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Dr. Google doesn’t always know what’s best

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By THE NEW YORK TIMES
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When faced with an actual or potential diagnosis of cancer, most people are inclined to consult Dr. Google, often before they see a real live medical expert. Unfortunately, Dr. Google doesn’t always know what’s best.

A generation ago, patients were largely dependent upon the physicians they consulted as to how best to deal with a disease like cancer.

Nowadays there’s the internet, replete with a virtual tsunami of information offered by all kinds of sources, from experts equipped with evidence-based facts to people selling products or outright quackery.

The trick is to know how to tell the difference, especially since the disparate guidance provided can become a matter of life or death.

“It’s easy for people to land on a site filled with misinformation that leads them to make decisions that may not be in their best interests,” Dr. Lidia Schapira, medical oncologist at Stanford University Medical Center, told me. She is editor of the very reliable site, www.cancer.net, that provides clear, scientifically vetted information about cancer and its treatment for patients, their families and friends.

As a specialist in breast cancer, Schapira has treated women who decline postoperative therapy with a drug like tamoxifen or an aromatase inhibitor because they read on the web that the treatments are harmful, despite extensive studies showing they can help prevent a breast cancer recurrence. “The conviction about harm is an emotional reaction, and it’s very difficult for a doctor to talk facts through emotions,” she said.

WRONG INFORMATION IS HARMFUL

As the American Cancer Society cautions, “The wrong information can hurt you when it comes to cancer. A lot of what passes for cancer information on the internet is made up of opinion, salesmanship, and testimonials, and is not grounded in careful science. Anyone can post any kind of information online, and some people may be passing along information that’s limited, inaccurate or just plain wrong. Some even try to deceive you.”

Worried about an unexplained symptom? The internet offers about two dozen “symptom checkers,” and patients can actually freak themselves out by searching the web for their symptoms and finding cancer as a possible cause.

Just about any symptom, from a persistent cough to chronic constipation, can be caused by cancer, but a qualified doctor can readily rule out cancer with a proper medical examination and review of a patient’s personal and family history.

Last year in The Hartford Courant, Dr. David W. Wolpaw, a family physician in Manchester, Connecticut, described a man in his 20s with a week-long sore throat who had done an internet search and thought he had oral cancer. The doctor reported that the man lacked risk factors for cancer, and an exam showed he had nothing worse than a cold.

“People shouldn’t expect a website to replace their physician,” Wolpaw wrote. In addition to having completed many years of education and hands-on experience, “your doctor knows you, your medical history, family history, risk factors, etc., much better than the internet,” he added. Furthermore, he wrote, “sites can look trustworthy even when they post information not supported by scientific evidence.”

People looking for the latest iteration of snake oil will surely find it on the web. Steer clear! The cancer society cautions to beware of any postings that make claims like “scientific breakthrough,” “secret ingredient,” “miraculous cure” or ancient remedy,” as well as products offering money-back guarantees, available from only one source or said to cure a wide range of ailments.

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That said, people facing cancer often can glean valuable information and support through the internet. “The internet can be a tool that can give people access to good scientifically vetted information,” Schapira said. “It can help patients be better prepared for a consultation with an expert. And after such a consultation, they can check on the wisdom of the advice they got.”

She suggests relying on web-based resources that are free of commercial interests. Even sites posted by medical institutions can be self-promoting. In addition to www.cancer.net, which is prepared by members of the American Society of Clinical Oncology, Schapira recommended information offered by the American Cancer Society (www.cancer.org) and the National Cancer Institute (www.cancer.gov), as well as the free patient-oriented arm of a site called UpToDate that translates into lay terms the best available information that doctors get.

The cancer institute notes that the three letters attached to a site’s domain name can give people insight into the independence and validity of information it contains; best to choose .edu or .gov over .com.

In addition to providing valuable information and guidance to trustworthy sources, the internet can help patients glean psychosocial support through online groups.

In a review of 170 studies of patients who use information technology, Danielle Gentile of the Levine Cancer Institute of Atrium Health in Charlotte, North Carolina, and her co-authors found that social media communities can be very helpful to cancer patients, especially those who lack personal social support.

Cancer patients can converse with others, anonymously or otherwise, about emotional and spiritual issues and glean helpful first-hand tips on dealing with treatment-related issues.

But while some online communities “are curated by medical professionals, others may be posted by people who have no scientific knowledge,” Schapira cautioned. The information patients glean through such lay communities is best discussed with their doctors lest they be led down the garden path of bad advice.

She also suggested that patients not be pressured to research their cancers until and unless they are emotionally and intellectually ready to deal with the information they uncover.

“It may be better to let others look things up,” she said. “Different people need different information at different times. Some people are not ready to absorb all the information upfront, and that’s completely normal. Some want to receive the information but leave decisions to the experts, while others want to have a hand in making the decisions.”

