OVER-COMMERCIALIZATION OF HEALTH CARE THE SCOURGE OF OUR TIME

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              rom the advent of the 8-4-4 education system, each and every year Kenya has developed a tradition of lionizing and proffering a copious outpouring of publicity upon the best performers in the K.C.P.E and K.C.S.E examinations. For the former prepubescent teenagers and for the latter young men and women are hauled shoulder-high by their definitely well- fed progenitors in pomp and pageantry for exemplary performance. Drum-beats and ululations rend the air in a manner likely to dissuade any inebriated villager who is not in the loop of the foregoing from the impression that celebrations are not in any doubt a foot. If you are one of these unfortunate characters sleeping in the culvert, you could be forgiven for thinking in the polemics of the great African linguistic legionary and wordsmith; Chinua Achebe, “a great titan and wrestling champion of all the seven villages has crossed the seven rivers, hills and the evil forest, gone to the land of the gods, conquered them including his personal Chi and returned unscathed with a tooth of one of deities; his spirit intact.” Back to the celebrations, of course members of the fourth estate and bloggers like yours truly are in attendance with high powered cameras, notepads, pens, outside broadcast equipment and all the requisite paraphernalia of the trade to cover this seemingly inimitable fete. For the primary school graduands, each and every one of the omnipotent students has more or less similar ambition. They seem cut from the same cloth. “I aspire to be a Doctor.” Another, “I feel the predilection to be a Neurosurgeon.” Why we still have only 8 neurosurgeons countrywide after nearly 30 years of the 8-4-4 is a matter I will leave to conjecture! But why is it so attractive to be a medic in Kenya? That is the question I am going to tackle in the subsequent paragraphs of this post.

Many will accuse me of being green with envy for the practitioners of the noble profession. Far from it! All the same, I must aver with unquestionable conviction and unerring contrition that I have never had any aspirations to be a doctor and as such I habour nothing but awe, appreciation and adoration for the practitioners of this trade. For me a spattering of blooded cotton wool is sufficient cause for institutionalization for trauma let alone witnessing a squirting of the life-sustaining body fluid from a severed limb! You may have realized I used the word ‘trade’ instead of ‘calling’ as it should be. It is not a misnomer but a pointer to the great value that should be accorded to the medical profession but is not. As a player in this field, you are no less second to only the Almighty in the words of the saying, ‘Doctors treat but God heals.’ You carry our lives in your hands at the moment we are most vulnerable and have the propensity to either nurse us back to health or at the drop of the surgical cap consign us to the morgue and ultimately the 6 Sq. Ft confines of the nether real-estate! This is vital more so in a developing nation where human capital is the principal factor of production and progression of enterprise. We need men and women in good health to drive the often poorly-lubricated cogs of our economic gear. However in Kenya, mostly in private hospitals this is treated as more of a trade than a calling which is objectionable.

Let me go through the chronology of qualifying as a doctor in Kenya. As stated before you have to be one of the bright intellectual outliers of your generation able to score an ‘A’ in Mathematics, the two national Languages, the three sciences and almost any other course you will take to hold up your aggregate mean. Then you are admitted to a registered and chartered University to slug it out for 6 years through courses like Physiology, Anatomy, Pathology and Parasitology. (There are others intentionally omitted with a view to provide you an abridged insight instead of an encyclopaedia for a blog!) In short you have to be adroit at internal medicine and what the French call ‘Chirurgie’ - Surgery to make it through.  Afterwards, you graduate with a Bachelor of Medicine and Surgery Degree (MB. ChB). During your graduation ceremony, there is a session specifically to recite and promise to ascribe to the ‘Hippocratic Oath’ for the preservation of Human life no matter the myriad distractions that may attempt to lay an incursion on your path. This is just the preliminary stage!  You then must serve a compulsory residency as an Intern under consultants for a period not less than a year. Following that, one works as a General Practitioner (GP) for some time, gauging their strengths, weaknesses, passion, opportunities and threats before deciding to master and specialize in one of the fields he best desires or is apt in performing. Then, one may decide to go for a sub-specialization on the field. Afterwards, you take an exam to ascertain your suitability to serve under the ambit of your professional licensing body, the Kenya Medical Practitioners & Dentists Board. This entire process may take as long as 12-14 years from the time one is admitted to University to when you are finally licensed to do all that pertains to nursing humanity back to health.

Noble as it may seem, there are others who will look at the period they spent in school as one of lost opportunity for the age-old ‘primitive accumulation of wealth’. They will cast their eyes far and wide and espy the jet-set lawyers, the Engineering braggadocios, the architectural aficionados, pilots and commerce practitioners seemingly reveling in corpulence and vain symbols of status. Riding in Toyota V8s or Range rovers, they will suffer the ignominy of seeing beside their contemporaries a beautiful bride; two healthy and rambunctious children admitted to the local versions of Ivy-league schools, pilots traversing the world enjoying life while getting paid by the truck-load. Their age-mates own land, real-estate, businesses and property almost to the moon! They find themselves muttering under their own breath, the quintessential Jomo-Kenyatta query, “woe is me, what have I done for myself by the ripe old age of 33?” Apprehension sets in as Medical Practitioners are caught scrambling to catch-up with their peers. They rent a backstreet alley; lo and behold, the Private practice has been set up. To remove any untoward elements from this narration for any aspiring doctor, it is never always like this; however, This is Kenya! (https://www.youtube.com/watch?v=lug6cupwmIw ) and (https://www.youtube.com/watch?v=T7uzheM1nGk ) Warning: I pay credence to the gifted owners of all copyright to the material ensconced within the two URLs above.

