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WAR ON DRUGS: Kenya, the Forgotten Hotspot of the Heroin Trade

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Nairobi, Kenya – A WATER GLASS SHARED BY 200 ADDICTS

In downtown Mombasa, a nondescript office sandwiched between multistoreyed buildings is busy as usual.

Every five minutes or so, gaunt youths, eyes bloodshot, walk into the tiny reception and straight away dash to the water dispenser at the far corner. They refill the only plastic glass next to the dispenser without rinsing it, and eagerly empty its contents before turning to the reception desk.

Between 9.30 am and 10.30 am, as this writer waits for the director of Reach Out Centre Trust, an independent outfit that helps Mombasa residents fight drug addiction, the 10-litre dispenser bottle is already finished, but it is instantly replenished. The office doesn’t seem to have a designated receptionist. But the hushed talk between the visiting youths and any official around the reception ends up in a familiar refrain.

‘Sorry, the methadone [an analgesic drug similar to morphine used in the treatment of heroin addiction] hasn’t arrived yet. We were promised a new batch a fortnight ago but nothing is here yet. But please, do keep checking.’ Then the dejected youths – one in five are female – leave the building. The ‘clients’ (known by the derogatory term mateja), are hooked on madawa, the local phrase for heroin and/or cocaine.

NACADA says 0.1% of Kenyans consume heroin; implicitly, Kenya is a trafficking rather than a consumer country although reports indicate that it is increasingly becoming an end-user

They want to break the habit, and methadone is the only solution they know about. But it has been in short supply lately. Donors had delayed disbursing funds for the acquisition of methadone. Nonetheless, the water appears to cool their nerves – for the time being. By the close of the day, more than 200 clients will have shared the glass, many of them without rinsing it.

Ominously, the casual way they use unwashed glasses (and thereby risk contracting hepatitis B), is the way they share heroin needles – a sure way of transmitting HIV. And as will be seen later in this report, injectable drug users (IDUs) have become the key agents of HIV spread in the country, accounting for about 18 per cent of new infections.

There are dozens of such methadone clinics, first introduced last year at Kenya’s Coast. Nairobi’s Mathare Hospital started administering this medication in 2014; its specialised clinic treats 450 patients daily. The 51 beds in the rehab ward are always full, with each patient staying 90 days. At the Coast, the Malindi and Mombasa government hospitals each treat 200 addicts a day.

The government moved to introduce methadone following the death of addicts triggered by heroin shortages occasioned by clampdowns on drug barons. Over 100 addicts died in 2011, many more in 2013-2014, though the total number is yet unknown.

According to the International Drugs Policy Consortium (IDPC), heroin started to be consumed in Kenya in the cities that were used as transit points (such as Mombasa) before spreading to other regions of the country and to Nairobi. Now, some 20,000 to 55,000 Kenyans inject heroin. The National Campaign Against Drug Abuse (NACADA) says it is monitoring 25,000 intravenous drug users (IDUs) spread around the country. The population that snorts the drug is still unknown but it could be larger than that of IDUs, according to the Anti-Narcotics Unit (ANU) officials.

These addicts are part of the $322 billion global drug market, as valued in 2011. And as will be seen later in this article, East Africa, a key transit hub for drugs destined for Europe and the United States, contributes $10 billion to this business. Kenya is a major player, as a trafficking hub, in this illicit global commerce.

NACADA says 0.1% of Kenyans consume heroin; implicitly, Kenya is a trafficking rather than a consumer country although reports indicate that it is increasingly becoming an end-user. ‘While data on heroin users in Kenya is limited, UNODC (UN Office on Drugs and Crime) has warned that heroin addiction appears to be on the rise in the country, particularly along the Coast,’ American online news portal huffingtonpost.com said a year ago.

‘Only a tiny fraction of the drugs believed to transit in and through Kenya is seized by authorities. Arrests rarely lead to convictions. When convictions occur in Kenya, they are of lower level couriers and distributors’

The heroin comes from Afghanistan and gets here via Pakistan. According to experts, things look bad this season. Afghanistan’s opium production could reach a new high about 8,800 tonnes (which can produce as much as 530 tonnes of heroin). Volumes have been on an upward trend since 2010, and reached a record high in 2014, says the UNODC. Eight per cent of this will pass through the East African region, what the UNODC calls ROEA (Region of Eastern Africa that draws in Kenya, Tanzania, Burundi, Djibouti, Eritrea, Ethiopia, Rwanda, Seychelles, Somalia, Sudan, Uganda).

Given that 12 per cent of that is consumed locally, 5 tonnes (with an estimated street value of $1.3 billion) will remain in the region, with Kenya being the major consumer. But other reports indicate a higher figure. About 8 tonnes enter Kenya, according to a Reuter news article of March 2015 headlined As Heroin Trade Grows, a Sting in Kenya.

BLOOD FLASHING: A DEADLY SHARING

A year ago, huffingtonpost.com published a worrying story about Kenya’s drug problem titled Recovering Addicts Battle Kenya’s Exploding Heroin Problem. It said as more heroin flooded into East Africa, more and more Kenyans were getting hooked on it.

‘Drugs are destroying our communities,’ MP Abdulswamad Shariff Nassir has lamented. His Mvita constituency is among those hardest hit by the drugs problem in Mombasa, with other hotspots being Likoni and Kisauni. ‘The courts have to protect our citizens, and that’s not happening.’

The Mombasa ‘carnage,’ in the words of a Coast-based senior medical officer, wasn’t entirely unexpected. As early as 1998, Noah arap Too, then head of the country’s Criminal Investigation Department, the police arm charged with arresting trafficking among other crimes, sounded a warning, as did the United Nations.

Nothing happened. Michael Ranneberger, the United States ambassador who during his tour of duty from 2001-2011 made the anti-corruption war a personal crusade, much to the chagrin of the then regime of president Mwai Kibaki, wondered whether the country’s inertia in fighting narcotics was ‘Incompetency? Lack of will? Or worse?’ as reported in Wikileaks.

The sin of omission has caught up with Kenya. Today in Mombasa, addicts do what is called ‘blood flashing’ – the sharing of heroin-laced blood between those already high and those in need of a quick fix, practised by addicts who cannot afford the drug. This fatal ritual has been going on for about a year now, according to medical experts at the Coast.

Rene Berger, the USAid Kenya HIV/Aids team leader, says blood flashing is putting anti-HIV programmes in Kenya at risk, and warns that joblessness, prostitution and drug abuse are fuelling a ‘sense of desperation’ at the Coast.

Already, injection of heroin is becoming a key factor in HIV transmission. Figures are scanty as no serious research has been undertaken to link the drug to the spread of the disease, but the information available indicates that HIV prevalence among male drug users is 18 per cent while among females it is 44 per cent. (The country’s HIV prevalence is 6 per cent)

Reports indicate that long time addicts have turned to cocktails – combinations of cocaine, heroin, marijuana and the so-called designer drugs such as methamphetamine, and alcohol – to get their fix.

‘It’s clear that the Coast is an entry point, and wherever there’s a path, there are some crumbs left behind,’ Sylvie Bertrand, regional adviser for HIV/Aids at UNODC’s Eastern Africa office, told the press.

TRAFFICKING HOTSPOT: A SURGE THROUGHOUT THE REGION

Each year, the Kenya Police and the UN issue reports on the drugs situation. One of the reports is global while the other is local; one is analytical, the other primarily statistical. Notwithstanding their different styles, however, both reports portray a country that is battling with a drugs problem.

A section called ‘Dangerous Drugs’ in the Annual Crime Report by the Kenya Police details trends in arrests of drug users and traffickers. It reveals a consistent increase in cases related to drugs in the past 10 years. For instance, dangerous drugs (which is the description for heroin, cocaine and meths) recorded a 12% jump in 2014 over the previous year. That year’s report shows that there were 73 heroin cases that led to 94 arrests, and recoveries amounting to 10.5 kilos, 558 sachets, 2,000 litres of diesel mixed with heroin, and 3,200 litres of liquid heroin.

In the 2015 annual report, the incidence of dangerous drugs went up 14% over the previous year.

On the other hand, the UNODC Maritime Crime Programme in its 2014 annual report talks about an ‘alarming spike’ in illicit drug trafficking throughout the Indian Ocean Rim. It says that there has been a ‘surge in rates of drug trafficking throughout the region, particular with respect to heroin’. Another report by this UN agency, Drug Trafficking to and from Eastern Africa, paints Kenya as a country in the grip of drug cartels. It says that ‘a review of drug seizures from 1998 to date indicates an increase in the trafficking of heroin’ in Kenya.

It turned out wasn’t just cars and TVs the clearing and forwarding agencies were clearing. Heroin and cocaine were far better earners. In fact, of the 10 known local drug barons, nine own, or once owned, import and export companies in Mombasa and Nairobi

In a report published this year, the US State Department says, ‘Kenya is a significant transit country for a variety of illicit drugs, including heroin and cocaine, with an increasing domestic user population.’

Kenya’s transformation into a trafficking hub has been picking up speed in the past 10 years. In April 2014, an Australian Navy patrol seized heroin valued at $290 million (about Ksh29 billion) off Kenya’s Coast. This amount is equivalent to all heroin seized in the East African region in the two decades 1990-2009. Today, 40 tonnes of heroin are believed to be trafficked through East Africa annually, up from 22 tonnes in 2013 and four tonnes in 2009.

Alarmed by the amount of drugs coming from Kenya into the West, the US Drug Enforcement Agency (DEA) jointly with the Kenya police created a 16-member specialised force called the ‘Vetted Unit’ to track down drugs and drug lords. And as will be seen later in this article, this is the unit that set up and arrested the Akasha brothers (Baktash Abdalla and Ibrahim Abdalla) and their Indian cohorts in a sting operation last January.

The multibillion-dollar trafficking business has attracted international drug barons, created local cartels, and left a legion of ‘mules’ serving jail terms in foreign lands, with dozens of them on death row. The industry’s proceeds are laundered through banks, supermarkets, forex bureaus, clearing and forwarding companies, hotels and real estate, lottery and gaming companies, casinos, hospitals and high-end bars and exclusive clubs.

The statistics that do exist would place a figure on the business as being worth between $100 million and $160 million annually. But these figures are based merely on seizures, and as the US State Department Bureau of International Narcotics and Law Enforcement Affairs says, ‘Only a tiny fraction of the drugs believed to transit in and through Kenya is seized by authorities. Due to a lack of political will and institutional capacity, arrests rarely lead to convictions. When convictions occur in Kenya, they are of lower level couriers and distributors.’

The deportation of 120 suspected drug barons in 2013 is an indicator of the allure of the Kenya market for the global underworld.

NO LONGER A BLIP ON THE GLOBAL MAP

Indeed, as indicated earlier in this report, it isn’t happenstance that Kenya finds itself in this situation. As early as 1990s, Noah Arap Too, the then Criminal Investigation Department head, had warned about an impending crisis in the country. ‘It will be a hard and challenging job for law enforcement officers,’ to eradicate narcotics in Kenya, he said.

