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(D)EVOLVED HEALTHCARE: Makueni’s trailblazing experiment in providing universal health coverage

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(D)EVOLVED HEALTHCARE: Makueni’s trailblazing experiment in providing universal health coverage

Universal health coverage is by many measures considered to be the Holy Grail of delivering quality healthcare. In fact, achieving universal health coverage by 2030 – ensuring that all people have access to the health services they need without the risk of financial hardship – was included as part of the Sustainable Development Goals (SDGs) adopted by the United Nations in 2015. Writing a year later, Marie-Paule Kieny, Assistant Director-General at the World Health Organization (WHO), described it as “the linchpin of the health-related SDGs; the one target that, if achieved, will help deliver all the others by providing both population- and person-centred high-quality services that are free at the point of delivery and designed to meet the realities of different people’s lives.” WHO estimates that about 150 million people around the world suffer financial catastrophe annually from out-of-pocket expenditure on health services, while 100 million people are pushed below the poverty line.

According to the 2013 Kenya Household Health Expenditure and Utilisation Survey, medical expenses account for more than 40 per cent of non-food bills in over half the counties in the country.

In Kenya, though access to quality healthcare is a constitutional right, the scarcity of quality public and private health facilities, as well as the high cost of care even when it is available, means that universal health coverage remains little more than words on paper for much of the population. President Uhuru Kenyatta has made achieving universal health coverage by 2022 a major part of his second term agenda and indicated in his inauguration speech that this would be achieved by expanding coverage under the National Health Insurance Fund (NHIF). The president said that half a century after it was established in 1966, the Fund has only attracted 6.8 million beneficiaries. The World Bank estimates that only a fifth of Kenyans have any sort of medical cover, which means that as many as 35 million Kenyans are vulnerable to the financial devastation occasioned by a medical emergency.

Related stories: Behind the Makueni Healthcare Revolution

When illness eventually strikes, it takes a huge financial toll. According to the 2013 Kenya Household Health Expenditure and Utilisation Survey, medical expenses account for more than 40 per cent of non-food bills in over half the counties in the country. In fact, direct payments by citizens accounted for a third of the country’s total health expenditure in the same year, according to Dr. Izaaq Odongo, the head of the Department of Curative and Rehabilitative Health Services at the Ministry of Health, with the balance being made up by government (36 per cent), donors (20 perc ent) and employers (10 per cent). As a result, many Kenyans are forced to resort to selling off property, relying on networks of relatives and friends, or even making desperate appeals on social media to raise the necessary funds. Hence the large, and seemingly never-ending appeals all Kenyans make when clearing medical bills. Despite this, according World Bank Country Director, Diarietou Gaye, the number of those thrust into poverty by medical expenses is close to one million.

Kenya’s network of public healthcare facilities has traditionally been hierarchically organised into 6 levels, with the lowest unit being community health workers embedded within communities. At level 2, dispensaries and clinics provide the link between community-based healthcare and the formal health system. Together with level 3 facilities – health centres, maternity clinics and nursing homes – these make up the primary healthcare units. Levels 4-6 are sub-county, county and national referral hospitals. It is at the lower levels that the majority of people interact with the healthcare system and it especially at the primary healthcare facilities that national government interventions with regard to cost have been most consequential.

Since independence, Kenya has blown hot and cold on the abolition of user fees and decentralisation, both of which, given the economic circumstances of most Kenyans as well as the devolution introduced by the 2010 constitution, are prerequisites for universal health coverage. In 1965, according to the paper “Reforming health systems: The role of NGOs in decentralization – lessons from Kenya and Ethiopia by Richard G. Wamai of the Harvard School of Public Health, “a free access policy abolished the KSh5 co-payment operative in the colonial healthcare system… [and] proposed expanding coverage through centralizing the delivery responsibilities from the counties and municipalities to the Ministry of Health”. Eighteen years later, the provision of health services was again decentralised as part of the District Focus for Rural Development programme and in December 1989, user fees were reintroduced in an effort to inject money into crumbling health facilities. The “cost-sharing” programme was part of a comprehensive health financing strategy that also included social insurance, efficiency measures and private sector development. The fees would, the argument went, generate additional revenue, incentivise use of low-cost primary healthcare services rather than the more expensive referral facilities and improve targeting of resources by reducing unnecessary demand.

Still, implementation problems led to the suspension of the policy less than a year later though it was gradually reintroduced in 1991. A 1996 study found that despite revenue increases and facilities being allowed to budget for three-quarters of the money they remitted to the districts, this did not necessarily result in improved quality of care because the funds were used to offset a fall in government funding for basic care. As evidence mounted that despite a waiver policy to protect the poor and children under five, user fees were proving to be a significant barrier to access, the government – in what came to be known as the 10/20 policy – again reversed course and in 2004 eliminated all fees in dispensaries and health centres, save for a minimum registration fee of KSh10 and KSh20, respectively. By 2007, it had instituted a maternity waiver allowing for free deliveries in public health facilities and introduced the Health Sector Service Fund (HSSF) to compensate these facilities for lost revenue.

Since October 2014, Makueni has been offering its one million residents free healthcare across all its public facilities, including county and sub-county hospitals.

However, as a study published in 2015 showed, this was largely ignored by health facilities for whom user fees represented almost all the cash income they used to cover basic operating costs. As a result, most patients ended up being charged for more than the specified amount while very few received waivers. In 2013, the government abolished all user fees in public dispensaries and health centres and allocated KSh 700 million to the HSSF.

The picture was further complicated by the fact that health is one of the services devolved by the 2010 constitution. This means that while the national government is still responsible for policy and managing two Level 5 referral facilities, namely, the Kenyatta National Hospital and the Moi Teaching and Referral Hospital, the bulk of public healthcare in Kenya is delivered in facilities run by county governments. A history of skewed investment that marginalised some counties, as well as the lack of policy coordination between the various counties and between the counties and the national government, have left a rather confused picture of access to healthcare across the country.