Men and women; supposedly the custodians of our public health care systems, find themselves juggling the conundrum that is their calling in Public hospitals vis-à-vis commercial interests. Some even go the extra mile of burning the midnight oil as lecturers. Sooner rather than later also due to economic pressure, commerce triumphs over calling as one realizes that he will mint more money apportioning extra time to his Private clinic as opposed to the well documented and predictably meagre pickings that is the government salary. The hustle is real out here and many are oft vulnerable to break-down under its weight and find themselves in the hallowed waiting room of these private facilities. For salaried and unionizable employees the allure of the fully-catered for medical insurance package is too coercive for a private medical practitioner to resist. Cases of men who bumped their head on the low-lying canopy of a ‘ma-three’, got a gargantuan bruise which had them worried sick so they ran to their ‘family-doctor’ to have a check, had CT and MRI scans recommended to them on top of the consultancy fees, were misdiagnosed with brain damage and had to be wheeled into surgery have not been few and far between. Besides, how callous can one get to recommend unnecessary treatment merely for pecuniary gain! Who does that?

Costs for all medical consumables like bandages, scalpels, splints, band-aids and the requisite medicine are hiked ostensibly to take advantage of that much touted item of good fortune, the NHIF. A deworming tablet sold over the counter at 20-30/- is now extrapolated to the irreverent figure of 150/- . All this in an effort to make hay while the sun-shines! In the week starting Monday 26^th November 2018, the social media platform - Twitter was awash with a trending hash tag #JusticeForBentaOpande . This as told in the grapevine is the harrowing tale of a lady who had incessant back pain that was rife on her to the extent of seeking medical redress. She casually drove herself to hospital, had the requisite tests and scans performed on her including the precursory X-ray just to determine where the problem was. Things were not looking good. She had slipped albeit weakened lumbar vertebrae that required firming and strengthening. After a studious look of the results a neurosurgeon ostensibly recommended the only course of treatment as surgery. To the untrained eye this may or may not be an over-kill. I chose to believe it was all for the best. In an episode as tear-jerking as any, on the appointed day the Civil servant drove herself and her two young daughters to hospital. As they held vigil for her praying and hoping, she was wheeled into surgery. In the ensuing macabre occurrence that has blurred the frontier between surgery and the handiwork of a butcher man the procedure was botched. Screws, washers, nuts and bolts were all fastened on her spine callously disdaining her animate state. The aftermath is all too gruesome to relate but I will try. The pain was amplified and as if this was not enough she started losing sensation on her right-side. Her right leg absolutely paralyzed if not utterly atrophied. Her distraught daughters could not stomach their grief when they were finally allowed to see their mother. Tears streamed down their faces as they surveyed the current convalescent state of dear mum. For the daughters it was familial concern and empathy while for Mama Opande it was mortal pain and infernal agony. To add insult to injury this exclusive private hospital also withheld her title deed as collateral if she failed to clear the bill! She had to be flown to India for more specialized care. The question I must now pose is this: Was this surgery really required any more than advise on posture, back pillows, proper comportment and popping of calcium tablets that can be opined by an ordinary chiropractor? In the backdrop of the new X-ray footage obtained, was the screw-up job performed by experienced orthopaedic surgeons, interns or a run-of-the-mill wielder of the proverbial meat cleaver? Could this be categorized as a case of medical negligence? Let the professionals at Kenya Medical Alliance in concert with Dr. Oluga and the Dr. Orokos of this world at KMPDU determine the case instead of opinionated albeit ardent Viu-Sasa medical-drama junkies like yours truly on the court of mere hearsay!

I would wish this case was an isolated one but not in the least I have one that hit close to home. In late 2009 my father was involved in a road accident that wrote off his vehicle and saw him fracturing a right humerus. He was more fortuitous than most escaping the ordeal with a slap-on-the-wrist style bruised thigh, clavicle and the aforementioned vertebral tid-bit. Grinning and singing the token, “Hakuna Mungu kama wewe…” number he was wheeled into theatre to fix the crocked appendage. He stirred up in some agony but this was to be expected of any surgery. After one and a half weeks he was discharged back to his solicitous kinsmen for some tender loving care. Then after a week instead of the pain abating it ingrained itself. Sleep became a luxury and analgesics became anything more than candy. He was compelled to return to the same private hospital. Prima-facie; the joint looked to be healing, but on close quarters it was clear the titanium plate had not been well secured. Screws had been drilled into the bone but the plate was still mobile and as such a second instance of surgery was required. After surgery #2, problems persisted and a secondary opinion was sought. Incidentally, after the third surgery dad was fixed although he had to suffer the ignominy of learning how to write with the left-hand in middle-age. On aesthetics; post third surgery, the clean-cut incisions of the first surgery were blurred such that his arm looked like tapestry out of a dog’s mouth! This raises another red-flag. Can a GP or let’s say gynaecologist perform orthopaedic surgery with the finesse of an experienced specialist? My Dad is living proof they should not, though he regained functional use of the limb in 9 months’ time. Heavy lifting is proscribed though we proffer orison to the Lord daily for that act of divine providence. But how many Kenyans can count on such in the absence of financial muscle and the uncanny happenstance of finding the right remedy? A drunk and bluntly honest sage once quipped, “The missteps of an engineer are fortified but those of a doctor are buried!” (https://twitter.com/dennis_mukoya/status/1067365514526277632 ) It’s that stark.

