As a Kenyan, you have 14 per cent risk of getting cancer before the age of 75.
For the past five years, cancer has been the third leading cause of death in Kenya, with numbers from last year’s Economic Survey showing that in 2017, 16,953 people died of cancer, up from 13,720 deaths in 2013.
Statistics from the World Health Organisation paint an even grimmer picture, with the Globocan 2018 report, showing that 33,978 Kenyans died of cancer in 2018.
Data compiled from the Eldoret and Nairobi Cancer registries, showed that the most common cancers in Kenya are breast, cervical, oesophageal and colorectal (bowel), with the most fatal being oesophageal and cervical cancer, which accounted for 14 per cent and 10 per cent of cancer deaths, respectively. Other fatal cancers were those of the stomach, prostate, bowel and liver.
While cancer is often seen as a disease of age (cells get damaged with age), In Kenya, six out of 10 people who have cancer are under the age of 70.
Further, the National Cancer Control Strategy (2011-2016), estimates that that a Kenyan has a 14 per cent risk of getting cancer before age 75, and a 12 per cent risk of dying from cancer before the same age.
For men, the most common cancers are prostate (15 per cent), oesophagus (12 per cent), colorectal/bowel (six per cent), Kaposi sarcoma (six per cent) and non-Hodgkin lymphoma; while for women, the most common cancers are breast (21 per cent), cervical (18 per cent), oesophageal (seven per cent), colorectal (four per cent), and stomach (four per cent).
There are some aspects of life that predispose people to cancer in ways we have no control over, such as age and genetics.
The longer you live, the more you are exposed to cancer-causing substances (carcinogens), and the more likely your cells are to get damaged and change in ways associated with cancer.
Then there are is the family history factor. If a close relative in your family had breast cancer, for instance, you might have inherited a higher risk of getting that cancer, but that doesn’t mean that you will definitely get cancer; it just means that if you carry the breast cancer gene, you are more likely to develop breast cancer than women with normal breast cancer risk.
Which brings us to the question, can we prevent cancer?
To some extent. While some risks such as age and genes cannot be modified, a third of cancer cases can be prevented by reducing exposure to the risks that make people susceptible to cancer.
These risks include tobacco (the largest single modifiable risk), obesity, physical inactivity, infections, alcohol, environmental pollution, occupational carcinogens and radiation.
When you maintain a healthy weight, adopt a healthy diet, incorporate regular physical activity to your life, reduce alcohol intake and avoid tobacco, you will have a lower risk of getting cancer than someone who leaves these things to chance.
How do Kenyans fare as far as these risks that they can do something about are concerned?
Avoiding tobacco: More than one in 10 Kenyans (13 per cent) report that they smoke or use tobacco, with one in four men (25 per cent), and less than one per cent of women reporting that they smoke.
A 2015 survey on risk factors for non-communicable diseases, including cancer, found that those who smoke daily, puff seven sticks on average, and that the mean age of starting smoking is 21 years.
Cigarettes are called cancer sticks for a reason – tobacco smoke contains at least 80 cancer-causing substances and is responsible for 22 per cent of cancer deaths. And it is not just the smoker who is at risk, inhaling second-hand smoke is just as risky.
When smoke is inhaled, the harmful chemicals pass from the lungs into the bloodstream and into the rest of the body, where they wreak havoc on cells.
The earlier one starts smoking, the more cigarettes smoked and the longer one keeps smoking, the higher the risk of lung, mouth and other cancers.
This is why the world’s tobacco control strategies (that include zero advertising, higher tobacco taxes, plain packaging, warning signs on packaging, and smoking only in designated smoking zones) came into being.
Maintaining healthy weight: Being overweight or obese (with body mass index above 25) has been linked to increased risk for 12 cancers, including bowel, pancreatic, endometrial, oesophageal, liver, kidney, gall bladder, breast, ovarian and thyroid cancer.
While overall obesity rate is six per cent, 33 per cent of women are overweight, while 10 per cent are obese. Excess weight is thought to contribute to cancer through inflammation, which can cause DNA damage, leading to cancer.
Moreover, fat tissue is linked to higher levels of oestrogen, associated with breast, endometrial and ovarian cancers, especially in postmenopausal women.
Healthier diet: Diets high in red meat, processed meats (sausages, bacon, salami, ham, frankfurters), salted foods and low in fruits and vegetables have been linked to colorectal cancer.
The World Health Organisation classifies processed meat as a group 1 carcinogen, while red meat (beef, pork, lamb, mutton, goat) is classified in group 2A (probably causes cancer).
Eating about three-quarter kilos of red meat a week increases your risk, as does every 50 grammes of processed meat consumed per day. The risk in red meat has been linked to processing and cooking (especially barbecuing and pan-frying), which causes carcinogenic chemicals such as N-nitroso compounds and polycyclic aromatic hydrocarbons (PAH), to form.
Moreover, nitrite and nitrate preservatives used on processed meat produce the same harmful N-nitroso compound.
The World Health Organisation’s classification of red meat as probably carcinogenic, means that other explanations for the observation that linked it to cancer, could not be ruled out. The recommendation then, is not to go vegetarian, but to reduce red meat intake to about a quarter kilo a week, and substitute it with chicken, fish, eggs, beans, lentils and mushrooms.
