History, Culture and Orature: A Study of Shimoni Slave Caves

Shimoni slave caves in Kenya are a significant historical site reminiscent of the history of slave trade on the East African coast. A people’s Orature always embodies their philosophical world view, their religious orientation while at the same time recording moments in and aspects of their history. In this regard, the study investigated whether the community around Shimoni reconstructed the traumatic experience of slave trade through their Orature. The objective of the study was to examine how the people’s philosophy of life is reflected through their oral narratives in their attempt to reconstruct their history. The data for the study was collected through face to face interviews with the informants. Participant observation was employed to enable the researcher to interact freely with the oral literature material. Purposive sampling and snowballing were used to identify the informants. The narratives collected were analyzed to establish the morals transmitted through them and their implication for the community. The functionalist theory was instrumental for the analysis of the function of the narratives. The findings reveal that the narratives of the community not only reconstruct the history of slave trade but also reflect the philosophical world view of the community. They show that the community believes in divine intervention, unity among its members and sanctity of life. Bad deeds were punished as a way of ensuring conformity. Keywords: Shimoni, Slave caves, History, Philosophy, Culture, Oral narrative

The Primary Solid Waste Storage Gaps Experienced By Nairobi Households

This study identifies and analyses the solid waste management service gaps and situations in these different socio-economic setups. The objectives of this study were: (i) To assess households’ current bin types; (ii) To assess households’ desired bin types; and (iii) To identify the bin gaps experienced by households. A total of 430 households were selected through stratified sampling from dwellings with different social status, as represented by estate to give the quantitative data. The qualitative methods such as key informant interviews, observation surveys, and secondary data were also used. All the 8 divisions in Nairobi were represented, in a ratio proportionate to households from slums, low income, and middle income estates. There is a bin gap of about 15% households needing bucket; 26% excess plastics; and a deficit of 12% households needing but short of metal bins; and a 6% deficit of the 5-10litre bins; a 13% excess of bins less than 5 litres; 1.6% deficit of 10-15 litre bins, and 14 % deficit of households needing bins larger than 20 litres. 30% of households have heavy to very heavy bins. Entrepreneurs should improve availability of storage bins of correct specification (size, material and make) as preferred by various households. Correct specifications of garbage bins should be designed to satisfy these household needs.Key Words: Household Storage, Solid Waste Management; Garbage Bin

Inflation and Economic Growth: a Review of The International Literature

This paper surveys the existing literature on the relationship between inflation and economic growth in developed and developing countries, highlighting the theoretical and empirical indications. The study finds that the impact of inflation on economic growth varies from country to country and over time. The study also finds that the results from these studies depend on country‑specific characteristics, the data set used, and the methodology employed. On balance, the study finds overwhelming support in favour of a negative relationship between inflation and growth, especially in developed economies. However, there is still much controversy about the specific threshold level of inflation that is appropriate for growth. Most previous studies on this subject just assume a unidirectional causal relationship between inflation and economic growth. To our knowledge, this may be the first review of its kind to survey, in detail, the existing research on the relationship between inflation and economic growth in developed and developing countries

Dialysis outcomes and practice patterns among chronic kidney disease patients receiving hemodialysis at a private dialysis centre in Nairobi, Kenya between May 2016 and July 2016

Background: Chronic Kidney Disease is a long-term condition caused by damage to both kidneys. It has become a major public health concern worldwide in the past decade and its prevalence is projected to rise in the coming years. Owing to its irreversible nature, renal transplantation has been proven to be the most effective renal replacement therapy. However, it is limited by its high cost and low availability of donor kidneys. Hemodialysis has therefore been adopted widely in Kenya as an alternative therapy for those with End Stage Renal Disease. This has led to an exponential increase in the number of dialysis units in Kenya over the past few years. This therefore raises a concern on the quality of hemodialysis delivered to patients around the country.Objective: To determine dialysis outcomes and practice patterns for Chronic Kidney Disease patients receiving hemodialysis at a private centre in Nairobi, Kenya.Methodology: This was a retrospective study. Records of 43 patients who received dialysis at the centre for more than six months were reviewed and the mid-year results for different parameters obtained.Results: 62.8% were male, 51.2% were Africans with the rest being Asian. The mean age of the patients was 63 years (±16) 79.1% were married. 60.5% had both hypertension and diabetes. Arteriovenous Fistula (81.4%) and Tunneled catheter (18.6%) were the only routes used for vascular access. Majority of the patients (72.1%) received dialysis twice weekly. 93.0% and 97.7% were on iron and erythropoietin supplementation respectively. Most patients (39.53%) had hemoglobin of 10-10.99g/dl. 56.34% of the patients had Parathyroid hormone levels of 150 – 450pg/ml; 73.18% had calcium levels of 2.0 – 2.4mmol/L; 65% had phosphate levels of 1.0 – 1.8mmol/LConclusion: Majority of hemodialysis patients were males, aged above 60 years; Coexistence of diabetes and hypertension was the most common comorbidity among ESRD patients; Majority (67.44%) of the patients had hemoglobin level of 10-12g/dl.; 83% of patients achieved adequate dialysis based on the Urea Reduction Ratio

Upper Abdominal Ultra-Sonography Findings in HIV Patients at Kenyatta National Hospital and the Defense Forces Memorial Hospital