Prior to this warning, Kenya was perceived a mere blip on the global map of heroin. News reports then named countries such as Nigeria, Colombia, Pakistan and Afghanistan. In fact, in Kenya, most drug-related stories were about marijuana that was being produced locally. Only a tonne of heroin was seized off the East African coast between 1990 and 2009.

This picture turned out to be deceptive. According to later reports, cocaine and heroin were already here, having arrived during the tourism boom of the 1980s.There were red flags here and there but authorities, either out of complacency or because of corruption or both, declined to read the warning signs.

Attempts to arrest suspected barons have been hampered by the fact that many are in government or have business associates within the government

For instance, drug lord Ibrahim Akasha was at the time assembling a deadly kinship machine that would later torment the West, forcing Americans to demand the deportation of his children to answer charges of transporting drugs to the United States and Europe. The Akasha family ‘controlled drugs along Mombasa to Europe’ as early as the 1990s, according to Wikileaks cables.

Another red flag was the mushrooming of clearing and forwarding companies, ostensibly to cash in on the booming imports of second-hand cars and electronics. By 2007, at least 824 had registered with the Kenya Revenue Authority, a figure that would shoot up to 1,298 by 2014. It turned out wasn’t just cars and TVs these agencies were clearing. Heroin and cocaine were far better earners.

In fact, of the 10 known local drug barons, nine own, or once owned, import and export companies in Mombasa and Nairobi.

And when the drugs business boomed, the barons went ahead to create their own Container Freight Stations (CFSs). At the CFSs, containers are verified, cleared, unpacked and delivered to their destinations. Until recently, these stations were barely policed, and so became conduits through which drugs could be smuggled into the country with relative ease.

Kenyan authorities have thus been sleeping on the job. Apart from an anti-narcotics law – that provides for life imprisonment, Ksh1 million ($10,000) fines and seizure of ill-gotten wealth, little if any concrete action has been taken. In 2009, some 11 years after Noah arap Too’s statement, the Anti-Narcotics Unit, had just 100 officers to police the entire country. They couldn’t even track the 824 clearing and forwarding companies registered at the time.

Now, Kenya is suffering from the sins of omission. That explains why Huffingtonpost.com, views Kenya as ‘a forgotten hotspot of the international drugs trade’.

A CONSUMER REPORT FOR THE UNDERWORLD

There is an Internet portal that prides itself on being ‘a consumer report for the underworld.’ Havoscope.com publishes the global prices of drugs, as well as figures for money laundering, piracy and counterfeiting on the black market. In the latest upload, the price of heroin in Kenya was listed as $1.9 per gram, the cheapest among the 72 countries the Internet portal has surveyed. Brunei’s $1330.04 per gram is the most expensive followed by New Zealand at $717.4 per gram. In the United States, the price is $200 while in the United Kingdom it is $61.

In Africa, South Africa’s price is $35.1 per gram, Zimbabwe’s is $27.1 and Nigeria’s is $6.8.

In one of the cables it has released, whistle-blower Wikileaks confirms the local prices of heroin at between Ksh100 and Ksh200 a gram. The same cables say mules earn between $3,000 and $6,000 depending on the destination of the drugs and how easy it is to traffic them to that destination. Mules can make as many as six trips in a year.

Yet these figures, mindboggling as they are, do not tell the entire story about the Kenyan narcotics business. Heroin here is almost the purest in the world – usually above 80 per cent and ‘readily available and relatively inexpensive,’ according to the Wikileaks cables.

(Addicts wary of contracting HIV/Aids prefer pure heroin because it can be snorted through the nose as opposed to the diluted form used by IDUs).

A number of reasons explain why the drug, though pure, is cheap: Corruption (within politics, government and security agencies), ease of operation by drug lords (entry and exit from the country), geographical location of Kenya in relation to the drug’s origin and destination, a poorly secured and policed financial market, legislation that is not deterrent enough, and the high stake politics that drive the country.

i. Corruption

The Bureau of International Narcotics and Law Enforcement Affairs, in its 2016 International Narcotics Control Strategy Report (INSR) says: ‘Stemming the flow of illicit drugs is a challenge for Kenyan authorities. Drug trafficking organisations take advantage of corruption within the Kenya government and business community, and proceeds from drug trafficking contribute to the corruption of Kenyan institutions. High level prosecutions or large seizures remain infrequent.’

Indeed, politics has come in the way of the work of the country’s anti-narcotics agency. ‘Politicians may be opposed to the drug barons in theory but when it comes to business, they are bed-mates,’ says an ANU officer. Attempts to arrest suspected barons have been hampered by the fact that many are in government or have business associates within the government.

Drug lords have contacts in the government, politics (governors, senators, MPs), the religion industry (evangelical preachers) and in the country’s top security agencies

The police source calls it ‘high-stakes politics’ because of the price drug lords pay to protect themselves and their trade. Almost all senior politicians, even those not directly involved in drugs, find themselves on the payroll of the narco-barons.

They have amassed considerable wealth they can use to intimidate and threaten the law and law enforcers.

Sometime back in December 2010, the then Internal Security Minister George Saitoti named in Parliament five lawmakers (Harun Mwau, William Kabogo, Hassan Joho, Simon Mbugua and Mike Mbuvi) as well as tycoon Ali Punjani and long-rumoured unofficial Kibaki second wife, Mary Wambui, all of whom he said were involved in narcotics trafficking. The unprecedented move followed pressure from the international community to have Kenya act against the vice.

A team of police officers formed to carry out investigations into the matter uncovered no evidence to charge the five. Kenya’s leading newspaper, Daily Nation, claimed succinctly that the probe had come ‘up with zero’.

The Interim Report on Drug Trafficking Investigations had said of Mwau, thus ‘No evidence has so far been found to link him with drug trafficking.’ Six months later, the US government declared Mwau a global ‘narco-kingpin’ and moved to freeze his assets. Americans estimate that he is worth $300 million.

Saitoti, who had earlier served as Kenya’s vice president, would die in a plane crash in June 2012. Several MPs, incidentally among them Mwau, claimed in Parliament that he was killed by drug syndicates although they released no evidence to corroborate their charge.

There are politicians and police who facilitate the trafficking of drugs and provide protection to the cartels, there are those who conceal the identity of the cartels, and there are those who get paid to ensure that vessels carrying drugs are not destroyed. And lastly there are those who benefit from drugs seized from traffickers. ‘The nexus is huge,’ says an anti-narcotics officer based in Mombasa.

‘Drugs barons have bought some of our officers and this is very sad… We have information that police vehicles and ambulances are being used to transport drugs within Mombasa County and the Coast region,’ Mombasa County Commissioner Nelson Marwa told journalists in December 2015.

Drug lords have contacts in the government, politics (governors, senators, MPs), the religion industry (evangelical preachers) and in the country’s top security agencies.

ii. Links

In 1998, Koli Lur Kouame, then local head of the UN control agency, described Kenya as a ‘port of call’ for traffickers. Since then, various reports have portrayed the country as a major transit hub for drugs.

Kenya has extensive air and marine links to Europe, the Americas and Asia, as well as within Africa.

According to sources, bulk heroin comes from Afghanistan through Pakistan or Iran, often concealed in consignments of sugar, rice, used motor vehicles, second-hand clothes, tea, fish and other imports. It is stuffed in bulk cargo to make it difficult for scanners to detect it at the entry points. The $290 million’s worth of heroin destroyed by Australian Navy in Mombasa in April 2014 was concealed in bags of cement.

UN officials say the coastline between Somalia and Mozambique is the major trafficking zone for heroin. Apart from the official entry points, such as Mombasa and Dar es Salaam ports, this coastline has hundreds of unregulated entry points that emerged centuries ago to facilitate the slave trade and now serve as trafficking points for drugs, humans and smuggled goods. The drugs enter directly through Kenya’s coastline or via its porous borders with Somalia and Tanzania.

The porous borders the country has with Somalia, Uganda, Ethiopia and Tanzania ‘provide low risk opportunities … for those engaged in illicit trade,’ Peter Gastrow says in his ground-breaking study, Termites at Work: A Report on Transnational Crime and State Erosionin Kenya, published in 2011.

In Kenya, the heroin is blended and repackaged as tea or coffee and chocolate to avoid detection, then transported through Jomo Kenyatta International Airport (JKIA) or shipped to West Africa, Europe and the United States. Some couriers, especially West Africans and Kenyans, ferry the drug as pellets in their tummies.

Initially, heroin made in Afghanistan entered Europe via Pakistan, Iran, Turkey and the Balkans, what is known as the Opium Trail, and the northern route via Central Asia and the Caucasus to Russia and the West.

For decades, it was the preferred route for drug networks. But in 2010, authorities in Tanga, northern Tanzania, after arresting four Tanzanians and two Iranians with 95 kilos of heroin destined for Kenya, stumbled on another route, the Smack Track or Southern Route.

The absence of a Coast Guard has made drug trafficking easy. The Navy boats on patrol cannot possibly track all the boats that ply Kenya’s 1,420-km coastline. Authorities are convinced that dhows, boats and big vessels pick up drugs on the high seas on a large scale and transport them to the mainland.

It is not certain how many boats and dhows ply the coastline but Lamu County alone, which covers 45.7 per cent of the coastline, has 4,000 registered boats. The actual number is unknown because most vessels are not registered with the Kenya Maritime Authority.

Kenya’s coastline, and Mombasa port in particular, is like a magnet for traffickers. Kilindini Harbour handles 700,000 standard size containers annually. Only 1% of the containers are inspected. Transit containers and big vessels are barely searched.

Joanna Wright in the UNODC report Transnational Organised Crime in Eastern Africa: A Threat Assessment, claims that there is ‘an awful lot (of heroin) coming in from the (Kenya) Coast’. The country is no longer ‘a backwater producer of marijuana,’ as it was regarded two decades ago.

However, reports indicate that Nairobi appears to be taking over from Mombasa as heroin distribution hub. ‘While international heroin traffic might still be heavy around the Kenyan coast, local supply chains are predominantly coordinated from Nairobi,’ says Margaret Dimova in the report, A New Agenda for Policing: Understanding the Heroin Trade in Eastern Africa.

iii. Laundering

Kenya’s 43 licensed commercial banks, dozens of microfinance institutions and mortgage finance companies, almost 100 forex bureaus, dozens of Somali-style hawallah networks, and many makeshift or unregistered/unlicensed ‘saving and lending’ organisations, are a major attraction to the underworld.

For years now, Kenya’s relatively developed financial infrastructure has been a boon to drug barons. The country’s 43 licensed commercial banks with their extensive branch networks in the region, dozens of microfinance institutions and mortgage finance companies, almost 100 forex bureaus, dozens of Somali-style hawallah networks, and many makeshift or unregistered/unlicensed ‘saving and lending’ organisations, are a major attraction to the underworld.

There are almost 130,000 money agents in Kenya, working mostly with the mobile money provider M-Pesa.

This vast infrastructure is attractive to drug lords out to conceal their earnings. They can transfer their ill-gotten wealth to their home countries, pay for the ‘goods’ or receive payments for the same, and clean up the money within Kenya by investing in the financial markets, real estate and other properties.

