TB (TUBERCULOSIS)

TUBERCULOSIS (TB)

What is TB (tuberculosis infection)?

TB or tuberculosis is a disease caused by a bacterium called Mycobacterium tuberculosis. Mycobacterium tuberculosis belongs to the sub group mycobacterium tuberculosis complex, in this group there are other members, and of notice are- (M. bovis, M. Africanum and M. bovis BCG). The bacteria can attack any part of the body, usually affecting the lungs (pulmonary TB). Other parts of the body can also be affected, for example lymph nodes, kidneys, bones, joints, etc. (extra pulmonary TB).

How TB Spread (route of transmission):

The TB’s primary route of transmission is through person to person by inhalation of droplet nuclei that contain the organism (infectious aerosols, 1-5um) that are produced when infected individuals with pulmonary TB cough, sneeze, speak, or sing; infectious aerosols maybe also produced by manipulations of lesions or processing clinical specimens in the laboratory. The droplets are so small that the air currents keep them air-borne for long periods of time and once inhaled, they are small enough to reach the lung’s alveoli.

TB in other parts of the body, such as the kidney or spine, is usually not infectious. People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers.

Signs and symptoms:

TB may mimic other diseases such as pneumonia, neoplasm, or fungal infections. In addition, clinical manifestations of patients infected with TB complex may range from asymptomatic to acutely symptomatic. Patients who are asymptomatic can still have systemic symptoms, pulmonary signs and symptoms and signs and symptoms that are related to other organ involvement (e.g., kidney) or a combination of these features. Of note, cases of pulmonary disease caused by M.tuberculosis complex organisms are clinically, radiologically and pathologically indistinguishable.

Common presenting signs and symptoms:

TB mainly affects the lungs (pulmonary tuberculosis), and coughing is often the only indication of infection initially.

Signs and symptoms of active pulmonary TB include:

A cough lasting three or more weeks that may produce discolored or bloody sputum (normally referred to as positive sputum) Unintended weight loss, Fatigue, Slight fever (low-grade fever), Loss of appetite(anorexia), Pain with breathing or coughing (pleurisy). Tuberculosis also can target almost any part of your body, including your joints, bones, urinary tract, central nervous system, muscles, bone marrow and lymphatic system.

When TB occurs outside your lungs, signs and symptoms vary, depending on the organs involved. For example, tuberculosis of the spine may result in back pain, and tuberculosis that affects your kidneys might cause blood in your urine. Tuberculosis can also spread through your entire body, simultaneously attacking many organ systems. It should be noted that immunocompromised patients i.e. the elderly and more so individuals infected with HIV are particularly susceptible to developing active TB. They are more likely to have rapidly progressive primary disease instead of the sub clinical infection. Of further concern is the diagnosis of TB which becomes more difficult in persons with HIV, because the chest radiographs of pulmonary disease often lack specificity and frequently the patients are allergic to tuberculin skin testing, a primary means to identify individuals infected with TB. The TB test or PPD (purified protein derivative) test is based on the premise that following infection with M.tuberculosis, a patient will develop a delayed hypersensitivity cell-mediated immunity to certain antigenic components of the organism. To determine whether a person has been infected with M.tuberculosis, a culture extract of M.tuberculosis (i.e. PPD of tuberculin) is intravenously injected. After 48-72 hours, a person who has been infected will exhibit a delayed hypersensitivity reaction to the PPD; this reaction is characterized by erythema (redness) and most important, induration (firmness as a result of influx of immune cells). The diameter of induration is measured and then interpreted as whether the patient has been infected or not. Different criteria exist for different patient populations (e.g., immunosuppresed persons, such as those infected with HIV). It is also important to bear in mind that the test is not 100% sensitive or specific, and positive reaction to the skin does not necessarily signify the presence of the disease.

Treatment:

Treating TB infection (asymptomatic)

If tests show that you have TB infection but not active disease, your doctor may recommend preventive drug therapy to destroy dormant bacteria that might become active in the future. In that case, you're likely to receive a daily dose of the TB medication isoniazid (INH). For treatment to be effective, you usually take INH for six to nine months. Long-term use can cause side effects, including liver disease-hepatitis. For that reason, your doctor will monitor you closely while you're taking INH. During treatment, avoid using acetaminophen (Tylenol, others) and avoid or limit alcohol use. Both greatly increase your risk of liver damage.