Don’t be afraid to discuss alternative remedies with the doctors treating your cancer, and be sure to tell them about any such remedy you plan to try in case it can interact badly with prescribed treatments. Nearly all major medical centres now have departments of integrative medicine, and today’s oncologists are well aware of how much the mind can influence the body’s well-being, Schapira said.



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General

Sordid tale of the bank ‘that would bribe God’

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Bank of Credit and Commerce International. August 1991. [File, Standard]

“This bank would bribe God.” These words of a former employee of the disgraced Bank of Credit and Commerce International (BCCI) sum up one of the most rotten global financial institutions.
BCCI pitched itself as a top bank for the Third World, but its spectacular collapse would reveal a web of transnational corruption and a playground for dictators, drug lords and terrorists.
It was one of the largest banks cutting across 69 countries and its aftermath would cause despair to innocent depositors, including Kenyans.
BCCI, which had $20 billion (Sh2.1 trillion in today’s exchange rate) assets globally, was revealed to have lost more than its entire capital.
The bank was founded in 1972 by the crafty Pakistani banker Agha Hasan Abedi.
He was loved in his homeland for his charitable acts but would go on to break every rule known to God and man.
In 1991, the Bank of England (BoE) froze its assets, citing large-scale fraud running for several years. This would see the bank cease operations in multiple countries. The Luxembourg-based BCCI was 77 per cent owned by the Gulf Emirate of Abu Dhabi.  
BoE investigations had unearthed laundering of drugs money, terrorism financing and the bank boasted of having high-profile customers such as Panama’s former strongman Manual Noriega as customers.
The Standard, quoting “highly placed” sources reported that Abu Dhabi ruler Sheikh Zayed Sultan would act as guarantor to protect the savings of Kenyan depositors.
The bank had five branches countrywide and panic had gripped depositors on the state of their money.
Central Bank of Kenya (CBK) would then move to appoint a manager to oversee the operations of the BCCI operations in Kenya.
It sent statements assuring depositors that their money was safe.
The Standard reported that the Sheikh would be approaching the Kenyan and other regional subsidiaries of the bank to urge them to maintain operations and assure them of his personal support.
It was said that contact between CBK and Abu Dhabi was “likely.”
This came as the British Ambassador to the UAE Graham Burton implored the gulf state to help compensate Britons, and the Indian government also took similar steps.
The collapse of BCCI was, however, not expect to badly hit the Kenyan banking system. This was during the sleazy 1990s when Kenya’s banking system was badly tested. It was the era of high graft and “political banks,” where the institutions fraudulently lent to firms belonging or connected to politicians, who were sometimes also shareholders.
And even though the impact was expected to be minimal, it was projected that a significant number of depositors would transfer funds from Asian and Arab banks to other local institutions.
“Confidence in Arab banking has taken a serious knock,” the “highly placed” source told The Standard.
BCCI didn’t go down without a fight. It accused the British government of a conspiracy to bring down the Pakistani-run bank.  The Sheikh was said to be furious and would later engage in a protracted legal battle with the British.
“It looks to us like a Western plot to eliminate a successful Muslim-run Third World Bank. We know that it often acted unethically. But that is no excuse for putting it out of business, especially as the Sultan of Abu Dhabi had agreed to a restructuring plan,” said a spokesperson for British Asians.
A CBK statement signed by then-Deputy Governor Wanjohi Murithi said it was keenly monitoring affairs of the mother bank and would go to lengths to protect Kenyan depositors.
“In this respect, the CBK has sought and obtained the assurance of the branch’s management that the interests of depositors are not put at risk by the difficulties facing the parent company and that the bank will meet any withdrawal instructions by depositors in the normal course of business,” said Mr Murithi.
CBK added that it had maintained surveillance of the local branch and was satisfied with its solvency and liquidity.
This was meant to stop Kenyans from making panic withdrawals.
For instance, armed policemen would be deployed at the bank’s Nairobi branch on Koinange Street after the bank had announced it would shut its Kenyan operations.
In Britain, thousands of businesses owned by British Asians were on the verge of financial ruin following the closure of BCCI.
Their firms held almost half of the 120,000 bank accounts registered with BCCI in Britain. 
The African Development Bank was also not spared from this mess, with the bulk of its funds deposited and BCCI and stood to lose every coin.
Criminal culture
In Britain, local authorities from Scotland to the Channel Islands are said to have lost over £100 million (Sh15.2 billion in today’s exchange rate).
The biggest puzzle remained how BCCI was allowed by BoE and other monetary regulation authorities globally to reach such levels of fraudulence.
This was despite the bank being under tight watch owing to the conviction of some of its executives on narcotics laundering charges in the US.
Coast politician, the late Shariff Nassir, would claim that five primary schools in Mombasa lost nearly Sh1 million and appealed to then Education Minister George Saitoti to help recover the savings. Then BoE Governor Robin Leigh-Pemberton condemned it as so deeply immersed in fraud that rescue or recovery – at least in Britain – was out of the question.
“The culture of the bank is criminal,” he said. The bank was revealed to have targeted the Third World and had created several “institutional devices” to promote its operations in developing countries.
These included the Third World Foundation for Social and Economic Studies, a British-registered charity.
“It allowed it to cultivate high-level contacts among international statesmen,” reported The Observer, a British newspaper.
BCCI also arranged an annual Third World lecture and a Third World prize endowment fund of about $10 million (Sh1 billion in today’s exchange rate).
Winners of the annual prize had included Nelson Mandela (1985), sir Bob Geldof (1986) and Archbishop Desmond Tutu (1989).
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Monitor water pumps remotely via your phone