In fact, Kenya is among the 67 countries the US Department of State denotes as ‘money laundering countries of 2015.’ In Africa, only Kenya, Nigeria, Somalia and Zimbabwe appear in the classification of ‘jurisdictions of primary concern,’ according to its publication, International Narcotics Control Strategy Report 2016. It states, ‘Kenya remains vulnerable to money laundering and financial fraud. It is the financial hub of East Africa, and its banking and financial sectors are growing in sophistication. Furthermore, Kenya is at the forefront of mobile banking.’

It is for this reason that the Financing Reporting Centre (FRC) was established in 2012 to track such illicit proceeds. However, because of the lack of capacity, the FRC has only managed to process 254 of the 878 suspicious transaction reports (STRs) submitted to it since it was created, and forwarded the results to investigation and prosecution agencies. Nobody has been convicted.

iv. Legislation

The Narcotics Drug and Psychotropic Substances (Control) Act came into force in 1994. It provided for a Ksh1 million ($10,000) fine and seizure of wealth. At the time, this was regarded as highly punitive and deterrent enough. But as it turned out, the legislation has hardly proved a deterrent.

Indeed, in hindsight, this piece of legislation may be a blessing in disguise for cartels.

Firstly, the drafters lacked foresight; the legislation appears to target marijuana and not necessarily hard drugs such as cocaine, heroin and the designer drugs. If you look at the penalties, in particular the fine, it is clear that authorities didn’t foresee a much higher-value drug. Heroin, cocaine and the so-called designer drugs are pricey. An offender needs just a half kilo of heroin to pay the fine.

In a report published after Kenya’s 2013 general election, the US Department of State said of Kenya, ‘Drug barons use the proceeds to contribute to political campaigns and to buy influence with government officials, law enforcement officers, politicians, and the media.’

Second, this legislation gives judicial officers considerable leeway that they can abuse to let drug barons off the hook – or mete out very lenient sentences. Ideally, the weight of the sentence should depend on the amount of drugs and/or their street value. But as a look at some of the rulings shows, the prices are arbitrary. For instance, in Criminal Case 313 of 2010, some 20 grams of heroin were valued at Ksh200. But in Criminal Case 702 of 2010, in Kibera, 11.054 kilos were valued at Ksh11,054,000 (Ksh1 million per kilo). And in Criminal Case 1302 of 2010, Mombasa, 2 grams were valued at Ksh4,000.

There is also a wide discrepancy in the sentences. In Criminal Case 1176 of 2011, the Mombasa principal magistrate convicted George Awuor Mbwana to 10years and Ksh1 million for trafficking 10 sachets of heroin valued at Ksh3,000 – although this sentence would be reduced to five years in 2014 upon appeal. In Criminal Case 705 of 2009, the Malindi chief magistrate sentenced Carolyne Auma Majabu to life imprisonment plus a Ksh1 million fine for trafficking seven sachets of heroin valued at Ksh700.

According to UNODC’s Country Review Report of Kenya 2010-2015, there appear to be problems in regard to proportionality, consistency and adequacy in sentencing/convictions in cases related to drugs as well as economic crimes, such as money laundering.

Cartels Battle

A year ago, Nairobi Governor Evans Kidero complained about ‘state capture’ by organised criminals. Without mentioning their identity, he said they were providing Nairobi residents with free-of-charge services that are meant to be sources of revenue to counties. He said the underworld individuals were out to purchase political power by using the proceeds of drug trafficking.

This wasn’t the first time such a complaint had come up. Within and outside Kenya, people are convinced that the underworld is not only entrenched in Kenyan society, but that it is influencing the country’s political development. MPs, Senators and Governors, military and police officers, preachers and businesspeople are linked to trafficking but their identities are only mentioned in hushed tones.

None of them has been prosecuted or charged in court for their involvement in the illicit business.

In a report published after Kenya’s 2013 general election, the US Department of State said of Kenya, ‘Drug barons use the proceeds to contribute to political campaigns and to buy influence with government officials, law enforcement officers, politicians, and the media.’

According to CID sources, authorities have isolated four types of networks that drive the Kenyan drugs underworld: The loose or fluid network often cobbled together for a one-off deal – which collapses thereafter; the highly secretive patriarchal or kinship-based networks that control the illicit trade at the Coast; the upcountry syndicates that bring together mostly business allies and their political friends; and the trans-border cartels that bring together Kenyans and foreigners.

Cartels operate on political expediency. Specific cartels emerge during specific political seasons or regimes. That apart, the divisions – sometime blurred – may also be based on location or base of operation of the cartel, smuggling routes, and nationality and family links

Whatever type of network, close relationships among the players, also called nodes, are critical to their conduct and survival – what Margarita Dimova calls ‘compact, supple’ in the report, A New Agenda for Policing: Understanding the Heroin Trade in Eastern Africa.

Normally, the Kenyan cartels comprise just dozens of players who are mostly family members or business partners or acquaintances. Extra hands may be roped in case of extra load or work.

According to sources within the ANU, the cartels combine drug trafficking and smuggling (of humans and goods) and counterfeiting. Thus, Kenya’s underworld never lacks choices; drug lords can easily switch their business to conceal their tracks.

Interestingly though, the networks transform very fast in response to the changing political landscape. In the past 15 years, a number of cartels have collapsed while new ones have been formed to fill the void. The Mombasa-based Akasha organisation went down during President Kibaki’s regime while others emerged, linked to the new crop of politicians at the Coast and further inland.

It is important to note that churches have become key conduit for drug lords. In February 2014, a New Zealand missionary who often travelled to Nairobi was jailed for 12 years for trafficking 6.15 kilos of meths and 2.87 kilos of heroin, all valued at Ksh200 million, to Australia

Cartels operate on political expediency. Specific cartels emerge during specific political seasons or regimes. That apart, the divisions – sometime blurred – may also be based on location or base of operation of the cartel, smuggling routes, and nationality and family links.

Nairobi-based operatives, Kenyans and foreigners, depend on the airports and land routes to transact their illicit business. On the other hand, the so-called Coast Mafia has seized Mombasa port, airstrips at the coast, and myriad docking points on the Indian Ocean coastline.

BRIBING A GOVERNMENT ALREADY STEEPED IN CORRUPTION

For a long time, while Kanu was in power and Daniel arap Moi was president, the narco-trade was controlled from Kenya’s Coast, especially at the port and in Malindi. The Coast Mafia (including the Akashas and a former nominated MP based in Mombasa) and Europeans (Italians and Germans) were in firm command of the business. Kenyans and Nairobi-based West Africans (Nigerians, Ghanaians and Guineans) played the role of couriers or middlemen.

Drug lords used their ill-acquired proceeds to bribe a government that was already steeped in corruption. In the process, the kingpins were able to easily launder money by investing it in real estate, exports and imports, and in trans-shipment.

The Italians, after elbowing out the Germans, invested their proceeds in real estate – constructing 4,000 villas and homes along the beach and on second row plots. There were complains that the villas were hideouts for fugitives but the government did little to investigate the claims. It now emerges that convicted Italian fugitive Leone Alberto Fulvio used Malindi as a hideaway from Italian authorities for close to 23 years. While in Kenya, Fulvio got citizenship, a gun licence and a certificate of good conduct, and was cleared by the Kenya Revenue Authority. His cover would later be blown by the Interpol. He is now fighting extradition.

According to Frederico Varese, the author of the book Mafias on the Move: How Organised Crime Conquers New Territories, Malindi provides an ideal mafia revenue source, and a locale for money-laundering.

On the other hand, the Coast Mafia formed clearing and forwarding companies and got into export and imports and the transport business. And during Kibaki’s regime, they began setting up Container Freight Stations.

THE AKASHA EXTRADITIONS

Earlier this year, a specially selected team of Police officers assisted by America’s DEA spirited the so-called Akasha brothers – Baktash Akasha Abdalla and Ibrahim Akasha Abdalla – and their Indian cohorts Gulam Hussein and Vijaygiri Goswani to the United States to face charges of narco-trafficking.

US prosecutors who sought the extradition say their organisation is responsible for ‘production and distribution’ of large quantities of narcotics. ‘As alleged, the four defendants who arrived yesterday in New York ran a Kenyan drug trafficking organisation with global ambitions. For their alleged distribution of literally tonnes of narcotics – heroin and methamphetamine – around the globe, including to America, they will now face justice in a New York federal court,’ said Manhattan U.S. Attorney Preet Bharara.

The four were arrested in a sting operation originating with a Moroccan informer in November 2014. It came four months after the Vetted Unit seized 341 kilos of heroin concealed in a ship’s fuel tank.

But it wasn’t until after the murder of their father, Ibrahim Akasha, that Kenya woke up to the fact that it had its prototypical global drug lord. For a long time, Ibrahim, killed in Amsterdam in 2000, was the drug kingpin of the East African region. He controlled Mombasa port and landing sites between Kilifi and Vanga in the south of Mombasa. The Italians reigned unchallenged from Kilifi north to the Somalia border.

Ibrahim’s battles with local businessmen were muted and rarely became public because he never ventured out of the drug business, even as his rivals moved into transport, import and exports, and real estate to launder their profits.

He suffocated the West Africans, especially the Nigerians and Guineans, who were forced to take up the secondary role of couriers or middlemen from their bases in Nairobi. Other Kenyans who have since amassed wealth from drug trafficking also played second fiddle to the Akasha narco-machine.

The Akashas used Mombasa port to bring in heroin and hashish from Pakistan and cocaine from the Americas. It would then be blended with tea or coffee, to confuse sniffer dogs, and then packaged, ready for export to Europe and the United States. He also had associates who did the refining, dilution and repackaging

While the Akashas controlled the maritime routes, foreign networks held sway at the JKIA and the Moi International Airport in Eldoret.

The Akashas’ empire flourished because it was kinship-based. But two things happened that changed the fortunes of this cartel and placed it on a warpath with itself: Patriarch Ibrahim was murdered; and Mwai Kibaki replaced Moi as president of Kenya.

When Akasha senior was killed, his protégés/understudies were left splintered and in confusion. The death stoked a bitter feud within the family that led to several deaths. A number of Kibaki allies used their influence in Nairobi to target the Akashas and get into the business.

It has taken time for the Akashas to rebuild. Now they are part of the supply chain that stretches from the poppy fields of Afghanistan through India into East Africa. US authorities who extradited two of the Akasha sons and their Indian cohorts say their organisation is responsible for ‘production and distribution’ of large quantities of narcotics.

In India, it was reported last year that the Akasha organisation and their Indian collaborators had transported 100 kilos of morphine base, which can be refined into heroin, in January 2016. Some months ago, the Times of India newspaper reported on a plan by the Akasha sons and their Indian collaborators – Vicky Goswami and his former actress girlfriend Mamta Kulkarni – to set up a manufacturing and drug refining operation in Kenya.

ENTER THE EUROPEANS, EXIT THE NIGERIANS

European cartels have also moved into Kenya following the collapse of the Opium Trail. They managed to solidify their base during Kibaki’s regime by creating networks with Nigerians and local politicians.