Treating active TB disease (symptomatic)

If you're diagnosed with active TB, you're likely to begin taking four medications - isoniazid, rifampin (Rifadin, Rimactane), ethambutol (Myambutol) and pyrazinamide. This regimen may change if susceptibility tests later show some of these drugs to be ineffective. Even so, you'll continue to take several medications. Depending on the severity of your disease and whether there is drug resistance, one or two of the four drugs may be stopped after a few months. Sometimes the drugs may be combined in a single tablet such as Rifater, which contains isoniazid, rifampin and pyrazinamide. This makes your therapy less complicated while ensuring that you get the different drugs needed to completely destroy TB bacteria. Another drug that may make treatment easier is rifapentine (Priftin), which is taken just once a week during the last four months of therapy. Sometimes you may be hospitalized for the first two weeks of therapy or until tests show that you're no longer contagious. Completing treatment is essential.

Because TB bacteria grow slowly; treatment for an active infection is lengthy - usually six to 12 months. After a few weeks, you won't be contagious and may start to feel better, but it's essential that you finish the full course of therapy and take the medications exactly as prescribed by your doctor. Stopping treatment too soon or skipping doses can create drug-resistant strains of the disease that are much more dangerous and difficult to treat. Drug-resistant strains that aren't treated can quickly become fatal, especially in people with impaired immune systems. In an effort to help people stick with their treatment regimen, some doctors and clinics use a program called directly observed therapy short-course (DOTS). In this approach, a nurse or other health care professional administers your medication so that you don't have to remember to take it on your own.

Treatment side effects:

Side effects of TB drugs aren't common, but can be serious when they do occur. All TB medications can be highly toxic to your liver. Rifampin can also cause severe flu-like signs and symptoms - fever, chills, muscle pain, nausea and vomiting. When taking these medications, call your doctor immediately if you experience any of the following:

Nausea or vomiting, Loss of appetite, A yellow color to your skin (jaundice), A fever lasting three or more days that has no obvious cause, such as a cold or the flu, Tenderness or soreness in your abdomen, Blurred vision or colorblindness.

Treating drug-resistant TB:

Multi-drug-resistant TB (MDR-TB) is any strain of TB that can't be treated by the two most powerful TB drugs, isoniazid and rifampin. Extensive drug-resistant TB (XDR-TB) is a newly developed strain of TB that's resistant to the same treatments that MDR-TB is, and additionally XDR-TB is resistant to three or more of the second-line TB drugs. Both strains develop as a result of partial or incomplete treatment - either because people skip doses or don't finish their entire course of medication or because they're given the wrong treatment regimen. This gives bacteria time to undergo mutations that can resist treatment with first-line TB drugs. MDR-TB can be treated. But it requires at least two years of therapy with second-line medications that can be highly toxic. Even with treatment, many people with MDR-TB may not survive.

And when treatment is successful, people with this form of TB may need surgery to remove areas of persistent infection or repair lung damage. Treating these resistant forms of TB is far more costly than treating nonresistant TB, making therapy unaffordable in many parts of the world. Because these resistant infections are spreading and could potentially make all TB incurable, some experts believe that ineffective treatment is ultimately worse than no treatment at all.

Treating people who have HIV/AIDS:

Treating people who are co-infected with TB and HIV is a particular challenge. HIV-positive people are especially likely to develop MDR-TB and to rapidly progress from latent to active infection. What's more, the most powerful AIDS drugs - protease inhibitors - interact with rifampin and other drugs used to treat TB, reducing the effectiveness of both types of medications. To avoid interactions, people living with both HIV and TB may stop taking protease inhibitors while they complete a short course of TB therapy that includes rifampin. Or they may be treated with a TB regimen in which rifampin is replaced with another drug that's less likely to interfere with AIDS medications. In such cases, doctors carefully monitor the response to therapy, and the duration and type of regimen may change over time. Without treatment, most people living with both HIV and TB will die, often in a matter of months. In such cases, the primary cause of death is TB, not AIDS.

