for a greater community
Call Us: +254 737 053 003

Kenya’s Father Of Paediatricians

Kenya’s Father Of Paediatricians

 

 

 

 

 

 

 

 

 

Report By: SIMON MULI

To medical practitioners in Kenya, Dr Mohan Lumba, OGW, needs no introduction, not least because of his professional credibility that spans more than 40 years. It is also because hundreds of the country’s paediatricians have trained under his tutelage or that of his students, something that has earned him the tag ‘father and grandfather of paediatricians.’
Dr Lumba’s contribution to the growing history of paediatrics in the country is immeasurable. From treating and teaching, policy formulation and community welfare, even civic duties, the father of three has worked to shape the local pediatrics landscape. Now in his professional sunset years, Dr Lumba still offers daily consultancy, drawing gratification from the comfort of a child who comes in wheezing and in respiratory distress and leaves with a broad smile, breathing normally, much to the delight of the parents. The pioneer paediatrician talks about the past, present and future of paediatrics in Kenya.

What sparked your interest in the medical profession in general and paediatric in

particular?

I was convinced from a very early age that my future lay in the medical field. I was fascinated by the aura of the profession. I qualified as a pediatrician in 1972, with special interest in asthma. I then started teaching, first in India and later here at The University of Nairobi School of Medicine at the Kenyatta National Hospital (KNH) in 1975. At the time there were only three pediatricians at the University of Nairobi (UoN) and two at Ministry of Health. The first batch of pediatricians qualified a year later. For many years, I was in charge of the main Pediatrics Teaching Ward (POW) at KNH. Thereafter, I went into private practice.

How was that switch into private practice for you – which did you prefer?

I have no preference; I was treating patients and running the hospital, although there was less teaching then. The UoN appointed me as an honorary lecturer and later on as an external examiner both, for the undergraduate and post graduate students. I find it very gratifying to comfort a child who comes in wheezing and in respiratory distress. To see him walk out of the clinic with a broad smile and breathing normally not only delights the parents but also fills me with joy. At the same time, I am a teacher and as such, have always taught my students that “the best way to learn is to teach.”

Teaching or treating, you have helped shaped the landscape of paediatrics in Kenya over the years. What are some of the
triumphs of your career, as a pioneer
paediatrician, that you are most proud of?

There are many. One of them is launching all the new vaccines in the past 30 years, so as to increase immunisation cover for children in Kenya. This has helped prevent common childhood infections and decreased childhood morbidity in Kenya. I am also the Founder Chairman of the Kenya Pediatric Research Consortium (KEPRICON), the research arm of the Kenya Pediatric Association and have been the Chair for nine years. I was made the first Honorary Life Member of the KPA and I was it’s elected Trustee.  I have also received a Commendation Award from Nairobi Hospital. I have published widely in peer-review journals and in the 1970s, highlighted speech and hearing defects in children as seen in KNH. The findings of both studies were published in East African Medical Journal. I have been the Chairman of Kenya Association for Prevention of TB and Lung Diseases (KAPTLD). In conjunction with Ministry of Public Health and Sanitation, we launched ‘Guidelines for the Management of Asthma in Kenya.’ I am also the Chair of the Influenza Task Force (Swine Flu) and the Kenya Typhoid Awareness and Prevention Campaign (KTAPC). I have represented Kenya in various capacities in over 25 countries including being a chair of the Scientific Committee of the second and third Kenya International Scientific Lung Health Conferences in Nairobi and also Chaired at the ‘All Africa Summit on Pneumonia’ at Cape Town, South Africa. At the “International Pediatrician Congress” held at Cancun, Mexico I was invited to give the vote of thanks on behalf of 110 International Pediatrician Societies. In 2014 I was the presiding chairman for the 10th “International Congress of Tropical Pediatrics” in Nairobi. I have also been invited to chair and present at many seminars and symposiums and sit as Board/Committee member of various “Medical Advisory Committees.” I am proud of all these achievements.

Children nowadays face an elevated risk of suffering from ailments that were once seen as a preserve for adults, such as cardiovascular diseases. What is going on?

Diet is contributing a lot to this. Parents nowadays don’t have time to cook because they are working. The economic situation forces both parents to work to survive. Therefore, they purchase ready-made junk food from the supermarkets. Children, on the other hand, spend a lot of time sitting and watching television, playing on their iPads and eating whatever is in the fridge. They rarely exercise. Some children I know go to school as early as 5.00am and return around 6.00pm. What do you expect them to do? They have no childhood and it is a cause to worry for paediatricians.

Dr Lumba, being a parent, especially a first time one, can be quite overwhelming; being told what to and what not to do, try this or that – how can they navigate through this information overload and separate fact from fiction?

As a child specialist, the paediatrician is essentially the myth buster whom parents can depend on. They know a lot about the growth and development of the child, be it physical, mental or psychological. They also administer vaccination in order to prevent the child from succumbing to diseases. Parents therefore need to discuss with paediatricians to derive the scientific and emotional basis of the problem.

One area that is often causing debates is on how to feed babies. Which way between breastfeeding and infant formula do you think parents should go?

Breastfeeding has all the benefit for the mother and babies. It helps the mother and the baby bond through skin-to-skin contact. There cannot be a more intimate connection between a mother and child than that. The World Health Organization (WHO) recommends all children must be entirely breastfed up to the age of six months. The international recommendation is that as long as you have milk, breastfeed. Kenya Pediatric Association (KPA) has been fighting to encourage breastfeeding and discourage the use of formula.  However, maternity leave is for three months in Kenya. Mothers cannot take babies to work, leaving her somewhat handicapped. That is why when women started working, formula feed was introduced. The initial intent was to help the mother take care of her baby. That is now all over the world; all employment areas have been encouraged to provide areas where babies can be nursed. Mothers can also express breast milk, which can be stored in the fridge for 24 hours and still be fed to the little one while away at work.

