Murino Kiereini – Modern-day nightingale and founder President’s nurse

Muringo Eunice Kiereini is a classic example of the gains made when passion meets hard work. Discovering her love for nursing early in life, she made a career of it and put this noble profession firmly on the map by rolling out the first advanced nursing programmes in Kenya. Credited for spearheading a move to improve the quality of nursing care in Kenya, Muringo Kiereini’s vision to raise the nursing profession to the highest level possible was the driving force behind establishing a centre for higher learning for nurses. We need to be willing to share our experiences, our ideas, our successes and our disappointments.

As one of the first people to study nursing in Kenya, Kiereini received her training in the UK in the early 1960s. Adapting to the British culture and weather were not the only challenges Kiereini experienced. Cutting up cadavers and getting used to seeing blood and gory situations, took some adjusting to. “As a junior nurse working in theatre, some of the surgeons would be quite naughty. I was once so absorbed in following orders to do this or that and then all of a sudden I was handed an amputated leg. I almost collapsed!” She found a changed Kenya when she returned in 1964. The country had gained independence and the government asked Kenyans in the Diaspora to come home and build their country. Her first appointment was at King George VI Hospital, today’s Kenyatta National Hospital (KNH). She was one of only three or four African nurses and conditions at the hospital were shocking. She recalls working incredibly long shifts, caring for 100 patients in a ward at a time. Patients were not used to nurses or doctors speaking to them, greeting them, touching
them, or inquiring about their families. Soon, change was evident. “Our attitude brought in something new. It was refreshing for them to see some of their own who really cared.” Kiereini gave nursing her all because she could see the results of genuinely alleviating patients’ suffering. Not only was she helping sick people get better, but also caring for their relatives and associates.

The trailblazer describes one of the profession’s highpoints as seeing a gravely-ill patient recover, get up and walk out of the ward to go home with relatives. “Just knowing you contributed to the recovery is deeply satisfying,” says Kiereini, adding that another awe-
inspiring moment is helping to deliver a baby. To Kiereini, Kenyan nurses were not being adequately prepared to meet the demands of their vocation. She believed that since they played a critical role in health care, nurses needed to be exposed to medical discoveries and advances. She decided to be part of the solution to that problem by going to New Zealand for a degree course in nursing education.

Back in Kenya, she was posted to the School of Nursing at the University of Nairobi. Together with other nurses and nurse educators, they decided to overhaul the curriculum. “Our goal was to transform the prevalent mindset and attitude, to prepare a properly- trained, clinically-competent nurse, one trained to look at patients as whole, not just focusing on a single problem area.” They got the World Health Organization (WHO) to assist in creating the Department of Nursing at the University of Nairobi and rolled out a new Diploma in Advanced Nursing programme. Doctors strongly resisted the proposal, arguing that nurses did not need too much education. The Government also opposed the idea, terming it a waste of money. Kiereini and her team fought long and hard to implement the proposal. It was only after receiving support from some good people in the Ministry of Health and from the Director of Medical Services that the team succeeded.

The department created in 1968 was the only higher learning centre for nurses in sub- Saharan Africa, apart from South Africa. It became a hub of excellence for training students from all over the continent. This was a major milestone for Kiereini because of its far-reaching impact. The hard work paid off. Kenya today has master’s and doctorate degree-holders teaching or working in clinical areas. “That has positively impacted the quality of nursing and overall healthcare delivery system in this region.” Similar programmes are coming up in
other universities, including Moi and Kenyatta, says Kiereini, whose career progressed from ward nurse to educator and administrator.
She also served as the Ministry of Health’s chief nursing officer, a role through which she was in charge of advising the Government on standards regarding nursing education and practice. Working with the Nursing Council, her proposals were implemented by mission,
district and private hospitals. Her accomplishments drastically altered the path of healthcare delivery in Kenya.