Physical inactivity: Seventeen per cent of Kenyans report being inactive, with 15 per cent of men and 19 per cent of women reporting being inactive.
Physical activity works together with maintaining healthy weight and consuming a healthier diet, to reduce excess body fat and the cancer risks associated with it.
Being physically active, described as at least 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic physical activity, or a combination, every week, can help reduce the risks of developing colon, breast and endometrial cancers.
Reducing alcohol intake: Men in Kenya take an average of 7.4 litres of pure alcohol, women take 1.3 litres, according to 2014 figures from the World Health Organisation. Alcohol increases the risk of bowel (colorectal) cancer, breast, mouth, pharynx and larynx (mouth and throat) cancer, oesophageal cancer, liver and stomach cancer. The more you drink, the higher the risk, though even moderate alcohol intake increases risk.
Infections: Viruses can cause changes in cells that make them more likely to be cancerous, as in the case of cervical cancer, which is caused by human papillomavirus infection. Hepatitis B and C virus can cause liver cancer and non-Hodgkin lymphoma, while the Epstein-Barr virus has been linked to lymphoma.
Helicobacter pylori infection, which causes inflammation of the stomach lining, has been linked to stomach cancer, while HIV/AIDS has been associated with Kaposi’s sarcoma.
Some of these infections can be prevented through vaccination. For instance, vaccinating children against the hepatitis B virus helps protect them against liver cancer, and while most children in Kenya have received the vaccine (83 per cent), a number who missed out remain unprotected.
For cervical cancer, vaccination against the human papillomavirus (HPV) which causes 99.7 per cent of cancer cases, has a protective effect. The HPV vaccine is usually given at age nine , before girls become sexually active, and exposed to the virus which is transmitted during sex.
The government has announced plans to vaccinate girls aged nine to 14 years from May to protect them against HPV infection.
Radiation: Prolonged and unprotected (without sunscreen) exposure to ultraviolet radiation from the sun can lead to skin cancer.
Exposure to ionising radiation from radon, x-rays, gamma rays and others may also increase the risk of cancer, especially for those who are exposed to radiation at work.
Screening: When cancer is identified early, there are higher chances that treatment will be successful, cheaper and with fewer side effects. Moreover, 30 per cent of treatable cancers can be cured if detected early.
However, in Kenya, eighty per cent of the cancers are caught at advanced stage. For some cancers, early detection begins with regular screening. For breast cancer, women are advised to conduct a monthly self breast exam to detect lumps, and to have a yearly clinical breast exam, with a yearly mammogram starting at age 45, in addition.
For cervical cancer, women should have their first test by age 30, and then have a regular exam every five years. There are also screening tests for prostate cancer and colorectal cancer.
Sources: Kenya Stepwise Survey for NCD Risk Factors; World Health Organisation; National Cancer Control Strategy; GloboCan 2018, National Cancer Institute (US)
Eighty per cent of reported cases of cancer are diagnosed at advanced stages, when very little can be achieved in terms of cure.
This has been attributed to the low awareness of cancer signs and symptoms, among other reasons. Some signs to watch out for:
Unusual lumps or swelling that may be painless and increase in size
Persistent coughing, breathlessness or difficulty swallowing
Changes in bowel movements – constipation, diarrhoea or blood in stool
Unexpected bleeding from the vagina or anus; blood in stool or urine or when coughing
Unexplained and unintentional weight loss over a short period of time
Fatigue. Extreme tiredness and severe lack of energy, usually with other symptoms
Unexplained pain that comes or goes or unexplained ongoing pain
New mole or changes in size, shape or colour of mole or skin. Mole that becomes crusty or bleeds or oozes
Needing to urinate urgently, more frequently or unable to pass urine or pain when urinating
Unusual changes in breast size, shape, feel, skin changes and pain
The human body is made of a trillion of cells, which grow old and die, or get damaged and die, and are replaced by new cells.
When the mechanism that regulates normal cell growth and death works, cells grow and divide to form new cells as the body needs them, and die when the body doesn’t.
If some cells keep dividing without stopping (divide and grow out of control) and spread to surrounding tissues, that’s when cancer begins. The normal process has broken down and the abnormal takes over.
The abnormality happens because of changes in the cell’s genetic material, which cause a breakdown in the normal mechanism that regulates cell growth and death. These changes are caused by age or when genes interact with risk factors such as radiation, tobacco, aflatoxins, or viruses, among others.
In the abnormality and breakdown, old and damaged cells no longer die. They survive and new cells, without specific function, form when they are not needed.
These extra cells divide without stopping and may form growths called tumours (solid masses of tissue), though blood cancers do not. If the tumour is benign, it usually poses no harm, unless it is interfering with other body organs.
If it is malignant (cancerous), it can spread or invade nearby tissues. And as it grows, it spreads by breaking off, travelling through the blood or lymph system and making a new home in a location away from the original tumour.
There are more than 100 diseases characterised by uncontrolled growth and spread of abnormal cell, which we know as cancer, and they are categorised into several types based on where they begin.
