inject the western-friendly culture/practice into the vacuum created. This time the tactics are no different. By looking at any possible link that may exist between HIV/AIDS and these customs, aiming to “tie” the disease with these cultural practices that run counter to theirs. Several means/tactics had to be tried for example blaming it to the “toxic mix” of factors that has fueled the HIV/AIDS epidemic, cultures that "condones, even encourages" polygamy but denies women the right to negotiate condom use, as the women in these societies are perceived to hold “less power”, some in the west argue.

This changes the subject to an equality and human rights issue, hence getting the subject more broad and appealing world over. And their answer is CIRCUMCISION?

The fact is, foreskins are the least of these countries problems and the pushers of circumcision in lieu of dealing with the real issues do nothing but displace the focus from where it should be and put lives at risk thereby.

Development and proper[appropriate]education programs are some of the only solution to these countries' HIV crisis. And development realistically will only come from within AND only when/if the underlying causes of corruption and cultural issues acting as a platform from which the disease spreads unchecked are addressed.

If you think for a moment about the above realities, you will eventually want to ask why anyone would focus on circumcision at all -- at least until these severe barriers preliminary to any prevention campaign are addressed.

The answer is probably a cultural one. For example American culture, the place from which this campaign originates, has more to do with it than any of these problematic studies do. As usual, and in accordance with the observations of many, the West, particularly the United States, is following its own well-worn path in the crusade to save Africa for example, from itself without understanding a thing about the place it seeks to help. Never mind that places like Lesotho and Swaziland, as just one example, share similar rates of HIV and economic pain while one is largely circumcised and the other is not.

The target here bears the appearance of being not just Africa, but America's own slipping rates of neonatal circumcision. Whether this is true or not is another matter, but the possibility cannot be discounted after the recent discussions at the CDC and among the vaccine initiatives' leadership.
The future is more chilling than ever and the politicization of HIV/AIDS has never been so far advanced and confused.


Sunday, October 5, 2008


Do Not Cloud the Message! - Kenyan politicians hailing from Lake Region.

There has been some excitement at international conferences around the globe on HIV/Aids like the one held in Mexico and others that, male circumcision can help prevent the spread of the pandemic.
Regrettably, some false hope is thus being indirectly cultivated that the cut is the means to keep the virus at bay.

The emerging statistics clearly call for caution. If the infection rate among circumcised men has declined from, say 7.5 to 6.5 per cent, on average, it is scant comfort, indeed. This means clearly that there is only one percent difference! As debate on whether circumcision reduces the risk of HIV infection or not rages, it is amazing how each side of the divide is getting carried away by emotions to the extent of losing sight of the available evidence.

This reminds one of the saying that "a good slogan can stop analysis for years".
It is true that there is evidence that HIV prevalence is lower among communities that practice male circumcision than among those that do not.
But there is also evidence to the contrary: that HIV prevalence is higher among communities that practice male circumcision than among those that do not.

This sounds somehow confusing, one would say. But in a nutshell, it shows that the evidence on whether male circumcision protects one against HIV infection is mixed.
Unfortunately, both the proponents and the opponents of the protective role of male circumcision have refused to soberly confront this reality, and thus think through an appropriate prevention strategy.

Since so much has been said about studies that show the protective role of male circumcision, Lets talk about the evidence that shows the contrary.
Two data sets from Malawi (the 2004 Malawi Demographic and Health Survey (MDHS) and the 2004 and 2006 Malawi Diffusion and Ideational Change Project (MDICP)) show that HIV prevalence was highest in the Southern region than in the Central or Northern regions.

Yet, a higher proportion of men from the Southern region, compared to those from the other regions, reported having been circumcised.
In contrast, individuals from the other regions were less likely to report multiple life-time sexual partners than those from the Southern region.
They were also more likely to report condom use during the 12 months preceding the survey than those from the Southern region.
At the individual level, HIV prevalence was higher among circumcised than among uncircumcised men. Among circumcised men, those who were HIV-positive were more likely to report multiple life-time sexual partners than their HIV-negative counterparts.

