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February 21, 2019

Why oral literature is crucial for success in public health

Kikuyu youths at the  Kikuyu's kiruugu feast in Laikipia West. Those born after 1980 may not know tetanus
Kikuyu youths at the Kikuyu's kiruugu feast in Laikipia West. Those born after 1980 may not know tetanus

Much of everything we do every day we forget. At the most basic physiological level we breathe, our heart beats so many times a minute, we are aware that this is happening but no more. In our interaction with the environment we hear sounds, some reassure like certain birds that herald morning, others are stressful like the sound of traffic not moving. Even those things that we actively participate in trying to read for some exam, or remember a good joke to tell a friend we struggle to remember every detail in the exact order. To remember something we often need some significance to be attached to it, a birthday perhaps, or some other event occurring to link the two.

And even then there is a lot of evidence to suggest that people remember what they ‘want’ to remember rather than the ‘true’ facts. Narratives change over time. In school, one the lessons learned was that African literature was oral passed down in the form of stories — spoken not always written. The problem with this is that it requires the person with the story to sit down and tell it, and the people listening to pause and take it in. Yet the ever evolving structure of our society suggests that this becomes more and more difficult with time.

Around Christmas time is when most of us take a little break look for family and spend time together. A constant news item around every December 24 is that of desperate families trying to get up-country, mattress cooking stove and all. Supermarkets in smaller towns empty as city types empty out the aisles. That is the cultural side of us.

The official side of life does the counting in the middle of the year June 30. That is when the average population for the year is recognised. In 2015, the population of Kenya is 46,750,000 people. Our population growth rate is still one of the highest in the world because of a high birth rate. It means means that we should not dismiss the story that follows at the beginning of the year of parents trying to get school supplies as, ‘How boring’! Because it is a new story every year because an every increasing number of children have joined the bandwagon.

The story becomes worrying at the health level because to stand still is to fall back. Children are the most vulnerable of the population to ill-health. Their immune system is less developed, they do not have the means, either knowledge or financial to seek healthcare when they most need it. They need adults to do this for them. This is why public health programs like vaccination are so important. One vaccine like diphtheria-pertussis-tetanus (DPT) vaccine immunises against three horror diseases. It is given to babies in the first few months of life, yet gives life long protection.

Much older people in their 60s and 70s or those from very remote areas may recall a case of tetanus, but most Kenyans have been born after 1990 and so have little first hand information about such diseases. Yet that is not to say that Kenya is free of such diseases. The immunization statistics give a picture of relative success.

From the 2014 Kenya Demographic and Health Survey about 89.9 per cent of children aged 12-23 months had received the DPT vaccine, which is good. But this means about 160,000 children more than the population of Machakos or Thika or Nyeri towns missed out on the vaccination.

Perhaps the reason it does not strike many as serious is because we no longer hear stories about what the disease are. All are diseases caused by bacteria; Diphtheria and pertussis start off like any other upper respiratory infection with sore throat, fever and weakness. In both the throat gets covered in thick mucus, which in the case of diphtheria is greyish in colour and is so tenacious it can suffocate the patient. Pertussis the patient has a characteristic ‘whooping cough’, but also has symptoms of vomiting. Tetanus is a little different because the patient presents with spasms and stiffness in the jaw muscles, difficulty in swallowing accompanied by fever and a rapid heart beat. Spain, a developed country, reported a case of a six year old boy dying of diphtheria because the parents did not take their child for vaccination. That is one case and it made headline news. What of us in Kenya where every year the equivalent of a major town are not protected?

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