In the decade from 2003 to 2013, this would morph into what Anti-Narcotics Unit sources called a ‘super cartel’ that roped in several MPs and foreign drug lords. It also recruited security and military personnel and powerful businessmen at the Coast.

The vicious cartel, which coalesced around close allies of president Kibaki, almost wiped out the Akashas and other networks of drug-lords cum politicians developed during president Moi’s time.

The super-cartel is alleged to have been behind the assassination on New Year’s Day 2006 of DCIO Hassan Abdillahi who had been tasked with investigating the theft of containers at the Mombasa Port. Three brothers of Kiambu governor William Kabogo (whom then US ambassador William Bellamy described in the Wikileaks cables as ‘known thug and rich-far-beyond-visible-means’) were arrested over the murder.

The cartel feared that the lead investigating officer was working with the Akashas to target them.

The government’s crackdown on the West Africans has created a void in the heroin trafficking business that has now attracted Kenyan, Tanzanian, Chinese, Indian and Eastern European cartels. Indeed, according to ANU sources, West Africans appear to have lost the heroin market to Asians, Tanzanians and Kenyans following the emergence of the Smack Track route. They had dominated this market so long that they had managed to push the pioneer drug-lords, including the Akashas, out of Nairobi, only to find themselves out of the loop when conflicts in North Africa and parts of Europe made the Turkey route impassable.

It is important to note that churches have become key conduit for drug lords. In February 2014, a New Zealand missionary who often travelled to Nairobi was jailed for 12 years for trafficking 6.15 kilos of meths and 2.87 kilos of heroin, all valued at Ksh200 million, to Australia. Ms Bernadine Terry Prince (aka Pastor Bernie McCully), 42, who was married to a Nigerian, was arrested after she had toured Nairobi, Nigeria, and Cambodia. She claimed she was the Australian chief executive of Oasis of Grace Foundation that has affiliates in Kenya, Ghana, and several other countries. She was a missionary with Oasis of Grace International Church in Nairobi’s Kayole Estate.

Prior to her arrest, she had attended a conference in Nairobi and later spent time in Nigeria and Cambodia. In her defence she claimed that a Kenyan, Mummy Rose, her given her seven backpacks with handicrafts to sell in Australia. The court found drugs and not handicrafts.

President Uhuru Kenyatta has moved to dismantle the cartels that formed during Kibaki era. But his war is unstructured and some of those he is targeting are close allies of his friends. Uhuru first targeted foreigners, clipped the wings of a cartel run by a former assistant minister and later trained his guns on the Coast Mafia, including Joho’s family.

A Senator allied to the ruling party runs a trafficking network that operates from Wilson Airport. According to senior military officials who have served in Somalia, as at last year, authorities in Somalia had confiscated two containers destined for Kenya that belonged to the Senator. ‘One had electronics and the other had a white substance. We couldn’t isolate the substance so it was anybody’s guess,’ a Somali official said. The military officer has since been redeployed elsewhere so it’s still not clear what happened to the containers.

According to the International Drugs Policy Consortium, a policy network that promotes open discussion on drug policy, the Kenya-Somalia border is a playground for drug cartels that operate without fear of being detected

‘Local and international drug smugglers are taking advantage of the limited resources of security forces and borders control like, for example, on the border between Kenya and Somalia where drug smugglers can operate without being detected,’ says the consortium report.

But, in an interview for this report, police spokesperson George Kinoti denied knowledge of the Somalia route. ‘So far, we have not been able to detect drugs trafficking on the Somalia route. The route has not been known for drugs coming to Kenya.’

The Mail&Guardian warns that drugs, crime and dirty money are so entrenched in Kenya that any threat to destabilise this underworld could actually be detrimental to the entire economy

STATE CHALLENGE: NO COHERENT RESPONSE

Kenya’s anti-drugs war is characterised by haphazard half-measures. Authorities appear to dither even as the prevalence of trafficking – illustrated by the number of couriers in jails and large seizure amounts – continues to rise. There hasn’t been a coherent response to the menace. Indeed, responses have oscillated from ‘mute, bizarre or half-hearted reactions, to outright lies to bold admission,’ according to a Western diplomat.

In a recent interview, Kinoti said, ‘Here in Kenya, I can say drug trafficking is a challenge but not a huge problem. Our security agencies are up to the task when it comes to dealing with drug trafficking.’

Hamisi Masa, the ANU boss, told Reuters, ‘Now, it is not just about us here in Kenya …The whole world is involved.’

When he destroyed a vessel seized with 370 kilos of heroin in 2014, President Kenyatta thundered, ‘We will not allow drug barons to destroy the future of our young people. We will track and deal with them decisively.’ Commenting on the destruction, John Mututho, the NACADA boss, promised to reveal the people behind the narco business in Kenya. ‘We are investigating 50 suspected drug barons and we are sure we will recommend action by the end of the year.’

After more than two years, no names have been released.

Few believe the government is serious in its war against the drug barons

Narcotics Impact

The Mail & Guardian, a leading South African newspaper, warned in a recent report that Kenya was hurtling towards becoming Africa’s second ‘narco-state’ after Guinea Bissau. Titled The Making of an African Narco State, the news piece warns that drugs, crime and dirty money are so entrenched in Kenya that any threat to destabilise this underworld could actually be detrimental to the entire economy. ‘Kenya is emerging as a money laundering hub; incredibly, trying to stop the illicit flow of money could hurt the economy more than letting it continue.’

(A narco-state, according to Collins English Dictionary, is ‘a country in which the illegal trade in narcotics drugs forms a substantial part of the economy.’)

‘We are in deep trouble,’ a senior anti-narcotics officer told this writer. ‘The security agencies, the police, the politicians and some mandarins are either in bed with the drug barons or are the kingpins. You cannot isolate the barons.’

According to reports, more than 3,000 Kenyans are rotting in foreign jails, with some serving life sentences while others await execution. Others have died in jails abroad. About 3,000 are in local jails, convicted over hard drugs. The politics of Kenya’s major towns, Nairobi and Mombasa, is now influenced by drugs. While some drug-lords hold top offices in the country – two governors, a Senator, several MPs and other politicians are on the radar of the Vetted Unit, others, including top bureaucrats, police and judicial officers, provide protection to the barons.

‘We are in deep trouble,’ a senior anti-narcotics officer told this writer, but asked that his name not to be published lest he offended his bosses, some whom are allies of known drug barons. ‘Will we get out this? I doubt it. The arresting agency is a prisoner too. In fact, the security agencies, the police, the politicians and some mandarins are either in bed with the drug barons or are the kingpins. You cannot isolate the barons.’

Undeniably, Kenya is a major trafficking hub for drugs. It also has a growing consumption problem. Those interviewed for this report detailed a number of approaches that can help defeat traffickers and trafficking: Detect, deter and interdict. It needs strengthening of the country’s data collection systems, international co-operation, effective border controls, and law enforcement.

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Mr Opala is a freelance investigator based in Nairobi.

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INVISIBLE CITIZENS: Branding Kenya for foreign investors and tourists

Kenya’s historical preoccupation with being an attractive destination for foreigners and their money has come at the expense of catering to the needs and aspirations of its citizens. By WANDIA NJOYA

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INVISIBLE CITIZENS: Branding Kenya for foreign investors and tourists

In March 2008, Kenya was reeling from the shock of post-election violence. Over 1,000 people were dead, hundreds of thousands were displaced, women were traumatised by rape and some were even pregnant from those rapes, and some men were victims of genital mutilation in the name of circumcision.

When the weapons were down and the burning had stopped after the February 2008 accord, the priority of the leaders would have been to heal the country, seek justice and reparations, and restructure the whole society to uproot the endemic inequality and tribalism that were at the root of the political crisis. But in the midst of such trauma and need for healing and reconciliation, what did President Mwai Kibaki do? He set up Brand Kenya.

The gazette notice establishing Brand Kenya paid lip service to promoting patriotism, but its main interest was not really whether Kenya was a country Kenyans would be proud of. Its primary preoccupation was that Kenya remained a country in which foreigners could invest or relax.

The government’s target audience was not the people of Kenya but foreigners. The focus on business was roughly similar to George W. Bush’s call on American citizens to express their patriotism after 9/11 by going shopping, except for a small difference. Unlike Bush whose appeal was to his fellow Americans, the Kibaki-Raila coalition sought to appeal to foreigners to invest or spend their money in Kenya.

The establishment of Brand Kenya is just one of the more egregious examples of Kenya’s history of governments more preoccupied with pleasing foreigners than with serving its own citizens. Every time Kenyans are in distress, the main worry of the government is whether the investors will notice anything, and how soon we can cover up our human weaknesses so as not to scare them away.

Hegemony

This idea of Kenya as a country for investors and tourists is normalised through social institutions like the media and education. Indeed, a few weeks before, on January 7, 2008, at the height of the chaos, Peter Kiragu would express concern about Kenya’s image in an article in the Star, making no mention about the injustice and horror that Kenyans were experiencing.

The establishment of Brand Kenya is just one of the more egregious examples of Kenya’s history of governments more preoccupied with pleasing foreigners than with serving its own citizens. Every time Kenyans are in distress, the main worry of the government is whether the investors will notice anything, and how soon we can cover up our human weaknesses so as not to scare them away.

Kiragu complained: “The 2007 elections have painted a bad image of Kenya, far from one which was created after the 2002 elections.” He expressed hope that foreigners would not think of us as a typical African country that cannot conduct elections properly, and concluded the article with this shockingly insensitive declaration: “The brand Kenya needs to be protected more than anything or anyone else.”

An interesting element that emerges from Kiragu’s article is Kenya’s notorious belief in its exceptionalism, which is in turn based on accepting the West’s racist disdain for Africa and expressing pride that Kenya is not a typical African country. Throughout the article, Kiragu talks of a Kenya that was doing well with tourism and export, and that had been the envy of other African countries, “many of which were in even more desperate shape than Kenya”. He contrasts Kenya to DR Congo, Somalia, Sudan and Côte d’Ivoire, distinguishing Kenya from the others as a country “best known for its unspoiled game parks, which attract hundreds of thousands of international visitors who want to see lions and elephants and other animals roaming free”.

One would wish that this was just one journalist writing a personal opinion, but unfortunately it isn’t. What Kiragu is voicing is the hegemonic definition of Kenya, if we think of hegemony in terms of the ideas of the ruling class that are diffused through social institutions such as religion, media and education.

Between the investor and the tourist

In Kiragu’s article, we also see a disturbing acceptance of the racist image of Africa that requires us to achieve two contradictory targets. These targets mirror the urban-rural dichotomy, the inequality in development, and worse, the ethnic distinctions between deserving “developed” and undeserving “backward” ethnic groups.

The rationale is that because Kenya must attract investors, it must work at meeting targets of “development” set by the West in the urban areas, while on the other hand, Kenya must continue to attract tourists, which it can do by offering resource-deprived regions as the image of an Africa untouched by Western civilisation, where wildlife “roam free”.

This dual and racist tension between the investor and the tourist permeates all Kenyan life and institutions. Since independence, the government has reserved the areas around the railway for “development,” and the areas further from the railway for tourism.

