Bold woman: Mukomunene champions universal healthcare for happier, healthier families

Emily Mukomunene’s journey into motherhood began in 1992 when she welcomed her first child. The excitement of being a first time mum quickly waned as the reality of the task ahead set in. It dawned on her it dawned on her, that a parent’s role in nurturing a child was a full-time responsibility.

This hands-on approach opened her eyes to everyday decisions that shaped the health and well-being of her child. Five children and two grandchildren later, Mukomunene who is now 54, says her commitment to raise healthy children led her to a path of championing better healthcare in Kenya.

“Everyday things like dressing my children warmly during cold seasons, planning healthy meals and teaching them personal hygiene such as hand-washing was paying off. However, that didn’t offset my fears and like any other parent, I wondered; could my children have hidden genetic conditions, what if they develop complications along the way, will the healthcare system work for us, what about the misdiagnoses, wrong treatments and high cost of treatment?”

But Mukomunene did not just sit on these fears. She took an active role in improving healthcare systems. She became a Health Researcher and Educator. Through multiple patient support programs, campaigns, books, advocacy, public talks and much more, Mukomunene is certainly making a difference in healthcare. She takes us back to 1983, where it all started:

Heart for street children

I started helping street children, when I was in form two in 1983. We had just moved to Zimmerman, Nairobi and this is where I encountered street children for the first time. I saw this young boy around the neighbourhood on Saturdays carrying a young baby on his back, going through trash. One day I approached him and asked what he was looking for at the dump-site. He told me that he was looking for some leftover food to feed his baby brother. When I probed further, he explained that they lived with their stepmother who never allowed them to eat the food cooked at home or to bath in her house. He also had a younger sister back at home and often spared the food from trash cans for her too.

I was moved by his story and we hatched a plan to invite him and his two siblings in our house where they could eat and shower. But first, we needed a means of communication to avoid getting caught by my mother who was likely not to approve of our plan.

We agreed on a sign—a red piece of cloth to indicate that my mum was around and a green one to show she was away so they could come in to eat and take a bath. The piece of cloth was to be tied at a window facing the road.

Discontinued from school

After a few visits, I noticed the children didn’t know how to read very well and on probing further, the boy told me they had been discontinued from school. I began tutoring them whenever they came home.

This “programme” went on until I completed my O levels at Ngara girls which was a day school then, but I lost contact with them, after joining a boarding school for my A levels (form 5 and 6). But that experience sparked undying passion in me. This thirst for humanitarian work later spiralled into bigger programs.

As I waited to join college, I started selling fruits in town to earn some pocket money. I would go to the market very early in the morning to buy my supplies and distribute to supermarkets. I started noticing homeless people sleeping in the streets every day. I was drawn to them and got to understand how they had ended up out in the cold. Some families had very intelligent children who were not getting the education they needed to break the cycle of homelessness and this really disturbed me. I began thinking of how best to help the children get into school and my research led me to a school called St. Mary’s in Karen, Nairobi.

Here, I had a chat with the late Mrs. Kimathi, a teacher from the school. I told about the children in the streets and to my pleasant surprise, she told me that she had been thinking of starting a school for vulnerable children. It was a perfect match.

The integrated school

Together, we established St. Francis Integrated School in Karen. Mrs Kimathi took up teaching roles and recruiting teachers and I fund-raised and looked for people to support the program. I was approaching 23 at the time and my passion to help vulnerable children was in full gear.

We had paid streams for those who could afford a subsidised school fee and unpaid streams for those who were unable to raise any money. At first, the focus was getting the children access to education and basic needs but as we continued with the program, I realised the children were captives to a failed system –poverty, lack of healthcare and leadership crisis at the national level.

By this time, I had become a mum and my campaign work levelled up as I realised that better systems were needed not only for vulnerable children but for all children including my own. I knew it was time to upscale my programs beyond the small community I was in and take it at national level.

Meeting Mwai Kibaki

I started a program to empower young mothers earn a living from music, theatre, drama, and bead-work. In the course of my research for this program, I booked an appointment with the late Njenga Karume, but whenever I went to the office, I never found him. By coincidence I bumped into the late John Keen at Karume’s office. Keen was a prominent politician back then. He had seen me at the office severally and was curious to understand why I kept showing up, with notebook in hand.

