Slow emergency response threatens our lives. Time to fix this.

First published Sunday Standard, November 12, 2017. Kindly reproduced here with permission from the Standard Group

The horrific accident that claimed the life of Nyeri Governor Wahome Gakuru has briefly shattered our sense of road safety once more. Sadly, he joins the worrying NTSA statistics that over 2,000 die on our roads each year. Within five days, it seems we have moved on to avidly discuss witnesses, his successor and burial arrangements. Yet, we have left the bigger question, how do we keep all Kenyans safe from emergencies?

One in ten of us will die in an emergency. Whether on our roads, giving birth, battling a heart attack, attacked by criminals or caught in a fire or collapsed building, we are at risk. Regardless of our politics, ethnicity, age or gender, this is the one equal opportunity destroyer. Without a functioning emergency health-care system we are all at risk.

Two years ago, a young security worker Alex Madaga was hit by a speeding vehicle and died after an unbelievable 18-hour journey in an ambulance. He did not have the power, privilege or visibility of Gakuru. He probably earned a tenth of the Governor’s salary. Like Gakuru though, he had a wife and children that miss him to this day.

The basic conditions needed to save Madaga in 2015 are sadly, still largely absent. Poor response times, under-resourced and poorly integrated facilities continue to facilitate thousands of deaths across this country. It took 40 minutes for the emergency services to reach our Governor and 60 minutes for him to reach Thika hospital. Without an emergency number, by-standers crowdsourced help from friends on social media. Horrified and helpless at what else to do, others simply took photos. Another valuable life was lost.

Propelled by the outcry after Madaga’s death, our Parliament passed the Health Act (2017) to give teeth to the constitutional promise of our right to emergency care. It is now a criminal offence to deny any patient life-saving stabilization care. Administrators of private or public facilities now face imprisonment or a fine of up to Kshs 3 million should they violate this right. Citizens must demand the full enforcement of this law.

It is only by doing this, that the traumatic experience of Madaga’s widow that fateful night will not be repeated. Pressed by the Kenya Ethical and Legal Issues Network NGO, The Medical Practitioners and Dentists Board found Coptic Hospital and Kenyatta National Hospital guilty of professional misconduct. Coptic had demanded Kshs 200,000 before they could admit him while Kenyatta kept him in an ambulance for four hours without referring him to any of the several private hospitals within a five-kilometer radius.

On Friday, national icon and one of the fastest runners alive David Rudisha, Emergency Medicine Kenya Foundation and KTN staged an unkind public stunt at the world premiere of Kenyan movie 18 Hours. He feigned injury, was placed in an ambulance and attempted to travel 2 kilometers in the Friday Nairobi traffic. Predictably, he got halfway and got out and ran the rest of the way carrying his insulin drip. His trip demonstrated the dangers of not having a single toll-free emergency number, our traffic behavior and the lack of an integrated public-private healthcare system.

Without effective ambulance quality standards, too many county governments have been allowed to remove seats and rebrand matatus as ambulances. Most have only one destination, Kenyatta National Hospital. Last week, the Economist magazine pointed out Kenya has 50 emergency ambulance service numbers. Is it time for FLARE? One of them is the NHIF, Red Cross and E-Plus number 1199. I tried it at 10.53am yesterday. Twenty rings later no-one had picked.

The inclination of our first-time responders and everyday heroes to rush all cases to Kenyatta National Hospital needs to be gently challenged. It is behavior learned from hard experience. Private hospitals often do not accept critical patients unless they are admitted with gold insurance cards, sacks of banknotes or a title-deed. It begs the question, is there another Constitution and Health Act that these institutions operate under?

Lastly, until our 47+1 Governments start investing more in ambulances and health-care than we spend in luxury limousines and public office perks, this problem will continue to endanger us. Perhaps, these are the conversations and choices we should be having in the wake of Gakuru, Madaga and all those who have died on arrival at our health-facilities. It would better honor their sacrifice.


National healing can take many avenues

First published Sunday Standard, November 5, 2017. Kindly reproduced here with permission from the Standard Group

Our thirteen billion shilling October 26 Presidential elections did not fix our politics last week. After an election and weeks of the IEBC, independents, business, civic and religious voices called for a #Return2rReason and national dialogue before the elections, JP hinted they may be ready for dialogue with NASA/NRM.