One institution in which this logic is evident is Brand Kenya. In the Brand Master Plan, a document that Brand Kenya commissioned Interbrand Sampson, a South African PR firm, to write, Brand Kenya prioritises people in the following descending order: foreign investors; foreign tourists; and Kenyan citizens. The master plan reduces our constitution into a selling point that could be exploited for the Kenyan “brand”.

The master plan is a shocking document to read because it uses the investor-tourist dichotomy in its description of Kenya. Indeed, the document has profiled Kenya as “an exotic destination that is surprisingly familiar, where people and nature live in harmony alongside ambitious economic developments”.

This description is disturbing because it rehashes the colonial anthropological discourses of the 19th century. For instance, being “exotic” and “surprisingly familiar” is an oxymoron typical of the European romantic period, because being exotic necessarily means being strange, and necessarily unfamiliar.

The brand document separates the people from the nation, and relegates us to a frozen past together with our natural environment. If there is any economic development, it is not part of our lives. We are just living “alongside”, meaning that the elite are promising investors that flesh and blood Kenyans will not interfere with their investments by being unruly, or being visible for that matter. Indeed, ecologist Mordecai Ogada often says that the tourism which Kenya markets is a tourism with wildlife and no people, which is why many of the photographs advertising tourism and wildlife do not show the pastoralists grazing their herds near the wildlife.

The brand document separates the people from the nation, and relegates us to a frozen past together with our natural environment. If there is any economic development, it is not part of our lives.

Even when the master plan considers the people, it is only as labour for capital. Any democratic claims are not for the Kenyan people to live in dignity, but for ensuring that Kenyans remain out of the way while businesspeople invest in the cities, and while tourists relax in the wild.

Likewise, the recently launched National Tourism Blueprint leaves no doubt about the stereotypical profiling of Africans, and particularly of the Maasai. The document contains a photo of a man in a Maasai shuka skipping while holding the hands of two white girls, with a caption that reads: “Enriching cultural encounters with friendly people and ancient tribes.”

After all the work done by theorists on Orientalism and “decolonising the mind”, references to Africans as “ancient tribes”, using 19th century anthropological tropes, are simply mindboggling.

Daily and institutional violence

The focus of Kenya’s consciousness on foreign affirmation would explain why Kenyans experience daily life and institutional and collective processes as a form of physical, moral, emotional and intellectual violence. The institutions are not for serving them, but for pleasing foreigners.

In electoral democracy, for instance, elections are often followed not with sympathy for Kenyans’ frustration with the ineptitude with which the process is handled. Rather, Kenyans are treated to expressions of irritation about the lengthy periods Kenyans take to complete the process of elections, which interrupt business in the country. Democracy is not for Kenyans to have a say in the governance of their country, but for the government to prove to the West that Kenya is an ideal business and tourism destination – because we can manage “civilised” ideals like democracy and elections, unlike other African countries.

Similarly, roads are not planned to serve poor Kenyans or to be used by ordinary Kenyans. As Patrick Gathara has said in different forums, roads are prioritised over the people who should use them. The poor are evicted to make way for roads, and the roads are so badly designed that they kill hundreds of pedestrians, fail to accommodate bus stops or bus lanes for commuters, and have no walkways or bicycle paths for users without cars.

Another example is healthcare where Vision 2030 and the Jubilee manifesto use tourism as the model for healthcare. The tourism framework for healthcare essentially leaves the cheaper treatment of communicable diseases in the realm of the public healthcare system, and reserves the more expensive treatment for non-communicable diseases, especially cancer, to private hospitals.

That is why the filling up the coffers of the National Hospital Insurance Fund (NHIF) is not the universal healthcare that the Big Four agenda makes it out to be. NHIF money will end up in private hospitals with the best equipment and specialists, which means a windfall for medical equipment manufacturers, pharmaceuticals and medical insurance companies. Meanwhile, government doctors fail to achieve the job satisfaction they went on strike for, and they watch as the government imports doctors from Cuba and pays them more than the local doctors.

In education, the same lack of care for Kenyan children applies. The shoddily written and launched curriculum includes pathways that are potentially discriminatory because they would allow schools to choose favourite or privileged children to pursue subjects that have better prospects of social mobility. Each time the Kenya Institute of Curriculum Development (KICD) officials discussed the document in public, the most common rationale for the curriculum change they cited was that the curriculum was what the business community wanted, and was following the trends in education abroad. And, no surprise, most of the theories on which the curriculum was tailored were up to 40-years-old and were almost all foreign.

Despite decades of major overhauls in political administration, the rationale of Kenya’s institutions has remained deeply colonial.

Starting afresh

Kenya achieved a great milestone when it ratified the progressive constitution in 2010. However, the institutions, their rationale and operational style remain firmly colonial and rabidly racist, which explains why Kenyan daily life is so violent.

Despite decades of major overhauls in political administration, the rationale of Kenya’s institutions has remained deeply colonial.

Calling our institutional culture colonial does not mean that our institutions have not changed over the past sixty years. Rather, it means that the colonial rationale is repeatedly and deliberately reinforced in the present day. Decade after decade, regime after regime, government institutions have wired themselves, built themselves, and reproduced policy documents to remain focused on the West, and to wipe Kenyans out of the picture. These institutional reinforcements would explain why the government seems to be meeting little institutional and collective resistance as it rolls back the political and social gains made with the new constitution.

Seeking to explain why political reforms in Kenya have never translated into the material improvement of Kenyans’ lives, Gathara wrote five years ago that Kenya had “tried everything except reform the patterns of thought that find their genesis in the attitudes and divisions of the half century of colonial rule that preceded them.”

Our biggest political problem is no longer our constitution. It’s our institutions.

We need to deconstruct, and probably destroy and rebuild, Kenyan public institutions. The few government documents I have interacted with, especially from the education and tourism sectors, are all riddled with racist tropes of Africans, and an obsession with Western approval so that we can earn Western money.

Kenyans will have to go through a national mental re-engineering that heals us of our inferiority complex and deals with our historical wounds, and then write an affirmation of dignity as human beings. Using that affirmation, professionals should write new major policy documents to cleanse them of their racist tropes, and to make the needs and aspirations of Kenyans paramount.

Such work will require a lot of brain work and will probably bring little glory. But if we do not spend time on understanding the ideas, attitudes and behaviour of Kenyan public institutions, the current government will reverse all the political gains we have made. And by 2022, Kenya will look curiously similar to the 1970s, when we were ruled by crony elites under a one-party system. We have to put our minds to work, and rewrite Kenyan policy documents and rebuild Kenyan institutions so that their primary reason for existence is to serve Kenyans.

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DREAMS OF EMPIRE: Stepping out of America’s Fading Lustre

As Donald Trump surrenders America’s global preeminence, Africans – at home and in the diaspora – should work to build an African superpower rather than succumb to Chinese colonization. By MKAWASI MCHARO HALL

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DREAMS OF EMPIRE: Stepping out of America’s Fading Lustre

The first African Diaspora Young Leaders summit was coming to a close in Washington DC. The State Department had sent me an invitation to the closing dinner. RSVP for one, I wrote back. State Department dinners are often a microcosm of the global political structure, and schmoozing around with the diplomatic corps is like listening to the whispers of countries bottled up in one room.

Sometimes you catch the ambitious Washington-based African ambassador gunning for the presidency in his or her country, but I’m yet to catch one with a big idea for a United States of Africa. Most of the African envoys do not want to stay in America once their tour of duty is done. They are not economic refugees and their dreams are made. I want to find out from the room filled with ambitious African youth if they want to stay on and catch the American dream. They are also looking to lead the continent in conquering an uncertain 21st century and the US might just be a launching pad.

I asked as many as I could, and without hesitation they all quipped a version of, “I’m going back home of course!” I qualified my question further and asked, “If you got an offer for a job or graduate studies here, would you stay?” One tall Malian fellow hesitated and shook his head in a circular manner. That was the extent of his commitment to pursuing the American dream. He did not care for pecan pie either. These are not singular-story instances meant to create a bias. America has lost its lustre even among young Africans.

In a short while, this realisation would be ascertained by none other than the Under Secretary of State for African Affairs. He stood up to speak and asked the young Africans to speak well of America when they got back to their countries; that America is not as bad as they show it on television. I almost keeled right off my playing-diplomat-for-a-night seat. When did the script change so drastically? It’s no longer Africa asking America to stop spreading the unsavoury story about a dark continent. Now an American top-ranking diplomat is trying to right the image of a superpower that’s suffering an ugly meltdown and the whole world has a front row seat.

In spite of America’s fading lustre, there is still a growing African diaspora in the United States, and they will in a few decades be part of the “people-of-color” majority in the United States. For the American-Africans or Continental Africans who have become citizens, this is their home, one that enables them to play out their transnational citizenship as successfully as other diasporas before them have. An understanding of Continental Africans’ positioning along the timeline of American empire-making is important. It should help get Africans becoming more proactive in establishing an influential presence in American politics and policy-making, and also in pushing Africans to conquer their own continent for themselves.

A savage inspiration

Empire rises through stages: Conquest of territory; elimination or assimilation of indigenous peoples; and the building of new and more efficient trade routes. Those who lead conquests embody the animus dominandi, a necessary force of evil in the usurpation of power, wealth and security.

The end goal in a humane conquest, if the oxymoron can be believed, is the establishment of peaceful coexistence with those conquered, or the removal of oppressive leadership from the land invaded. In modern history, only one humane conquest comes to mind: Tanzania’s invasion of Uganda in 1979 to dislodge the brutal regime of Idi Amin. It lasted all of five months. America’s preemptive invasion of Iraq post-9/11 was sold to the people as a remedy that mirrored Mwalimu Julius Nyerere’s Uganda invasion: to free the people of Iraq from Saddam Hussein’s oppressive rule. But it soon became clear it was a greed-driven opportunity for war profiteering and expansion of the American corporate empire that had become a monstrosity.

Empire rises through stages: Conquest of territory; elimination or assimilation of indigenous peoples; and the building of new and more efficient trade routes. Those who lead conquests embody the animus dominandi, a necessary force of evil in the usurpation of power, wealth and security.

There are many wars that America has fueled to maintain its interests and footprint in foreign soil. It wasn’t always like that. America grew out of European immigrants who were running away from persecution, famine, and war in their own lands. They came to America seeking fortune and new beginnings, and they formed a country that rejected monarchy and its extreme powers. America was the biggest and boldest experiment in democracy and freedoms that attracted people from all over the globe. This roaring inspiration was also ruthless as European immigrants who became white Americans held millions of Africans in bondage and massacred millions within indigenous nations, with the survivors confined to reservations. Vicious greed easily becomes a reality in empire-building.

Eventually, a civil war that killed over 600,000 Americans brought an end to slavery. This is a price they had to pay for the dream of a truly free nation whose citizens were all considered as created equal and endowed with the same inalienable rights. It took bold and selfless political leadership to apply this principle of freedom to enslaved persons. President Abraham Lincoln’s emancipation proclamation in 1863 was met with disdain and dismissal from his friends and enemies alike. It ranked poorly as a political move.