Similarly, among married women with circumcised husbands, HIV prevalence was higher among those whose spouses reported multiple life-time sexual partners than among their counterparts whose spouses reported one life-time sexual partner.
At a recent meeting when engaging a fellow participant on this exceptional evidence from Malawi, one of the participants got carried away and branded opposing view a circumcision-basher. Is circumcision some tender pet or victim whose feelings we ought to respect?

That one of the participants did not even stop to listen to what the opposing side had to say. Yet, the intention was to see whether, given the two sets of contrasting evidence, that there could be a way of thinking through a better way of confronting the HIV and Aids scourge.

It was surprising at to how low some scholars have sunk, to the extent of reducing the debate to "us versus them". It left one, wondering how the so-called circumcision-bashers refer to those on the other side of the divide.

In any case, HIV and Aids should concern everyone and any effort aimed at combating it is laudable.

However, aware of the two sets of contrasting evidence, the concern has always been the manner in which male circumcision is being presented to the public, as if it is the ultimate method of protection against HIV/AIDS infection.
The ultimate view should be, the promotion of male circumcision should be accompanied by riders encouraging people to use other means of protection even after the cut.

Otherwise we run the risk of creating the false impression that once a man is circumcised, he can start sleeping around without any care in this world.
Given the evidence from Malawi, one can only shudder at what this might lead to. The Malawi exception also brings into focus the issue of the position of the woman.
It suggests that we can circumcise the men alright, but as long as they remain promiscuous and do not use any protection, their women are still at risk. The question then is; how do we protect the women?

It is against this backdrop that a new way of thinking has started gaining ground within program circles, what is known in program parlance as MC-plus (Male Circumcision plus other preventive methods). Isn't this what we ought to be promoting?

The grave danger still lurks out there, and it must be made clear to all that circumcision is no panacea.
There is need to continue waving the banners of abstinence, being faithful to one's partner or using condoms, because the naked reality is that no cure for Aids has been found.

Circumcision is thoroughly unhelpful if one's partner is infected or if its taken for immunization. It's no good reason for people to dance around, clouding the message that the scourge is curable.AS OF NOW IT IS NOT!


Saturday, October 4, 2008



WHY? (3)-CONTINUED-Uncircumcised men are thought to be more susceptible to AIDS because the underside of the foreskin is rich in Langerhans’ cells, which attach easily to the virus. The foreskin may also suffer some small tears during intercourse, making it more susceptible to infection.

New factors to consider

Scientists Discover 'Natural Barrier' to HIV
E.J. Mundell of HealthDayNews reported that;

Researchers have discovered that cells in the mucosal lining of human genitalia produce a protein that "eats up" invading HIV -- possibly keeping the spread of the AIDS more contained than it might otherwise be.
Even more important, enhancing the activity of this protein-(Langerin) could be a potent new way to curtail the transmission of the virus that causes AIDS, the Dutch scientists added.

Langerin is produced by Langerhans cells, which form a web-like network in skin and mucosa. This network is one of the first structures HIV confronts as it attempts to infect its host.
However, "we observed that Langerin is able to scavenge viruses from the surrounding environment, thereby preventing infection," said lead researcher Teunis Geijtenbeek, an immunologist researcher at Vrije University Medical Center in Amsterdam.

And since generally all tissues on the outside of our bodies have Langerhans cells, we think that the human body is equipped with an antiviral defense mechanism, destroying incoming viruses," Geijtenbeek said.
The finding, reported some time ago in an online issue of Nature Medicine, "is very interesting and unexpected," said Dr. Jeffrey Laurence, director of the Laboratory for AIDS Virus Research at the Weill Cornell Medical College, in New York City. "It may explain part of the relative inefficiency of HIV in being transmitted."
Even though HIV has killed an estimated 22 million people since it was first recognized more than 25 years ago, it is actually not very good at infecting humans, relatively speaking.

For example, the human papillomavirus (HPV), which causes cervical cancer, is nearly 100 percent infectious, Laurence noted. That means that every encounter with the sexually transmitted virus will end in infection.
"On the other hand, during one episode of penile-vaginal intercourse with an HIV-infected partner, the chance that you are going to get HIV is somewhere between one in 100 and one in 200," Laurence said.