Too late. Their opponents already moved to a 90-day strategy of people’s assemblies around longstanding grievances and economic boycotts. The political ground just shifted and citizens were served with two choices – move on or scale up and join the resistance campaign.

Political strategists and children have one thing in common. They love to play games. Creating game theories is an essential part of the fun. The basic question all games revolve around is when to stage conflict or seek cooperation with your opponent. For the last 90-days we have been playing the game called “chicken”. This is the one where two matatu drivers speed towards each other until one of them swerves. Swerves by NASA and JP have saved the country from ruin but left some of us reaching for pain-killers or attending funerals. This column has repeatedly called for our political leaders to play another game, the age old Maasai game of collective cattle-herding. The cattle in this case, are Kenya’s common interests.

Reasoned voices are now calling for constitutional reform to fix the political stand-off. Expand the cabinet to a Prime Minister and two Deputy Presidents, re-introduce the parliamentary system or stagger the six level elections to allow the losers to vie for other positions are some of the ideas floating around. There are two viruses that come with these arguments. Firstly, Kenyans are over-represented as it is. I am not convinced that the quality of our democracy or essential services will improve. Secondly, mature constitution-making requires constitutionalists not opportunists seeking positions.

NASA/NRM’s strategy exercises our belief in public participation. They seek to create conversations around electoral justice, effective devolution, security reform, deepening democracy, stopping corruption and an inclusive economy. The one issue that is conspicuously missing is national cohesion. Thankfully, the street protests are now on hold.

In this moment, JP seems caught like a gazelle in NASA/NRM headlights. The party strategists are considering four options; clampdown, bribe the leaders, negotiate a deal or seek mediation. The first two options are familiar. More controversially, they are the reason we are in this dark place.

Heavy-handed and dismissive politics has produced the fear of exclusion and destruction among many. Transactional politics has produced the obsession with “state positions and goodies” and the zero sum politricks we experience.

Leadership requires getting ahead of all the people, especially those that don’t follow you yet. Remaining self-interested, short-term focused and tactical will not work. There are some possible places to start. Convene a public review of the police service and the human rights independent offices, constitutional commissions and NGOs to discuss how live bullets will never again be used on protesters and bystanders including infants and school-children.

Revive and make the Truth, Justice and Reconciliation Commission report the first order of business in the National Assembly. Commence the Public Benefits Organisations Act and restore some policy sanity to the development sector. Declare intention to reform the Leadership and Integrity Act (2014) and the election and campaign financing regulations to give it some real teeth and rein in the abuse of public resources. Act decisively on the gender two thirds constitutional promise.

Reassure our constitutional offices and the Judiciary that they will be adequately financed and their independence respected. By not dealing with long-standing grievances, the previous national administration has handed the new administration-elect some real issues to deal with. They can either repeat the strategies that led us to this point or declare a break from the past and regain the confidence of the 71% who didn’t bother to vote last week.

Two giants from different parts of the country also died this week. Communications expert and leadership coach Prof Okoth Okombo and Catholic Bishop and peace maker Cornelius Korir. They were very different and equally remarkable human beings. Okombo excelled in provoking us to be bold, articulate and effective leaders. Korir spoke to our compassionate and caring side. Both spoke courage fluently and on many occasions, truth to power. We must become them. Our country depends on this.


Common-ground not battle-grounds are what we need to build now

First published Sunday Standard, October 28, 2017. Kindly reproduced here with permission from the Standard Group

The boil just burst. Like most boils, these presidential elections are a hot mess and have left a gaping wound. With at least ten dead, scores injured and 86 arrests, our nation’s fault-lines have deepened in the last 72 hours. Ethnic profiling, police brutality, anti-IEBC violence and a divided leadership pull us further away from a political resolution. Yet like all other boils, there is an anti-septic treatment for this condition if we are all prepared to listen.

Rigid political interests fueled this current crisis. JP wanted to retain power at all costs and NASA wanted to win power at all costs. The fear of losing the national Presidency has loomed larger in the parties’ minds than any person’s death, even that of poor baby Pendo. In the process, our public institutions, laws and minds became their battle-grounds.  Now that we have some lives on the line in Migori, Siaya, Kisumu, Homa Bay and Kawangware, is it time to revisit the call for building common causes? Now that we know the elections, massive police presence or new laws will not heal our country, is it time to build a common ground?