Background: Easy availability, accessibility and affordability make ultra-sonography an invaluable  diagnostic tool in clinical investigation of infectious and non-infectious complications of human immunodeficiency virus (HIV).Objective: To determine the pattern of upper abdominal abnormalities in HIV infected patients at ultra-sonography and correlate with clinical presentations.Design: A descriptive cross-sectional study.Setting: Kenyatta National Hospital and the Defence Forces Memorial Hospital, Nairobi, Kenya.Subjects: HIV infected patients referred for upper abdominal sonography within the study duration of eight months.Results: Two hundred and seventy three (273) patients were included in the study. Overall, upper abdominal pain accounted for 31.9%, pyrexia of unknown origin 30.40% and general abdominal pains  27.68% of clinical indications for sonography. The main clinical indication for liver sonography was  hepatitis (45.80%) and the kidney was renal failure (66.67%). The most common liver pathology was diffuse fat infiltration at 35.71%. The most common renal pathology was renal parenchymal disease (93%). Para-aortic lymphadenopathy was present in 42.90% and ascites 25.60% of patients. Conclusion: Renal parenchymal changes (type I and II), fatty liver, intra-abdominal lymphadenopathy and gallbladder sludge are common findings in HIV infected individuals despite paucity of clinical suspicion

Size, efficiency, market power, and economies of scale in the African banking sector

Abstract There is a growing body of evidence that interest rate spreads in Africa are higher for big banks compared to small banks. One concern is that big banks might be using their market power to charge higher lending rates as they become larger, more efficient, and unchallenged. In contrast, several studies found that when bank size increases beyond certain thresholds, diseconomies of scale are introduced that lead to inefficiency. In that case, we also would expect to see widened interest margins. This study examines the connection between bank size and efficiency to understand whether that relationship is influenced by exploitation of market power or economies of scale. Using a panel of 162 African banks for 2001–2011, we analyzed the empirical data using instrumental variables and fixed effects regressions, with overlapping and non-overlapping thresholds for bank size. We found two key results. First, bank size increases bank interest rate margins with an inverted U-shaped nexus. Second, market power and economies of scale do not increase or decrease the interest rate margins significantly. The main policy implication is that interest rate margins cannot be elucidated by either market power or economies of scale. Other implications are discussed

Convergence of Health Expenditure in Sub-Saharan Africa: Evidence from a Dynamic Panel

To address the problem of underfunding of health systems in SSA the Abuja Declaration of 2001 set a target to allocate 15% of a country’s budget to public health expenditure. However there is no empirical evidence on whether SSA countries are converging or diverging from the target and whether there is significant effect of the Abuja instrument on other health expenditure indicators. This study tested convergence of health expenditure in SSA in the post Abuja declaration period. The linear dynamic panel model was estimated by GMM-IV method on a panel of 41 SSA countries for the period 2000 to 2011. The empirical results show evidence of absolute and conditional convergence of health expenditure in SSA. Real income per capita, donor funding for health care and benefitting from HIPC debt relief influenced direction and rate of convergence of health expenditure. The Abuja policy instrument (public health expenditure as a percent of government) reduced the rate of convergence of other health expenditure measures except for private health expenditure as percent of total health expenditure which was increasing in the study. The results imply that continued reliance on donor funding for health systems directly or through debt relief is likely to delay convergence to Abuja target. SSA governments can formulate sustainable health financing mechanisms that reduce dependency on external source for health system support in the long run. Keywords: Convergence, Health Expenditure, SSA, Dynamic Pane

Evaluation of the Potential use of Bagasse and Sugar Millswaste Water as Substrate for Biogas Production

Biogas is a sustainable alternative source of energy to fossil fuels. Its production also serves as sink for biological wastes and it is a pollution control measure. Most of biogas generation units in Kenya utilize animal wastes as the substrate. However, the bio fuel potential of bagasse, the abundant crop residues like co-products in sugarcane-based industries remain underutilized. The idea of converting bagasse into additional energy is gaining attention, especially through government commitments on increasing the renewable energy generation combined with the reduction of carbon dioxide emissions. In this study bagasse samples collected from Chemelil sugar mills were passed through multiple sieves of different sizes to obtain different particle sizes. Mills waste water was also collected from Chemelil sugar factory and analyzed for pH and Total Dissolved Solids (TDS) to establish their biogas production potential, the analyzed mills waste water was then mixed with different particle sizes of bagasse and allowed to be digested anaerobically. Volume of the gas collected from each flask containing different particle sizes of bagasse was measured to identify the optimum conditions for biogas production. The study showed that the mills waste water that had the highest TDS (130g/L) yielded relatively higher volumes of biogas when mixed with bagasse of different particle sizes. Bagasse of particle size ≤0.600mm produced the highest volume when mixed with the mills waste water with TDS and pH of130g/l and 4.67 respectively. Designing and installing a digester system that allows for the control of TDS and pH in mills wastewater and utilizes bagasse of particle size ≤0.600mm would be expected to produce reasonable amount of biofuel and put a check on environmental pollution problems associated with bagasse and sugar mill waste waters in sugar factories

Massive Cervico-Lingual Cystic Hygroma

Cystic Hygroma (CH) is an aberrant proliferation of lymphatic vessels  creating fluid-filled sacs that result from blockage in the abnormal lymphatic system. These benign lesions are characteristic in their capability to grow to an enormously huge size has potential pressure effects on the neighboring structures. The massive expansion can also lead to gross disfigurement of the neck and face. In this paper, we present a rare case of cervico-lingual CH in a 17-year old Rwandese boy. Though the lesion had caused massive expansion of the tongue (12cm x 10cm) and led to gross deformity of the mandible, the boy had no signs of respiratory distress. His main concerns were inability to eat solid foods and compromised speech. The management challenges and literature review on cystic hygroma of the head and neck region are discussed.Key Words: Cystic Hygroma, Cervico-Lingua