Another major issue causing debate is co-sleeping versus putting the baby to sleep in a cot. Which one would a paediatrician recommend?

Our parents and grandparents always slept next to us, because baby cots did not exist back then. This is more of a European concept. If you keep a baby away from you, how will you bond? That is why you see in hospitals now, when children are admitted, there is a provision for a big bed to allow the mother and child to share the space. It is always better to keep the child as close to you as possible.

You have done a lot of work with vaccines and immunisation. Do you think parental refusal to immunise children should be deemed as medical neglect?

Yes. In many developed countries, unless your child is fully immunised, they cannot be admitted to school. Even here, that should be the case but we lack the facilities to check up on this. Approximately 30 years ago, the City Council used to visit schools to check if children had been vaccinated. They no longer have the manpower to do it these days. Parents may refuse vaccination because of religious and wrong beliefs; they should be reminded that “Vaccines Work.” And this can be seen by the eradication of small pox and measles and from most parts of the world, polio. An old saying goes, ‘Prevention is better than cure’. A more current saying is, ‘What can be prevented must be prevented.’

There are three countries which are not polio free; Pakistan, Afghanistan and Nigeria. What explains the recent polio vaccinations campaigns in Kenya?

There is Polio Type 1, Type 2 and Type 3. Type 2 is usually a very mild disease and therefore, WHO recommended the discontinuation of Type 2 polio in oral vaccines. However, what happened is that when the Ministry of Health cultured sewage, they found the type 2 polio virus in Eastleigh. This turned out to be vaccine Type 2 virus. It is not dangerous, but you still have to administer the vaccine to be safe.

Moving on and what do you think about the future of paediatrics in Kenya?

There is an increased number of medical schools. We have three universities churning out paediatricians. In other four or five years, every district hospital will have a paediatrician. That being said, however, the commitment of doctors in general is not like what it was 40 years ago. 

How about parents; how supportive are they of paediatricians?

Parents have become more aware and worried about children as they opt to have few children. They now prefer to take their child to a paediatrician than a general practitioner. Secondly, because of the internet, they are more aware of the diseases children are suffering from. Most parents I know ‘Google’ on the diseases ailing their kids – but you can’t help it because they come and tell you about what they found out. For instance, if a child has a temperature, headache and is vomiting, a parent will tell you that Google says the child may have menengitis. Now, that is the rarest thing to think of. The thing about medicine is that common ailments occur commonly; the rarer your diagnosis, the rarer your chances are of being right.

How do you handle the problem where a parent feels you haven’t treated their kids if they don’t leave the hospital with a bag full of medicine?

First principle in childcare is no medicine. For the paediatrician, if you have to, prescibe the mildest of medicines. If the mildest is worse than the disease in terms of side-effects, don’t use it. Let the child know how to fight, conquer and develop immunity. Don’t rush to give the medicine.

You have also done a lot of work in the society, not just your Arya Samaj community, but elsewhere too. Could you highlight some of that?

Yes. I have been actively involved in the Hindu Council of Kenya (HCK) and have been a member of the Managing Committee and as well as a past Vice-Chairman. I have also been a member of the Managing Committee of the Arya Samaj, Nairobi and its Vice Chairman. For many years, I acted as the Ombudsman for the Arya Samaj community in Kenya, helping resolve internal misunderstandings and complaints. I also held the Docket to Chair ‘Conflicts Resolutions’ between various Hindu societies, families and individuals, so as to keep harmony within the societies affiliated to HCK. At the moment, I am involved in putting up for the Arya Samaj community, an ultra-modern state-of-the-art nursery school. I am the convener of this project. On numerous occassious, I have been honoured as a Chief Guest at various Hindu religious functions. I believe in the words of the Bhagwat Gita which say, ‘You only have the right to perform your duty but are not entitled to any benefit resulting from your action. At the same time you are not entitled to a state of inaction. Never consider yourself to be the cause of or for the result of your activities. Act according to your stature without any hope of enjoying the fruit of your actions.’

Well put. You have also done a lot of civic work in the country. What are some of the things you would like to highlight?

I was nominated by the Hindu community as one of the nine panelists to select the Chairman and Commissioners for the Independent Elections and Boundaries committee (IEBC). We were five from the religious society and four from the political side. It was an honour to serve in that capacity. I was a lead committee member to finalise the ‘Draft Rule & Regulations for the Hindu Marriages Act,’ under the Attorney General’s office. I was also actively involved in discussions regarding the rules to formalise ‘The Religious Societies Regulation Act,’ to be approved by an Act of Parliament. I have also compiled and written constitutions of KPA, KAPTLD, KEPRICON, Hindu Council of Kenya and Arya Prithinide Sabha and Arya Samaj.

What do you do during your free time?

I read the Bhagwat Gita a lot. I also read a lot about recent advances in the medical field. The whole management of medicine has dramatically changed because now, it is ultimately boiling down to the genetic basis of medicine. We were not taught those; you have to keep in touch.

What advice would you give upcoming paediatricians?

To be honest to yourself. Know your limitations and do the best you can for your patients. The biggest fool is he who deceives himself. If you think you don’t understand a problem or you can’t handle, it refer it to a senior colleague.

Looking back, what makes you most proud about your professional life?

That many paediatricians I have trained are now training others. If my students can step into myshoes, what more could I want? The old order changes and must give way to the new.

Read Paper

Newsletter Sign Up



Traffic

Pages|Hits |Unique

  • Last 24 hours: 0
  • Last 7 days: 0
  • Last 30 days: 0
  • Online now: 0