The fear of the “other” and conflict generates a very real feeling of being in an abusive relationship. The noise it creates can make it impossible to listen to your opponent’s good-will or those voices of reason to dialogue with. Hardliners listen and respond only to other hardliners. Their script is predictable. Watch them call for arrests of leaders, more elections, more laws and “robust” military action. In an unintended way, when they act like this, our leaders are like bald men fighting over combs.

As @JKNjenga wrote this week, we have not yet learned from 2008. Some of us only changed sides. I might add, some didn’t even change sides. I wasn’t born in the state of emergency of 1952. I wasn’t an adult at the beginning of the one-party state in 1969 but I was there in 1994 when the country raged from ethnic cleansing and political intimidation. This feels different, deeper, more pervasive and could be more difficult to come back from. We must approach the coming week with a deliberateness of purpose.

The elections will continue to be messy. As predicted in this column two weeks ago, the turn-out will not give Uhuru Kenyatta a popular mandate. What other options exist for him beyond the predictable knee jerk reaction to grimace, grin and move on?

Kenyatta can publicly call on his leaders to reach out to their counter-parts at the constituency level. He can declare his support for calling off the elections in the four affected counties. Like Johnson Sakaja in the PanAfric Hotel incident, he can bravely calm the youth militia in Kawangware and elsewhere before they plunge the country into further violence. He can also declare his support for an enquiry into the way that the security has managed these elections and the NASA protests. Denied news by his advisors, Kibaki lost his voice for four days as the country burned in January 2008. Kenyatta has a new opportunity to show up.

Raila Odinga and the National Resistance Movement must go beyond asking their followers to stay at home. Their leaders must come out to the road-blocks of Kondele and Migori bridge and dialogue with the angry electorate. They must publicly call for active non-violence and coordinate peace corridors and safe spaces for ethnic minorities. Summarizing @JKNJenga again. Militias are like snakes. You can keep one in your home to scare away thieves but your children may be the first to be bitten.

NASA must also look beyond active non-violent disruption to building inclusive and accountable governance model in the counties they control. A more powerful political strategy than mass “whatsapp lefting” (succession) would be to demonstrate a better governed set of counties and watch the population move to live and work in NASA counties.

By playing to an extremist gallery, politicians are slowly eroding the institutions that give them legitimacy to govern us. Citizens must continue to raise their voices in the spaces we can. Some of us must also create new spaces and narratives that do not inflame the nation. As Van Jones would say, we must move from the battle-ground to building common ground and quickly.

Uhuru and Raila, there is nothing to govern in a divided Kenya

First published Sunday Standard, October 22, 2017. Kindly reproduced here with permission from the Standard Group

October 26 looms. It looms like a boil on our national and personal conscience. Having run divisive campaigns for the last ninety day campaigns, our leaders are unsure how to handle it. NASA chooses to ignore it. JP demands it be lanced whatever the consequences. Beneath these unequivocal positions lies the common fear that neither party’s position carries the entire nation with it. We are now, officially a divided society.

Hardliners dismissed the growing call for dialogue on the management of the Presidential Elections this week. Some argued that the best form of dialogue was the election itself. When in doubt, have a monologue was what I thought of this argument. Others polished up the unconstitutional two-state succession option. Others still, took confidence in their control of security forces.

JP missed the opportunity for consensus building last week. We approach the Thursday elections with a fractured IEBC, serious administrative challenges and only one significant player willing to take to the pitch. For the rest of us, we remain unsure whether it is worth buying tickets to a football match when only one team wishes to play. The country is deeply divided on how to conclude this electoral season.

As Obama tells us, skillfully governing a country after waging divisive politics is hard. A casual review of Bosnian, Congolese or Iraqi leaders’ biographies will also tell you this. Prolonged adversity produces leadership conservatism, intolerance and over-dependency on counter violence strategies. The rest is just tragedy economics. Two police officers for every polling station, one tear gas canister for every five protesters and five body-bags for every demonstration.

Faced with perpetual legitimacy challenges, it takes an incredible leader to continue to invest in actions that expand their legitimacy. Most remain in repeat mode and stop caring what impact they leave on the people who disagree with them. Inevitably, they come to rely on suppressing than transforming dissent. This is why, the next five days may be the defining moment for the next five years.

