THE SIX HALLMARKS OF CANCER!

1. Self sufficiency in growth signals
-Secrete growth factors that stimulate own growth
-Increase growth factor receptors
-Cell surface receptor is mutated in the "on" position-constant cell growth/division
2. Insensitivity to antigrowth signals
Antigrowth signals stop unregulated growth- are inactivated in cancer
3. Evading apoptosis (Cell Death)
-Normally apoptosis triggered in response to normal development and excess growth
-Pathway to apoptosis is disabled (mutation of p53)
4.Limitless replicative potential
-Activate telomerase to restore and maintain telomeres at the end of chromosomes
-Protect their chromosomes- retain the ability to divide over and over again
5. Sustained angiogenesis
Stimulate angiogenesis to form their own blood supply- delivers O2 and nutrients
6. Tissue invasion and metastasis
-Specific mutations activate ability of cells to metastasize
-Ex. decreased cell to cell adhesion, secretion of preteases that digest surrrounding barriers, and ability to grow in new locations
Courtesy of Quizlet.com

THE GENESIS OF THE NURSES STRIKE-PART ONE.

With the heightened political temperatures rising by the day it might be lost that the Kenyan nurses are on strike,save for the paltry updates on the local media and extensive updates on the social arena,thanks to energetic George Isaiah Shivekah et al. Well, let it be known that until the negotiated and agreed CBA is signed and deposited in a court of law the strike is here for the long haul, Its 38 days and still counting. It is important to note that the current stalemate is a product of disjointed and deliberate disorganization of the employer, in the context of C.O.G with the ultimate motive of derailing the whole process. The strike therefore is a culmination of long term engagement that dates back to 2008 and it has been subject to unfruitful deliberations for over 9 years. In December 2016, the Kenya National Union of Nurses, KNUN a nurses umbrella body arrived at the conclusion to call for a national strike to voice their frustrations through alternative avenues as provided by the law  when the discussion over CBA hit a dead end. However further engagement with the employer yielded a RTWF with nursing service allowance provided to specifically address the peculiar services by a nurse. As cunning as they have always been, the allowance or NSA as it was famously known was withdrawn later in January with no explanation by the employer. As it has been argued, the allowance was meant to entice the nurses to go back to the health facilities since the doctors had taken to the streets as well, as we all know the doctors strike lasted for eternity. With the RTWF and in the best interest of the lives of Kenyans the nurses agreed to go back to work as the union officials engaged the employer together with other relevant authorities, SRC and MOH included. The negotiations were a timed process that was supposed to end in March 2017. In fact it was concluded and agreed upon, a document was available and naturally any responsible employer should have expeditiously had the document signed and deposited in court  to avert the current strike and prevent the untold suffering Kenyans have underwent. The employer with their usual cat and mouse games haven’t disappointed either and they are back at it with blame games and all manner of accusations, threats, intimidations and un ending cycle of irresponsible utterances as recently depicted by  the C.O.G chair, C.O.G health committee chair and SRC. They have gone to the extent of compromising a former chair of the union who has unlawfully purported to speak on behalf of the union to create confusion and division but their effort will not see the light of the day. The Kenyan nurse has been pushed to the elastic limit and the only language they understand at this point is either a CBA or a CBA, yes there are no two ways about it. It’s either now or never na Punda amekufa, the wait for better remuneration has been long and painful.

It is important to state the following. That the strike suspended in December was just re-activated, so the arguments by an imposter in the name of John Bii regarding the legality of the strike is both misleading and unfounded, besides the official communication from the union as mandated by the law is done by the secretary general. The current CBA which has been subject to the negotiations that was conclusively agreed upon is worth 7.2 Billion a year and 28 Billion in four years and not 40 Billion as claimed by the opponents of the nurses’ quest for better pay. The ballooned figure of 40 Billion only exists in the minds of the governors’ and it is meant to scare the public on inexistent mind reaping economic consequences and incite them against  hard working nurses already reeling from un explainable burn out. The CBA in summary is the irreducible minimum at this point in time that hopes to address issues of uniform, responsibility and risks in line of duty. As opposed to the shoddy job evaluation done by SRC, a nurse is up to 30 times at risk of nosocomial infections compared to any other cadre in the health fraternity. This is according to proven scientific findings, a case in point is the study done at Kenyatta national hospital and it was in concurrence with research done across the globe. In conclusion I wish to urge the C.O.G and SRC to end Kenyans further misery as the ball squarely lies in their court, and that no amount of intimidation will work. Secondly the Kenyan media should  give more coverage to the situation, as it stands what is being highlighted is a pale shadow of the real situation , lastly Kenyans should hold the leaders of the day accountable and should join the nurses to achieve better remuneration. A motivated nurse is highly efficient and productive besides a nurse is the heart of the health facility or so they say. Meanwhile the Nurses will Stay put until the CBA is signed and deposited in court.