Prevention:

In general, TB is a preventable disease. From a public health standpoint, the best way to control TB is to diagnose and treat people with TB infection before they develop active disease and to take careful precautions with people hospitalized with TB. But there are also measures you can take on your own to help protect yourself and others:Keep your immune system healthy. Make sure you eat plenty of healthy foods, get adequate amounts of sleep and exercise regularly to keep your immune system in top form.Get tested regularly. Experts advise getting a skin test annually if you have HIV or another disease that weakens your immune system, live or work in a prison or nursing home, are a health care worker, or have a substantially increased risk of exposure to the disease.Consider preventive therapy. If you test positive for latent TB infection, but have no evidence of active TB, talk to your doctor about therapy with isoniazid to reduce your risk of developing active TB in the future. A vaccine, BCG, is available and has been of some benefit in preventing TB. It is more commonly administered in countries where TB is more common. The vaccine isn't very effective in adults, although it can prevent TB from spreading outside the lungs in infants. Vaccination with BCG also causes a false-positive result on a Mantoux skin test and for that reason, isn't recommended for general use in some countries like US.

Researchers are working on developing a more effective TB vaccine. Either way, finish your entire course of medication. This is the most important step you can take to protect yourself and others from TB. When you stop treatment early or skip doses, TB bacteria have a chance to develop mutations that are resistant to the most potent TB drugs. The resulting drug-resistant strains are much more deadly and difficult to treat.

To help keep your family and friends from getting infected if you have active TB:

Stay home. Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active TB. Ensure adequate ventilation. Open the windows whenever possible to let in fresh air. Cover your mouth. It takes two to three weeks of treatment before you're no longer contagious. During that time, be sure to cover your mouth with a tissue any time you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away. Also, wearing a mask when you're around other people during the first three weeks of treatment may help lessen the risk of transmission.

Coping skills:

Undergoing treatment for TB for a long period of time can be complicated, yet sticking with therapy is the only way to cure the disease. You may find it helpful to have your medication administered by a nurse or other health care professional so that you don't have to remember to take it on your own. In addition, try to maintain your normal activities and hobbies and stay connected with family and friends. Keep in mind that your physical health can directly impact your mental health. Denial, anger and frustration are not uncommon when you learn life has dealt you something difficult and unexpected. At times, you may need more tools to deal with these or other emotions. Professionals, such as therapists or behavioral psychologists, may help you put things in perspective.

KENYA POLITICIANS AND "MUDUS OPERANDI"

CUT AND PASTE-protocol war?

Editorial Cartoon [ Sunday, May 04, 2008 ]

THE KENYAN POLITICS

There are voices who, rightly point out that ODM was short changed in the sharing of Cabinet positions. With most people citing the beefy positions that went to a PNU clique from the Mount Kenya region.

And then there are also these grumblings of south rift leaders threating to form their on party because they felt short changed? I am not sure, but maybe Kenyans might as well give each VILLAGE CHIEF a ministerial position, full with assistant minister-in tow and Ps! or something of that sort, if this is where we are headed.

The story that five MPs and more than 100 councillors were threatening to withdraw their support for ODM over Cabinet appointments was a cheap blackmail attempt by these so called leaders to say the least. The current and former MPs from the South Rift accused Prime Minister, Mr Raila Odinga, of sidelining the Kipsigis. "The community got a raw deal in the appointments," they said in a statement read by Chepalungu MP, Mr Isaac Ruto.

Speaking at Tea Research Foundation, Kericho, on Saturday, they called for a political party for the community. The Konoin MP, Dr Julius Kones, said the community would use the by-elections in Ainamoi and Trans Mara to stamp their authority. Among the MPs at the meeting were Mr Franklin Bett (Buret), Mr Magerer Lang’at (Kipkelion), Mr Zakayo Cheruiyot (Kuresoi)and former MPs, Mr Paul Sang and Mr John Terer.

These leaders said they held Raila responsible for shortchanging the community.In the region, only Bomet MP, Mr Kipkalya Kones, is a cabinet minister (Roads), while Mr Charles Keter (Belgut) and his Sotik counterpart, Mrs Lorna Laboso, were appointed assistant ministers in the ministry of Energy and office of the Vice-President respectively. On Thursday, ten MPs from the Rift Valley raised concern over Cabinet appointments, saying they were shortchanged.

Meanwhile, Budalang’i MP, Mr Ababu Namwamba, has asked Raila to contact ODM MPs who missed the appointments and assure them that all was not lost. "We have many other opportunities and all is not lost for the MPs who missed Cabinet appointments. That is what our PM should tell them now," said Namwamba.

