This study examines the landmark rulings in the “BBI Case”, adjudicated successively by the High Court, Court of Appeal, and Supreme Court of Kenya, from the perspective of comparative political process theory [“CPPT”]. The BBI case involved a constitutional challenge to a set of seventy-four proposed constitutional amendments to the Constitution of Kenya, 2010. It raised a host of issues, ranging from the applicability of the basic structure doctrine, the role of the President in initiating constitutional change, Presidential immunity, and Fourth Branch institutions, among others. This paper analyses two crucial issues in the case: the articulation – for the first time in its history – of a process-oriented basic structure doctrine, by the High Court and the Court of Appeal; and the concurrent holding of the High Court, the Court of Appeal, and the Supreme Court prohibiting the President of Kenya from initiating a constitutional amendment through the “popular initiative” route. It argues that on these issues, the Kenyan courts’ reasoning constitutes a creative, unique, and valuable contribution to CPPT, in the context of constitutional change. When faced with the possibility of abusive amendments within the framework of a two-tiered amendment process, the Kenyan courts responded by setting out rigorous procedural constraints upon the amendment power. As a corollary, the role of the judiciary under this approach is not to invalidate or veto abusive constitutional amendments, but to ensure that they pass through a substantive, rich, and deep process of public participation.

This article seeks to explain how Mau Mau combatants selected and killed their civilian targets. The central argument is that Mau Mau members shared a moral logic that informed whom they killed, how, and why they did it. This moral logic was partly based on traditional Kikuyu ethics of violence, which were widely held and traceable to the late nineteenth century. Yet it was also a logic born out of novel, albeit contested, ethical convictions that developed in the context of an asymmetrical anticolonial war in 1950s-Kenya. Using captured guerrilla documents and oral history interviews with Mau Mau veterans, the article analyzes the perceived offenses that civilians committed against Mau Mau, the motives of Mau Mau assailants, and the internal conflicts that arose regarding the killings of some civilians. Ultimately, this article demonstrates that the moral logic of Mau Mau killings was firmly rooted in a dialectical tension between longstanding Kikuyu ethics of violence and the harsh realities of waging an asymmetrical anticolonial war. It also shows that Mau Mau debates over who to kill formed part of a larger process of sacralization, whereby members of the movement reimagined what they deemed sacred, moral, and just measures for conducting the war.

Tourism in Africa was entangled with colonialism from the start. However, after the Second World War it became an integral part of the colonising powers’ development agenda, albeit one that has received little scholarly attention so far. This presented African states with a serious dilemma when most of them gained independence during the 1960s. On the one hand, tourism promised to stimulate economic growth, provide much needed foreign currency, and create employment opportunities. On the other hand, international tourism had the potential to threaten the economic independence of post-colonial states and perpetuate colonial stereotypes, as well as international and local power imbalances and inequalities. The newly elected governments had to deal with this “colonial baggage.” This article focusses on the transition from colonial to post-colonial tourism in two East African countries, Kenya and Tanzania. I explore how the late colonial government pursued tourism as a development strategy for the region. I also demonstrate how Kenya and Tanzania approached tourism and its colonial legacies in different ways after independence. To trace their respective tourism histories, I draw on published reports and newspaper articles, historical research literature, in particular, from tourism scholars of various disciplines, as well as archival sources.

This article analyzes the transformation of an image of ritual violence on the Kenyan coast from the sixteenth century to the present. Drawing on a range of sources, it shows how understandings of “mung'aro” — a ritual of senior male initiation among Mijikenda-speaking peoples — changed as it became an object of inquiry for generations of missionaries, explorers, colonial administrators, local intellectuals, and foreign historians and anthropologists. In the mid-twentieth century, mung'aro became a key feature of Mijikenda traditions of origin in Singwaya, but in such a way that it reversed the direction of a specific form of ritual violence described in nineteenth-century traditions. By focusing on the transposition and recombination of ritual motifs across practical and discursive modalities (namely, ritual and narrative), this article offers a new approach to “the limits of invention” regarding traditions of origin.