Lincoln was driven by his own conscience and the American Constitution, a document that captures the ideals of a people, written with the ink of human kindness. It is also a document that has made America the “home of the free and land of the brave”. The irony of it all is that America was also built through the savage inspiration of those who stopped at nothing to succeed; immigrants who never gave up, never made excuses, and never let hunger, disease or the ravages of unpredictable Mother Nature stop them.

Dust bowls came and threatened famine, and the new Americans started afresh. The Ireland famine they escaped from was far worse as it had killed over a million. Floods came and carried the homes of new Americans carving a home from scrub in the wild West, and they rebuilt. They had far worse memories of homes shelled with bombs and bullets in war-torn Europe. Religious persecution in Europe brought the Anabaptist Amish to America where they found freedom and thrived in exclusive communities of their own defining. Persecuted Mormons trekked west through harsh territory and built their city on the hill out of a mirage of hope. Diseases came and killed families that moved to nowhere-places in the expanding America, and they picked up their shredded hearts and kept on striving. The Chinese suffered calculated segregation through the Exclusion Act but they found a way to remain an important part of building America throughout the 1800s.

Enter the Africans

How could anyone not feel inspired by a country made up of people who came from every corner of the world and found more ways than one to dream and achieve? Is it any wonder that the American Dream phenomenon took root and became the country’s biggest thought export that kept drawing in the rest of the world? The land where every dream is possible also became the allure for African immigrants from the mid-twentieth century, their numbers spiking from the early 1980s.

New legislation broke the Europeans-only influx into America and allowed more Africans to become part of America’s citizenry. A place of great contradictions: on one extreme, African descendants were enslaved for two-and-a-half centuries, and on the other extreme, free and educated Continental Africans were provided a way in through the Immigration and Nationality Act of 1965.

Empire and smart nation-building knows that human capital is key in its expansion and stability. From the Roman Empire that had earlier been the cradle of modern democracy to the United States of America, citizenship held the highest value for the inhabitants. It gave them the power to vote, to gain access to economic opportunities, to hold office, and to move freely.

New legislation broke the Europeans-only influx into America and allowed more Africans to become part of America’s citizenry. A place of great contradictions: on one extreme, African descendants were enslaved for two-and-a-half centuries, and on the other extreme, free and educated Continental Africans were provided a way in through the Immigration and Nationality Act of 1965.

Stages to citizenship become goals that an immigrant works very hard to achieve. In a land where the biggest pull factor is the American Dream, achieving that dream becomes a calculated get for African immigrants so that tales of their personal conquest will vindicate their desertion of home. When Europeans set out for the United States on boats and scraps of boot, many died out of pride, refusing to return to homes that still had their arms open wide for them in case things did not work out. The shame of not achieving that dream would be too much to bear. They would die in the gold rush melee, in the coal mines, in the cowboy ventures, in the farmers’ fight against nature, and in the run-in with Native Americans fighting to hold on to their lands.

Africans who come to the United States are no different from those first immigrants. Much as most come with a mind to acquire their education, a slice of the American Dream, and promptly go back to beloved Africa, they discover that the road to achieving what they came for is entangled in legislation and privilege. They are outsiders standing in a long line of immigrants waiting to get in to the gates of a new belonging.

Becoming American for an African is very rarely a personal goal but a necessity acquired to assist with personal conquest. Africans do not carry the pride of nation as Americans do. My neighbours, like many Americans, fly the US flag every public holiday and any other odd day. I have recently purchased a Kenyan and a US flag that I will fly on my front porch to test out the feel of nationalism. In Kenya, I would not be allowed to fly my Kenyan flag. However, in a changing America, pro-Trump neighbours will also look at my Kenyan flag askance as it will indicate an unwelcome immigrant presence.

As the latecomers in the game of American belonging, there isn’t much out there on African immigration statistics. Shaw-Taylor and Tuch (2007) surmise that about a million Africans immigrated to the United States between 1965 and 2007. These records are usually far below the real numbers as many who come and stay do not participate in the census. Second generation Continental Africans have also increased significantly. The Nigerian diaspora has become one of the fastest growing, both in numbers and in economic success. A Bloomberg research bursts the myth that Asians are the only ones at the top of the intellectual wealth pyramid.

The Kenyan diaspora, meanwhile, continues to astonish as its remittances to Kenya grow to a whopping Sh197 billion (nearly US$2 billion) this year, up from Sh174 billion (about US$ 1.8 billion) last year. The tragedy of the Kenyan diaspora, at least those in the US, remains their insistence on staying cocooned in cliques and tribal mindsets while abroad, an attitude that makes them ineffective pawns in America. A long straw extends from the mouths of family and community in Kenya and dips into diaspora pockets, and each year, the gulp gets bigger, thanks to the powerless generosity of a splintered diaspora. With all their smarts, Kenyans in the US have refused to invest in the strategy of building a united front as a power bloc, and so their remittances remain untapped influence. Eight years after the constitutional enshrining of their right to vote, the Kenyan diaspora in the US still cannot vote back home.

The Kenyan diaspora, meanwhile, continues to astonish as its remittances to Kenya grow to a whopping Sh197 billion (nearly US$2 billion) this year, up from Sh174 billion (about US$ 1.8 billion) last year. The tragedy of the Kenyan diaspora, at least those in the US, remains their insistence on staying cocooned in cliques and tribal mindsets while abroad, an attitude that makes them ineffective pawns in America.

No immigrant community has ever achieved influence without the strategic politics of mobilisation and organisation in their adopted country. Kenyans are adept at splitting their power by dismissing each other’s efforts. They duplicate, triplicate and quadruplicate initiatives instead of supporting what is on the ground. The new entrants to a cause will dismiss others as failures and with great humility argue that they are the ones who will make it happen. The community politics of the Kenyan diaspora is not only a microcosm of Kenyan society in Kenya but a far darker version of it.

Lessons from how other immigrant communities in the United States conquered in spite of their political or ethnic diversity are yet to sink in for the Kenyans. Collective intelligence is a switch that an initiative-taker turns on, but the bulb will not light up until the people with their hands around it stop the sabotage. (I have played significant roles in the Kenyan community in America long enough to observe its ways, which gives me a measure of authority on the subject.) Perhaps the growing second-generation Kenyan-Americans will shape its power.

Conquest, China and African superpowerdom

If the American republic has risen to superpowerdom through conquering occupied lands, eliminating indigenous peoples, and building infrastructure through the wilderness, all while using stolen labour and the legitimisation of a cruel injustice, why hasn’t the African continent achieved as much in its own continent where its nations are free? Dreams of a Pan-African state have flared up with the staunchest Africanists and died like a kerosene flame, leaving only a smoky trace of it that still lingers.

To build empire, Africa would not need to engage in the cruelty of displacing or enslaving anyone. The Morgenthaunian animus dominandi or necessary evil-nature approach to raising empire has to be redefined if Africa is to use it to achieve superpowerdom. By superpowerdom I do not mean a hunger for domination over others, but a reaching towards the highest levels of self-realisation as Africans. Such realisation comes with technological advancement, an end to poverty, the inalienable right to freely acquire knowledge for its own sake, and definitely the restructuring of political systems and inculcation of integrity in the continent’s democratic processes.

But is Africa interested? The current trend has African countries firmly serving nationalistic self-interest at best, and more of individual strongman interests. A continental trading bloc covering at least fifty African countries has been in the works, but its success is yet to unfold. The assumption that an African economic bloc could set the giant continent off to the 21st century superpowerdom is unlikely; at least not without independent institutions powerful enough to ensure economic accountability and social justice.

The success of America’s rise, savage inspiration that it was, also came from the independent institutions that checked its rogue politics, demanded a righting of wrongs, and allowed for people power. If African is not ready to hold its rogue leaders to account as South Korea recently did by throwing its corrupt president in jail, an economic bloc will only create a deeper chasm between those who can manipulate trade and those too far from the decision-making table.

Africa is a willing victim in the unfolding conquest by the rising Chinese global power, which is carrying out open surgery on the continent. As they open up the innards of Africa and plant Confucius centres in colleges, popularise Mandarin classes, establish television stations to transmit Chinese propaganda, and build breathtaking infrastructure, Africa seems content with the drip of modernisation-on-loan feeding its arteries. There is nothing the Chinese are doing that global powers of the past – Malian, Roman, British, American and others – did not do.

China’s Belt and Road Initiative (BRI) that seeks to etch the most ambitious trade routes across several continents is reminiscent of the Trans-Sahara trade routes that gave superpower status to the kingdom of Mali for a span of seven hundred years – until the Europeans made more efficient trade routes through the Atlantic. It wasn’t until America built the Transcontinental railway that connected it from sea to shining sea that the country actually started its rise to superpower status. Throughout history, control of new and more efficient trade routes have led to the rise of new empires. How is it that free African nations and their rich diasporas cannot build an engineering marvel from Cape to Cairo all by themselves?

The unfolding conquest of Africa is a willing victim eyes-wide-open surgery on the continent by the Chinese rising global power. As they open up the innards of Africa and plant Confucius centres in colleges, popularise Mandarin classes, establish television stations to transmit Chinese propaganda, and build breathtaking infrastructure, Africa seems content with the Chinese drip of modernisation-on-loan feeding its arteries.

White nationalism and the Age of Trump

Trump’s America is a surrender of empire in exchange for white nationalism. Stoking trade wars and supporting white extremism is a calculated recipe for white nationalism. The president has been on an anti-globalisation rampage. He has attacked regional and inter-governmental trade treaties, environmental agreements and military alliances that have kept America at the helm of the current global political structure. The president is in the throes of a ferocious tariff war against China, Canada and European countries, all trading allies of the United States. It has become common to wake up to news about American industries now making significant losses and some shutting down because the targeted countries are no longer buying American products. Farmers and fishermen whose products are exported to China now need a government bailout to survive.

Anti-immigrant policies have restricted temporary work visas that usually bring in seasonal workers from Mexico to work on farms and in the crab industry. As a result, massive fields of unpicked crop have gone to waste and the crab industry has suffered. The same policies have created the parent-child separation debacle in Texas, a racket that turns out to be, no surprise at all, a profiteering racket. While the world reels in shock at how low America has sunk, the detention business continues to thrive as it nets in new clients in immigrants seeking asylum. The GEO Group that runs private prisons also happens to be the biggest contractor for the U.S. Immigration and Customs Enforcement (ICE). The company is also accused of sponsoring politicians in Texas, the same state where unconscionable detention of children is happening.

In all this, good old American activism stays fired up and keeps agitating its way to justice. A company as powerful as the GEO Group now feels threatened by the Dream Defenders Action who have exposed them. A strategic and sustained fist pumped in the air has proven a formidable weapon against massive corruption in a country as powerful as America.

As the Mexican border immigration wars rage, some African immigrants who never thought themselves unsafe now find themselves targets of the government’s ransacking of those who supposedly cheated in their citizenship interviews. The U.S. Citizenship and Immigration Services is on record explaining the task to de-naturalise “errant” Americans who took up citizenship since 1990. That is the decade the numbers of Africans in America started rising significantly.