There have, however, been some wins. For the first time since independence, residents of historically marginalised counties, such as Lamu and Mandera, now have access to Caesarean section procedures within their county. There have been problems too: from the controversy arising from the national government forcing counties to lease equipment they neither wanted nor had the resources to use, to ambulance purchases that seemed more about burnishing a governors’ image than delivering care to constituents, to the First Lady’s much trumpeted Beyond Zero initiative that today is in shambles, with many of the facilities either abandoned or turning patients away.

The Makueni model

Nonetheless, an ambitious experiment in the provision of universal health coverage is underway in Makueni, a county that borders Kajiado, Machakos, Kitui and Taita-Taveta counties. Since October 2014, Makueni has been offering its one million residents free healthcare across all its public facilities, including county and sub-county hospitals. It is a model well worth examining if President Kenyatta is serious about expanding access to medical care across the country.

“When we took over in 2013, we realised that 40 per cent of the people of Makueni would sell land and exhaust family income to pay medical bills for relatives,” says Makueni’s Governor, Prof. Kivutha Kibwana. Given that medical services in dispensaries and health centres were already free and paid for by the national government, the county government figured that if it doubled the 100 million that its Level 4 sub-county hospitals were collecting in user fees, it could offer free, across the board healthcare to its residents.

Thus MakueniCare, as the county government has labelled it, was conceived. It piggybacks on the national government’s free primary healthcare policy and the national coverage provided by NHIF to plug the gap in between with the aim of providing seamless cover across all public health services.

Thus, for an annual subscription of KSh500 per household, which covers parents and all their children under the age of 18 years (or up to 24 years in case of students), Makueni residents can access free primary healthcare at dispensaries and health centres courtesy of the national government, free treatment, including inpatient care and ambulatory services, at the 13 level 4 hospitals within the county paid for by the county government, and, if they’re subscribed to NHIF, free care at referral facilities outside the county. The Level 4 hospitals provide free care and bill the county government, which also supplies them as well as the primary healthcare facilities with drugs, equipment and medical staff.

LISTENBehind the Makueni Healthcare Revolution

However, universal health coverage is more than eliminating out-of-pocket expenditure; it is also about ensuring access to healthcare. According to Dr. Cyrus Matheka, the head of the county’s Health Promotion Services, MakueniCare took two years to plan and was preceded and piloted by a programme offering free care to those over the age of 65 without a requirement for registration. Within that time, the county government invested in expanding facilities, from dispensaries and health centres to sub-county hospitals, and has continued to do so. In under five years, it has more than doubled the number of health facilities built by the colonial and national governments over the last 50 years. Apart from an additional 113 dispensaries and health centers, the county now boasts 13 Level 4 hospitals and has employed 160 doctors, compared to just 38 doctors and 3 hospitals in 2013. At KSh2.3 billion, health is the county’s single largest budget item.

All this means that the county can offer a wide array of free services to residents, from hospital admission, surgical procedures, X-ray imaging, laboratory testing, to dental and counselling services. Even in death, patients benefit from 10 days of free mortuary services. However, the cover does not apply to specialised care and equipment that are not available at the hospitals, including dialysis for patients suffering from kidney failure, intensive care units, implants, as well as auxiliary devices, such as wheelchairs.

Insurance schemes are essentially funds where people pay into a pool when they are healthy – in this case through both taxes and direct contributions – which they can draw on when sick. The Makueni recruitment model reversed this, thus courting adverse selection, or the tendency of people to get insurance only when they are seriously sick, which can consume huge resources.

Dr. Andrew Mutava Mulwa, the County Minister of Health, estimates that MakueniCare covers at least 93 per cent of the county’s healthcare needs. He says it is built on a platform of ensuring adequate provision of primary care by increasing facilities, improving services and ensuring that medicines are available. “Someone who is sorted at the dispensary will not find their way to the hospital,” he says, adding that only 35 per cent of patients in Makueni need to seek care in the secondary institutions covered by MakueniCare or in tertiary referral facilities outside the county.

Challenges

However, the programme has had its share of challenges. The first, rather surprisingly, was low uptake. In March last year, when The Elephant visited Makueni, less than 10,000 households had signed up for the programme out of a potential 200,000. The scheme had a mere 30,000 beneficiaries. Part of the reason for this was the decisions taken to make the coverage voluntary, to register subscribers at county hospitals when they sought care and to make the cover active immediately upon registration and payment. Initially there did not seem to be much of a public campaign to get residents to register: there were no posters announcing the programme in all the hospitals The Elephant visited and, despite officials claiming to advertise on vernacular radio, most residents we spoke to had not heard about MakueniCare.

Julia Musau of Kaselia village, who we met at the Tawa Sub-County Hospital, is a typical case. She had been unaware of the scheme until a month prior to our visit. She found out about it after she took a patient to the Makueni General Hospital in Wote, and had difficulty settling the bill. It was another woman whose child had been admitted there who told her about MakueniCare. That was when she enrolled her family immediately.

However, even those who know about it opt to wait till they or their dependents get ill to register since there is no penalty as the cover is activated immediately and registration is done at the hospitals, anyway. This made registration vulnerable to industrial action by medical personnel. For example, during the nationwide strikes, first by doctors and then nurses, fewer people went to the hospitals as there was little expectation of receiving care. In any case, According to Dr. Matheka, less than 5 per cent of the county’s population seeks medical care at any one time, and many of these are over the age of 65, a group that already enjoys free care. This means registration will inevitably be slow unless there is a serious epidemic.

The Makueni model also faces other challenges. Insurance schemes are essentially funds where people pay into a pool when they are healthy – in this case through both taxes and direct contributions – which they can draw on when sick. The Makueni recruitment model reversed this, thus courting adverse selection, or the tendency of people to get insurance only when they are seriously sick, which can consume huge resources. This brings into question the sustainability of the programme. However, in more recent times, according to Wambua Kawive, a former Makueni County Minister, the county government has ramped up its recruitment efforts and has now launched a mass registration exercise targeting 100,000 registrations by the end of the year.