Whispers of this can be heard already. Did you know Daniel arap Moi ruled the country with less than 20% of the electorate in the eighties? Or did you know George W. Bush became President in 2000 without the popular vote? These arguments normalize mediocre leadership and must be challenged. Should we celebrate also slavery, colonialism and genocidal regimes which also functioned without popular mandates? The real challenge for all leaders in divided societies, Uhuru Kenyatta and Raila Odinga included, is how will they leave behind a nationally cohesive country after they have left our political stage.

The answer lies less in what to do with the egos and interests of our political class. I am convinced that our country’s resources are not big enough to satisfy their appetite for more. Before devolution, calls for more cabinet positions or proportional representation may have been useful inquiries. With 47 county administrations, this argument is less convincing. Pro-actively deepening our national values in all our spaces is where our attention needs to turn.

We must welcome and expand the voices of religious, civic and political leaders who called for consensus-building, the artists engaged in #TuliaTubonge flash mobs, the few police officers who have exercised restraint, the protesters who risk their lives to protest the loss of others’ lives and the community peace-workers who rose to stand between those calling for violence. Leadership is defined less in terms of the position you occupy but more by the direction you are leading others towards.

Ultimately, it is the IEBC that holds the key to what happens next. A day is a long time in politics it is said. Last week, this common phrase got shortened to six hours. There is still time for the IEBC to seek an advisory from the Supreme Court on whether the constitutional threshold of Article 81 can still be met given the current political and administrative conditions. There is still time for Kenyatta like Odinga to meet with our chief referee and then for all the parties to meet.

Should they not, we must accept that the freedom to vote or not to vote is also anchored in our constitution. All JP and NASA leaders and supporters must embrace Kenyatta and Odinga statement that this right shall be protected on October 26. Each of us must vote or not according to our conscience. Choose powerfully.

Time for Uhuru and Raila to drop hardline stance, dialogue

First published Sunday Standard, October 15, 2017. Kindly reproduced here with permission from the Standard Group

This week I write to reach the ears of the two men at the center of our electoral crisis. I write with the courage of the slave who centuries ago walked up to a Roman leader celebrating his recent conquest of the city. He gently whispered, “Remember, you are still only human.” In so doing, he rescued the leader from the danger of believing his own propaganda. The elections crisis enters its tenth week. The stakes for NASA and JP have been high but the stakes for the country have always been higher. A dizzy set of political, legal and media actions has kept us reeling from deadlock to drama, uncertainty to confidence. The most expensive election in our history has bankrupted our Treasury and pushed the majority of our 47 Governors towards the revolving doors of commercial banks. Investors claim we have burnt Kshs 15 billion in paper wealth and business profits have plummeted. Our streets are now battle zones of battered bodies, blood and now body bags. Each political rally and demonstration waters seeds of ethnic and political intolerance. Our public schools are no different. Student learning has been disrupted by two short academic terms while their parents hurl ethnic abuse at each other on social media groups. As they too, talk at each other rather than to each other, the value of dialogue is slowly being crushed. Many of us welcomed the striking down of that vexatious charge of misuse of a licensed communication gadget by Justice Mumbi Ngugi last year. The charge had been arbitrarily applied to intimidate and criminalize scores of bloggers and whistle-blowers. This week, I found myself wondering whether we should institute a selective charge for our leaders for the misuse and non-use of a licensed communications gadget. Withholding communication and dialogue is shattering this country at its core. What is happening between Uhuru Kenyatta and Raila Odinga can only be described in modern relationship terms as “ghosting”. This is the practice of ending personal relationships by suddenly and without explanation, withdrawing from all form of direct communication. This week, the former spoke only to his own supporters. The latter packed his unsigned Form 24A and flew out to England to speak to his foreign supporters. Meanwhile, the deteriorating relationship of their able lieutenants Moses Wetangula and Fred Matiang’i lay exposed on their mobile phones for all to see on our television screens. Tragically, the safety of both protesters and police officers was lost in the rashness of the moment. One-way communication, accountability dodging, threats to public institutions and ever-expanding egos are destroying our leaders the opportunity to be great. Without integrity, neither legal intelligence nor political energy will guide us through this moment. The ultimate cost of the electoral crisis is that millions of us can no longer see an end to the state of the “permanent election”. Non-partisan civic, private and religious voices and actions are growing. A tipping point is coming when their volume will drown out those who are increasingly exhausted, exhausting and running out of options that do not bring the country to the brink of a political meltdown and international ridicule. We know from Kenyan history that all conflicts are ended by powerful conversations. What will distinguish this crisis will be how many lives we lost, how much property we destroyed and how long it took to heal the country. This is not a constitutional nor a communications crisis. It is a political crisis and we must urgently create the statecraft needed to start the conversations. Until they can, perhaps both Kenyatta and Odinga could borrow a leaf from Turkish modernizer Mustafa Kemel Ataturk and issue a standing order that any instruction they give in anger, should be ignored. Like Ataturk, you are surrounded by hardliners who carry no responsibility nor direct danger to their legacy. Failure to lead them may earn you a future tombstone that will read “Here they lie now. They thought they were indispensable.” Like that tired and impatient Moses in the Bible, the time has come for your followers to stop hitting the rock. It is now time for both of you to #Return2Reason and dialogue. Other readings on leadership and leading powerfully Lessons from Abraham Lincoln Building leadership accountability Tips from leaders in previous crises Forging leaders from crisis

