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SURGEON’S DIARY: Surprise meeting with medical friend





By Yusuf K. Dawood
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The fact that I could not do any mountaineering did not diminish my fascination with mountains. While in Nairobi, I have often been to Mount Kenya Safari Lodge and Treetops just to see the highest mountain in Kenya. Marie and I stayed in Kilaguni Lodge when it opened in the early sixties and watched the highest mountain in our continent of Africa, Kilimanjaro, with as much awe as we did the elephants at the salt-lick right in front of the lounge.

We have been to Kilaguni many times since, both to see wildlife and Kilimanjaro, with snow gleaming on its summit. Further afield, when I was a medical student at Grant Medical College in Mumbai, I followed with great interest the climb of Mount Everest by Edmund Hillary from New Zealand and Sherpa Tenzing Norgay of Nepal and its conquest on 29th May, 1953, to coincide with coronation of Queen Elizabeth.

Edmund Hillary was knighted for his timely feat. When asked what motivated him to climb and conquer the summit at 29,035 feet above sea level, he nonchalantly replied, “Because it was there!”

Many years later Marie and I, with our two children, made a nostalgic visit to Kathmandu to see Nepal and the Himalayas at a close range. The capital city is like a dent in the roof of the world, a scenic valley surrounded by snow-capped mountains, with the horizon bending to kiss their peaks. At ground level it is a city of palaces and temples, stupas and prayer wheels, rich Ranas and monks wearing saffron-coloured robes and religious fervour flourishing side by side with squalor, poverty and drug-peddling.

We did the usual tourist circuit by visiting Buddhist temples with richly carved wooden doors, with Buddha sitting inside in majestic repose and a thousand butter lamps burning around him and surrounded by Lamas with their shining tonsures.

We took the Angel’s flight, which perilously flew us between the Himalayan peaks, reminding us of a similar flight we had taken in Zimbabwe to see Victoria Falls and Zambezi River from above. We also visited Fishtail Lodge, the most popular tourist Nepalese attraction outside Kathmandu.

Apparently, we followed Prince Charles who had stayed the night before in the suite we occupied during our stay. Marie being British vainly looked for any royal mementos he might have left behind.

At the end of our week-long sightseeing, I realised that I had a spare day in Kathmandu. By then, like a smoker who misses his ubiquitous cigarette from between his fingers, my hand was missing the scalpel. Marie with her feminine intuition noticed that I was suffering from withdrawal symptoms and suggested that I visit a hospital.

“The children and I will go shopping,” she added to assure me that she would occupy herself. So I asked my taxi driver. “Is there a hospital nearby? I am a doctor and would like to visit one tomorrow since I have a free day.”

“The government hospital is 15 minutes away by taxi.” He replied. “When would you like me to pick you up?”

So at nine sharp, he was waiting for me in the hotel car-park. As I sat in the front besides him, he thrust what looked like an album in my lap, saying, “I was a bit shy to tell you in front of your memsaab yesterday but there are other tourist attractions in this city. They are experts in the erotic art and I have obtained an album of their photographs for your perusal.”

“I would rather visit a hospital.” I replied pushing the album aside.

“I beg you to look at and if you like a face and figure, I can book her for your next visit,” he said.

Convinced that he was incorrigible, I casually looked at the photographs until we arrived at the hospital. I went into the CEO’s office and used my charm with the secretary to let me see him, which happened to be a her.

She condescended to send my business card to her inside when a visitor came out.

After a few minutes, an attractive Nepalese woman came out of her office holding my card. She studied it for a few minutes and asked,” How can I help?”

“As my card says, I am a surgeon from Kenya, on holiday here and wondered if I could see the type of surgical pathology you see here,” I replied.

She went back inside her office bidding me to follow her. She picked up her phone and dialled a number. After a short conversation in Nepalese, which I didn’t understand, she held the receiver and said. “It is an operating day for Dr Narayan and he would be happy if you joined him in the theatre.”


“Beggars can’t be choosers,” I replied, “The operating list will give me an idea of what is surgically common here.”

She whispered something in the receiver and put it down, saying to me: “I will take you to the operating room.” The surgeon was starting on a case of cancer tongue and said to me. “Biopsy has proved the lesion to be malignant and I intend to do left hemi-glossectomy since it is early malignancy confined to the left border with no palpable sub-mental glands.” He meant removal of the left half of the tongue and the glands he was referring to were below the chin.

As he was dealing with the usually bloody procedure, I was busy watching the anaesthetist because he had caught my eye. Despite the surgical mask he was wearing and the beard he had grown, his penetrating blue eyes gave him away. They proved to be the windows of his heart. It took me a little time to place him because we had met almost 30 years ago when I was a surgical registrar in Banbury training to be a surgeon and he held the same rank in anaesthesia, preparing for his fellowship in the speciality of his choice.