Back to the accord-the National Reconciliation Act provides for a sharing of executive authority between Kibaki and Raila. The President remains the Head of State, but the responsibility of running the country is clearly shared between the two. This is a salient point which needs to be fore grounded in any discussion about the power sharing deal for it has far reaching implications on how the country will be managed henceforth.

That is why it is important for all Kenyans to know that for once we have a governance arrangement where the President will not enjoy the sweeping powers that have traditionally been associated with his office. The sweeping presidential powers have been the cause of many of our problems. The existence of a Prime Minister who the Constitution now fully recognizes as holding executive power means that the President’s sole imperial responsibility of running the State and Government has been moderated.

African states have failed in the past to institutionalize democracy due to the imperial powers held by those in the presidency. The provisions of the National Reconciliation Act have undoubtedly given Kenya an unprecedented opportunity to strengthen democracy, accountable leadership and to take a lead role in showing Africa that new beginnings are possible. Additionally, the Act gives this country a new impetus to move a way from the impunity of the past while introducing measures for a fair system of rule where the President will directly account to some other authority by way of consultation and teamwork.

Africa’s history is full of fine examples of leaders who hold unfettered power, which they have tended to use in ways that have brought disrepute, suffering and reduced freedoms to their peoples. This is what has led to the ills of cronyism and patronage. Presidents have tended to use their powerful positions to reward and punish according to their whims thus stifling alternative voices of reason.

The creation of the premier’s office provides real possibilities for minimizing unaccountable leadership and fostering openness and consultation as a vital process in governance. This way of running Government business does provide for automatic checks and balances in the decision making and governance processes thus eliminating despondency.

Another point to make is that, although PNU took the politically strategic ministries of Defence, Finance and Justice, this does not necessarily make the party privileged. ODM’s haul of infrastructural and service oriented positions of Agriculture, Local Government, Tourism, Water, Roads and Public Works, indeed does put it in better stead to push a strong development agenda based on equity and fair distribution and utilization of national resources for the benefit of a majority of Kenyans.

Also another factor to consider is the aggregate annual budgetary allocations to the ministries taken by ODM against those with PNU. There is negligible difference in this regard, meaning that none of the parties was handed a raw deal. This is an important point considering that both parties would want to have a direct say on how and where Government resources are used.

It is only fair and correct to say that real power sharing is not exactly in the sharing of Cabinet positions. The real power sharing is in the possibilities for responsibility sharing between the Prime Minister and the President.

The debate around Cabinet appointments did miss these points, yet these are precisely what has redefined the country’s political and governance landscape.

PS:We need to remind the idler-MPs that, there lie a head a daunting task of rebuilding a new Kenya's socio-economic, infrastructure, tackle unemployment, correct the historical injustices over land/resources distribution, resettlement of the IDPs et cetera et cetera. The time to start working was yesterday! Instead of throwing tantrums and issuing meaningless press reports lets come together for the good of the nation. These are distractions we can ill afford at this juncture.

KENYA'S NEW "SHARED" COALITION SWORN IN

Nearly three months after Kenya's disputed elections, the country's new power-sharing cabinet has been sworn in, including ODM's leader Raila Odinga as a Prime Minister.

As he was being sworn-in in front of dignitaries including Kofi Annan, the former UN chief who brokered the power-sharing deal with President Mwai Kibaki, Mr Odinga not only began a new phase of his political career, but a new era for Kenya.

"We will ensure that power, wealth and opportunity are [in] the hands of many, not the few," he said after taking his oath of office as Prime Minister. He becomes the second Prime Minister in the country's history.

At a lengthy ceremony in the capital, Nairobi, Kenya's 42 ministers and 50 assistant ministers - half belonging to or aligned with President Mwai Kibaki's Party of National Unity, and half from Prime Minister Raila Odinga's Orange Democratic Movement - took office.

The event officially puts in place the power-sharing government agreed upon by President Kibaki and Mr. Odinga in an agreement mediated by former U.N. Secretary General Kofi Annan in late February.


Mr. Annan was on hand for the event and urged support for the new government, despite concerns that the large number of ministers, the most in Kenya's history, is a waste of resources.