Hardline political positions is widening mistrust

First published Sunday Standard, October 8, 2017. Kindly reproduced here with permission from the Standard Group

When opposing political leaders start to sound and lead like each other, it may be a sign that they have lost sight of their real differences. When leaders look and act like their followers, they may have lost control of the strategic context. Last week’s actions on our streets and in our Parliament, may have looked very different, but in many ways, they were driven by the same impulses, logic and strategy.

Last week, I coincidentally received invitations to join the NASA demonstrations and to address the Senate and National Assembly Select Committees on the Election Laws (Amendment) Bills. I appreciated both invitations and declined both. The right to peaceful assembly, demonstration and petition public authorities used to be the preserve of a handful of activists. Over 2016-2017 alongside hundreds of others, I have marched for wildlife conservation, constitutional awareness, an end to the Doctors strike and safety from police extrajudicial killings. We may not beat Hong Kong’s annual record of 11,000 demonstrations, but our use of Article 37 has expanded dramatically.

Public participation is also crucial for all our national and county legislative assemblies. Article 1 affirms that all power comes from the people. Alongside others, I have warmly seized opportunities to petition National Parliament on leadership integrity, corruption, public health or shrinking civic space. At this moment, somewhere in the email in-boxes of both Clerks of the Senate and National Assembly lies unanswered requests for partnership.

Like Article 37, Article 1 has become a rallying cry for all political parties including the incumbent Presidency Jubilee. This, again, is healthy for us all. It stands in contrast to the growing authoritarianism that lurks in our region and the world today. So why did several citizens and civic organisations decline both invitations this week?

Both invitations emerge from highly conflictual political strategies. The zero-sum logic underlying them obstructs the issues they raise. None of the amendments address the Supreme Court ruling. The SCOK called for the IEBC to conduct the fresh election in “strict conformity” with the constitution and existing elections laws. Some of the amendments are unnecessarily intrusive of the IEBC’s internal workings. Jubilee’s attempt to push them through without bi-partisan agreement widens the mistrust in NASA. It is simply bad parliamentary strategy and no different from the antics of the NRM in Uganda.

NASA’s insistence on its irreducible conditions and bi-weekly demonstrations reflect the same logic. Organising public demonstrations requires a level of management to avoid the violence, criminality and loss of life and property we have seen. It is also now provoking counter-demonstrations. How we went from abusive utterances by Babu Owino to his repeated arrest and detention to scores of university student injuries inflicted by indisciplined forces and then, 8,000 students being sent home, needs further reflection.

Ironically, both NASA and JP leaders and supporters are publicly rejecting and deriding international community efforts towards dialogue. Nearly one year after the IFES deregistration, our Ministry of Foreign Affairs and the NGO Coordination Board just deregistered The International Development Law Organization this week. Two vital institutions; the IEBC and Judiciary will no longer have access to international assistance. If that isn’t bad enough, Moody’s Investors Service is considering downgrading the Government’s international credit rating. Left unchecked, our half-truths and political hard-lining could leave us isolated in a quicksand of our making.

It is often said that there are only two types of leaders. There are those who reflect the temperature of their followers and those who control their followers’ temperature. Sitting now in this very hot matatu called Kenya, like the air-conditioning we have in cars, the leaders we need right now are thermostat leaders not thermometer leaders.