Carcinoma begins in the skin or tissues that cover organs.
Sarcoma begins in bone, cartilage, fat, muscle blood vessels or other connective tissue.
Leukemia starts in blood-forming tissues such as bone marrow. Lymphoma and multiple myeloma begin in cells of the immune system.
Carcinogens: Cancer-causing substances
Carcinogens are substances that change how a cell behaves, thereby increasing the chances of developing cancer.
The International Agency for Research on Cancer has listed more than 100 group 1 carcinogens, after evaluating the cancer causing potential of more than 900 substances.
Some of the substances are categorised in group 2A, which means they are probably carcinogenic, while those in group 2B are possibly carcinogenic.
Substances in group 3 are unclassifiable as carcinogenic, while those in group 4 are probably not carcinogenic. The following fall in the list of known carcinogens (group 1).
Acetaldehyde (from consuming alcoholic beverages)
Arsenic and inorganic arsenic compounds
Asbestos (all forms) and mineral substances (such as talc or vermiculite) that contain asbestos
Coal (indoor emissions from household combustion, gasification)
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.
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).
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.
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.
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.
“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.
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.
As part of aggressive campaigns for his presidential bid, the DP, who views the former Prime Minister as his main challenger in the 2022 polls, will begin his tour in Migori and Kisumu in the third week of July, and thereafter Homa Bay and Siaya in the last week.
The DP has rolled out a ground operation that includes United Democratic Alliance (UDA) party and aspirants’ regional forums, regional economic forums, allowing affiliate political parties to sprout without the demand that they merge with UDA and assembling a wide array of professionals to front his presidential bid.
In a politically changed environment unlike the one in 2017 when he was an influential voice in government and the chief campaigner, DP Ruto now finds himself technically being the head of the opposition after the acrimonious fall-out with the President.
The relationship has worsened further after President Kenyatta’s truce with the ODM leader, his main challenger in the 2017 disputed presidential vote, thus alienating the DP further.
His allies say he’s building the infrastructure that will help him win decisively in the first round in next year’s presidential election.
Leading the preparations for the DP’s Nyanza tour is Mr Odinga’s former aide, management consultant and strategist Eliud Owalo, who is also the convener of the Luo-Nyanza Economic Caucus.
Yesterday, he said the DP will start his Nyanza tour in mid-July for what he termed an intensive grassroots tour aimed at campaigning for his presidential bid.
“The leader of the Hustler movement, Deputy President William Ruto, will make an intensive grassroots tour of the four Luo-Nyanza counties within the second half of the month of July.
In the two-legged tour, he will first visit Migori and Kisumu counties in the third week of July 2021 followed closely by a tour of Homa Bay and Siaya in the fourth week of July 2021,” read a statement sent to newsroom, which Mr Owalo signed.
Apart from the meet the people tour, the DP is expected to attend church services as well as continue with his economic empowerment programmes for youth and women groups.
The DP is expected to use the tour in his political opponent’s backyard to popularise his bottom-up economic model.
The region has always voted overwhelmingly for the ODM chief in the past elections.
“We want the Luo Nyanza region to lay its stake in any future governance dispensation on the basis of a responsive and feasible development agenda for our people as opposed to positions that individual members of the community will be holding in that government,” Mr Owalo said.
The DP started courting the region last year when Kapseret MP Oscar Sudi hosted more than 100 youths from Nyanza under the umbrella of “Nyanza Youth Movement for Ruto 2022” led by Mr Stephen Midenyo aka Mada and 2013 Rangwe Parliamentary candidate Everest Okambo.
A year ago, as part of a broader plot targeting the region, Mr Sudi and his Kiharu counterpart Ndindi Nyoro made a discreet visit to Bondo and Kisumu counties in what they described as “private functions” but which had a strong political inclination.
A week ago, Migori governor Okoth Obado, who is viewed as a rebel in the region, was hosted by Mr David Ruto, the DP’s brother.
The plan, Mr Sudi says, is to target the youth, women’s groups and the church to reach out to the Nyanza populace and lure a significant number of voters to join DP Ruto’s bandwagon.
“We’re reaching out to the whole country because the hustler movement is not confined to a certain region,” Keiyo South MP Daniel Rono told the Nation.
A meeting convened by Mr Owalo at a Nairobi hotel in mid-May had many former foot soldiers of Mr Odinga attending. They include those who decamped after losing ODM nominations in 2013 and 2017 elections, among them former Kisumu Governor Jack Ranguma, former Rongo MP Dalmas Otieno and former Rangwe MP Martin Ogindo.
Also in attendance was Citizen’s Convention Party (CCP) leader Grace Akumu.
UDA Secretary-General Veronica Maina told the Nation that in their recruitment drive, Nyanza is not left out. The party’s clerks, she said, are stationed in the region.
Won’t bear fruit
Mr Odinga’s troops led by Suba South MP John Mbadi have been on record saying that such meetings won’t bear fruits for the DP.
Mr Mbadi said the DP needs to understand why people of Nyanza associate with ODM and believe in Mr Odinga. The DP is also said to be making inroads in Mr Odinga’s other support bases of Western and Coast.