"I know there has been some debate as to the size of the government, but what is important is that we do have a government," he said. "We have an opportunity to put Kenya back on track and build a stronger Kenya and it is essential that you all support the leaders and the government."

Ugandan president Yoweri Museveni, Prime Minister Odinga, and President Kibaki also delivered speeches. President Kibaki sounded an optimistic note on moving forward.

KENYA NAMES A COALITION CABINET

Mwai Kibaki announced the cabinet on April 13th, 2008.

Mr Kibaki called for politics to be set aside and real work to start, while announcing the new power-sharing cabinet following a deal that the two brokered during the latest secrete meeting at sagana lodge to end the long-running political crisis.

Kibaki officially named Raila Odinga as the new prime minister, after the pair agreed the deal on Saturday in their secret talks.

The crisis was sparked by presidential elections in December that triggered violence in which over 3,500 people died and more than 600,000 displaced.

The deal overcame a row over how the cabinet posts would be divided.

Local and international pressure:

Mr Kibaki said in a live televised speech alongside Mr Odinga: "My challenge to the new cabinet members and the entire national leadership at all levels is: let us put politics aside and get to work."As both the local and international pressure pilled on the two leaders.


KEY POSTS:

Office of the Prime Minister:

Prime Minister: Raila Amollo Odinga
Assistant Minister: Alfred Khang’ati

Office of Vice-President and Home Affairs:

Vice President and Minister for Home Affairs:Stephen Kalonzo Musyoka
Assistant Minister: Lorna Laboso

Office of the Deputy Prime Minister and Ministry of Local Government:

Deputy PM and Minister for Local Government: Wycliffe Musalia Mudavadi
Assistant Minister: Robison Njeru Githae

Deputy Prime Minister and Minister for trade:Uhuru Kenyatta
Assistant Minister: James Omingo Magara

Kibaki added: "Let us build a new Kenya where justice is our shield and defender, and where peace, liberty and plenty will be found throughout our country."

Two deputy prime ministers were named - Uhuru Kenyatta of Mr Kibaki's Party of National Unity and Musalia Mudavadi of Mr Odinga's Orange Democratic Movement.

Finance Minister Amos Kimunya retained his post and the ODM's William Ruto becomes agriculture minister.

A total of 40 posts were named in an even split between ODM and the PNU and its allies.

Even though Kenyans had protested and argued the country could not afford so many posts with the looming food crisis and future socio-economic appearing bleak as over 600,000 people are still displaced while more than 3,500 lost their lives, the kibaki train took no such notice and stuffed a bloated cabinet nonetheless.

It is also clear that, with the exception of local government the key posts remain with PNU's close followers.

Although its apparent that the cabinet appeared unreasonably large, Kibaki said, many Kenyans will breath a collective sigh of relief that perhaps the country can now move forward.

It is understood that the cabinet will work on framing a new constitution over the next year that will tackle long-standing grievances over land, wealth and power.

The two leaders had come under intense international pressure to achieve a breakthrough.

The deal on power-sharing had been brokered by former UN secretary general Kofi Annan in February and a cabinet was scheduled to be announced on 6 April.

But the talks seemed to break down this week as Mr Odinga held out for the 50-50 split in cabinet posts following the signed accord.

The country,needless to say is still on a cliff hanger given the over 3,500 who died and more than 600,000 who were displaced during the election crisis. Many thousands have yet to return to their homes.


Full Cabinet list:

1)Ministry of State for Provincial Administration and Internal Security

Minister: Prof George Saitoti
Assistant Ministers: Simon Lesirma and Joshua Orwa Ojode

2)Ministry of State for Defence

Minister: Yusuf Haji
Assistant Ministers: David Musila and Joseph Nkaisserry

3)Ministry of State for Immigration and Registration of Persons

Minister: Gerald Otieno Kajwang’
Assistant Minister: Francis Baya

4)Ministry of State for National Heritage & Culture:

Minister: William ole Ntimama
Assistant Minister: Joel Onyancha Omagwa

5)Ministry of State for Planning, National Development and Vision 2030:

Minister: Wycliffe Ambetsa Oparanya
Assistant Minister: Peter Kenneth

6)Ministry of State for Public Service:

Minister: Dalmas Anyango Otieno
Assistant Minister: Aden Ahmed Sugow

7)Office of Deputy Prime Minister and Ministry of Trade:

9)Ministry of East African Community

Minister: Amason Kingi Jeffah
Assistant Minister: Peter Munya

10)Ministry of Foreign Affairs

Minister: Moses Wetangula
Assistant Minister: Richard Momoima Onyonka

11)Ministry of Finance

Minister: Amos Kimunya
Assistant Minister: Dr. Oburu Oginga

12)Ministry of Justice, National Cohesion and Constitutional Affairs
Minister: Martha Karua
Assistant Minister: William Cheptumo Kipkorir

13)Ministry of Nairobi Metropolitan Development

Minister: Mutula Kilonzo
Assistant Minister: Elizabeth Ongoro Masha

14)Ministry of Roads

Minister: Kipkalya Kones
Assistant Ministers: Wilfred Machage and Lee Kinyanjui

15)Ministry of Public Works

Minister: Chris Obure
Assistant Minister: Dickson Wathika Mwangi

16)Ministry of Transport

Minister: Chirau Ali Makwere
Assistant Minister: John Harun Mwau

17)Ministry of Water and Irrigation

Minister: Charity Kaluki Ngilu
Assistant Minister: Mwangi Kiunjuri

18)Ministry of Regional Development Authorities

Minister: Fredrick Omulo Gumo
Assistant Minister: Judah Katoo ole Metito

19)Ministry of Information & Communications

Minister: Samuel Poghisio
Assistant Ministers: George Munyasa Khaniri and Dhadho Godhana

20)Ministry of Energy

Minister: Kiraitu Murungi
Assistant Ministers: Charles Keter and Maalim Mohamud Mohamed

21)Ministry of Lands

Minister: Aggrey James Orengo
Assistant Ministers: Silvester Wakoli Bifwoli and Samwel Gonzi Rai

22)Ministry of Environment and Mineral Resources

Minister: John Michuki
Assistant Ministers: Ramadhan Seif Kajembe and Jackson Kiplagati Kiptanui

23)Ministry of Forestry and Wildlife

Minister: Noah Wekesa
Assistant Minister: Josphat Koli Nanok

24)Ministry of Tourism

Minister: Mohamed Najib Balala
Assistant Minister: Cecily Mtito Mbarire

25)Ministry of Agriculture

Minister: William Samoei Ruto
Assistant Ministers: Japhet Kareke Mbiuki and Gideon Musyoka Ndambuki

26)Ministry of Livestock Development

Minister: Mohamed Abdi Kuti
Assistant Minister: Bare Aden Duale

27)Ministry of Fisheries Development

Minister: Paul Nyongesa Otuoma
Assistant Minister: Mohamed Abu Abuchiaba

28)Ministry of Development of Northern Kenya and other Arid Lands

Minister: Ibrahim Elmi Mohamed
Assistant Minister: Hussein Tarry Sasura

29)Ministry of Cooperatives Development

Minister: Joseph Nyagah
Assistant Minister: Linah Jebii Kilimo

30)Ministry of Industrialisation

Minister: Henry Kiprono Kosgey
Assistant Minister: Ndiritu Murithi

31)Ministry of Housing

Minister: Peter Soita Shitanda
Assistant Minister: Bishop Margaret Wanjiru Kariuki

32)Ministry of Special Programmes

Minister: Dr. Naomi Namsi Shabani
Assistant Minister: Mohamed Muhamud Ali

33)Ministry of Gender and Children Affairs

Minister: Esther Murugi Mathenge
Assistant Minister Atanas Manyala Keya

34)Ministry of Public Health and Sanitation

Minister: Beth Wambui Mugo
Assistant Minister: Dr. James Ondicho Gesami

35)Ministry of Medical Services

Minister: Prof. Peter Anyang’ Nyong’o
Assistant Minister: Danson Buya Mungatana

36)Ministry of Labour

Minister: John Kiyonga Munyes
Assistant Minister: Sospeter Ojamaa Ojamong’

37)Ministry of Youth and Sports

Minister: Dr. Helen Jepkemoi Sambili
Assistant Ministers: Wavinya Ndeti and Kabando wa Kabando

38)Ministry of Education

Minister: Samson Kegeo Ongeri
Assistant Ministers: Prof. Patrick Ayiecho Olweny and Andrew Calist Mwatela