In a latter post, I will divulge the 1001 demerits of allowing Health care in Kenya to be a devolved function! That was an ill-advised policy step, megalomaniacal at worst and pandering to popular benightedness at best. Yes, I said it! But today I will delve into characters of the ilk of Mugo wa Wairimu who has gained notoriety by tapping into the gravy train that is Private Medical practice in Kenya. With absolute disregard to any form of licensing, respect for neither the sacrosanctity of human life nor limb, answering to no higher call of the Hippocratic Oath and with stereotypical love for the lucre; he set up shop in Githurai 44, Nairobi. No one would have realized the aberration in this circumstance if the monster within had remained bottled up. Operating a gynaecological practice is not for the faint-hearted and when I say this I mean it with all the fallibilities and perversion that may come with it for the sons of Adam. As men we are physiologically predisposed to be attracted and display manic affection for the most favoured mate. Years of scholarly pursuit logged in the pedagogical development of Medical learning, eon of wisdom thereby inculcated and a new-found appreciation for professionalism are supposed to tame the animal instinct in a man! A Doctor is duty-bound to abide by a higher sense of ideal and morality than the ordinary man but not the aforementioned -wa Wairimu. On the 1^st of November 2014, a young woman sauntered into his clinic coaxing within him a fire of the manner he was ill-accustomed to resist. Like a hyena; the faux-medic sized up his prey, the unsuspecting victim eloquently describing her symptoms in abeyance. In the back of his mind he already had a prognosis. A dose of ‘sugarcane’ would do! He sedated the damsel, had her half-dead, licked his lips, pulled down his trousers exposing an appendage that looked like a half-consumed piece of firewood and in typical sociopath-narcissistic fashion proceeded to hit pile-drivers into the woman if you get my drift. The ensuing fiasco is all too graphic for the church-boy in me to countenance! When the lady came back to her senses she had not been treated of her ailment, reeked of the pungent odour of ‘human-seed’ and was absolutely slovenly in dress. What she did not know was that a heinous crime had been perpetrated against her person and she carried within her an impromptu zygote. You all know how it went when the lady discovered this and pressed charges. Lady Justice was hot on his trail. From Makuyu, to Thika and finally to Gachie where the long arm of the law caught up with Mugo. He was nevertheless, in stupefying fashion let go with nothing more than a whimper as retribution and continued his illicit medical practice. In late 2018, the same character has hit the headlines yet again for similar shenanigans! Apparently, the Kenya Medical Practitioners and Dentists Board does not have anyone fitting his profile in their records and as such have no jurisdiction to take any action on him, the allegations and his illegitimate economic venture notwithstanding. What??? Also the limitations of statutes may have lapsed and the legal arm has been decapitated against this predator. Double what?? A case of moving rivers to escape the riparian reserve! 

What makes private medical facilities so attractive to everyone? The crucial stricture here is having a doctor who takes seriously to the professional code of ethics, viewing his gift as a calling and not merely a trade. The well-oiled establishments they man have a 24-hr fully functional medical team, an in-patient and out-patient unit, fully furnished medical supplies repositories, well remunerated and fervent staff, a sufficient number of  well-spaced beds, no linen reeking of urea, private suites for the contagious, presidential suites for VVIPs, clean hospital wards, a well-articulated and thought out strategy for the assimilation of health insurance, fully-furnished & serviceable ambulances, an onsite morgue and milky-white walls with attractive signage. Accountability is the common denominator. The most important thing is client referrals from those who have enjoyed the ambience of the same and have lived to tell the tale after visiting the facility. Keeping mortality rate low is an added advantage. I reiterate and urge the current Health cabinet secretary to implement a framework that will have Health reclaiming its lustre as a calling and not a cash-cow for the uninitiated yet moneyed investor.

RAISING TAXATION FOR ESSENTIAL GOODS WILL BE COUNTERPRODUCTIVE FOR A DEVELOPING COUNTRY

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rom the Bible, there is recounted the tale of some hostile inquisitors who sought to box in Jesus, the much heralded ‘King of the Jews’ into an explicitly perilous position. Their grouse was on whether his compatriots should continue to pay taxes to the Roman Government or simply withhold it till they have their own dominion. They anticipated a scenario where Jesus would take an adversarial stand against the norm and therein find a suitable excuse to hand him over to the Governor of Judea, Pontius Pilate for treason. Thinking of him an ordinary man, they attempted to massage his ego by praising his integrity, altruism, sense of justice and unwavering adherence to virtue. Having tenderized their prey, the Pharisees and Sadducees took their chance to drop the gauntlet and pounce. He preceded his defense by dubbing them “hypocrites” and “sons of the serpent.” Then with the much vaunted slipperiness of an eel he asked to be shown a Roman coin. He asked whose head and inscription featured prominently on it and the answer immediately rang back, “Caesar!” In a sagacious response he told them to render onto Caesar his due and onto the Lord what is God’s. He left them with the double whammy of being both in awe and satisfaction as they went on their way.