Another challenge the system needed to cope with was an initial influx of patients into hospitals once the policy was implemented. Tawa Sub-County Hospital Administrator, Justus Kilonzo, told The Elephant that the workload at the hospital had increased, which necessitated the recruitment of more staff. Further, there has been an influx of people from neighbouring counties who sought to take advantage of the system. Geoffrey Kirui, the Health Administrative Officer at Makindu Hospital next to the busy Nairobi-Mombasa highway, spoke about having to filter out patients from other counties, especially Taita Taveta, Kajiado and Kitui. Still, trying to determine someone’s place of residence using identification cards, birth certificates and a ward administrator’s or chief’s letter is an inexact science and one gets the sense that this too was not well thought through.

MakueniCare also faces a hazard where, having paid the subscription, patients will head to the hospital for even minor complaints that can be addressed at lower levels, adding stresses to the system.   They may also engage in risky behaviour knowing that there is the safety net of free care. Such behaviour may be inadvertently complemented by a shift in focus from preventative to curative care by hospitals seeking to generate more revenue and county officials seeking to make political hay from the scheme.

The latter is particularly important. It is crucial to note that MakueniCare is undergirded by an administrative structure that was created to deliver a different type of healthcare where users contributed directly. Suddenly eliminating such fees can have unintended deleterious effects on both the facilities and their ability to deliver quality services. One study on the effect of the removal of user fees found that although the revenue generated was generally low, it served to ensure that facilities met the costs of services and salaries for support staff not directly funded through the government’s budget.

There is also a legitimate fear that the political priority placed on MakueniCare may be diverting resources from primary and preventative care at the health centre and dispensary levels.

In Makueni, a doctor-turned-administrator who did not want to be named told The Elephant that MakueniCare had created a mismatch of skills, with doctors having to do administrative tasks rather than attend to patients. When MakueniCare was first proposed, the doctor told us, there was much resistance from hospitals, which were concerned about the lack of a clear system as well as lack of necessary training and preparation. “Why the rush to launch in October 2016?” asked the doctor, concluding that the timing had largely been influenced by the interests of county politicians vying in the August general election.

MakueniCare essentially transfers control over funds and decision-making away from hospitals to bureaucrats at county headquarters in Wote town. Hospitals not only have to worry about delays in receiving reimbursements for resources spent in providing care – which can happen if, for example, the national government delays disbursements to the county governments – but also about losing their largely autonomous decision-making power on the equipment they need to procure and the staff they need to recruit. Similarly, where and when new facilities are built may reflect more the political priorities of those running the county government rather than the genuine health needs of the populace. Lastly, as with all government-driven procurement decisions, the spectre of corruption is never far away.

There is also a legitimate fear that the political priority placed on MakueniCare may be diverting resources from primary and preventative care at the health centre and dispensary levels. Ilatu dispensary, which was built by the Kenya Pipeline Company and opened in March 2014, may be a case in point. In September 2015, the facility was handed over to the county government that provided staff and equipment. Adjacent to a settlement scheme, it is the busiest facility in Kibwezi West and offers outpatient, maternal and child health, family planning as well as HIV testing and counselling services. The staff of two nurses and one laboratory technologist attend to between 70 and 100 patients every day. The county government is upgrading it to a health centre and building a 40-bed inpatient facility.

Jacinta Mbula is the nurse in-charge. She says staffing and resources are big challenges. When The Elephant visited the facility, her fellow nurse was on maternity leave and she was running the facility on her own. She said that there is only enough accommodation for one nurse to stay at the facility and take care of overnight maternity cases, and that nurse still has to report to work the next day. Although they receive adequate supplies of essential medicines from the county government, they do sometimes run out of non-essential drugs.

Further, she only gets KSh60,000 – “peanuts” – every quarter from the county government to pay casual labourers and purchase essential supplies. She currently employs one casual worker and one watchman but says she actually needs – but cannot afford – two casuals and a groundsman to manage the 10-acre facility. And because it was not built by the national government, the dispensary is not entitled to access the HSSF, despite its workload, though other less busy facilities do. Ilatu does, however receive, as all facilities do, reimbursement from the national government for maternal deliveries –KSh2,500 each.

Dr. Matheka says the average distance to a health facility has been nearly halved, from 9km to 5km in the last 4 years. However, having more facilities will not necessarily improve health outcomes for the people of Makueni if the quality of care they provide begins to decline as a result of underinvestment.

So as the county keeps building more dispensaries and health centres, questions must be asked about whether underfunded facilities can truly serve as the bedrock for universal health coverage even though access has been improved. Dr. Matheka says the average distance to a health facility has been nearly halved, from 9km to 5km in the last 4 years. However, having more facilities will not necessarily improve health outcomes for the people of Makueni if the quality of care they provide begins to decline as a result of underinvestment. Further, especially as the county expands the number of Level 4 hospitals, one must wonder whether this is being done at the expense of funding primary healthcare.

Makueni officials say some of the potential pitfalls are ameliorated by enhancing public participation. Governor Kibwana says local committees of citizens participate in co-supervision of projects and must, along with technical people and administrators, give approval. This, Kawive asserts, removes politics from the equation and makes bureaucrats and hospital administrators directly accountable to citizens. While it is definitely a good idea to involve local communities, true accountability must be accompanied by real access to information as well as consequences for those who are implicated in wrongdoing.

Though MakueniCare faces its share of challenges, everyone The Elephant spoke with in Makueni who was aware of the programme was full of praise for its ambition, including those who were critical of its implementation. The fact is, as Kenya ponders the way to achieve universal health coverage, the country would do well to pay attention to the lessons from Makueni. The expansion of NHIF cover by itself will not suffice; the national government must work with county governments to outline a plan that creates a seamless spectrum of cover at every level of care and provides the necessary resources at the appropriate time.

