In the rural areas, dogs have a much more devolved status compared to dogs in urban areas. The urban dog is at best confined to a compound. More and more the norm, the urban dog is becoming small, white and fluffy and is found in an apartment.
The urban dog is bought and brought for food. The food will contain ingredients that make it ‘balanced’, ‘natural’ and ‘nutritious’.
At regular intervals, the person employed by the owner has to walk the dog. The rural dog lives a different lifestyle.
Technically it has an owner, the person mostly likely to throw it some bones on days when meat is eaten; but for all practical purposes, the dog forages for its own food just like all the other animals in the homestead. It would therefore not be unusual to see a rural dog leave the homestead alone, trot into the bush, hunting for a nutritious and fresh meal.
The different lifestyle creates dogs that look and behave different. Urban dogs sit around more and so are more likely to grow fat. They also bark more.
There could be several reasons for this. It could be that living such a pampered life requires broadcasting, how else to explain the many radio stations where the presenters talk, but the listeners gain little by way of knowledge.
It maybe that the rural dog appreciates danger more, both internal and external, animal rights are less enforced, and so is much more careful about making noise.
Picture a scene where you are woken up at 1.45am by a dog barking, a short hacking bark; which when you finally realise is not going to stop drags you to the window, head smouldering with anger and you begin to shout, ‘Shoo’! Stop it! Is an urban one.
The lack of pebbles in the house means that there is nothing to throw at the silly dog, and the small heavily grilled windows we build as part of the vision of a middle income country means there is a risk of a missile not making it through any window opening anyway.
We are left frustrated; marvelling at the capacity of the person appointed to oversee security sleep through such episodes. But it may not be a totally bad time to be awake, once in a while.
This is the time to listen to the other occupants in the house. If all is quiet, all is well, but if you hear someone with a cough then pay attention.
Coughs come in all kinds of shapes and sizes. There is the purulent, productive chesty cough where the person is obviously sick and the cough drains them to the extent that they collapse back into themselves after every coughing bout. Such people are quickly rushed to hospital.
There is the cough of self-importance made in meetings where the person wants to draw attention to themselves. Such are best ignored, though it is good hygiene to remember not to shake their hands thereafter.
The cough that you need to monitor is the cough that is short, one or two coughs long, the person not quite ill, but there is something in their eyes that is not quite right and on listening long enough, persistent.
During the day, the persistent nature of such a cough is easy to miss, we rarely pay attention to each other to notice.
At night however, the silence, the TV and computer off, make it easier. A dry regular cough needs investigation, especially if having been woken up twice in a month by the barking dog you realise that the person still has the cough.
If the person complains about the nights being unusually warm and is not eating as well as they could be then it may be something worse that an ordinary respiratory tract infection. It could be tuberculosis.
Kenya is one of the countries that has a high rate of TB infection. The problem with TB is that the bacteria that causes it is, relative to other bacteria, slow growing and so treatment takes a long time, up to six months of antibiotics.
TB bacteria are opportunistic attacking people with lowered immunity, so our high rate of HIV contributes significantly to our TB burden.
Crowding in houses, poor hygiene, that is poverty, are some of the underlying factors that maintain the bacteria. Kenya is one of the most unequal countries economically in the world. So being rich alone does not in itself reduce the burden of TB.
Your poor neighbour in the overcrowded slum across is still breeding the stuff.
Diagnosis is done by taking a chest x-ray and checking the cough sputum for TB bacteria. About 100,000 cases were diagnosed in Kenya in 2012. Contact tracing to prevent more cases of TB is vital so anyone who has been in close proximity with a TB patient needs to be checked.
So if you are woken up by your neighbour’s barking dog and cannot go to sleep immediately, do not sit up counting sheep or your debts. Count instead all the people you have met during the day and who do not have a cough.
If that is too morbid, then spend time with your watchman and get the secret to a good night’s sleep.