Her wish is for these modern advancements in technology, medicine and science to spread beyond the urban areas. She looks forward to the day doctors and well-prepared nurses will be readily available to work in rural health centres. She believes that the benefit of service from qualified medical personnel is a right for all Kenyans, not just urbanites. Kiereini found herself in the trusted position of being the President’s nurse. Kenya’s founding father, President Mzee Jomo Kenyatta was well-acquainted with her father, a prominent Chief, through politics. They had worked together in mid 1940s at the Kenya African Union. Having also demonstrated outstanding ability in her career, it made sense that Mzee would have her as his nurse. He consulted Kiereini on whether he should take any medicine prescribed to him. Since she could not be with the President all the time, she hand-picked the nurses of integrity assigned to attend to him. Kiereini has been published widely. She has also served in various local and international bodies. Her proudest moment was being elected president of the International Council of Nurses (ICN), a prestigious global organisation created in 1819. “I was the first Black, first non-European, first non-American, and first person from the Third World to be elected. It was both exciting and challenging.”

In this role, Kiereini represented the interests of nurses worldwide and travelled extensively for meetings in UN agencies such as WHO, UNICEF and UNESCO. As president, Kiereini was instrumental in getting ICN’s first headquarters in Geneva. With her team, she mobilised funds for the building that she calls “a dream-come-true”. Kiereini was also the first African to sit on the Global Commission on Aids, in Geneva. Locally, she has served as: a board member of Nairobi Hospital, chairperson of Family Health Foundation of Kenya, the Regional WHO Midwifery Task Force, the University of Nairobi Council and is chairperson of AMREF’s Flying Doctor Society of Africa
(FDSA). The top nurse maintained a balanced outlook because she was modest, courageous and ambitious. “Once you have decided to do something, you want to do it well. You look back to those people who have come been before you and reason that if that person did it,
surely if I try, I can do something. You set your goals and start working towards them.” With a vision to raise the nursing profession to the highest level possible, her journey has been inspired by other leading nurses such as: Dame Nita Barrow who was the first female governor of Barbados, Dr Verna (Huffman) Splane of Canada, and founder nurse Florence Nightingale.

Impact East Africa is one of her pet organisations. Founded in the UK, Kiereini heads the organisation’s regional branch. Impact doctors and nurses go to schools across the country to examine and treat children in a bid to prevent deafness and blindness. In her spare time, she loves to golf and has participated in tournaments to raise funds for various charities. She is especially passionate about fistula a cause she champions in her role as chairperson of FDSA. The team raises funds to mobilise camps all over Kenya through which hundreds of women who suffer from the condition have been treated. “This condition is highly treatable yet it is a national disaster!” If it affected men, this humiliating and crippling condition would quickly have been eradicated, she opines. She hopes that the Ministry of Health can set aside funding to fast-track treatment countrywide. “It would be deeply fulfilling if fistula can be eradicated in my lifetime. Reflecting on the medical profession in Kenya today, Kiereini regrets that selfishness seems to have permeated an entire generation. “These days even in health care, people don’t really care much about one another. The field has been slightly detached from what we used to call tender loving care. We seem to be so self-centred and too busy trying to make money.” Kiereini hopes to inspire women and men to make a difference. “Such a spirit would enable us to bring up a young generation that is committed and patriotic to our nation.”

Words of Wisdom

• “Be honest with yourself. Know your ability. Be ambitious because if you don’t know what you want, people will tell you what to do.”
• “Delegate responsibility without micromanaging. This gives people the confidence that you trust them and safeguards you from overburdening yourself.”
• “If we recognise the important role of our doctors and nurses, we will have fewer of them exiting the country. We need to look at the whole reward system and compensate them not just in terms of money but also in benefits.”
• “You are not dealing with an illness; you are dealing with a human being.” Kiereini is convinced that without her family as her primary support system, she would not have achieved so much. “My sisters, my children and especially my husband encouraged me right through.

“My husband has always been a busy man. At one point he was the chief secretary, second to the Head of State, yet he still found time to encourage me. Never did he pull me back saying, ‘You’re neglecting the family’. We complement each other.” She is eternally grateful for the loyal support of her late sons Mburu and Githae. It was not easy balancing career and family when her family was young, but she says, “by the grace of God”, she managed to cope. She was able to manage the home front by conferring regularly with her husband and by spending quality time with her family. Her sons grew up appreciating her altruistic endeavours for the less fortunate. As a result they
wholeheartedly embraced her charity initiatives and used their personal networks to mobilise support for them.

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