Further, there should be horizontal cooperation among counties in providing healthcare and any plan must strive for equity but without punishing the counties that have taken serious strides. Criteria for eligibility for county programmes should be clearly spelt out and counties should be encouraged to collaborate in designing their schemes within the framework of the national plan.

Thirdly, the system should primarily invest in and direct resources towards building the capacities of the public health sector, not in creating opportunities to generate private profits. It should embrace a rights-based approach that seeks to deal with health as a human right rather than an industry. That shifts the focus away from the needs of “investors” to those of citizens. As Ann Wanyoike notes, “an expanded role for the private sector became a health sector reform theme of the 1990s” but this resulted in “a dichotomous health structure that was characterised by the rich opting for high-cost private healthcare providers, with a majority of the populace who had no such means relying on the publicly run health institutions”. This means that those who can contribute the most to a national universal health coverage scheme have little incentive to do so, especially if such contributions are voluntary. More on that later.

In addition, it does no good to simply superimpose universal health coverage on a system designed for hospitals to generate revenue. The latter must be fundamentally retooled to suit the former and this will take both time and resources.

Fourth, the plan must prioritise prevention and care at the lower levels. In 2013, according to the Kenya Service Availability and Readiness Assessment Mapping report, less than 6 out of 10 health facilities in the country have the capacity to provide the Kenya Essential Package for Health (KEPH) – a standardised comprehensive package of health services – and less than half have the basic amenities to provide healthcare services. And while two-thirds have half the basic equipment required, 59 per cent do not have essential medicines. Only 2 per cent of facilities are providing all KEPH services required to eliminate communicable diseases. Providing universal healthcare on such a foundation would be building on sand.

Universal healthcare requires a substantial increase in the resources both levels of government commit to health. The point is not that both levels of government should spend more on health at the expense of other social services; rather they should increase spending on the full range of human rights and social determinants of health. For example, Kenya’s Health Policy identifies reducing the burden of violence and injuries as one of the top objectives and notes that this will require addressing causes. Given that road crashes account for between 45 and 60 per cent of all admissions to surgical wards, comprehensively addressing the problems on our roads would free up considerable resources in the health sector.

According to Djesika Amendah, an associate research scientist at the African Population and Health Research Centre, Kenya spends most of its health budget on salaries, allowances, drug supplies and other recurrent costs; only 7 per cent of the budget goes towards capital expenditure to improve the quality of healthcare by building new facilities or purchasing equipment to care for more people in the future.

How the money that is allocated to the health sector and how it is spent should also change. According to Djesika Amendah, an associate research scientist at the African Population and Health Research Centre, Kenya spends most of its health budget on salaries, allowances, drug supplies and other recurrent costs; only 7 per cent of the budget goes towards capital expenditure to improve the quality of healthcare by building new facilities or purchasing equipment to care for more people in the future.

In addition, the country spends nearly four times as much on curative care as it does on disease prevention and “we devote a higher share of our health shillings (20 per cent) on governance, health system and financing administration; in other words, paying people in the ministries of health who actually do not see any patients rather than spending money on preventing diseases or promoting health.” Further, although most Kenyans live in rural areas, government health expenditure has in the past tended to favour urban areas. Given the country’s limited resources, more prudence will need to be exercised if universal access to care is to be guaranteed to all.

Along the same lines, there should be an emphasis on getting Kenyans to pay into the system when they are healthy and not to wait till they get sick to get the cover. This also means making it easier for people to register and pay. For example, one can currently download a registration from the NHIF website but one then has to deliver it physically to their offices. There appears to be no way to pay via mobile money or credit/debit card. With nearly all Kenyans able to access the internet though their mobile phones, allowing online registrations and payments would be an easy way to bring in more registrations.

Further, whether the scheme should be voluntary or compulsory is a matter for serious debate. While Makueni’s system is completely voluntary, the NHIF is compulsory only for those in formal employment. Yet the WHO’s 2010 World Health Report titled “The Path to Universal Coverage” says that “there is strong evidence that raising funds through compulsory prepayment provides the most efficient and equitable path towards universal coverage. In the countries that have come closest to achieving universal health coverage, prepayment is the norm, organised though general taxation and/or compulsory contributions to health insurance.”

Makueni teaches us that universal health coverage is doable and that we do not need to have the resources of an industrialised country to achieve it.

There is also the question of whether, like in Makueni, everyone pays the same amount regardless of income, and whether wealthier people are asked to pay a little bit more in order to lighten the load on the poor. As the WHO notes, “financial risk protection is determined by how funds are raised and whether and how they are pooled to spread risks across population groups” and “rais[ing] funds equitably … usually implies a degree of progressivity (where the rich contribute a higher proportion of their income than the poor)”. The NHIF, rather strangely, only has a graduated scale for contributions from those in formal employment; others who join pay a flat monthly fee regardless of income. This is curious for a country where, according to the United Nations’ Economic Commission for Africa, only a quarter of workers are in the formal sector.

Fifth, accountability must permeate the entire system. Implementation of the scheme should not become, as we have seen with the free primary education reintroduced in 2003 and the Standard Gauge Railway, hostage to political priorities. Kenyans must accept that if it is to be done well, it will not be done overnight. Public participation at every stage should be encouraged and resources, especially human resources, should be utilised in the most appropriate and effective manner. Effective public participation as well as transparency will be indispensable if the country is to avoid universal health coverage becoming another avenue for looting by the state.

While universal health coverage focuses on reducing the financial burdens of patients, more will be required if access to the healthcare system is to be expanded. As the World Health Report notes, “eliminating direct payments will not necessarily guarantee financial access to health services, while eliminating direct payments only in government facilities may do little to improve access or reduce financial catastrophe in some countries. Transport and accommodation costs also prevent poor people using services, as do non-financial barriers, such as restrictions on women travelling alone, the stigma attached to some medical conditions and language barriers.”