We had a conversation and I told him about my program. He took me to the late and former president, Mwai Kibaki’s office, and introduced me. I got an appointment for the following week to discuss my ideas with the former president. I told him about my work with vulnerable families. I expressed my concerns about the lack of education among street families. I explained that running the integrated school was like a drop in the ocean. We had this conversation in the year 2000, just two years before he became the president. Although we never talked again, when he took over the government, he implemented free basic education for all the children upon assuming office.

To ensure that street children were not left out, we revived social halls to rehabilitate street families. They bathed, ate and led better lives, eventually transitioning to the free public schools without feeling out of place.

Major milestone

The free education programme was a major milestone in the country and it gave me an opportunity to explore the area I am now passionate about. As I worked with vulnerable families, I noticed that there was a pressing problem in the health sector. Some of the young mothers would contract Tuberculosis, which was (and still is) highly infectious. The diseases then spread to their children and other close associates. Poor health in a family unit may lead to a vicious cycle of chronic illnesses among family members that never seem to get out of the rut. I felt pressured to educate the masses on basic health. With the free education in place and working, I felt it was time to shift focus on another crucial issue that affected vulnerable families; healthcare. I closed St. Francis Integrated School in 2003, and ventured into Health Education and Research.

Milestones

I founded Disease Eradication Civil Society Assembly (DECSA), which deals in health education, patient support and connecting patients (especially cancer patients) with potential sponsors. We also try to link food suppliers with vulnerable patients so they can get basic nutrition as they continue to take their medication. Patients often require more specialised diets than an average person and sometimes their income cannot cater to their dietary needs while providing for their families and paying medical bills. DECSA caters to both communication and non-communicable diseases. We have worked with patients across the country through referrals, health education programs in the media and other platforms and WhatsApp groups.

I have also been very vocal about disease eradication through my books like The Doctor Must be Crazy and Handy Tips on Cancer, talks and petitions and lobbying with the government. I was the first person to write a book on Coronavirus in Kenya, just six weeks after the first Covid-19 case in Kenya. Though I research and educate people on all matter’s health, I am mostly, drawn to two areas; Cancer and TB. I was part of the team behind the campaign geared toward declaring Cancer as a National Disaster in 2019 which attracted a lot of attention. It has been a long journey and a lot more still needs to be done. But there are a lot of milestones I celebrate today.

Free basic education

Being a pioneer of free education from vulnerable children at St. Francis, I am happy to have inspired the late President Mwai Kibaki in introducing free basic education.

In 2018, I wrote to the PS of Education, requesting for health education in schools. The program was to cover more than just guidance and counselling which was already there. In 2020, Health Education the Ministry of Education incorporated health studies into the curriculum.

 I lobbied for Cancer and TB patients to be treated without waiting for the usual NHIF maturity period and this bore fruits. I’m currently running a program called Adapt a Patient, through Cancer Information and Education program which I founded with Jane Francis. It involves requesting the capable masses to adapt a cancer patient and pay for their NHIF monthly remittance. It has been going on for the past three years and it is doing well.

Reactive culture

In my work around health education, I noticed that as a country we are dealing with many obstacles that stand in the way of us becoming a healthy nation. Ignorance is one of the biggest challenges. A good example is our eating habits. In the morning, most of us will take tea and bread, then at 10 we take another cup of tea and add rice and potatoes over the lunch hour. In the evening, one might invest in a healthier meal. A lot of us are eating to eliminate hunger, and we never stop to think about our nutritional needs.

There is also a big problem in our culture which is more reactive than proactive. When a loved one in the family is diagnosed with calcium deficiency, we start altering their diet to increase their calcium intake. What we may not understand is that our eating patterns as a family might have led to that diagnosis, and other family members are at risk of getting sick too. Instead of evaluating our diet, we just focus on the diagnosed person.