But the real question they forgot to ask is how much should we pay to Caesar?

A few weeks ago there were acrimonious scenes in the National Assembly of Kenya as the President in typical African strongman style buttressed the passing of the Supplementary budget and appropriation bill in consort with the majority and minority leaders, afterwards rushing to assent the act into law. This was in spite of the rare scenes of parliamentarians united in a gesture transcending party lines, proffering copious outpouring of hue and cry against the expropriationate measure to levy 8% taxation on fuel. They had in one voice cried “Nay!” when the motion of intent to levy the percentage of tax was tabled before the house. Despite that deafening roar, the “ayes” had their way. As the Social Media generation would put it, “Handshake Things ™!” Naturally, with politicians and their chameleonistic nature it is rather difficult to sift among the wheat and chaff for their true intentions. As they say, Politics is a game where loyalties are transient while interests remain supreme albeit common! My brief here today is not to wade the murky waters if not the clandestine interstices of what is fact or fiction but to rather scientifically and inextricably extrapolate the graphical hanging lines that are the potential fall-out from the raising of taxation on essential goods in the backdrop of a financial downturn.

Kenya is regionally renowned as the land that has fiercely embraced capitalism to such an extent that we have mangled up whatever would have been made of its human face! The repercussions are clear for all to see. For instance, the same brand of vehicle is to be imported by our landlocked neighbours, Uganda through our Kenyan Port in Mombasa. After going through the requisite statutory licensing it is conveyed onwards to the Malaba border, carted 1000 Kilometres into Kampala. The shock does not lie in this long drawn out transportation modalities but in the price differences with the same brand in a Kenyan Motor vehicle showroom. Many a plastic surgeon have had to thank their good fortune from the burgeoning number of reconstructive surgeries performed on Kenyans collecting their jaws from the floor after information on prices filters through! This is of course in jest. The Kenyan price is markedly higher. But not quite, as the cost of doing business is impossibly high in Kenya compared to our regional neighbours and even some continental superpowers. However, let us revert to microeconomics. A few years ago, as the Professor teaching us Engineering economics harped on about taxation we were merely being lulled into slumber not paying much credence to his ‘voice crying out in the wilderness’ brand of teaching. He started by terming Taxation as a ‘Pecuniary’ imposition by the government on its citizenry. Then he added terms like ‘ad-valorem’ when many of us had been left still grappling with the meaning of the P-word! Today, we wish we were more attentive. Nevertheless, what did not pass us was the Principle of Taxation stating, “High Income taxes rather than bolstering enterprise only work to discourage production while killing the morale of employees. A good tax system should be at a rate concomitant with promoting economic activity.” In the same token, it is no wonder that our Litigator-in-Chief, Okiya Omtata went to court asking for a reinstatement of the moribund ‘Moi-Day’ and in appreciation of public sentiment the High Court Judge assented. This was irrevocably supposed to be an antiquated relic of a time simply worth forgetting, but if the people want a holiday who was he to refuse? Even he may have felt the exertion of working so hard merely to raise more taxes for the government. Shouldn’t there be dignity in doing work and appreciation of the role of taxes in nation building? How is industrialization to be achieved when people celebrate imposed holidays more than economic development?

Widening of the tax-base has variously been opined as one of the ways to raise more taxes. What I mean is being more innovative with our tax regime. Some have even opined that in view of the widely popular yet covert use of marijuana it should be legalized and join the tax-generating bracket. For this one the jury is still out. However in keeping with the letter and spirit of this post, we must not tax so much as to drown enterprises under the mire of double taxation. It is a well-understood fact that agriculture and the Small & Middle Holdings are the essential pillars holding up our economy. As such rather than over-taxing the Government aficionados at the treasury should look at means to subsidize instead of exacerbating what is already being levied on these two facets of society. Many SMEs and Start-ups exist poised on the periphery of survival. A minuscule shove and they are off the cliff of actuality. Many are the heart-rending stories of the proverbial young man running his ‘kibandaski’ being on the verge of recompense of his capital investment loan and finally breaking even. He is just one installment repayment from completing the loan when the 8% VAT starts getting levied on fuel inflating the cost of all his factors of production, some of which he previously got for free. The situation becomes so untenable that he is unable to meet his standing–order obligations and his business is repossessed by the affected financial institution and auctioneers. I cannot fathom a situation more soul-sapping than someone being on the path to financial independence in a thriving enterprise being suddenly robbed of all the fruits of his toil, thrown back into the simmering cauldron that is the millions of job-seekers scavenging for mere sustenance. From prosperity one is knocked back into the rat-race for survival. Reminds me of the high school Short Story by Ezekiel Mphalele, ‘Man must live.’ Men will accuse, castigate, deride and even ridicule you. They will accuse you of insubordination and a lack of respect for them in your confidence, they will accuse you of dishonest dealing in business. They could deny all they want but in the fullness of time one is compelled to wake up sooner rather than later to the hard, cold and indisputable reality that man must live!    