TURKANA COUNTY SUCCESS STORY-EXTRACT.

A few years ago, mothers delivering at home in most villages of Turkana county was common practice. At Nanam village one would have to fight hard to convince mothers on the need to seek prenatal care services and the need to deliver at health facilities.
Despite the risks associated with home deliveries, these deliveries were the order of the day for the mothers of Nanam location in Turkana West sub county.
However, the story is changing albeit slowly and at least five mothers are now giving birth at Nanam health center every month after the maternity wing was fully equipped.
The facility’s nursing officer, John Cheruiyot said a total of 88 mothers delivered at the facility last year thanks to the equipping of the maternity wing of the health centre.
“The maternity wing is fully functional and was constructed at a cost of Shs 10 million has been serving five to six clients per month,” said Cheruiyot.
The facility is one of the three facilities in Nanam ward the others being Lopiding sub county hospital, and Nasinyono dispensary. The ministry of health has been allocated one of the largest budgetary allocations ostensibly to address the long distances that patients had to cover to reach health facilities. Last year it was allocated Shs. two billion.
The ministry is headed by Jane Ajele and is said to be among the top performing ministries in the county.
According to the nursing officer, the three facilities serve an average population of 60,000 which is mainly comprised of persons who migrate in search of water and pastures for their livestock thereby causing the figure to vary at various seasons.
Another notable development at the facility is that HIV positive patients are administered with anti retroviral drugs. Tuberculosis treatment which was previously being done at sub county hospitals only is only available at Nanam health centre.
Cheruiyot says these measures have really helped in the fight against TB because in the past most patients who were referred to Lopiding sub county hospital never used to go to the hospital.
The ministry of health has also increased staff at the facility from two to six health care providers who include two nurses, community worker, one nutritionist, one HIV testing and counseling service provider, and a data clerk.
In a bid to make their stay comfortable the ministry has constructed two housing units for the staff . Other developments at the facility include a male and female ward.
To ensure the smooth running of the health facility, Shs. 470,000 from the health sector development fund is injected to the facility every financial year in additional to drugs and a motorbike attached to the facility to ease mobility.
However the main challenge facing the facilty is access to water. The demand for water at Nanam ward is very high since much of the water is used by livestock.
Residents are now appealing to the county government to put measures in place to ensure they get enough water supply since the borehole at Nanam cannot meet their demand for the precious commodity.
By master Bakari