Fortunately, there are signs of a way out of the current stand-off. The IEBC Chairperson’s announcement of a fresh team on Friday helps this. The withdrawal of these clumsy and one-sided amendments, cessation of demonstrations and multi-sectoral dialogue could offer new hope for a weary country besieged by intransigent hard-line positions. Christ is the Answer Ministries Bishop David Oginde’s sermon said as much last week and I support him. All Kenyans must now prevail on our leaders to offer real leadership and find a way out together from this prolonged conflict.

Taking mothers hostage in our hospitals must alarm us all

First published Sunday Standard, October 1, 2017. Kindly reproduced here with permission from the Standard Group

Ten years ago, reports of mothers detained without dignity in hospitals were alarmingly commonplace. Despite new laws, policies and 47 County Governments, it seems holding mothers’ hostage until they can pay their hospital bills is on the rise again.

Last week, police officer Judith Amoit finally returned home after her bill was settled by the National Police Service. Nairobi West Hospital had detained Judith with her dead twins for over a month when she couldn’t pay her bill. Judith’s case is the second known case at the Nairobi West Hospital this year. Veronicah Nyangai sued the hospital earlier in the year for detaining her for two months after losing her baby in unexplained circumstances.

Their horrific accounts are repeated in twelve other known cases this year alone. They include the four mothers of Embu who were locked in the basement of the County Medical Centre over Kshs 400,000 in January. One month later, six Bungoma mothers were stripped of their IDs, forced to share beds and then neglected with their new-borns. In August, a mother born with premature triplets was detained by the Pandya Hospital in Mombasa. This month, Christa Marianne Hospital in Kisii detained a class 8 student mother until her family could pay her bills.

Pregnancy, child-birth and aftercare carries great risks. Every single day, twenty women die giving birth in Kenya. Fifteen counties are responsible for 98.7% of these deaths. Mandera alone, is responsible for 50% of the deaths. With existing technology and medical knowledge, most of these deaths are completely preventable. That women should risk their lives giving birth and then suffer imprisonment, abuse and neglect in our hospitals must alarm us all.

Kenya is signatory to both the African Union Maputo Protocol on the Rights of Women and the Charter on the Rights of the Child. Article 43 of our Constitution (2010), the Patients Charter (2013) and the new Health Act (2017) affirm our right to the highest standard of health, including reproductive health. Holding mothers and their babies as hostages should offend our moral compass.

When it happened to Margaret Oliele and Maimuna Awuor, they weren’t just offended by it, they sought justice. In September 2015, they were compensated Kshs 2 million by the Constitutional court who found their post-delivery detention by Pumwani Maternity Hospital was unlawful and unconstitutional. In so doing, they and the Centre for Reproductive Rights breathed life into our constitution.

Government policy has been driven from the top. In 2013, President Kenyatta re-affirmed an important 2007 directive to abolish all costs of maternity services in public hospitals. This time, funding shortfalls left public hospitals unable to cope with the additional demand for services. It was this that prompted First Lady Margaret Kenyatta, or as I like to call her the Fast Lady, to rally Kenyans to run and raise funds to boost County maternity services. Last year, National Health Insurance Fund guaranteed expectant mothers free check-ups and immunizations for their children.

So why are we seeing a resumption of these cases and what can be done? Public health financing is still woefully inadequate overall. Tenderpreneur cartels walk much too confidently in our Government corridors. Yet without patient’s rights education, most patients still have much less confidence. 4/5 Kenyans are not yet registered with the NHIF and women’s organisations have not rallied effectively to protect mothers’ rights. The line between care and captivity is now so thin it discourages those who need maternity health-care services most.

In 1991, mothers of political prisoners led by Wangari Maathai fasted and chained themselves in Uhuru Park to protest their imprisonment. Perhaps it is time for families to join detained mothers in hospitals until they are released.

This coming Thursday October 5th, concerned citizens are meeting in the Kenya Cultural Centre to discuss what they can do about the quality of maternal health care. As County Governors attend their own orientation this week, let them declare a ban on detentions and generate innovative financing strategies. Let them also resolve the crippling nurses strike and pre-empt growing disputes among other cadres of health-workers.

It is time for 47 Beyond Zero campaigns, localized and ran from the counties. The scale of the challenge faced by our mothers cannot rely on a few passionate advocates in power. To make a difference, we must make this a cause, the public can rally around.