Finally, Makueni teaches us that universal health coverage is doable and that we do not need to have the resources of an industrialised country to achieve it. All that is needed is a belief that Kenya should be run for the benefit of all Kenyans and that Kenyans are just as capable as any other people of imagining and creating better worlds and better futures. This may be the greatest lesson we can learn from Makueni County.

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Mr. Gathara is a social and political commentator and cartoonist based in Nairobi.

Features

Uganda: Why Only Public Oversight Can Stem Corruption and Incompetence in the Public Service

It is more productive for Ugandans to focus on the underlying incompetence in public administration and to devise means of increasing public oversight of the Treasury.

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Uganda: Why Only Public Oversight Can Stem Corruption and Incompetence in the Public Service

It is that time of the year when the Auditor General’s annual report, released at the end of December, is drip-fed to Ugandans, query by query. The majority of the population will only ever know headlines such as “Uganda’s Public Debt Worrying”. Along with the news that Uganda’s public debt has risen by 22 per cent, the latest report carried the first official confirmation that the country’s sovereignty has been put at risk by the terms and conditions of some loans. These two alarming pieces of information received minimal response from the public.

What did not make the news was that significant amounts of the petroleum fund set aside for infrastructure development is being used instead to fund the recurrent budget (wages, consumables, transport etc.) amounting to UGX.125.3 billion ($34,137,671).

Revenues receivable from oil developers amounting to UGX 12,877,415,932 ($3,508,073), have not been collected. A number of other entities have failed to collect monies due to them and it is possible the receivables have been diverted.

Outstanding Receivables

Outstanding Receivables

There is a real risk of loan default given that borrowing and on-lending to parastatals has increased by 975 per cent, from UGX 431 billion ($117,409,571) in 2015/16 to UGX 4,634 billion ($1,262,612,871) in 2017/18 even as parastatals continue to fail to repay earlier loans. Parastatals have traditionally been conduits for public funds in to private hands.

The debt to revenue ratio is now 54%, the highest in the region and projected to rise to 65% in 2020 when some loans expire. Historically, nothing above 40 per cent debt to revenue ratio has been sustainable. Interest payments as a percentage of revenue collection, at 17 per cent, are also above the accepted threshold of 15 per cent. The AG first flagged unsustainable interest payments in 2016 when they were still at 16 per cent of revenues.

Other areas of deterioration in financial management reported are: a rise in contingent liabilities (including potential court awards) to UGX 9.4 trillion ($2,560,731) from UGX 7.5 trillion ($2,043,187) a year ago; unpaid court awards and compensation against the government have risen to UGX 655 billion, from UGX 648 billion ($176,509,616) in 2017. Interest on a section of judgment debts is UGX 124 billion ($33,790,210). Yet awards made in favour of the government amounting to UGX 20.6 billion ($5,611,883) have not been collected.

The debt to revenue ratio is now 54%, the highest in the region and projected to rise to 65% in 2020 when some loans expire. Historically, nothing above 40 per cent debt to revenue ratio has been sustainable.

The country has continued to fall short of the amounts it is required to contribute to donor-aided projects. In 2017, the shortfall was UGX 43 billion ($11,714,056) and rose to UGX 1.6 trillion ($435,891,546) in 2018.

The Youth Livelihood Programme attracted more attention than the debt situation, with its salacious details involving revolving loans being made to youth groups, 67 per cent of which do not exist. A small minority will find out from Twitter that 79,000 army veterans haven’t been paid their pension and gratuity arrears worth UGX 500 billion ($136,211,575) or that UGX 65.6 billion ($17,843,484) was released by the Treasury for pensions but was returned after the recipients could not be verified or were being deliberately frustrated by ministries, departments, agencies and local governments. (The latter is more likely. This writer was involved in arm-wrestling the Education Service Commission and the Ministry of Education for an elderly friend’s gratuity. A Ministry of Education official demanded an unspecified “share”; it was denied to him, and so the gratuity was not paid.)

The full report will come into its own with daily television coverage later in the year when the Parliament Accounts Committee (PAC) gets round to debating it. There will be further scrutiny if and when COSASE, Parliament’s committee on commissions, statutory authorities and state enterprises, debates its management. COSASE might spend some time trying to understand why out of the 11 public enterprises in which the government has invested UGX 70 billion ($19,067,642) only Kalangala Infrastucture Services is operational. KIS first came up for mention by the AG in 2016 when it was discovered that it had been paid UGX 16 billion ($4,358,994) to run two ferries between Ssesse Islands and the mainland while the nine other ferries countrywide were operated on a combined total of UGX 10 billion ($2,724,196). The AG pointed out that a new ferry can be acquired for UGX 14 billion ($3,813,865). KIS has never declared profits since the project began in 2012.

All except two of the government’s non-operational commercial enterprises are in the agricultural sector and were designed to transform smallholdings into commercially viable farms (See the State of the Nation Address 2018), fruit and sugar factories and tea factories and growers.

Non-operational Projects

Non-operational Projects. Source: Auditor General’s Report, December 2018

This should come as no surprise given that the AG had earlier warned against these investments made without strategic plans or feasibility studies;

Lack of guidelines for strategic investments

“The government, through the Uganda Development Corporation, is undertaking investments countrywide in the areas of fruit processing and helping others to set up industries in Soroti, Luwero, Kabale and Kisoro districts. These investments cumulatively amounted to UGX 26.6 billion ($7,246,598). However, I noted that there was no policy to guide the establishment of these investments.” The Auditor General’s report of 2016 also shows that some of the investments have been undertaken without feasibility studies on marketability and commercial viability.” (Auditor General, 2018)

The competence of parliament and the general public to oversee public expenditure is also in issue. Kira Motor Corporation (KMC), recently in the news for test-driving a car supposedly made in Uganda, was audited and is listed as non-operational in 2018.