It was all a hush-hush affair but when it broke out, the consequences for him were lethal and served as a warning for me not to ever get out of the confines of medical ethics and never to forget the Hippocratic Oath we had sworn to on qualifying as a doctor.

There were a few more operations after hemi-glossectomy, which I watched, and after the operating session, as we changed in the surgeon’s room, I had a good look at the anaesthetist, which stirred my memory but I could not place him. Like a roulette ball in the casino, it was rolling all over the board but did not settle in a slot. In deference to my wishes, Dr Narayan took me to the wards to see the surgical cases in his wards.

There were cases similar to what I see in Nairobi and yet others pathognomonic of Nepal. At about five in the evening, Dr Narayan looked at his watch and asked me “Have you any transport and where is it meeting you?”

“My taxi dropped me outside the CEO’s office and I asked him to meet me there,” I said.

“That’s a long way from here and I better ask Dr O’Donoghue to take you there,” Dr. Narayan replied, and dialled a number from the ward.

Five minutes later, in walked the anaesthetist ready to escort me. I thanked my surgical colleague and left in the company of Dr O’Donoghue. It was a long walk among the well laid-out garden and I took my opportunity. “I take it, with that name, you are from Ireland.” As he nodded in agreement, I popped the essential question. “Did you ever work in Banbury?”

Hearing that question, he came out clean. “Yes. You were a surgical registrar and I was your counterpart in the department of anaesthesia. As you remember, I became very fond of chloroform and started inhaling the gas. In time, it stopped giving me the “high” and I went over to heroin and pethidine because I could lay my hands on it easily in the hospital.

“Of course, I was caught because pethidine ampoules went missing from the anaesthesia trolley and then from drug cupboards in the wards. As for obtaining heroine from the black market, it ruined me financially and sometimes I was high when I was anaesthetising patients, and surgeons complained so the hospital set up a committee to investigate me quietly and ultimately caught me red-handed. They complained to the General Medical Council who barred me from practising anaesthesia for two years and deregistered me.”

As I was listening intently to his candid confession, he continued: “After two years my practising rights were restored and I got a job in the hospital. But it was difficult to ignore the stealthy glances from my colleagues and nurses in the theatre. I gave up the job and decided to apply for jobs abroad to get away from it all.”

“Did the fact that Kathmandu is the capital of drug peddling have any bearing on the choice you made to come here?” I asked.

“I suppose,” he replied, “unconsciously yes, but there was an opening for an anaesthetist in Kathmandu, so I took the job.”

Then he added, “God knows that they don’t need any drugs here, their religion and the ruling Ranas have given them enough dope to last a few generations.”

By then we had reached the CEO’s office where my taxi was waiting for me. I bid Dr O’Donoghue goodbye and went back to my hotel where Marie and the children were back from their shopping spree.


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Public officers above 58 years and with pre-existing conditions told to work from home: The Standard




Head of Public Service Joseph Kinyua. [File, Standard]
In a document from Head of Public Service, Joseph Kinyua new measure have been outlined to curb the bulging spread of covid-19. Public officers with underlying health conditions and those who are over 58 years -a group that experts have classified as most vulnerable to the virus will be required to execute their duties from home.


However, the new rule excluded personnel in the security sector and other critical and essential services.
“All State and public officers with pre-existing medical conditions and/or aged 58 years and above serving in CSG5 (job group ‘S’) and below or their equivalents should forthwith work from home,” read the document,” read the document.
To ensure that those working from home deliver, the Public Service directs that there be clear assignments and targets tasked for the period designated and a clear reporting line to monitor and review work done.
SEE ALSO: Thinking inside the cardboard box for post-lockdown work stations
Others measures outlined in the document include the provision of personal protective equipment to staff, provision of sanitizers and access to washing facilities fitted with soap and water, temperature checks for all staff and clients entering public offices regular fumigation of office premises and vehicles and minimizing of visitors except by prior appointments.
Officers who contract the virus and come back to work after quarantine or isolation period will be required to follow specific directives such as obtaining clearance from the isolation facility certified by the designated persons indicating that the public officer is free and safe from Covid-19. The officer will also be required to stay away from duty station for a period of seven days after the date of medical certification.
“The period a public officer spends in quarantine or isolation due to Covid-19, shall be treated as sick leave and shall be subject to the Provisions of the Human Resource Policy and procedures Manual for the Public Service(May,2016),” read the document.
The service has also made discrimination and stigmatization an offence and has guaranteed those affected with the virus to receive adequate access to mental health and psychosocial supported offered by the government.
The new directives targeting the Public Services come at a time when Kenyans have increasingly shown lack of strict observance of the issued guidelines even as the number of positive Covid-19 cases skyrocket to 13,771 and leaving 238 dead as of today.
SEE ALSO: Working from home could be blessing in disguise for persons with disabilities
Principal Secretaries/ Accounting Officers will be personally responsible for effective enforcement and compliance of the current guidelines and any future directives issued to mitigate the spread of Covid-19.