Our tax regime is simply too complicated! Among the Cardinal Principles of Taxation is one of being explicit and simple. Many people are just ordinary folk, law-abiding citizens, with simple ambitions to raise their children, build a small house and basically enjoy life. For them a simple tax regime is exactly what the doctor ordered. Not only will it be easier to comprehend and hence comply with their liability, it will also reduce administrative costs of revenue collection. This cannot be made any easier by double taxation. When the same enterprise pays for business permits but is still charged KShs. 50 daily by county officials as operating fee something will have to give. Costs of doing business in terms of Capital and Operating expenditure being what they are it is acridly immoral to add to the same and still preach the gospel of economic emancipation for those affected. Some evade tax by default not by design. This is merely because they do not know what is to be taxed and what isn’t. But instead of enlightenment they are usually harshly admonished, condescendingly being reminded that their ignorance is no defence and charged huge penalties in fines for non-compliance. Civic education on tax implications is lacking despite politicians eternally preaching to us the self-serving gospel of an acute shortage of nincompoops in Kenya, majorly buttressing home the fact that any education will not only be appreciated but rapidly internalized and put into proper use. There are cases of systems failure on the i-tax portal where you register for a specific tax obligation, the ostensibly automated system gives you an acknowledgement, even printing a registration certificate, contented you go home. Come the appointed time to file returns you in great horror and consternation realize the obligation you enlisted for isn’t in the list of those to honour! Optimistically, in your considered opinion decide that in filing the others, the spirit will be deemed willing concerning the hidden obligation and the gesture appreciated by the Kenya Revenue Authority. Days later, you receive a spine-tingling notification. You owe the government a fine of 20,000/- for failing to file returns in good time and the system has conveniently rather miraculously activated the V.A.T obligation such that it is now visible possibly from Pluto! I am at liberty to confirm neither the occurrence nor nullity of this story. If true, isn’t this the quintessential manifestation of State robbery against its tax-paying cadre?

Retrogressive Tax regime. A progressive tax regime is one developed in the understanding that taxation is meant to enhance social welfare. This is the Principle of Proportionate application. To this end, it is expected to logically levy more upon people who can remit more. The Rich are expected to have a higher proportion of their earnings taxed compared to the poor. However, is that the case in Kenya? Much income is forgone simply because the government doesn’t have an inkling of cognizance how to tax it. The informal and the real-estate sectors are two that are minting new millionaires with every passing day. But are they included in the taxation net? We find ourselves with a government that was elected majorly on the promise of their Big 4 agenda. They vowed to provide Food Security, affordable housing, Revive Manufacturing and universally affordable Healthcare. Let’s not forget our strife for the attainment of SDG’s and Vision 2030. How will these be met in the backdrop of unmet fiscal expectations? Even the free primary education, among the keystone projects of the previous regime will be pilfered into ashes when taxation is not channeled back into it commensurately. Health care will no doubt be left to mortification if inputs and supplies are disproportionately taxed.

What do we stand to lose by taxation of the most essential factors of production?

We will no longer be able to produce globally competitive goods by the parameter of price which will be to our detriment as a nation. Who will want to buy commodities at a higher price point when they can get cheaper varieties serving the same purpose elsewhere?

We will suffer brain drain. The most skilled and commercially adroit sectors of our population will either move to other countries themselves or take their enterprises with them. There are already many innovative and useful former countrymen manning the Silicon Valley in California in the United States and elsewhere. Can we risk to lose any more? If we do how will that bode for our future prospects of development? But the usual policy response in Kenya today is that there are enough Chinese to address that! Or perhaps Kenyans are born every day so we are unlikely to ever lack intuitive manpower. I rest my case.

Killing foreign investment. Economics 101 course furnishes each student with the Cardinal Principle, ‘reduce Expenses to boost Profit margins.’ If the cost of electricity, licensing, legal fees, overheads and raw materials is lower in Malawi compared to say Kenya; what moral authority and personal obligation do I have as a foreign investor to have my potential revenues swallowed by the behemoth that is that nation without a policy convivial for investment? An efficient tax system will score a nation competitive edge against her competitors and win more investment to her side. Needless to say, more investment equals more employment that ultimately translates to a bigger tax base.

Increased dependency ratios. I have earlier in this post spoken about the fragile state of many fledgling enterprises. Any one is more vulnerable at infancy as compared to any other time of their development. So much has already been gushed about many start-up firms not living long enough to celebrate their 3^rd birthday. When these firms collapse many youth will ultimately rush back to their ageing parents’ households, go into alcohol and drug abuse and there-in re-introduce dependency on the same parents who had thought would be free of them after providing sound education and even some start-up capital for their commercial ventures when they moved out of home. How is a tax-paying cadre to be widened when so many who would erstwhile have been gainfully engaged find themselves mired in unemployment and consequent poverty brooked merely by an unyielding taxation regime?

The very existence of taxation is supposed to be overall wealth redistribution and provision of a safety-net to cushion low income earners while building them up to the required stable level of financial health. This will not be possible when you tax even the very food they eat and basic factors of production like fuel, stationery, airtime and even internet bundles.