It was only noticed when in February 2019 a parliamentary committee visited KMC and found that the plant does not exist. Where foundations and scaffolding worth UGX 15 billion ($4,087,095) had been expected, there was only bush. Like other presidential initiatives announced to fanfare and outside the NDP, KMC is being revealed as a scheme for gaining access to Treasury funds that have been embezzled.

Nugatory expenditure is a useful indicator of competence in the public service. The AG defines it as avoidable and therefore wasteful “expenditure that does not achieve any result”. In 2017 UGX 2.74 billion ($746,508) was wasted on “delayed settlements of obligations arising from contracts for construction services, court awards.” In 2018, the Ministries of Water and Education lost UGX 1.6 billion ($435,900) on “interest charges including on interest on delayed payments, litigation costs for wrongful termination of contracts and refund of embezzled funds”.

Masked corruption

However, the details are no longer important and not many more can be taken in by an exhausted polity. It is more productive for Ugandans to focus on the underlying incompetence in public administration that gives rise to audit queries such as these and to devise means of increasing public oversight of the Treasury. Some audit queries arise out of incapacity but most mask corruption.

It was only noticed when in February 2019 a parliamentary committee visited KMC and found that the plant does not exist. Where foundations and scaffolding worth UGX 15 billion ($4,087,095) had been expected, there was only bush. Like other presidential initiatives announced to fanfare and outside the NDP, KMC is being revealed as a scheme for gaining access to Treasury funds that have been embezzled.

Take wetland management. It has been government policy for at least a decade to halt encroachment on wetlands. The reasons are both to prevent environmental degradation and to maintain access for communities that derive livelihoods from them. The Wetland Management Department has not updated the inventory of wetlands since 2000; they are neither demarcated nor gazetted. This omission is convenient for those who acquired illegal title in the wetlands in anticipation of the planned standard gauge railway and the compensation that would have to be paid for them being vacated. In 2017 the National Environment Management Authority announced that the titles were to be cancelled. In 2018, the AG found that the cancellation exercise was not funded and therefore did not take place.

The target of restoring 12 per cent of destroyed wetlands by 2020 is unlikely to be met. Degradation of the wetlands outpaces restoration, with only 0.3 per cent of the targeted restorations having been implemented.

Furthermore, it has been found that reclaiming wetlands as part of irrigation schemes has led to enclosure of the irrigated land and exclusion of the local populations dependent on them for their survival. Land management generally is in similar straits with two million hectares belonging to the police, prisons and Ministry of Agriculture encroached upon. At the time of writing a massive tract of wetland is being filled with earth on the Bombo Road – a highly visible highway leading north out of Kampala. The public is mystified.

Thirty-four per cent of ministries, departments and agencies (MDAs) and local governments are understaffed. The level in 2016 was more or less the same – 119 local governments were understaffed by over 40 per cent. “This affects service delivery as a majority of these are critical jobs like doctors, clinical officers, Professors, Commissioners.” (Auditor General). The most affected are public universities and local governments. Following[1] is a sector by sector list of audit findings for MDAs highlighting the understaffing and other difficulties they face.

Then there is the usual corruption, such as the case of six officials in Apac District receiving over UGX 2 billion ($544,883) without supporting documents; financial controls are still being overridden because the twenty-year-old IFMIS has still not been rolled out country-wide. Where it does operate, controls have been by-passed to allow UGX 369 billion ($100,531,084) in expenditure not related to the relevant budget line (up from 168 billion in 2016), unaccounted for expenditure of 21.7 billion ($5,912,119) and nugatory expenditure of 66.9 billion ($18,226,765). Undisclosed arrears, which may or may not be genuine, amount to UGX 377 billion ($102,707,560).

Overall responsibility must be ascribed to the top leadership of the public service, the planning departments of the Ministry of Finance, line ministries and local governments. Unfortunately, that is where the largest gaps exist between expected services and outcomes.

In 2016, a large number of MDAs failed to submit strategic plans “as a result most sector plans and targets are not aligned with the National Development Plan (NDP) and assessing service delivery and level of implementation of the NDP is difficult without service delivery standards and regular interviews.”

However, the details are no longer important and not many more can be taken in by an exhausted polity. It is more productive for Ugandans to focus on the underlying incompetence in public administration that gives rise to audit queries such as these and to devise means of increasing public oversight of the Treasury. Some audit queries arise out of incapacity but most mask corruption.

Low debt absorption is understandable now that it is clear that money is borrowed without plans. In 2016, UGX 18 trillion ($4,903,604,818) was committed but was not disbursed. The Treasury paid UGX 20 billion ($5,448,388) in wasted commitment fees for those loans. In 2018, the trend continued; municipal councils under the Uganda Support for Municipal Infrastructure Development failed to utilise UGX 95,006,243,857 ($25,881,547) while the project support unit did not utilize UGX 6,722,829,229 ($1,831,386). This occurred against the background of “various incomplete and abandoned works due to non-payment of contractors. Work on Mbarara-Nkenda and Tororo-Lira transmission lines was delayed for almost 8 years resulting into cancellation of the loan by the funder with an undisbursed loan amount of USD 6.5m”.

The same loan was audited in 2016 when the unabsorbed amount was UGX 94.783 billion. Officials at that time attributed the failure to a lack of specialised staff (understaffing), which in turn limited their capacity to procure specialised equipment, such as for land surveys.

A minor but interesting detail is that 115 properties under the management of the Departed Asian Custodian Board (DAPCB) have been repossessed by their former owners who were compensated for these properties in 1999. These properties may be lost to the State once the winding up of the DAPCB is complete.

Class action suits

Returning to the issue of an appropriate response to the Auditor General’s findings, the aggrieved have a number of options. The most promising would be to file class action suits for negligence and any losses consequent upon that, be they avoidable deaths in hospital or those caused by bad roads.

