On March 13, Kenya clocks one year since the first case of Covid-19 was reported in the country. Confusion, anxiety and pain then characterised the months of March to May.
Amidst these hazy moments, Dr Mercy Mwangangi, the Chief Administrative Secretary (CAS) in the Ministry of Health was among national leaders making key national decisions. She sat in the technical team that developed quarantine protocols to save the lives of Kenyans. The 34-year-old describes the events in the first months to the emergence of the pandemic as having placed her in a ‘furnace’.
“There was a lot of pressure. Before you saw us on the TV screen, there was a lot going on in the background to ensure we have the commodities and our testing capacity is as it should be. Dealing with the public apprehension and allaying fears, particularly for a disease we knew very little about,” she says.
At the time, catching some sleep was a mere luxury.
“We hardly slept. The minister, Mutahi Kagwe, often joked that he was able to send texts at 2am, 3am, 4am, 5am and most times, to his surprise, we would reply back (immediately),” she shares.
“Were there effects of no sleep? Of course yes, there are times we really struggled. You really feel exhausted but then the country was in a crisis and we needed to brace ourselves and fight the pandemic.”
In those tough times, her parents and her younger brother – she is the first born in a family of three siblings- came through for her; reaching out for all the support she needed.
The emergence of the pandemic is some sort of baptism by fire for the healthcare leader who loves hard-hitting challenges. She had hardly served for two months before Covid-19 unleashed its lethal power in Kenya, prompting her to flex her muscles.
It put her at the centre of a difficult situation, which was made worse by the virtue that apt understanding of its dynamics was elusive to health professionals globally.
She nevertheless, leveraged on extensive consultation, whose findings consolidated the National Emergency Response Committee’s (NERC) responses and creation of appropriate structures to noose the pandemic.
“I remember waziri (minister) reaching out to his friends in the UK. Myself reaching out to my colleagues in South Africa, America and Australia, trying to get much information on how they were managing the pandemic,” she says.
Remarkably, Dr Mwangangi and Health CS Mr Mutahi were the faces of risk communication, taking turns to address the nation on the status of the spread of the disease daily, and creating awareness on self-protection and management in case of infection.
Unknowingly, she became the face of empathy and hope in the hearts of the distressed Kenyans including children.
“As we went around the country; numerous times children could run up to me and identify with the mask and tell me how their day was. How they washed their hands , and how they put on their masks.”
One of her tasks though yielded unpopular self-protection measures.
“I was part of the team that technically drafted the first protocols on quarantine and I know those were not popular. The public was upset but these were measures were needed (to contain the spread),” she says.
On leading in the pandemic, she is on a different scale. She has learnt big lessons, she says.
First, is the necessity of having sex-disaggregated data. For instance, at the beginning of the pandemic, the ministry released non-sex disaggregated data.
During NERC meetings, however, the Ministry of Public Service and Gender raised the issue of the need for data identifying the male and women infected. That is how the Health ministry got to break down the data. A learning lesson for her, she reckons.
Wear gender lens
She also learnt that addressing a pandemic requires wearing a gender lens. Out of the female Cabinet Secretaries (CSs) sitting at NERC, the ministry became conscious of the existing gender gaps in tackling the pandemic.
Public Service and Gender CS Prof Margaret Kobia, Dr Monica Juma (Defence) and Raychelle Omamo (Foreign Affairs) raised questions that informed the government’s tact against the pandemic.
“Key questions like how to ensure a woman who contracts Covid-19 and is the caregiver in her home, is able to isolate or quarantine herself, came up” she says.
This led to Mr Mutahi establishing a sub-committee constituting of the three CSs, which then advised the ministry on gender responsive measures. These included ensuring women continued to attend ante-natal and post-natal care in the wake of a lockdown and fear of contracting the disease at the hospital.
It also led to collating of data on gender-based violence (GBV), responding to the rise in the incidents and integrating anti-GBV messaging in the anti-Covid-19 communication.
Further, the female CSs advisory led to simplifying hygiene protocols by use of pictorials for ease of understanding for caregivers, who are mainly women.
“The messages we were sending out was that you need to protect yourself and your family. And so we realised that fewer mothers were attending ante-natal clinics for fear of getting infected,” she says.
Between March and June, there was a 23 per cent drop in mothers seeking maternal healthcare services, she says.
To save the situation, she engaged other women from international and local development agencies to establish a technical team that not only amplified maternal healthcare messaging, but also came up with a logistical solution in form of free taxi services for expectant women.
The third lesson for her is that women need to use their attention to detail skill-set to end a pandemic.
“When you are planning a response to fight a pandemic, you need someone in the team who pays a lot of attention to details,” says Dr Mwangangi who also led in drafting nutrition guidelines to boost immunity of Kenyans.
She explains: “You can imagine dealing with almost 47 million people (and being mandated to put) in place testing centres, procedure to get tested, and many other nitty gritties.”
She says women at the Health ministry pushed harder to ensure call centres were established and psychologists deployed to respond to the public’s mental health issues.
Dr Mwangangi is among the few women publishing studies on Covid-19, as at now.
A study Where are the women? Gender inequalities in Covid-19 research authorship (2020) published in BMJ Global Health Journal indicates that women account for about a third of all authors who have published papers related to Covid-19 since the beginning of the outbreak in January, 2020.
Together with Dr Wangari Ng’ang’a, who works in the Office of the President and in collaboration with Kemri Wellcome Trust, they have written four papers relating to the level of exposure to Covid-19 in the country. They could soon be published in a medical journal, she indicates.
How Dr Mwangangi, who was born in Machakos and raised in Nairobi, captured the President’s eye for the appointment, exemplifies her nature as an aggressive person and most of all, resilient. “Once I have a bone in my mouth, I hardly let go,” she describes herself.
Interestingly, she opted to jump into the medical ship out of rebellion.
“My mother is a lawyer and I thought I am not going to be a lawyer. So what is the opposite of a lawyer? I said doctor,” she says.
And so, as she joined Pangani Girls High School, Nairobi, her eyes were on the target of performing well in sciences to become a doctor. She gave her all and clearly, it has paid off.
She joined University of Nairobi for a degree in Medicine, graduating in 2009 at the age of 23. In less than a year, the Health ministry deployed her to Chuka in Meru South Sub-county to serve as a district medical officer.
She later got an Australian scholarship to study her Master’s in Health Economics and Policy at the University of Adelaide in Australia.
She completed in 2015 and returned to Kenya and found herself in the jobless club. The idleness pinched her every single day.
So one day, she decided to submit a request for an observership opportunity at the Health ministry. It was granted. For 18 months, she worked without pay. She could be in the office by 6am to do the work assigned to her and depart at 8pm.
This is how she proved herself and consequent to that, she got to be absorbed into the Monitoring and Evaluation Unit, before being deployed to head the health financing division.
During a 2018 conference in Washington DC, which she attended on her own budget to present a paper, she met Ms Sicily Kariuki who at the time was the CS for Health. She offered to mentor her.
Thereafter, she joined the CS’s team as a technical adviser. Through continuous learning and guidance from Ms Kariuki, her star shone so bright that it dazzled the President’s eyes.
For one to succeed in whichever facet of life, “You have to continuously work on improving yourself.” It is the food for thought from the medical doctor who is in the process of enrolling for a doctorate degree.