Poverty is also a major challenge. It’s hard for a patient who slept on a hungry stomach to spend whatever money they get on bus fare to the hospital instead of basic food. Our farming methods also need to be checked. We are using pesticides, chemicals and inorganic green houses to produce food yet consumers may not have the capacity to tell which food products are safe before buying. I think the ministry of health and agriculture should work on establishing safety standards. These are some of the reasons I insist on preventing disease through health education.

The universal healthcare goal

My biggest goal is to see our country achieve Universal Healthcare. According to WHO, UHC means everyone can access health facilities and receive quality health services, when they need them, without going through heavy financial burdens. Unless we achieve UHC, we cannot tackle all other problems we face as a country. A sick nation translates to an uneducated population, a weak economy, poverty and security issues. It’s all interconnected.

But we cannot achieve UHC is people do not understand the basics of disease prevention, drug adherence and nutrition. In the past we have tried to achieve universal health coverage, which is different from Universal Healthcare. Coverage is not sustainable because healthcare facilities will just be overwhelmed with patients who can access free or cheap services. Healthcare, then becomes a business. But when people are informed, they take care of their bodies and are able to detect symptoms early. Health education should start from primary school, all the way to adulthood.

Sick nation

Regrettably, it is taken an overwhelmed healthcare system for us to become more receptive to health education. For the years I’ve been educating people on health matters, I have seen people become more receptive and thirstier for knowledge. While this may be due to improved literacy levels or spread of information through social media and mainstream media, our experiences with health issues and sick loved ones are compelling us to learn more. Most us have a loved one, a friend or a neighbour who has lived with or died from a chronic illness. We are all affected by poor healthcare directly and indirectly and it is taking a toll on us, emotionally, financially and economically.

As individuals we have to take our place and take up roles in healing the country. The family unit is at the core of this healing journey. If children are taught how to cook vegetable properly, cleaning fruits and vegetables, drinking enough water, and eating a variety of nutritious foods at an early age, they grow up with healthy and sustainable habits which eventually translate to disease prevention among the masses.

Negative eating habits are also acquired at the family level. Often, people struggle with chronic illnesses which may seem genetic, while in reality, it could be a specific food the family has been eating for decades that’s causing the diseases. If you have eaten food with lots of bad cholesterol since you were a child and you pass on the same eating habits to your children and they pass this on to your grand-children, you are likely to find multiple cases of cholesterol related illnesses and possibly deaths in the family. But well-informed families can evaluate themselves and break such habits, which reduces the cases nationally.

Then there is hygiene which is also an important piece to the healthcare puzzle. Sinks, toilets and surfaces spread diseases and children can only learn to clean up after themselves at home. But when all the work is delegated to house helps, they will never learn.

Poor and wanting

Unfortunately, the state of the family unit in Kenya is very poor and wanting. People do not understand why they are starting families. Some have hidden agendas, unrealistic expectations and others just want to fit in or meet the society’s expectations. When two people who do not know their responsibilities in a union, they fight and children suffer. In the long term, this translates to people abandoning their responsibilities. Unless we start building healthy family units, we will continue to grapple with an overwhelmed healthcare system.

We can always repair our family habits little by little. Simple lifestyle changes such as ensuring everyone takes a spoon of vegetables every day, drink enough clean water, eating more fruits or just drinking glass of warm water in the morning can make a big difference. Also avoid stress and learn how to address conflict effectively so as to protect the mental well-being of every member of the family.

Dealing with diagnosis

Nevertheless, there are those who are reading this after receiving a heart-breaking diagnosis. There is still hope. For a successful healing journey, take time to research and understand the diseases. Take note of the dos and don’ts; dos are the things that will improve your health and don’t are those that worsen the condition. Self-discipline is also important as you need to adhere to treatment and maintain a healthy lifestyle. Lastly, understand the treatment and how it works in your body. As for caregivers stay strong and positive.

Let’s bear in mind that we are responsible for our health. There are no spare parts for our bodies, hence we need to start understanding what our bodies need. Your health is your asset, let’s invest wisely for ourselves and our families. Most importantly, share what you learn with your loved ones. One of the lessons I have learnt this far is that it doesn’t take a multitude to make a difference, just one willing and committed person can inspire change and make the world a better place.

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