Where funds have been available and commitments made, the failure to transmit electricity for eight years and resulting loss of industrial capacity and simple comfort of the affected population is similarly actionable. Nugatory expenditure is actionable in its own right but various communities can demonstrate in lawsuits how it has adversely affected them and obtain compensation.

It is the right of affected populations to petition the Ombudsman, individual MPs, as well as COSASE. If they appear toothless, it may be because the public they represent has abdicated responsibility for the economy.

[1] ANNEXURE II: SUMMARY ENTITY FINDINGS OF MDAS Table 2.1 Adverse Opinions

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The Original Sin: Land, Politics and the History of Ethnic Tensions in the Rift Valley

As the theatre of the politics of succession leading to 2022 plays out in the expansive Rift Valley region, the spectre of the ever-simmering land question looms large.

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The Original Sin: Land, Politics, and the History of Ethnic Tensions in the Rift Valley

“Chitap koret,” this is my ancestral land, a Kalenjin from the Sabaot community, one of the nine ethnic dialects that make up the Kalenjin nation, said to me at the foothills of Mt Elgon, in Trans Nzoia County. Sabaots are a pastoralist community and just like the Maasai people, believe in keeping cattle – even the poorest Sabaot must have a cow or two. “Kalenjin believe North Rift especially belongs to them and nothing will change that,” said Kip, my Sabaot acquaintance.

“These people (the Kikuyus) will always be tenants on our land,” said Kip. “They are here temporarily. It doesn’t matter whether the land they occupy has been bought legally or not, was dished out, bought from one of us or any other person, whether it has a title or not. One day they must vacate this land.” Kip said mutual suspicion between the Kikuyus and Kalenjin in the Rift Valley will always abound. “Mark my words,” said Kip emphatically, “just like the Kikuyu don’t forget, we Kalenjin don’t forgive – we will revisit the issue of land ownership in the Rift Valley. We will soon show them who the true owners of the Rift Valley are.” It was an ominous threat.

Every time there is a shift in the political relations at the national level, between the Kikuyu and Kalenjin elites, every time these elites engage in a public spat, the Kalenjin people of the greater Rift Valley allude to foreigners among them who should be ejected. Every time the issue of foreigners arises in the Rift Valley region, the first targets are specifically the Kikuyu people, some of whom have lived in the Rift Valley region for the last 70 years.

Kip said mutual suspicion between the Kikuyus and Kalenjin in the Rift Valley will always abound. “Mark my words,” said Kip emphatically, “just like the Kikuyu don’t forget, we Kalenjin don’t forgive – we will revisit the issue of land ownership in the Rift Valley. We will soon show them who the true owners of the Rift Valley are.” It was an ominous threat.

The genesis of the land quagmire between the Kalenjin and Kikuyus in the Rift Valley region, traces back to the 1940s, which the British colonial government exacerbated by settling the Kikuyus in the area. An annual colonial write-up of 1957 reported, “In common with other Kalenjin people, however, there is everywhere else, dislike of the Kikuyu settlement being established in what is regarded as their district’s sphere of influence in Uasin Gishu”.

Yet, the colonial government had, by the turn of the 19th century, sowed the seeds of discord, when it pushed many of the ethnic communities into reserve lands and squatter camps, to create room for cash crop growing by the European settler farmers in the White Highlands. Central Kenya, Rift Valley and Coast Province were the major culprits in this settler land colonial project.

A pastoralist community, the Kalenjin, however struck an exceptional deal with the settler farmers: provide manual labour in the farms for exchange of grazing rights. But come the mid-1940s, this arrangement was destabilized, because the settler farmers needed more land for their cash crops. Why? World War (II) had ended in 1945 and Europe had decimated most of its agricultural lands for cash crop production. In addition, the Kalenjin people were expanding in population, even as their livestock grew in numbers. They too were demanding more land to graze their animals. This naturally created further tensions.

The first thing the colonial government did in reaction to this agitation by the Kalenjin was, to contain them in squatter camps and deny them grazing land. A warrior-like people, the Kalenjin refused to be squatters in the settler farms. So, in search of pastureland, they trekked off. This migration led them to central Rift Valley, Taita-Taveta and even in as far as Tanzania.

Every time there is a shift in the political relations at the national level, between the Kikuyu and Kalenjin elites, every time these elites engage in a public spat, the Kalenjin people of the greater Rift Valley allude to foreigners among them who should be ejected

To replace the departing Kalenjins, the colonial government brought in the Kikuyus from Central Kenya to work in the settler farms arguing that the agrarian, sedentary Kikuyus were hardworking and attuned to plant cultivation, unlike the “lazy” pastoralist Kalenjin.

By 1950s therefore, Kikuyu population in the Rift Valley had tremendously grown and this greatly upset the indigenous Kalenjin. This is around the time the Kalenjins started agitating for their land and viewing Kikuyus as strangers and intruders. Hence, the temporary halting of more “importation” of Kikuyus from Central Kenya to Rift Valley, according to colonial reports that quoted Mr P.H Brown, the Uasin Gishu District Commissioner (DC), who recommended the stop.

But, no sooner had Brown stopped further Kikuyu migration into the Rift, than his successor revoked the decree. Mr R.S Symes-Thompson pointed out that Kikuyus were central to agricultural success in the settler farms. It is an arrangement that Jomo Kenyatta inherited and perfected when he became first, the Prime Minister in 1963 and, later President in 1964.

When it became apparent that the British would have to relinquish its power in Kenya, they bought between one and three million acres of land to resettle the landless. They also put a caveat to land ownership: any Kenyan would own land anywhere in Kenya, regardless of their ancestral origins and ethnicity. Secondly, there was no free land. If anybody wanted to buy land, it would, henceforth be, on a willing-seller, willing-buyer. It is an arrangement that greatly favoured the Kikuyus and that Kenyatta took to heart and implemented it even better than the departing British. To date, these two decrees appear in the new promulgated 2010 constitution.