Tracking and monitoring motor vehicles is not new to Kenyans. Competition to install affordable tracking devices is fierce but essential for fleet managers who receive reports online and track vehicles from the comfort of their desk.

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Agricultural Development Corporation Chief Accountant Gerald Karuga on the Spot Over Fraud –

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Gerald Karuga, the acting chief accountant at the Agricultural Development Corporation (ADC), is on the spot over fraud in land dealings.

ADC was established in 1965 through an Act of Parliament Cap 346 to facilitate the land transfer programme from European settlers to locals after Kenya gained independence.

Karuga is under fire for allegedly aiding a former powerful permanent secretary in the KANU era Benjamin Kipkulei to deprive ADC beneficiaries of their land in Naivasha.

Kahawa Tungu understands that the aggrieved parties continue to protest the injustice and are now asking the Ethics and Anti-corruption Commission (EACC) and the Directorate of Criminal Investigations (DCI) to probe Karuga.

A source who spoke to Weekly Citizen publication revealed that Managing Director Mohammed Dulle is also involved in the mess at ADC.

Read: Ministry of Agriculture Apologizes After Sending Out Tweets Portraying the President in bad light

Dulle is accused of sidelining a section of staffers in the parastatal.

The sources at ADC intimated that Karuga has been placed strategically at ADC to safeguard interests of many people who acquired the corporations’ land as “donations” from former President Daniel Arap Moi.

Despite working at ADC for many years Karuga has never been transferred, a trend that has raised eyebrows.

“Karuga has worked here for more than 30 years and unlike other senior officers in other parastatals who are transferred after promotion or moved to different ministries, for him, he has stuck here for all these years and we highly suspect that he is aiding people who were dished out with big chunks of land belonging to the corporation in different parts of the country,” said the source.

In the case of Karuga safeguarding Kipkulei’s interests, workers at the parastatals and the victims who claim to have lost their land in Naivasha revealed that during the Moi regime some senior officials used dubious means to register people as beneficiaries of land without their knowledge and later on colluded with rogue land officials at the Ministry of Lands to acquire title deeds in their names instead of those of the benefactors.

Read Also: Galana Kulalu Irrigation Scheme To Undergo Viability Test Before Being Privatised

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“We have information that Karuga has benefitted much from Kipkulei through helping him and this can be proved by the fact that since the matter of the Naivasha land began, he has been seen changing and buying high-end vehicles that many people of his rank in government can’t afford to buy or maintain,” the source added.

“He is even building a big apartment for rent in Ruiru town.”

The wealthy officer is valued at over Sh1.5 billion in prime properties and real estate.

Last month, more than 100 squatters caused scenes in Naivasha after raiding a private firm owned by Kipkulei.

The squatters, who claimed to have lived on the land for more than 40 years, were protesting take over of the land by a private developer who had allegedly bought the land from the former PS.

They pulled down a three-kilometre fence that the private developed had erected.

The squatters claimed that the former PS had not informed them that he had sold the land and that the developer was spraying harmful chemicals on the grass affecting their livestock and homes built on a section of the land.

Read Also: DP Ruto Wants NCPB And Other Agricultural Bodies Merged For Efficiency

Naivasha Deputy County Commissioner Kisilu Mutua later issued a statement warning the squatters against encroaching on Kipkuleir’s land.

“They are illegally invading private land. We shall not allow the rule of the jungle to take root,” warned Mutua.

Meanwhile, a parliamentary committee recently demanded to know identities of 10 faceless people who grabbed 30,350 acres of land belonging to the parastatal, exposing the rot at the corporation.

ADC Chairman Nick Salat, who doubles up as the KANU party Secretary-General, denied knowledge of the individuals and has asked DCI to probe the matter.

Email your news TIPS to [email protected] or WhatsApp +254708677607. You can also find us on Telegram through www.t.me/kahawatungu

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William Ruto eyes Raila Odinga Nyanza backyard

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Deputy President William Ruto will next month take his ‘hustler nation’ campaigns to his main rival, ODM leader Raila Odinga’s Nyanza backyard, in an escalation of the 2022 General Election competition.

Acrimonious fall-out

Development agenda

Won’t bear fruit

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