Experts have long puzzled why HIV is relatively tough to contract, compared to other pathogens. The Dutch study, conducted in the laboratory using Langerhans cells from 13 human donors, may explain why.
When HIV comes in contact with genital mucosa, its ultimate target -- the cells it seeks to hijack and destroy -- are immune system T-cells. But T-cells are relatively far away (in lymph tissues), so HIV uses nearby Langerhans cells as "vehicles" to migrate to T-cells.

For decades, the common wisdom was that HIV easily enters and infects Langerhans cells. Geijtenbeek's team has now cast doubt on that notion.
Looking closely at the interaction of HIV and Langerhans cells, they found that the cells "do not become infected by HIV-1, because the cells have the protein Langerin on their cell surface," Geijtenbeek said. "Langerin captures HIV-1 very efficiently, and this Langerin-bound HIV-1 is taken up (a bit like eating) by the Langerhans cells and destroyed."
In essence, Geijtenbeek said, "Langerhans cells act more like a virus vacuum cleaner."

Only in certain circumstances -- such as when levels of invading HIV are very high, or if Langerin activity is particularly weak -- are Langerhans cells overwhelmed by the virus and infected.

The finding is exciting for many reasons, not the least of which is its potential for HIV prevention, Geijtenbeek said.
"We are currently investigating whether we can enhance Langerin function by increasing the amount of Langerin on the cell surface of Langerhans cells," he said. "This might be a real possibility, but it will take time. I am also confident that other researchers will now also start exploring this possibility."

The discovery might also help explain differences in vulnerability to HIV infection among people.
"It is known that the Langerin gene is different in some individuals," Geijtenbeek noted. "These differences could affect the function of Langerin. Thus, Langerhans cells with a less functional Langerin might be more susceptible to HIV-1, and these individuals are more prone to infection. We are currently investigating this."
The finding should also impact the race to find topical microbicides that might protect women against HIV infection. Choosing compounds that allow Langerin to continue to work its magic will enhance any candidate microbicide's effectiveness, the Dutch researcher said.

Laurence did offer one note of caution, however.
"In the test tube, this is a very important finding," he said. "But there are many things in the test tube that don't occur when you get into an animal or a human. Having said that, this is a very intriguing finding, he said."

WHY?(4)-Other factors also to consider:

Kebaabetswe et al obviously believe the conventional wisdom that heterosexual sex is the major vector for the transmission/reception of HIV, and that male circumcision is an effective deterrent to infection. Based on that belief, they have constructed an elaborate and impressive study of the acceptability of circumcision as a prophylactic measure in Botswana. Furthermore, they argue for a programme of neonatal circumcision in Botswana in the hope of reducing the HIV infection rate 15 years later.


It has been believed since about 1988 that heterosexual coitus accounts for 90% of the HIV infection in Africa.
Many studies do argue that circumcision can reduce the transmission of HIV through heterosexual coitus. The quality of these studies has been criticized for their methodological flaws, including their failure to control for numerous confounding factors.

Gray et al found that transmission by coitus ‘‘is unlikely to account for the explosive HIV-1 epidemic in sub-Saharan Africa.’’ It now appears that these studies have not accounted for the largest confounding factor of all—iatrogenic transmission of HIV. Sometimes back, the International Journal of STD & AIDS published a trilogy of articles.

These articles strongly argue that unsafe health care practices, especially non-sterile injections, not heterosexual intercourse, are the principal vectors by which HIV is transmitted. A program of mass circumcision would be ineffective against iatrogenic transmission of HIV through unsafe health care. Heterosexual transmission of HIV that one sees in Africa also cannot explain the incidence of HIV in children. Circumcision has some little known effects that may promote rather than deter HIV infection. The human foreskin has physiological functions designed to protect the human body from infection. The sub-preputial moisture contains lysozyme—an enzyme that attacks HIV. Circumcision destroys this natural protection.
Circumcision removes erogenous tissue, desensitizes the penis, changes sexual behavior, and makes males more likely to engage in unsafe sex practices. Circumcised males, therefore, are less willing to use additionally desensitizing condoms.