It is well-known that Trump has an issue with Nigerians, an identifier he uses to mean Africans. And he’s not alone in calling all Africans Nigerians. Perhaps it is the rising power of Nigerians in America that feels too threatening. The whitening of America in the Trump era is real. The immigration witch-hunts conjure up histories that led to some of the worst human atrocities in places like Nazi Germany where unwanted groups of people who had started thriving were exterminated.

While this remains an interesting time in America, perhaps the incredulous nature of it drives one to the conclusion that it is all in futility. The numbers will sort it all out. Unless white people increase their population at an astronomical rate in the next few decades, America is destined to become a country of majority “people of colour”, for lack of a better term. It is a scary thought that stoked the flames of white nationalism in Britain, leading to Brexit, and now in the United States. Human civility is superficial. Once threatened with the possibility of extinction, conquest or minority status, the human becomes the brute in a jungle where all civility disappears.

While this remains an interesting time in America, perhaps the incredulous nature of it drives one to the conclusion that it is all in futility. The numbers will sort it all out. Unless white people increase their population at an astronomical rate in the next few decades, America is destined to become a country of majority “people of colour”, for lack of a better term.

Only communities that have lived in close connection to the earth will tend to have a greater sense of civility and welcome for the stranger, conquering only to ensure their own survival, but not to fuel uncontrollable greed. America is a corporate empire built upon unexpiated savagery, and like all empires, it will come to its end.

An ode to indigenous peoples

Sitting Bull. Crazy Horse. Little Wolf. Spotted Tail. Red Cloud…the list is long. These Native American warriors who defended the usurpation of their land with fierce skill and legendary valour will inspire for ages. Their defeat will also depress the human spirit that cheers on the emancipation of the conquered. Victories of Native American nations against American expansion are filled with breathtaking courage. The Lakota, the Nez Perce, Cherokee, Navajo, Sioux, and many of the almost 600 indigenous nations held their ground against an army with numbers, resources and technology they could not match. As with most peoples who get conquered, the lack of a united front plays into their defeat.

A story is told in the annals of history that Sitting Bull once had a dream that his Lakota people of Standing Rock would vanquish the approaching American army led by the feared General Custer who had never lost a battle. On this day, Sitting Bull and his vastly outnumbered Lakota warriors prepared to fight yet again. His dream came true, and to America’s shock, the inconquerable Custer was killed and his army decimated at the famed battle of Little Bighorn.

But it wasn’t the dreams of one who prayed to the Great Spirit that won the battle; it was the ferocious zeal to survive when faced with extinction. It was the same zeal that led Shaka Zulu to victory against a British army with superior weaponry at the battle of Isandlwana; the same Ethiopian dare that trounced the invading Italians at the battle of Adoa; the same fire that led to the Mau Mau uprising against Empire in Kenya.

It is the same fire of indigenous African peoples that need instruction to rise and conquer a continent they already occupy, lands that already belong to them, resources that are theirs to exploit. The unfolding development in Africa is the footprint of another encroaching superpower. Africa should not surrender to a second colonisation so soon.

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HEALTH FOR ALL: A reflection on the current state of healthcare in Kenya

The goal of universal healthcare must take into account how Kenyans access and pay for health services, and eschew the concept of “world class” as a standard for what good quality care should be. By NJOKI NGUMI

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HEALTH FOR ALL: A reflection on the current state of healthcare in Kenya

There are three main concerns Kenyans from all walks of life have during illness or any manner of health crisis: 1) Who is going to take care of me, and where do I have to go to access that care? 2) Will all the options I need for full care be available to me, and are they the best ones there are? 3) Who is going to pay for the options I take? Is it going to have to be me, and what does that mean for my budget and my life?

These are obviously very valid and important questions, and it is a challenge to separate them because they weave so intractably into each other. Where we go and who we see when ill are dictated by who we are. Our age, gender, religion, socio-economic class, employment status, tribe, and proximity to an urban area or hub dictate the options available, and all these rest on the bedrock of the available funds to create and maintain a system of administration, equipment and skilled workers that avail healthcare services. All that considered, let us unpack each of these questions to see much more clearly where we sit in this often confusing and scary place.

Becoming a patient

The first thing we need to remember is that nobody plans for illness, and in that African cultural and spiritual way, we actively assume full wellness in anyone until they are on the verge of collapse. This is rooted in a commonly understood and yet completely unsaid superstition that if we summon illness it will come to stay; so we deny it until we cannot any longer. Kenyans are much less likely to be hypochondriacs than they are to sit uncomfortably on a symptom until it is alarmingly close to its worst possible manifestations.

The first thing we need to remember is that nobody plans for illness, and in that African cultural and spiritual way, we actively assume full wellness in anyone until they are on the verge of collapse. This is rooted in a commonly understood and yet completely unsaid superstition that if we summon illness it will come to stay; so we deny it until we cannot any longer.

A lot of this is linked to the roles we play in society: many people have hostile employers who view illness as a way to chicken out of work. Additionally, there are things we cannot opt out of, even while ill: parenting, especially by mothers of small children, is an example of a 24-hour shift regardless of our state of health. Many doctors will actually make a decision to admit and keep a mother who needs bed rest in hospital because sending her back home is a guarantee that nobody will let her stay in bed longer than five minutes. Many mothers cannot even have a short call in peace when in a house with a small and active child, let alone have a quiet meal or a full night’s sleep.

The idea of who is going to take care of a sick person, therefore, has to begin with who is available to take over or cover for the tasks they have, because this helps them on the path to acknowledging lack of wellness that is severe enough to need intervention from an outside source. Women again tend to draw the short straw and take on a third shift of minder to the sick and frail in a household. Predictably, another woman will likely be destabilised from other roles to come and hold fort for a woman if she herself is sick. Women therefore end up trading their time (as it is seen as less valuable) to take sick relatives to hospital and to assist recuperation there and at home.

Where we go to find help

When seeking help for illness, we prefer to play our cards as close to our chests as possible, and as Kenyans we cannot really blame ourselves for this. In a society where trust metrics have been in active decline for a while now, we are used to being scammed. We watch liars every day on our news channels and listen to them every Sunday at church. Choosing the devils we know, however inefficient they may be, is an easier option emotionally for a people weary of untruths.

One option is to go straight to a chemist, because most people end up at one, one way or another, to buy medicine. They relay the group of symptoms to the person behind the counter, whose only claim to care is a white coat. This person listens to the symptom list: to be fair, it is usually pain, stomach problems, or something respiratory, the majority of which are not too serious, and these things can mostly be managed over the counter. There is definitely room for one-stop interventions and medications, but one key issue is that a single quick public exchange often reduces the quality of the questions and the depth of the answers given. It is thus very easy to miss the subtle nuances between a series of self-limiting symptoms which need instant calming for quick relief, and an unfolding disease process which would need a more intensive treatment plan, as mapped out by lab and image investigations.

Another key locus in an honest healthcare analysis in Kenya is the traditional practitioner, who can be a herbalist, spiritualist, medium or even a medicine man or woman. Often the holders of cultural knowledge and trust, and able to speak to us deeply in language we can understand, using a frame of reference we are instantly familiar with, they have often been much more affordable and much easier to access, sparing us the long queues on hard chairs which end with cold, uniformed people using hard words that nobody understands.

Traditional practitioners can also seamlessly weave in spiritual ideology around healing, which can be a challenge for Western-trained caregivers. Several schools of thought would seek to corral or erase the traditional practitioner, but if anything, they are becoming increasingly popular in light of the limits current care has in seeing the person as a whole being as opposed to a concatenation of symptoms that need solving. Additionally, with the rise of Eastern practices, we are seeing more of Chinese medicine and Ayurvedic methods being explored in academic spaces. A reasonable strategist can project that the diverse African healthcare methods are the next frontier for Big Pharma. This is a conversation that is going on globally, not just in Kenya, and we would do well to take the brief headstart we have to explore some of these areas to whatever advantage we can.

The list of formal facilities available to Kenyans includes public hospitals, clinics and dispensaries, known mostly for understaffing, overcrowding, and subsequent inefficiency. Though many Kenyans go in and out of them daily without too many issues, they boast few stories of consistently stellar service. Faith-based and mission spaces have had many successes, but the vast majority of them are small operations and the footprint of their impact, even cumulatively, is thus limited. Private facilities close out the ranks; they are known for better quality amenities and offerings, but with the price tag we have learned to expect from all private suppliers of goods that should be publicly available—including transport, education and security. They are mitigated by market forces alone, and not subsidised by our taxes or regulated by public policy.

The list of formal facilities available to Kenyans includes public hospitals, clinics and dispensaries, known mostly for understaffing, overcrowding, and subsequent inefficiency. Though many Kenyans go in and out of them daily without too many issues, they boast few stories of consistently stellar service.

The case against being “world class”

We should really worry about the concept of “world class” as an abstract standard permeating our ideas of what good quality should be, especially with a sector as vast as healthcare. First of all, the idea of urbanness and urban contexts is intractably tied to the availability of specialist caregivers and facilities all over the world. Attracting and keeping certain cadres of healthcare providers necessitates certain amenities and access to a lifestyle associated with upward social mobility. However, rural contexts have human beings who are just as much in need of these exact services, but “world class” escapes an association with village life and small scale. There is nothing inclusive about it. It is not a term that was designed to make room for people who fall outside its reach.

Secondly, the trappings of “world class” care are almost, blow by blow, things that can be associated with luxury and availability of high budgets to afford the comforts over and above the basics. In the mostly capitalist context of the Kenyan economy, dignity is one of those things, because in many senses people have to pay to matter. The speed at which people will rush to the bedside of a VIP will tell you that even though the value system of care argues that all people are equal, the Orwellian situation where some are more equal than others, as detailed in the classic literary work Animal Farm, can most often be trusted to prevail. A “world class” situation where people who pay and people who don’t pay are getting the same quality of service can create conflicts, and we therefore find that we have to create discomfort for people who pay less in order to justify the comfort of those who are paying more. A practical example of that is the ever-shrinking size of economy class seats in most airliners.

Thirdly, “world class” in resource-limited contexts like these has tended to focus, rather dangerously, on flashiness of equipment and an array of available specialties, rather than on how the people feel about how they are being treated and guided on the path back to health. We have seen billboards with photos of futuristic diagnostic machines, but heard horrifying stories of patients suffering in the same hospitals where the sci-fi imagers sit. In many ways, we like the idea of a hospital that looks like one abroad but haven’t thought beyond that to a hospital where Kenyans are treated as though they matter.

But even as regards care, we must focus on the caregivers, and the situation with them in this country has been tenuous for a while. The line between public healthcare workers and private ones is very thin because most of them receive their education in the same institutions. The labour issues of the healthcare sector have been known for a while, with strikes rocking the nation at different points, causing unfathomable gaps in direct patient care and public health interventions for vulnerable populations, such as children under the age of 5, people living with HIV, pregnant mothers, the elderly etc. For many reasons, top among which are understaffing, overwork and underpayment, many caregivers are burned out and unable to engage humanely in the lives of their patients, and this humane engagement is the bedrock of what the intention of the word “care” is. Professor David Ndetei et al published a preliminary sample study in 2014 that found that over 95 percent of caregivers at Kenyatta Hospital, Kenya’s largest teaching and referral hospital, were showing clinical signs of burnout. As such, we can have all the best machines in the world, but if we do not also ensure that our caregivers are at their best, we are already running a losing race. The same can be said of healthcare support and administrative staff.

