The unlikely doctor inspired by mother’s death to help others

Dr Stephen Mutwiwa

Jhpiego country director for Kenya, Dr Stephen Mutwiwa, when he obtained a PhD from the Great Lake University of Kisumu in 2013.

Photo credit: Pool

1973. A boy is born at one of the farthest corners of today’s Makueni County, right next to the Tsavo National Park. Stephen Mutwiwa is his name. He is the sixth child of the second wife of his father, who has 14 children in total.

1986. The boy is to head to Class Eight but his father is struggling with school fees. His father wants him to repeat Class Seven to let his elder siblings complete their studies. His teachers won’t have none of that.

This is a boy too bright to waste three years of his academic journey, they think. They help him apply for a scholarship at Starehe Boys Centre and School. The centre accepts him. He sits KCPE, excels and is admitted at Machakos Boys. The centre pays his fees for the entirety of his secondary school.

1989. Mutwiwa gets a strange illness while in Form Two. Body pains and diarrhoea are among the symptoms. It is strange because whenever he is planning to see a doctor, the disease mysteriously disappears. And it bounces back when he returns to school and takes supper. It also “hides” when he takes a bus from Machakos to head home in Makueni.

Could this be the infamous Ukambani witchcraft at play? Could someone envious of his performance be out to sabotage his studies? He keeps wondering. Machakos Hospital is just across the road from Machakos Boys. There, doctors examine him and tell him that the specialists who attend to what is ailing him are based at the Kenyatta National Hospital, and that they visit every six weeks. So, they give him a date he should return.

He comes back on that date and is subjected to lab tests, questions, and more questions. Then they give him a humongous tablet. He has never seen such a huge tablet in his young life. A doctor also gives him a piece of paper with some writings on it. Medics don’t tell him a word about what is suffering from. It is a handwriting he can’t decipher. It creates this lofty dream in him: ‘I will work hard and become a doctor so I can read what they wrote about me.’ I will also be a doctor who explains things to my patients, not give them cryptic notes and pills without explaining, he tells himself.

1990. Mutwiwa’s mother is involved in an accident when fixing a roof for their house. In the Kambu area where he comes from, it is women who do house roofs during those times. She falls and injures her back. She is admitted to the Machakos Hospital for well over two years, until Mutwiwa is almost done with his secondary education. On many Saturdays, he takes a break from school to be with his mother in hospital. Another resolve builds up in him. He wants to become a doctor so he can treat his mother. He thinks she can be helped because, except for her back, she is doing just fine. She chats as usual, though she can’t do much. He thinks there is a way he can help her.

1991. Mutwiwa gets someone who preaches to him about God when at home for December holidays. He readily accepts the message of salvation and prays for forgiveness, for he believes he has been living a “dirty” life. He prays fervently for recovery against this enigmatic disease. Somehow, by the time he is in Form Four, the disease has gone away. It never attacks him again.

1994. Mutwiwa is a third year medical student at the University of Nairobi. He is in a microbiology class and they are examining a number of organisms under a microscope. Then as he jots down a word, his brain immediately clicks with the scribblings on that piece of paper that contained his prescription when he was sick as a high school student. It is a piece of paper he has kept for all those years. The main subject of those scribblings was bilharzia, he figures out. The disease that doctors didn’t tell him about was bilharzia. And being one of the boys who swam in River Kambu that has been known to be infested with bilharzia-causing organisms, it doesn’t come as a surprise to this medical student.

1999. Two months before Mutwiwa graduates from medical school, his mother dies. It shatters his heart. He went to medical school to find a solution for his mother’s condition; to understand the ropes and rock that medics had tied to her in hospital for months on end; to understand why that injury was beyond the reaches of modern medicine. He wanted to come up with a way to cure her. But now she is dead. Being the reflective person he is, he resolves that henceforth, he will go out and treat the mothers of the world.

2001. Mutwiwa is posted to Voi's biggest hospital, today known as the Moi County Referral Hospital – Voi. There, most cases he attends to are either accident victims courtesy of the frequent Mombasa Road crashes or complicated births due to a belief that “real” women should be able to push out children at home. This notion that women who deliver without the intervention of a doctor are the ideal type disturbs him. One particular case requires him to conduct a long and complex surgery because a birth went so wrong it ended up in a dead baby showing up in the mother’s intestines. He handles so many cases of mothers that his peers feel he should specialise in gynaecology or surgery. But no, he wants to pursue something else. He works out that if he goes into those recommended specialisations, he will be receiving women who are already in complex situations. Why not go into global health so he can educate communities on better practices and see how policies can change by engaging leaders and other stakeholders? He asks himself. And that is the direction he takes.

2008. Mutwiwa, now Dr Mutwiwa, sees his last patient in a hospital setting. He is now ready to go into global health. Being a specialty that deals with the policies that guide medical practice on the ground, he feels he is ready to spark change.

2010. Dr Mutwiwa joins Jhpiego, an affiliate of the Johns Hopkins University that has been in Kenya for since the 1970s. He joins as a technical advisor. Because Jhpiego is big on reproductive health policies, he considers this a natural fit into his aspiration to change things from the ground before they get complicated in the final stages. Jhpiego, whose initial name was the Johns Hopkins Programme for International Education in Gynaecology and Obstetrics, has engaged in various health activities in Kenya like supporting facilities that offer antenatal care, backing initiatives for HIV counselling and testing plus HIV care, supporting malaria programmes, adolescent and youth health, among others.