What became of the sin tax? I see no difficulty in taxing specific luxury goods for instance alcoholic drinks like Johnny Walker, VAT65 and the Jameson affordable only by the most affluent groups in society. Heavy duty is to be imposed on fuel guzzlers as compared to the eco-friendly variants of conveyance. Also tax betting and gambling firms. Some will accuse me of enforcing punishment for success but far from it. This besides influencing behavioural change will also be a sure bet in raising revenue that is much needed so that we are not forced to revert to taxing kerosene and maize flour. Also with proper collection we could finance sectors like Research and Development which is a precursor to any expansionist eventuality.  

Many will argue that taxation uptake for meaningful use could be a panacea to all the over-taxation we see. How is this possible? Cut out that one-third lost to corruption every financial year. Additionally shed off inefficient government bureaucracy, complex taxation regulations and poorly structured policy directions; innovate more, provide populace financial education, resurrect our work ethic, cap inflation, stabilize our politics and finally have foreign currency controls. Overtaxing obligatory factors of production will extinguish any remaining embers that currently survive to steam-roll economic emancipation of our people from crippling poverty.

YOUTH EMPOWERMENT CRITICAL TO ATTAINMENT OF SDGs

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or those not in the loop, the acronym SDG stands for Sustainable Development Goals. This is a raft of 17 global goals set by the United Nations General Assembly as part of a resolution of achieving global transformation and the amelioration of the fortunes of the Least Developed Countries by 2030. Without a doubt, these initiatives have to be tailored pragmatically to both the strengths and growth potentials of the member countries involved as that is the only way to make the goals either achievable or sustainable as is nominally suggested. This multi-partisan process fronted by the UN and its 193 member states at the time was meant to replace the Millennium Development Goals whose time frame lapsed in 2015 as a development mantra. As consummate realists they set out a roster of goals, time-frames and estimated cost of implementation.
To my rapt, ardent and longtime audience this topic may look familiar. This is because in the run-up to the 2017 Kenyan Election I made a short yet incisive post espousing most of the merits of electing younger leaders while still maintaining respect for the more experienced brigade. But that was the portion for leaders and perhaps I have to commend Kenyans for electing more of that youthful breed of leaders into both the County and national government leadership space. Impressive was the ascension of the chronologically greenwood, Stephen Sang into the governorship of Nandi county. This was in the backdrop of battle-hardened and more heavily resourced perennial campaigners in the race not less the incumbent who were roundly routed. Kudos Nandi County, aptly named the county of champions for basically being the provenance of the primordial soup that has birthed many of our world beating middle to long distance athletics champions. Enough of the exaltation! May be not as many as I envisaged have been either elected or nominated but at running the risk of being labelled a grumpy, perpetually insatiable grouch let’s just work with what we have. I still will stand immutable in my castigation of the winning coalition, Jubilee Government’s move to appoint fewer than expected of the youthful cadre into the Cabinet, as Principal Secretaries or State Department heads. But that is merely at the discretion albeit whims of the Head of Government, payment of fealty to him by loyalists notwithstanding. But empowerment is not merely to get younger leaders into the political space. The ordinary youth at the grassroots also has to be supported to be gainfully engaged. Many young men and women remain unemployed as the current positions in both the Government and Private sectors can never be enough to satiate the burgeoning number of youth that are ready to take up employment annually. Important to note is that Kenya is a youthful country with almost 70% of the demographic below the age of 35 according to data from our highly vaunted Kenya National Bureau of Statistics. I am proffering such high praise to them in aversion of lampooning them because I am yet to understand why they wrote on our gates and white walls with marker pens soiling them, yet it is clear enumeration is slated to be done next year. Besides, anywhere there is a gate in a residential area there is likely to be a household or several so there is no need to waste ink and puissance fruitlessly. Maybe it is a product of youthful exuberance consequent to their high energy levels and gratefulness for finally getting state engagement or just a poorly thought out strategy but that is neither here nor there! Enough of my pettiness.
Today more than at any other time the youth face a steeper climb in an attempt to attaining a brighter and more audacious future for themselves. The derogatory statement about ‘Kazi kwa vijana pesa kwa wazee’ rings ever so true. The hurdles to self-actualization teem and have an added difficulty level in absolute disregard to the myriads of mushrooming financial organizations and mobile phone apps that provide ‘soft’ loans with limited strings attached. If the International Labour Organization is to be believed, our position in the labour market more often than not is constrained to that of the sporadic, poorly paid and encumbered by non-protection of law due to alleged naivety to the same on our part. For those who try a hand at entrepreneurship, rebukes of “we fund prototypes not ideas and potential” blasted at them on visiting financial service providers have not been few and far between. Disenfranchisement and poverty is cause for an early debut for job-seekers some barely out of their toddler stage. According to the UN Sustainable Development Summit resolutions, the young men and women are the cornerstone and prime movers of any development envisaged. Provided with the requisite skills, competence and opportunity needed to attain their full potential they are a vital cog to attainment of real development, by extension contributing to peace and global security. One way of doing this is by fostering of the concept of Economic Citizenship by national policy makers and leading youth-serving organizations. Just like ordinary national citizenship it is the program geared at pecuniary and civic engagement to promote sustainable livelihoods, financial well-being and respect of human rights both social and cultural. The system has four pillars as its mainstay. The Financial Inclusion Pillar entails the capacity to afford financial services. The Financial Education pillar entails improvement of financial knowledge and skill. Social Education pillar has within it the bettering of one’s awareness to their rights and obligations as per law. It also has embedded within the development of life skills such as problem-solving, critical thinking and cross-personal interaction skills. The last and arguably most important is the Livelihood Education pillar which furnishes the citizen with the ability to secure sustainable livelihood through a skill assessment to strike a balance between entrepreneurial and employability skills. These pillars if enforced provide the building blocks for economic and social well-being, increase inter-group engagement, build understanding albeit respect for basic rights eventually leading to perpetual and mutually supported livelihoods for the most vibrant rung in society; the youth.
The Sustainable Development Goals may seem as foreign if not idealistic policy document items but they are merely simple steps understandable and conceivable for any nation in spite of scale. They include:

1. Dealing a Death-knell to Poverty in all its forms everywhere

A sage once stated that the most pervasive and crippling form of poverty that can be inflicted upon society is intellectual bankruptcy. However, a close second ranks economic disenfranchisement. Access to quality, accessible, affordable and convenient financial services can majorly contribute to extreme poverty alleviation. This is empowerment of the proportion living on below a dollar a day. Financial inclusion is only important if integrated with financial, social and livelihood education for continued accumulation of savings and responsible fiscal habits which are useful qualities in absorbing the impact of economic shocks.
In the words of the UN Secretary-General; Mr. Antonio Guterres, “In exclusion of the private sector, we will neither be able to create sufficient jobs nor build synergy that brings dynamism and stability to the societies that need to be assuaged with the implementation of the SDGs.”

2. Greater Food Security (Zero Hunger)

No nation can claim to be truly developed if its lacks the ability to feed herself. We have all heard of countries; tongue in cheek, proclaiming middle income status where famine exists all year round due to one instance or another of poor planning! In that particular country both drought and floods can easily strike the same segment of the populace in consecutive seasons despite still paying credence to having a policy and a ministry of Special programs to boot! That said, the youth can be an essential boon in efforts to end hunger. They are the people who possess the most verve, energy and enthusiasm to without shackles throw themselves into the throes of agricultural production if accorded the chance. They also possess the innovativeness and enterprise evidenced by the young men who have developed mobile phone apps that work as early warning systems at the onset of drought, give a flood warning, find markets and even determine if the conditions are optimum for army worms or locusts that can adversely infest existing crop in the farm, if not weevils to raid the silos. The youth; in the backdrop of not being shackled by ghosts from the past, are more willing to experiment with novel solutions that could potentially be the remedy to surmount whatever challenges they face.

3. Access to Health Services and well-being for all

To fully harness the potential ensconced within a nation there is no option but to guarantee the physical, emotional, psychological and spiritual well-being of all segments of that society. That can only be made possible through ensuring societies are raised to the economic situation, income level, working position and level of education that can ensure wholesome and adequate enjoyment of health services. A healthy culture of concern for both our own and the other man’s well-being is a distal determinant of a healthy society. Social education bestows upon its receiver a fully functional cognizance of the rights, empathy and respect for the next person. For this particular item of the SDG to be achieved nations will have to set aside funds for Universal Health Care covering essential health services and sheltering the most vulnerable in society. An all-inclusive Health Insurance fund is vital in this regard. Also there is need for fully stocked and furnished hospitals that can only be brought about as a product of public-private partnership among the various players in the sector. Universal access to information more so pertaining to sexual health for the youth is critically crucial. Prevention is oft better than cure.

4. Equitable and all-encompassing Quality Education

“The only weapon against poverty is a good and wholesome education.” This was a statement once quipped by Nelson Mandela. Attaining literacy and numeracy for all cadres of society is not a luxury but a cardinal concern of modern life. There is no greater equalizer or tool to achieve the full harnessing of raw human potential that only education can provide. Financial and livelihood education can increase the number of youth and adults with the relevant skill, competence including of the technical genre and soft skills for either employment or business. The link between a decent sustenance and a proper education cannot be gainsaid.

5. Gender Equality and Empowerment for Women and Girls

There is an overworked statement of empirical wisdom that if you educate a woman you have educated the rank and file of society. In the past women and girls were relegated to the lower echelons of toil in the kitchen, garden work, home-making and child-bearing. Essentially, in the days of yore women were considered the property of a man and so if one was asked to declare their lucre it was not uncommon to hear cattle, cereals in the store and wives lumped in the same sentence. They were merely meant to be seen and look beautiful but never to be heard in the ambient of real men. However times have changed. Today, give a woman a chance and they excel far beyond the capabilities even of the menfolk of society. Looking at the University Graduation lists of many universities, who can miss the observation that most of the First Class Honours Degrees are scored by wait for it… ladies! Universal education irrespective of gender can be the only way to attain the development goals we all aim for. The story of what Kennedy Odede has done in the Kibera slums basically with constrained resources and logistical support with regards to women empowerment is not only inspirational but worthy of replication. Their male counterparts are not to be completely ignored in this regard as only a cross-sectional look around of the entire system can be beneficial to society.