A fourth element of “world class”, which we may have been phased out due to unfocused policy, is matching the disease burden and health needs of the people with the opportunities for training new specialists. This country is only just coming to terms with its prevalence of cancer and many non-communicable diseases, for instance. Our previous leaning on tropical medicine and infectious diseases without keeping a sharp eye on the peripheries has allowed this to feel like it snuck up on us when in reality people have always been suffering: it is just us who didn’t take notice.

We can add to this list the conditions that are considered “rare” and therefore possible to ignore because their sufferers have not reached a number large enough to make macroeconomic investment worthwhile. As such, those with the means are able to get treatment and management in other countries which, whether for free market reasons, solid national planning, or both, enabled spaces where this is available. Often we hear of VIPs who manage public resources having the additional perks of opting out of the care available here, which is almost as though, when it is convenient, they get to stop being the Kenyans they are happy for the rest of us to be. This is not an indictment on everyone who has had the privilege of getting on a plane to places like the UK, India or South Africa to access treatment: it is, however, a recognition of the tragedy in the lives we have lost because so many were not able to access the same options. It becomes pricklier when we consider that sometimes there is room for our national public insurer to pay for people to get care abroad, which is obviously wonderful, but why do we remain unable to do what it would take to avail those options here to all Kenyans? How can we ensure that all lives are viewed as equally valuable?

Often we hear of VIPs who manage public resources having the additional perks of opting out of the care available here, which is almost as though, when it is convenient, they get to stop being the Kenyans they are happy for the rest of us to be. This is not an indictment on everyone who has had the privilege of getting on a plane to places like the UK, India or South Africa to access treatment: it is, however, a recognition of the tragedy in the lives we have lost because so many were not able to access the same options.

A general issue with accessing care abroad is that the great equaliser of persons as regards quality of care becomes emergency services. Regardless of who we are, if we are involved in a road traffic accident or suffer some other acute trauma, we are bound to the nearest facility, wherever it may be, to get the interventions that we need in order to make sure that we buy time and avoid death. During such moments, it is not how much we can pay that matters as much as the assurance that wherever we go, the people in both private and public spaces can give us the exact care we need to keep us alive. Currently that is a difficult assurance to give Kenyans, and so these aspirations towards world-class care are more distractions than they are honest analyses of what is actually possible for us.

Who pays for universal healthcare?

The organic segue when discussing value of life in healthcare is to ask ourselves a few rather philosophical questions. How much are states willing to invest in the life and wellbeing of their citizens? A quantification of the amounts of money a nation’s citizens pay out of pocket for healthcare would be one way to understand that. Understanding where citizens have to plug in from their own net income—and why—may be a more qualitative way to map out any gaps in a country’s healthcare spend.

We have to negotiate the practicalities of actively rolling out what we call universal healthcare. It cannot qualify as universal if citizens cannot access it, or if they are paying a significant part of its cost from their own pockets. It bears explaining that once rolled out, Kenyans may not pay for it, but it is far from free: What it means is that everyone’s care is averaged out and charged to each citizen via the varied taxes we already pay, as well as from the net incomes of a nation from the items it offers for sale to the global market. Basically, we put money in Caesar’s pocket, and it is added to whatever Caesar already has coming in, and then Caesar pays for everyone. The reliance on a central source of funds for our healthcare can be worrying if we consider our rising national debt, and our known tendencies to make monies intended for public expenditure disappear. Furthermore, it has been a long time since Kenya even pretended to spend 15% of its total budget on healthcare, as it pledged in the 2001 Abuja Declaration, so how we move from blatant disregard to even just toeing the minimum will be a matter of the ideal sustained political will that is known to elude us on many other matters of public interest.

The other source of money for healthcare spend is medical insurance, and because of the relatively tiny percentage of people who are privately insured in this country, most of whom access this as a benefit of formal employment. Comprehensive comparisons and analyses have also been hard to come by, but it is the rare client who has not been blindsided or left in the financial lurch by the sudden onset of red tape and small print. Additionally, it is notable that the list of exclusions are not a fair reflection of the disease burden of this population: the alarming number of services that women are unable to easily access as part of comprehensive reproductive health are testament to that. By and large, it is understandable that insurance companies would want to keep a tight handle on spending and payouts, especially when having to work with a relatively small number of customers. It has, however, been disappointing that for professionals who are well versed in betting on the macroeconomics of health and profiting off savvy investments, the clear advantages of a demographic youth boom such as Kenya’s has not created a space in which to partner with the state in more scalable ways to make healthcare available for more people.

It is impossible to consider healthcare without considering the effects of harambee, ubuntu or community contributions. Many Kenyans have reaped the benefits of belonging to a culture that values, for many reasons, coming together to help a person in need. The person does not even have to belong directly to our tribe, religion or family: we will sacrificially find coins to help someone who has been visited by the misfortune of an illness whose treatment surpassed their ability to pay.

However, the intervention of the many is suited to a one-time issue which will hopefully go into remission forever. The burdens of a chronic condition can quickly elicit compassion fatigue in even the most charitable people. Additionally, personal finances are finite, especially in shaky economic times, and the same person who could be generous at one moment can find his circumstances changed radically during a subsequent request. Because of the unpredictable nature of misfortune and the opaque nature of healthcare costs, someone can so easily come from contributing to another’s issue only to find himself the next victim of these particular debts that can so easily impoverish. Moreover, healthcare costs are unrelenting: they don’t care whether the person is working (and in the case of some illnesses and conditions, the sufferer’s ability to do so is actually taken away) or able to pay for them; they just continue to rack up. It is a terrible and cruel thing for any person to have to contemplate whether it is fair that they cannot raise the amount of money they need in order to guarantee healing and well-being in this life.

It is impossible to consider healthcare without considering the effects of harambee, ubuntu or community contributions. Many Kenyans have reaped the benefits of belonging to a culture that values, for many reasons, coming together to help a person in need.

Light at the end of the tunnel

Despite the fact that it would be easy for cynicism to set in, there are actually several things to be optimistic about as regards healthcare in this country. First among these is that we can always hope that the seemingly renewed state commitment to health for all can be a multipartisan agenda whose achievement can transcend the short-term possibilities of political gain for a few. We may, for many reasons, actually get the high political will and follow-through with this that would not only make it a success but also be a shining light for the failures in provision of other public goods for Kenyan citizens. The massive strides forward we are seeing in Makueni County, helmed by its determined governor, Kivutha Kibwana, are practical attempts at universal healthcare that redefine it as possible, not merely as an ambitious pipe dream.

Secondly, the labour conflicts in this sector have illuminated and mapped out the gaps faced by the civil servants who work in it. Because of this, we have a much clearer picture when we look at the issues raised by both them and the patients or service consumers about what is wrong, and are thus in a much better position to look for solutions, with the great advantage of a multidimensional approach.

The presence of devolution is a mixed bag. Many argue that the complexities of healthcare service provision meant that Counties were prematurely bequeathed this responsibility, especially without a data-driven approach to truly understanding the direct concerns of each county. Others had hoped that because each county has such distinctly different needs, the room for and success of innovative solutions that have been created by this separation from national overview can outperform the wide blanket of country-wide strategy by far. Again Makueni County’s innovative methods stand out significantly. All agree, however, that we need a much slower, more deliberate plan to tease out the relationship between the state and the county as regards the healthcare for citizens, especially along the lines of who pays for what.

A fourth advantage is the position of Kenya regionally and continentally as a hub for quality and ambition as regards healthcare policy and practice. Kenya’s public sector is known across the continent for its progressive, almost radical HIV care, treatment and prevention policies. Kenya was the second country in Africa and is still among a minority in the world to roll out pre-exposure prophylaxis to the masses and is deeply involved in research and experimentation towards both a cure and a vaccine.

Another example is our no-nonsense approach to maternal mortality, most recently elaborated as the Beyond Zero campaign led by the Country’s First Lady, Margaret Kenyatta. This campaign has been highly praised globally and is being studied to map out how its implementation can be replicated in other spaces. We’re currently debating and drafting legislature on fertility treatment and surrogacy, and despite our societal and religious conservatism, have been able to shift sexual and reproductive health conversations, especially as part of women’s rights, in very significant ways. The private sector has not been left behind; for many of the region’s citizens, Kenya, and Nairobi in particular, are destinations for quality specialist care and access to services that are not available to them at home. There are definitely ethical concerns in turning a country into a medical tourism hub offering services that are not available for the majority of its own citizens. It is, however, a comfort to note that the ingredients for success are already here.

Kenya’s public sector is known across the continent for its progressive, almost radical HIV care, treatment and prevention policies. Kenya was the second country in Africa and is still among a minority in the world to roll out pre-exposure prophylaxis to the masses, and is deeply involved in research and experimentation towards both a cure and a vaccine.

A follow-up to this is the rising numbers of both facilities and care workers in training. Again, we remain aware that tertiary institutions in this country, and the wider education sector, have also had their struggles with labour tensions, privatisation, underemployment and reduced funding from central government, but that is a whole other article. On the bright side regarding health, there are many more training opportunities available, but the vast majority of these are for first certificates, diplomas and degrees. Specialist training programmes for all cadres of healthcare givers are still inordinately expensive, and the government-sponsored opportunities for those have long waiting lists at both national and county levels.

One other place that Kenya has had some tensions is in negotiating the differences in roles between clinical officers, nurse practitioners and doctors. The facts on the ground remain that we still have a dire shortage of primary care interventionists, and our hybrid approach that allows varied cadres to see patients covers a much larger population base than a purist model would. That being said, we could still do with a more iterative, responsive understanding of who is trained to do what, so that patients are very clear about the clinical boundaries of each cadre.

A final point to note (and this list is by no means exhaustive) is that there is a general change in public attitudes to healthcare, the result of the diffuse access to information that has been occasioned by the Internet. There is more education about topics that were previously covered over by a lot of stigma and ignorance: one example is mental health. Because of this, the public has been empowered to ask more questions and demand timely, satisfactory answers from individual care givers, institutions and the sector at large. A part of it is definitely a more entrenched awareness of their rights as citizens as broken down in the Constitution, which is very explicit about the right to health and even specifically, access to emergency care. Citizens are also able to take to social media streets and host online conversations and debates, which have become offline calls for accountability that have been successful in stopping malpractice and neglect. The media are also taking the need for accessible, comprehensive information more seriously, and there has been a significant rise in health-centred human interest stories, and more expert journalists who are able to unpack complex health issues in ways that Kenyans are happy to learn from, engage with, analyse and debate.

There is a lot of room to stick it out and hope for the better—just because so much has been so bad for so long does not invalidate the good things that have been happening under the radar. All said and done, though, we must wait and see if true universal healthcare is possible within the context of what Kenyan healthcare has been and has the potential to be.

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