Male circumcision produces hardened scar tissue that encircles the shaft of the penis. The scar scrapes the inside of the partner’s vagina during coitus and, therefore, may enhance the transmission/reception of HIV. A program of mass circumcision would expose African males to unsafe genital cutting, would destroy the natural protection of the foreskin, would not be effective against iatrogenic unsafe health care, would divert scarce medical and social resources from measures of proved effectiveness, and, therefore, is likely to increase the transmission of HIV. The proportion of HIV infection attributable to heterosexual intercourse has been placed at 90%. Gissellquist and Potterat now estimate the proportion attributable to heterosexual intercourse at only about 30%—only a one third of the previous estimate.
Circumcision has not yet been shown to be an effective deterrent against HIV infection. The Council on Scientific Affairs of the American Medical Association says that ‘‘circumcision cannot be responsibly viewed as ‘protecting’ against such infections.’’ The Task Force on Circumcision of the American Academy of Pediatrics identifies behavioral factors, not lack of circumcision, as the major cause of HIV infection. The article by Kebaabetswe et al seems to show a strong cultural bias on the part of the authors in favor of circumcision. This may be due to their desire to preserve their culture of origin.

WHY?(5)-Bioethics and human rights-Finally, to address the legal and ethical issues. As noted above, male circumcision excises a large amount of functional healthy erogenous tissue from the penis. It is a clear violation of the basic human right to security of the person.

Several authorities report that circumcision degrades the erectile function of the penis. Circumcision, therefore, must be regarded as degrading treatment. Degrading treatment is an additional violation of human rights.
The leading international statement of medical ethics is the European Convention on Human Rights and Bioethics. Article 20(1) prohibits non-therapeutic tissue removal from those who do not have the capacity to consent. Children have a right to the protection of the security of their person and to protection from degrading treatment. Circumcision would violate those human rights. Doctors must respect patient human rights. Prophylactic circumcisions ethically may not be carried out on minors. Circumcisions, therefore, would have to be limited to adult males who legally may give informed consent.

WHY?(6)-Political factors

Ntozi warns-He says-It is important that, while circumcision interventions are being planned, several points must be considered carefully. If the experiment fails, the groups(Africans and others being used in these experiments) are likely to feel abused and exploited by scientists who recommended the circumcision policy. In a region highly sensitive to previous colonial exploitation and suspicious of the biological warfare origin of the virus, failure of circumcision is likely to be a big issue. Those recommending it should know how to handle the political implications.

Approval of circumcision by the surveyed Botswana people apparently is based on their belief that circumcision is efficacious in preventing the spread of HIV. If circumcision fails to control HIV, there would be disillusionment and anger. African and others- males would have sacrificed their erogenous tissue for a false hope of preventing HIV infection. There is no evidence that Kebaabetswe et al have considered the political issues that would arise if a circumcision experiment should fail.


Kebaabetswe et al propose the universal circumcision of male children in Botswana. They accept without question that HIV is primarily sexually transmitted in Africa and other areas by heterosexual coitus and that circumcision reduces or prevents the transmission of HIV; however, medical authorities do not accept the evidence of this. Kebaabetswe et al propose to provide in-hospital circumcision of male children in Botswana. However, there is already a substantial incidence of infection among children in South Africa as a result of iatrogenic infection from non-sterile injections, etc. They have not shown that safe, aseptic circumcisions can be delivered in Botswana. A program of mass circumcision would destroy the natural protections of the foreskin, further expose children to an apparently unsafe health care system, and would be more likely to increase than decrease infection.
Even if circumcision eventually should be shown to provide some protection against HIV infection, that protection could only work to reduce the 30% of infections that now are attributed to sexual activity. It would have no effect on the other 70%. Its effect, therefore, would be minimal at best and could not have an effect for the first 15 years during which time behavioral changes could be introduced into society through education, and a HIV vaccine could be developed to provide immunity.
Circumcision of male children with the intent of reducing an epidemic not of their making is unacceptable from medical, ethical, and legal perspectives. As a public health measure, male neonatal circumcision fails all tests.