39)Ministry of Higher Education, Science and Technology

Minister: Dr. Sally Jepngetich Kosgey
Assistant Ministers: Kilemi Mweria and Asman Abongotum Kamama

40)Office of the Attorney General
Attorney General: Amos Wako

MADE IN KENYA

Countries world over promote themselves with the label's such as MADE IN CHINA,MADE IN SINGAPORE,MADE IN MALAYSIA,MADE IN JAPAN,MADE IN S.KOREA, MADE IN USA,MADE IN VENEZUELA,MADE IN MEXICO,MADE IN GREAT BRITAIN,MADE IN RUSSIA,MADE IN BRAZIL,MADE IN COLOMBIA,MADE IN INDIA,MADE IN SOUTH AFRICA,MADE IN THE PHILIPPINES... et cetera et cetera...This, in actual sense means that these countries are proud to be associated with the products/and or what they make and are. But in Kenya,things are different...there is a unique taste into what they make.

It is in Kenya that a general election can be bungled to a point where one is left wondering whether the people involved really live in that same country. Or whether they have any afterthought of the future.In Kenya, electoral commission can chose to completely ignore the constitution or pick parts of it to side step.this is the same constitution on which they are supposedly formed or to operate under, without anybody raising a finger or ever being taken to court of law for the mismanagement.

It is not a surprise to find out that its only in Kenya that a sitting president can organize, steal-(in abroad daylight-ask a small kid, he/she will tell you....yes he stole and everyone knows it- kind)the election and put on a brave face and say to the world that "I am the duly elected president of Kenya" without giving it much thought! It is only in this country that not only can one steal the election, over 3000 innocent lives and more than a quarter of a million people be refugees in their own country, the perpetrators can actually get a way with it-NO QUESTIONS ASKED.

It is also in Kenya that a sitting president can bungle the election and still be in the coalition government where a staggering 40 plus cabinet ministers and unspecified or similar numbers of assistant ministers are proposed and justified to be a good number even though the country is in a bleak economic/social and political times. And the issue of almost 90% of the populace living under ksh 60.00/day do not arise.THIS IS A TRUE KENYAN MADE!

Yes it's only in Kenya where politicians can buy themselves into the parliament, once there, they can get to appoint themselves into the cabinet and cherry-pick which posts massages their ego better and fight/throw tantrums to get.They also can fix their salaries at will- making sure that they get paid/or pay themselves the highest in the world...given the country's GDP. And while at it, also make sure that they are in apposition to grab anything-everything as much as they can.

It is also in Kenya where major scandals such as angloleasings, goldenburgs, Ndung'us, krolls types..among numerous others not to forget to mention the mobiteleas can be conceptualized-executed and continue to thrive without loosing any sleep over it. OOOh and the IPO?


Abdulahi Ahmednasir said this much on his article to the standard:

Eight years after conception, the riddle that is Mobitelea remains unresolved. With the floatation of Safaricom shares in the Nairobi Stock Exchange next month, the long drawn saga of Mobitelea will officially end. Like other grand scams that litter our landscape, Mobitelea will then be buried without any rituals among the haunting ghosts of Anglo Leasing and Goldenberg. Mobitelea costs the taxpayer a staggering Sh10 billion according to the current valuation of Safaricom. How can a scam of this magnitude be conceptualised, successfully executed, and its fruits so publicly eaten, while no one in power raises a finger? Please read the bewildering narrative that is Mobitelea.

In May, 2000 Vodafone, a blue chip British enterprise finally realised its long cherished dream of buying for a song a sizeable stake in Safaricom. It has been trying to do for a long time. To realise the goal, Vodafone enlisted the service of Mobitelea, a company solely created for that task, and which in turn, ordered four important institutions in Kenya to do its bidding.

So how did Vodafone and Mobitelea pull the transaction? Mobitela offered its service to Vodafone and guaranteed that it can force Kenyan officials to sell Safaricom shares to Vodafone at a price determined by the later.

Vodafone, as many European companies do, tried to pay off Mobitelea in one cash transaction for the services rendered. Mobitelea resisted this and insisted on being given a percentage of the shares Vodafone wanted to buy in Safaricom.

Further negotiations between the parties ensured. Mobitelea, on condition that it will be allotted some of the shares of Vodafone, was additionally mandated to ensure that there should be no independent valuation of the Safaricom shares.