Mental health challenges are common following cancer diagnosis, negatively impacting treatment and quality of life for breast cancer (BC) patients. This pilot study provides an understanding of the impacts of BC diagnosis and care experiences on the mental health of patients seen at the Aga Khan University Hospital in Nairobi, Kenya. We conducted 40 in-depth interviews, including 10 women with newly diagnosed BC, 10 women with metastatic BC, 10 family members and 10 healthcare professionals. Data were transcribed, translated into English as needed and coded using Dedoose software. Following BC diagnosis, it was reported that patients faced various physical, social, psychological and spiritual factors affecting their mental health and quality of life. Our interviews with each group indicated that BC patients experienced feelings of stress, anxiety and depression related to treatments and accompanying side effects. Disclosure concerns, financial impacts, relationship strain and negative outlooks on life were common among BC patients. The findings indicate that BC diagnosis and care experiences influence mental health in this population. With this basis, understanding and addressing the mental health challenges of BC patients is crucial to improve mental health and quality of life.

Visceral leishmaniasis (VL) is a severe infectious disease caused by protozoan parasites of the Leishmania donovani complex. Blood cytokine concentrations in VL patients can inform us about underlying immunopathogenesis and may serve as a biomarker for treatment effectiveness. However, cytokine levels have not yet been studied in VL patients from Kenya, where case load is high. This study measured the serum cytokine profile, blood parasite load and clinical and haematological features of VL patients from West Pokot County, Kenya, over the course of treatment with sodium stibogluconate and paromomycin (SSG-PM). VL patients recruited at the hospital presented with splenomegaly and weight loss, and frequently had pancytopenia and anaemia. Median Leishmania parasite load in blood, determined with real-time polymerase chain reaction, was 2.6 × 104 parasite equivalents mL−1. Compared to endemic healthy controls, serum interferon gamma (IFN-γ), interleukin 5 (IL-5), IL-6, IL-10, IL-12p70, IL-17A and IL-27 were significantly elevated in untreated VL patients. Severe VL was associated with higher IL-10 and lower IFN-γ levels. After 17 daily injections with SSG-PM, disease symptoms disappeared, leukocyte and thrombocyte counts significantly increased, and blood parasite load decreased to undetectable levels in all VL patients. There was a significant decrease in IL-10 and IL-6, whereas IL-17A levels increased; the remaining cytokines showed no significant concentration change during treatment. In conclusion, the results suggest that SSG-PM treatment of VL patients from West Pokot was effective. Moreover, both inflammatory and regulatory immune responses appeared to decrease during treatment, although the increase in IL-17A could reflect a partial continuation of immune activation.

Estimating value of statistical life (VSL) is an important input to many benefit-cost analysis (BCA) approaches, but for many low- and middle-income countries, there are limited or no data estimating VSL. Current guidance relies on extrapolation of results from high-income settings, which may be unreliable, leading to low confidence applying VSL. During 2019, we surveyed 1,820 low-income individuals (average consumption per capita USD329) across four diverse regions in Ghana and Kenya, to inform recommendations about effective spending in the development sector. We elicited VSL using a stated-preference approach, capturing the willingness-to-pay to reduce the risk of death for themselves and their children. Additionally, we conducted multiple “policy choice experiments” (PCEs) in which we asked respondents to choose, from the perspective of a decision-maker, between programs that save lives of different ages, and save lives and provide cash transfers. VSL estimates for this population fell in the range of USD66,795–USD90,453 (PPP-adjusted). We found similar results in the PCE but uncovered much stronger preferences for saving younger lives. Overall, our results suggest that VSL in low-income countries may be higher than estimates based on extrapolations from wealthy countries and that within these communities, policymakers should place more weight on saving the lives of young children. We also explore methodological learnings about how to apply and collect data for BCA in particularly low-income, low-education settings. We find that through careful training and gatekeeping, it is feasible to elicit complicated preferences in this population, and both approaches have their benefits and drawbacks.