6. Clean Water and Sanitation

Clean and adequate water is an important aspect in the attainment of SDGs. I shall not be drawn on the uses of water which I could take a whole day to itemize but still not exhaust! We need to be creative in both looking for newer sources and also preserving the ones we have as posterity will depend on it for progress. Water harvesting and storage must rank high in our priorities. Environmental conservation, equally so if our water tables are to be maintained at the current level. Also new tech in desalination of sea water; a massively abundant resource, could be an important way to secure that basal reservoir. Good hygiene practice is the cheapest way to avoid the vagaries of water-borne and communicable illness.

7. Affordable and Clean Energy

The youth are a salient part in developing renewable energy resources that will be essential for our future prospects going forward. Solar, wind, tidal and geothermal power resources must be looked at as a means to revamp if not supplant the current energy sources. Oil and gas is a finite resource which will ultimately run out in due course. So will hydroelectric power be petered in the succeeding generations. The inculcation of renewable energy into our energy generation stream could enable the injection of more skilled and focused manpower into the workforce to handle our energy needs for the future ensuring we kill two birds with one stone which is nip labour-market redundancy and despondency in the bud while supplying clean energy. A multi-sectoral set up of new and independent power producers is the way to go to achieve affordable energy. The trend of having power utility companies existing as monopolies is an outdated way of doing business that has proven unsustainable and has no place in the future. Electric cars and trains are irrevocably the conveyance of the hereafter!

8. Decent Work for Sustainable Economic Growth

Isn’t it sad that you wake up early every morning, worried out of your wits about getting late for work just to lend your skill to an enterprise that will not even provide ample roll to pay your rent? That is the phenomenon many youths joining the workforce have to grapple with today. The prospect of being among the working poor. Doesn’t it kill initiative and engender a feeling of helplessness to toil but see no tangible returns? But some will argue this is better than unemployment. The youth are the most affected by this malady in society. A lack of relevant skills coupled with minimal financial resource for an upgrade has left many frustrated. Add to that the less than tantalizing prospect of constrained access to appropriate and sufficient financial services to start business and you will drink a ghastly cocktail. Training in livelihood education can enhance youth employability and stimulate their entrepreneurial nous.

9. Industry, Innovation and Infrastructure

The much revered 3 Is of sustainable development. Kenya has taken a quantum leap in ensuring innovation and industry is achieved through the subsidizing of youth polytechnics for the uptake of technical skills training that is will be a boon to youth enterprise. Tech-parks and innovation hubs are the way to go to enable youth to condense and distill their creativity into workable frameworks, prototypes and in a safe and resource rich space to foster their ingenuity. Infrastructure development projects will provide the youth with the perfect platform to showcase their newly-acquired skills at work. Block chain technology has to be learnt and milked dry of its benefits.

10. Reduced Inequalities

All humans given equal opportunity have the propensity for the equi-proportionate attainment of their potential. Let us not draw chalk circles of discrimination against each other. Let’s live in a harmonious, non-hierachical and a synergistic understanding of the fact that brilliance is evenly distributed yet opportunity only sparsely.

11. Inclusive, Safe, Resilient and Sustainable Cities

We need to make better use of space in our cities. In Nairobi, the best case-study of sustainable use of space is the Two Rivers Mall on the frontier between Nairobi and Ruaka. Here you will find roof-top parking, energy saving solar powered street lights and not to forget a solar farm as a roof canopy. What can be better than that? Additionally residential quarters have to be built upwards to make better use of metropolitan vertical space. Roof-top and gunny bag kitchen gardens are the way to go. On safety I will vouch for the use of IT enabled security systems.

12. Responsible Consumption and Production

Let’s produce and only use what we need. We should never import what we produce locally also in the words of perennial Kenyan presidential contender Mohammed Abduba Dida, we should be minimalists in our consumerism. Automation in industry will foster scalability and optimization.

13. Climate Action

Climate change is a reality of our time. It is already in the public purview that the actions of the developed nations as far as industrialization is concerned have a negative correlation in the less developed tropical regions. We entreat the superpowers to do more as we all will suffer the consequences of wantonness. Reduction in the release of greenhouse gases that are actually trapping heat in converting the earth to an oven is our doomsday reality. Shun CFCs to protect our ozone layer.

14. Preservation of Marine Life

We need marine habitats more than they need us!

15. Terrestrial Symbiosis

As the most intellectually adroit creatures, humans have a duty of care to protect the delicate balance that is the circle of life on land.

16. Peace & Justice for Stronger Institutions

The only way to maintain real Peace is by Truth and Justice. Institutions do not exist in isolation and can only be strengthened by a value system and an adherence to principles. Social education is essential in steering the younger members of society judiciously for posterities’ sake.

17. Partnership for Goals

A common destiny can only be charted when we work in synergy with each other and to one another’s strengths. Any system can only be as strong as its weakest link. Partnership is essential in creating consensus as these are universal goals anyway.
As a prologue attaining the SDGs relies not just on setting of goals but also a responsive action plan harkening to the unmistakable and boisterous criess and needs of the youth. Empowerment by skill, knowledge and self-esteem will be imperative if this lofty ambition is to be attained over the next decade and a half. Synergistic action and long term strategies will be necessary as the youth will inevitably inherit the earth long after their progenitors are gone.