2015. Dr Mutwiwa becomes the Jhpiego country director for Rwanda after a stint at Jhpiego’s Embu office.

2018. Dr Mutwiwa becomes Jhpiego’s country director for Kenya. But he hasn’t yet handed over in Rwanda, so he operates in both countries for some time.

2019. The DusitD2 terror attack. Jhpiego’s head office is one of the tenants at 14 Riverside Drive. The afternoon terror attack happens as most of the staff are in. But due to his rotation between Kenya and Rwanda, the Tuesday when the attack happens finds him in Rwanda. He is promptly informed of the attack. People are hiding under chairs, he is told. Gunshots are ringing. Explosions have torn into the quiet of this address. Some staff have jumped down three storeys, scaled a wall and escaped along the river he sees to his left when in his office. He takes it upon himself to ensure everyone is safe, even from far away in Rwanda. By a stroke of luck, the terrorists don’t enter the block containing the Jhpiego offices. A memorable photo taken later that day captures panicky Jhpiego employees squatting behind a police officer with a ready gun as they are being led to safety. The man behind the officer is a former military doctor, who was a major in the defence forces before joining Jhpiego. The others are shaken employees praying that they live to see another day. All make it to safety. Jhpiego doesn’t lose a single employee in the attack, though the other offices are not as lucky. When Dr Mutwiwa later returns, he finds a bullet hole in his office window facing the main entrance of the complex. He doesn’t want to think what the bullet could have done if it found him in there. The employees are later counselled, then asked whether to stay at the complex or move elsewhere. They overwhelmingly vote to stay put, in a show of defiance against terrorism.

May 4, 2023. 8 am. Dr Mutwiwa arrives in his Riverside Drive office for a morning interview with Lifestyle. He is carrying a bag with him, which later we learn is carrying his prized meal of githeri. An enthusiast of traditional dishes and non-refined carbohydrates, he eats only two meals a day: breakfast and lunch. No heavy meal for him after 3pm.

“My routine does not have dinner,” he says. “I can take fruits, but I will not take a meal. Of course, there are exceptions if there are visitors, if there is a party and all that.”

In the interview, he explains a couple of things, among them the question on whether doctors are actually trained to write illegible things — which is why he couldn’t read the note that made him desire to go to medical school.

He replies to the negative, accompanying it with a laugh.

“There is actually emphasis, especially nowadays, that your writing should be legible. But from my experience, first of all, the training is usually very intense and quite fast; so you have to learn how to write fast,” he says. “Secondly, again from my experience, a lot of your writing you do when doing the ward rounds when you are standing. So, you are holding a piece of paper in the name of a file and you have to write those details.”

Being the Jhpiego country boss means there is a lot on his plate. With about 117 employees and 17 projects currently across different counties, and given that he has to update the headquarters regularly on what is happening, he is always engaged.

His mornings are usually packed with meetings.

“My team in the headquarters is waking up around 2pm or 3pm my time. So, I have to engage with them for the better part of the afternoon and late in the evening,” he says. “Between 4pm to 6pm, I like to switch off and get into a kind of relaxing mode, where either I’ll go for some jogging or I’ll just be meeting friends for social interactions. Later at night, I can look at what came in that needed some urgent attention before I sleep.”

Jhpiego is supported by a list of organisations that include Usaid, Johnson & Jonhson, Bill and Melinda Gates Foundation, Unitaid, among others, that fund various projects.

“The fact that we are donor-funded means we are project-based. And projects come and go. If you’re finishing a project, it means you are letting go of staff,” he says, noting that managing the human resource under him is always an acid test as some people may feel aggrieved.

“Human resource management has to be in line with the labour laws. And all other operations have to be in line with the laws of the land,” says Dr Mutwiwa.

He is a single father of three children aged between 21 and 15. On Sundays, he likes sharing a meal with the family. And when he has time on his hands, he engages in long drives to clear his mind.

“Driving long-distance gives me a way to relax. Getting out there at the village gives me an opportunity to interact with nature and just sit there and look at stuff and come back to Nairobi totally energised and refreshed,” he says.

An ardent fan of English Premier League side Arsenal, Dr Mutwiwa is a firm believer in mentality and how it affects athletes.

“A lot of times, it’s your mental status that determines whether you win or not,” he says, noting that mentality is often the determiner of how the table settles at the end of a season.

“[The final games of the season] are now a mind game. It’s not technical. All the guys are technically good. But it’s the stamina of your mind,” he says.

He is also a financier of Wembe Queens, a girls’ football team that has surprised many by its achievements, having four of its players recently selected to the Makueni County team that carried the trophy earlier in May after beating Siaya County 5-0 in the women’s final of the Kenya Youth Inter County Sports Association Games.

“All the five goals were scored by one girl from the village. So, I’m very proud,” he says.

As a parting shot, he believes more can be done to ensure Kenyan women get attended to during their pregnancy.

“What if we can get to a situation where a woman is able to know they are pregnant the day they get pregnant and the same day they get linked to the health system?” he wonders.

“Whether that will take totally reorganising the health system; whether it will take more use of technology, it’s something that I believe is possible. If today we have our phones in our pockets, I don’t think there is any limit,” adds Dr Mutwiwa.


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