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Uhuru convenes summit to review rising Covid-19 cases: The Standard




President Uhuru Kenyatta (pictured) will on Friday, July 24, meet governors following the ballooning Covid-19 infections in recent days.
The session will among other things review the efficacy of the containment measures in place and review the impact of the phased easing of the restrictions, State House said in a statement.
This story is being updated.
SEE ALSO: Sakaja resigns from Covid-19 Senate committee, in court tomorrow

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Drastic life changes affecting mental health




Kenya has been ranked 6th among African countries with the highest cases of depression, this has triggered anxiety by the World Health Organization (WHO), with 1.9 million people suffering from a form of mental conditions such as depression, substance abuse.

KBC Radio_KICD Timetable

Globally, one in four people is affected by mental or neurological disorders at some point in their lives, this is according to the WHO.

Currently, around 450 million people suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.

The pandemic has also been known to cause significant distress, mostly affecting the state of one’s mental well-being.

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With the spread of the COVID-19 pandemic attributed to the novel Coronavirus disease, millions have been affected globally with over 14 million infections and half a million deaths as to date. This has brought about uncertainty coupled with difficult situations, including job loss and the risk of contracting the deadly virus.

In Kenya the first Coronavirus case was reported in Nairobi by the Ministry of Health on the 12th March 2020.  It was not until the government put in place precautionary measures including a curfew and lockdown (the latter having being lifted) due to an increase in the number of infections that people began feeling its effect both economically and socially.

A study by Dr. Habil Otanga,  a Lecturer at the University of Nairobi, Department of Psychology says  that such measures can in turn lead to surge in mental related illnesses including depression, feelings of confusion, anger and fear, and even substance abuse. It also brings with it a sense of boredom, loneliness, anger, isolation and frustration. In the post-quarantine/isolation period, loss of employment due to the depressed economy and the stigma around the disease are also likely to lead to mental health problems.

The Kenya National Bureau of Statistics (KNBS) states that at least 300,000 Kenyans have lost their jobs due to the Coronavirus pandemic between the period of January and March this year.

KNBC noted that the number of employed Kenyans plunged to 17.8 million as of March from 18.1 million people as compared to last year in December. The Report states that the unemployment rate in Kenya stands at 13.7 per cent as of March this year while it stood 12.4 per cent in December 2019.


Mama T (not her real name) is among millions of Kenyans who have been affected by containment measures put in place to curb the spread of the virus, either by losing their source of income or having to work under tough guidelines put in place by the MOH.

As young mother and an event organizer, she has found it hard to explain to her children why they cannot go to school or socialize freely with their peers as before.

“Sometimes it gets difficult as they do not understand what is happening due to their age, this at times becomes hard on me as they often think I am punishing them,”

Her contract was put on hold as no event or public gatherings can take place due to the pandemic. This has brought other challenges along with it, as she has to find means of fending for her family expenditures that including rent and food.

“I often wake up in the middle of the night with worries about my next move as the pandemic does not exhibit any signs of easing up,” she says. She adds that she has been forced to sort for manual jobs to keep her family afloat.

Ms. Mary Wahome, a Counseling Psychologist and Programs Director at ‘The Reason to Hope,’ in Karen, Nairobi says that such kind of drastic life changes have an adverse effect on one’s mental status including their family members and if not addressed early can lead to depression among other issues.

“We have had cases of people indulging in substance abuse to deal with the uncertainty and stress brought about by the pandemic, this in turn leads to dependence and also domestic abuse,”

Sam Njoroge , a waiter at a local hotel in Kiambu, has found himself indulging in substance abuse due to challenges he is facing after the hotel he was working in was closed down as it has not yet met the standards required by the MOH to open.

“My day starts at 6am where I go to a local pub, here I can get a drink for as little as Sh30, It makes me suppress the frustration I feel.” he says.

Sam is among the many who have found themselves in the same predicament and resulted to substance abuse finding ways to beat strict measures put in place by the government on the sale of alcohol so as to cope.

Mary says, situations like Sam’s are dangerous and if not addressed early can lead to serious complications, including addiction and dependency, violent behavior and also early death due to health complications.

She has, however, lauded the government for encouraging mental wellness and also launching the Psychological First Aid (PFA) guide in the wake of the virus putting emphasis on the three action principal of look, listen and link. “When we follow this it will be easy to identify an individual in distress and also offer assistance”.

Mary has urged anyone feeling the weight of the virus taking a toll on them not to hesitate but look for someone to talk to.

“You should not only seek help from a specialist but also talk to a friend, let them know what you are undergoing and how you feel, this will help ease their emotional stress and also find ways of dealing with the situation they are facing,” She added

Mary continued to stress on the need to perform frequent body exercises as a form of stress relief, reading and also taking advantage of this unfortunate COVID-19 period to engage in hobbies and talent development.

“Let people take this as an opportunity to kip fit, get in touch with one’s inner self and  also engage in   reading that would  help expand their knowledge.

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