The price Vodafone paid was solely agreed between Vodafone and Mobitelea. That explains the generosity of the British company. Both parties shook hands. Mobitelea became the rich owner of 10 per cent of Safaricom.

In executing its task, Mobitelea did pull four important strings. First, it forced the Finance ministry to approve the sale of Safaricom shares to Vodafone. Only the Minister of Finance had the legal power to allow Telkom Kenya, which was the parent company of Safaricom, to sell its shares to a foreign company.

The Finance minister in May 2000 is thus a material witness to this saga for he knew the human faces behind Mobitelea.

Second, who was the Minister in charge of Transport and Telecommunication in May 2000? That ministry was in charge of Telkom Kenya and its subsidiary, Safaricom. It is impossible for Telkom Kenya, as a wholly owned parastatal, to sell its equity in Safaricom without being sanctioned by the minister in charge of this docket. He, too, knows the human faces behind Mobitelea.

Third, the management and board of directors of Telkom Kenya in May 2000 were the foot solders of Mobitelea. They have all the details of the transaction.

Four, before any transaction of the magnitude of Mobitelea can join the big league of Kenya’s scams, the State Law Office must legally sanction it. A legal opinion validating the transaction must be lying somewhere in the State Law Office.

Political compromise

The narrative goes on. In 2002 when the National Rainbow Coalition government came to power, powerful individuals in government came after Mobitelea threatening that the authorities will repossess Mobitelea’s shares in Safaricom. Both the owners of Mobitelea and those making the threat being members of the same political elite struck a compromise. One to two per cent of Mobitelea’s shares in Safaricom were given to the new kids on the block and Mobitelea retained the rest. That is the end of the narrative.

The Mobitelea saga raises disturbing questions on a number of fronts. This is yet another instance when billions of shillings jointly stolen by our leaders and friendly foreigners. I think it is in order for the British High Commissioner to Kenya Mr Adam Wood to address the ethics of a British corporation in one of his forthcoming lectures. What is his government doing about this Imperial British East African Company?

Kenyans must appreciate that the sale of Safaricom shares to Vodafone was not a backroom deal. It was officially sanctioned at all levels of government. There is even a possibility that the Cabinet gave the seal of approval. Further, the Kenya Anti-Corruption Commission and the Attorney General have all the details of the transaction. They know the details of who the original owners, how the transaction was negotiated, who signed what documents, and who received what amount. They also know who in government was given shares in Mobitelea in exchange for political protection. Of course, Kenyans are not too foolish to expect these two offices to go after their political masters.

Even though it will be difficult to trace the Mobitelea shares once it is off loaded in the stock exchange, Kenyans still have a good recourse. The weakest link in this corrupt transaction is the shares of Vodafone in Safaricom. A viable legal challenge can be mounted against Vodafone to invalidate the transaction and return all the shares to the Government. This is because the underlying basis of the entire transaction was a bribe to induce the Government to offload its 40 per cent stake in Safaricom.

Lest we forget, some of the ministers who in 2000 sanctioned the Mobitelea scandal will be among the 40 ministers to be appointed today. The more we think we have changed, the more we remain the same.

KENYA'S COALITION CABINET READY?

The much a waited Cabinet is finally here?

The reports are trickling in that PNU and ODM are ready to form the new cabinet.
After haggling for almost a month about every little things imaginable and PNU brigades with their usual antics showing their true colours and how myopic they really can be/are, Kenyans had been reduced to mere spectators save for their fate being in the precipice.

Addressing reporters after talks, Mr Odinga said the agreement has been reached and that the new cabinet will be formally announced on 6 April. "We have agreed to announce the cabinet on Sunday and that the cabinet will be sworn in on [the following] Saturday," Mr Odinga said.

A statement from President Kibaki said both parties were pleased with the outcome of the discussions in the spirit of give and take. The long consultations were necessary to enable there be an agreement that is amicable and good for the country, the statement added. Civil society groups have called on the leaders to appoint a lean cabinet with untainted personalities.

Early this week, the activists lead by Nobel Prize winner Wangari Maathai were tear-gassed by police when they held a demonstration against proposals by President Kibaki to raise the cabinet positions from the present 34 to 44. And Transparency International chairman Richard Leakey warned that the continued delay in appointing the cabinet was creating room for corruption to thrive in government.