AN OPEN LETTER TO MARYANNEWAWERU

Hello Maryanne, how are you? I hope you are fine and safely arrived in nairobi. Going through the social media i came across your article following your visit to Turkana county,i hope you enjoyed your stay and got a feel of Tukana hospitality and ofcourse you must have ended your visit at eliye springs resort,an oasis and hotbed of luxury in the desert.How i wish i had your email perharps i could have responded there. But again judging by the response from the readers of your article it appears your message was received in different versions some agreeing with you and others with contrary opinion,so kindly allow me to address you through the same platform.What did not come out clearly  is your time of visit ,wheter it was before or after devolution.If it was before then you might need to visit again,a transformation is in the offing for you and if was after then i guess your travel was curtailed and limited to small area which does not in any way reflect the county image from a realistic perpective.I want to assume you are of a higher caliber journalism with a balanced opinion as opposed to having bias towards negative stories .Having been here for close to five years now and working in the ministry of health where your passion in journalism lies i found it necessary to respond to some of the issues you highlited in your master piece article, but first lets look at facts as they.The Surface area of the county is approximately 77,000 sqkm, 2nd largest of all 47 Kenyan counties ,Neighbouring with Ethiopia, South Sudan and Uganda as well as the counties of West Pokot, Baringo, Samburu and Marsabit.The latest Population estimates is Approximately 1,000,000  or thereabouts and not 855,000 as you mentioned. The Population density is approximately  13 persons per sqkm.As you rightly observed the main economic activity is pastrolism save for pockets of agricultural activities in Katilu and Todonyang.The county has 7 sub counties,namely Turkana West,Turkana North,Turkana South,Turkana Central,Turkana east,Loima and Kibish .You touched on nutrition and maternal health here and there ,i noted there was no specific reference but i would like to shade some light on these critical areas,according to kenyan government guidelines on intergrated management of acute malnutrition,version 1 of 2009 malnutrion is defined as a state of the body where there is less of the required nutrients or excess .The guidelines also highlights unicef conceptual framework which clasiffies causes of malnutrition into 3 categories.Immediate,underlying and basic causes,i would wish to focus on the basic causes wich 3ntwils national policies,geographical isolation and poor infrasctructure which directly or indirectly has an impact in completing the malnutrion complex cycle.For the longest time in the history of this counrty the county has been isolated and marginalised,be it by default or design is a topic for another day.If you had the opportunity to travel by road you will understand my point ,especially how poor infrasrructure hampers delivery of food and its impact on business,food security among others.A journey that last over 9 hours at bare minimum wheres idealy its supose to take 3 to 4 hours. However i have a feeling you flew via commercial aircrafts that serve the northern part of kenya from Nairobi and you therefore missed the opportunity to get the real situation on the ground.Notably the county is far and wide,with 77,000 sqkm in comparison to your home county its over 110 times,infact one of the locations in the county where i work is 2,356 sqkm!Yes you heard me right thats a location and still it is 3 times Nairobi county.And with pastrol nature of most of the community members who are in constant movement in search of pasture,it therefore means immense resources and realistic strategy needs to be put in place to overturn these challenges.The answer lies in devolved system of governance.Just incase it escaped your attention let me inform you that the county through its strategic framework has health as its key priority area,increasing access and improving quality of healthcare are its main objectives.To achieve this there over 70 new health facilities built and spread across the county besides other county infrastructual undertakings,ECD centres,administrative units just to mention but a few.The county government also did a massive recruitment of healthworkers in 2015 and as i write  this letter a second batch are picking their appointment letters from the PSB, Infact more than 70 additional medical oficers have been recruited by the county.As a result of these prudent actions there is marked and measurable improvements in consumption of healthcare services.To demonstrate this kindly allow me to use two examples to give you an overview in critical areas.Skilled delivery and Antenatal clinic services,mentioned in your article.From an average of five thousand deliveries annually to over 12,000 which represent 50% increase and Improvement of 55% to 127% coverage for mothers attending antenatal clinic.It would therefore be impossible not to notice this drastic improvemnts however biased one can be,infact it is miscarriage of facts to say but the least.The statistics thefore demonstarates clearly that the county has a plan and it is executing it accordingly.On nutrition its a complex matter compounded by several variables key among them;Pastoral nature of settlemments ,geographical isolation and poor infrastructure linking the county to the rest of the country.However in the fullness of time the county will find a breakthrough in challenges facing its people health or otherwise.Even Rome was not built in one day or so they say,credit should go where it is due. A kiswahili saying goes "mgalla mue, lakini haki yake mpe."Well, i can go on and on but let me end it there for now with that brief.I hope you will be back again soon on fact finding mission. Have fruitful week,wont you!

WITH CANCER, MONEY IS THE GREENLIGHT TO BETTER HEALTHCARE

Money is the green light to better health care,if you have it then you are in a better position,were the words of Fatuma Adan, A 45 year old Mother whose only son  succumbed to cancer of blood,leukemia.Sometimes in june i came across the story of Harun Abdulahi on Al Jazeera website highlighting the plight of 17 year old boy from a very poor background in Garissa, Northern Kenya .Indeed the mother explained the agony of the hospital trips, either for blood transfusion or complication arising from his condition which was made more complex by their lack of financial ability to access critical oncology care in his fight with leukemia.To bring this to perspective lets juxstapose the story of Rose Nasimiyu,the girl who at 9 years came to the public limelight oozing confidence ,courage and determination in her fight against Hodgkin’s Lymphoma. Cancer that affects the lymphatic system.Since she had the privilage of publicity,Kenyans of goodwill were able to contribute money and Nasimiyu was flown to UK for specialised treatment, she recently came back after 5 years and she is now cancer free .Appearing on Churchill show and Jeff Koinange live,one could easily notice the difference.She is a fully grown teenager,her british accent mesmerised me the most,infact i found it difficult to comprehend whether she was the only one on the bench.For a moment i wanted to imagine that my old black and white LG greatwall television had technical hitch so that a third person,possibly a briton women wasn't in my  view,but alas!it turned out to be the young and lively Nasimiyu.Being the village boy that i have always been, i was honestly lost in the interview on more than one occasion as those english words passed over my ears.Well,that is besides the point ,the lesson here is that cancer if diagnosed early and adequate treatment is avaliable in a timely manner several lives will be saved.However,its important to highlight the fact that a combination of several factors facilitate cancer treatment,early diagnosis and intervention is paramount,even with lots of money at late stages cancer will reign on you badly and the end result is fatal.A case in point is Harison Kiptoo,a young brother to the deputy president who died of kidney cancer,it is reported that he kept his condition to his chest only revealing it when the condition had advanced to late and irreversible stages,in the end he passed away.With better health institutions and affordable care rources will also not go into waste,did you know that over 10,000 kenyans seek  treatment outside the country annualy?Unfortunately its only those in the upper class that can afford or those surviving at the mercy of kenyans of goodwill like Nasimiyu or better still through Harambees. All is not lost though,there is a ray of hope as the Tesla cancer centre is due for competion next year. The indian prime minister in his recent visit to kenya also promised to provide critical equipment and drugs as well as built a hospital in Kenya.Its only a matter of when the promise will come to fullfillment. On that note i wish to pass my message of condolecence to the family of AK President Isaiah Kiplagat who lost his fight to  cancer the other week,may his soul rest in peace.Have a lovely weekend ahead,wont you?

PALLIATIVE CARE IS EVERYONES BUSINESS

Today i begin on a very sad note,the other week i did an article about a young family from Kisii whom their second born daughter,Nelvin was battling nephroblastoma.Unfortunately the child passed on last monday at MTRH.She was due to start chemo but then they had been discharged home as they awaited for the return date,however they had to come earlier than scheduled after the child developed anorexia and dyphagia.The child passed on immediately upon arrival and the several months of misery came to an end,my condolences to the family and may she R.I.P.This is not to mention the fact that they came all the way from Kisii county,today she was laid to rest at Nakuru cemetry.Why the burial at cemetry?I know thats the question lingering on your mind,well i will refer you to my previous article to get an insight of the matter.

Misfortunes of this world,cancer included knows no race ,gender nor tribe or so they say.The quality of healthcare in this country is still at developing stage,especially in the mashinani where common mwananchi is found,with devolution however there has been slight improvement though not to the desirable optimum.It mostly depends on which county one is coming from,with respect to palliative care its only fair to say that practically nothing is happening in most counties except in Nairobi,Eldoret,Kisumu and may be Mombasa.While he served as the health CS Mr Macharia stated that the govt have plans to avail cancer equipment worth Sh21.5billion in at least 94 hospitals across the country and was setting up four cancer radiology centers set to be launched by July in Nairobi, Mombasa, Kisumu, and Nyeri counties and is also set to cater for patients from other countries in East Africa.Until then the hoi polloi of this country will be at the mercy of the Lord,shockingly the Cs clearly stated that over 10,000 cancer patients in Kenya spend Sh11.28billion for treatment in hospitals overeas.Yes,you heard it right 11 billion and for your information Cancer deaths in the country are third after infectious diseases and cardiovascular ailments. Each year, according to the Ministry of Health, there are nearly 40, 000 confirmed cancer cases.This is suppose to raise genuine concern of any responsible leader worth its name. Both at the national and county level.Health is a fully devolved funtion of the county government.Sometime last year the health workers wanted to petition parliament to reverse health funtion to the national government citing mismanagement,however the governers were up in arms and the story ended there.

It is therefore imperative that palliative care should and must be everyones business.Today you are in good health, tomorrow is in the hands of the almighty God.Mr kipkirui lelgo higlighted the story of Agnes Cherotich of Kenegut battling Ca breast,complete with pictures to back it up however scary they may have been on social media last week,and i was glad and delighted in equal measure,concerned Kenyans expressed their sympathy,others pledging donations,however it should not stop there.We should look beyond and modify our lifestyles which largely constitute rrisk factors as advised by the experts.I personaly visited Agnes at Rehema ward in  MTRH.I am glad she is responding well to treatment and hopefully she will be back to her normal life soon.Aproximately 900 metres away in memorial wing within the same hospital is another old man from Kericho as well battling Ca stomach,and the story goes on and on....I want to end  it here today with a polite request to Kericho county and South rift leadership  in general,there is a greater need to create a focus and establish reason for the spiraling cases of cancer from the region,efforts should focus on screening,management and timely refferal,when the worst comes to worst as is mostly the case,there should be an hospice so that the terminally ill can spend their last days in peace.Have a blessed week,wont you?

JOHN: THE AGONY OF CANCER ON A YOUNG FAMILY FROM KISII.

JOHN: THE AGONY OF CANCER ON A YOUNG FAMILY FROM KISII.: Born in mosocho Kisii county,Mr David Ogoti did not have an idea of how rocky life would be 35 years later.Just three years after he was bor...