To this end, the British colonial government gave Kenyatta’s government 100 million sterling pounds under the Settlement Fund Trustees (SFT) to buy land for the squatters – many of who were Kikuyus. In 1969, fiery Nandi MP Jean Marie Seroney, convened a charged meeting to debate the land question in Rift Valley. The Nandi Hills Declaration was the aftermath of that meeting, which decreed all land in Nandi belonged to the local community, that would henceforth oppose any further acquisition and settlement of Kikuyus in the area.

Moi who was the Vice President and Minister for Home Affairs and was Seroney’s political nemesis, threw him into detention. The Kalenjins have always argued that even when they had money to buy their own land, the Kenyatta government opposed the move. They cite the example of the Makonge (sisal) Farm in Ziwa. The attempt to buy this land was thwarted by the state in 1976, leading to the arrest of Eldoret North MP, the controversial Chelagat Mutai. The farm, instead, was handed to a land buying company belonging to Kikuyus.

In Property and Political Order in Africa: Land Rights and the Structure of Politics, published in 2014 by Cambridge University Press, Catherine Boone, ably tackles the intricate interconnectedness of supra local politics and land ownership in the volatile Rift Valley region.

“The statist land tenure regime (LTG) established in the Rift Valley farming districts by the colonial state was perpetuated and elaborated by the Kanu government after independence,” writes Boone. She says, the government bought the land from the departing European settlers, and allocated the land through settlement schemes to smallholder farmers between 1960–1975. “The rest of the land so acquired was transferred in the form of large estates to high ranking members of the Kenyatta regime entrenching their status as an economic, as well as a political elite.”

Burnt Forest area – which become infamous in December 2007, after some Kikuyu families were trapped in a Pentecostal church and that was set on fire, burning mostly women and their children below 10 years – “become a zone of mostly Kikuyu settlement schemes and was purchased by the state in 1965.” During the highly contested presidential 2007 election, the Opposition coalition led by Raila Odinga, running on an ODM ticket cried foul and accused the Mwai Kibaki led Party of National Union (PNU) of stealing the elections, provoking ethnic cleansing in Rift Valley, especially in areas that were heavily populated by Kikuyu. Burnt Forest became one of the notorious flashpoints of that ethnic warfare.

“Many settlers on the Uasin Gishu and Trans Nzoia Districts schemes were Kikuyu who had previously been employed on European farms in these areas” points out Boone. “Under Kenyatta, the kanu government used its land powers to open the Rift to settlement by peoples and persons who were not recognized by the state as indigenous to these jurisdictions, and who did not claim ancestral or customary rights in these areas.” Boone adds, “Under colonial rule, these people were categorized into state-recognized ethnic groups (the Nandi, Kipsigis, Maasai, Tugen, Elgeyo, Samburu, Marakwet, Sabaot, Pokot Terik, Turkana and so on).”

Catherine Boone who is a professor of Government, International Development and Political Science at the London School of Economics (LSE), makes the point that even after these communities were pushed to the margins of their lands (presumably to create room for the sedentary communities such as the Kikuyu to engage in agricultural farming), the loss (of land) did not decrease, or become less onerous, overtime.

Conflicts over access to land in Kenya’s Rift Valley have marked all stages of Kenya’s national history and shaped each critical juncture, says Boone. “The colonial state expropriated much of what is now Rift Valley Province from the Maasai and other people indigenous to the Rift. The British proclaimed direct jurisdiction over what it designated as Crown Land in the Rift Valley in 1904.”

Boone argues in her book that “the farming districts of Kenya’s Rift Valley Province are some of the most productive and highly commercialized rural zones of sub-Saharan Africa. These districts – Nakuru, Trans Nzoia, Uasin Gishu and Nandi – are territories with high in-migration and high ethnic homogeneity and with settlement patterns and land allocation authored directly by the central state. It is also one of Africa’s worst conflict-ridden rural areas, with a long and bloody history of land-related struggles.”

Once Daniel arap Moi was in control of the state organs, after succeeding Mzee Jomo Kenyatta in 1978, “he used the central state’s land prerogative in Rift Valley to reward its own clients, who were encouraged by the regime to coalesce around ethnic identity, Kalenjin-ness that was centred on indigeneity (autochthony) in the Rift Valley,” notes Boone. “From 1986 on, government forestlands became caisse noire of patronage resources that were used to cement elite alliances and build political support for Moi among Kalenjin constituencies he needed as a mass power base.”

Hence, “evictions of Kenyatta-era forest squatters and the declassification of new forest land opened a land frontier that Moi used to settle thousands of Kalenjin families. Most Kikuyus were expelled from the Mau Forest in the 1980s, so that Kalenjins could move in. Many were allowed to settle south of Njoro.”

In the South Rift, largely composed of the Kipsigis, Kalenjin’s biggest dialect, a simmering anger of volcanic proportions is going on, brought about by the eviction of the Kipsigis people from the Mau Forest beginning 2018. Many were settled there, originally by President Moi in the early 1980s, soon after becoming the second president of Kenya, and for some as late as 15 years ago during the tenure of President Mwai Kibaki. The Kipsigis are now accusing the Deputy President William Ruto of ominous silence, as they are forcefully being kicked out and their property burned.

Daniel Burgei told me the Kipsigis helped marshal Kalenjin vote for Jubilee Party through Ruto, “now he is mum about the evictions. This is very troubling as we watch this whole spectacle in bewilderment. The Kipsigis have been practicing shamba system in the Mau Forest, where the soils are rich, do not need fertilizer and are good for cabbage, maize potatoes and tomato production. They also have been keeping livestock; cows, donkeys, goats and sheep.” Yet, in the process, they have hived huge chunks of the forest by cutting trees, hence destroying the natural environment, all in the name of giving way to farming, said Burgei.

Ruto, like Moi in the 1970s when he was Jomo Kenyatta’s VP is accused by a section of the Kalenjin people of keeping quiet in the face of the long-standing issue of land ownership in the Rift Valley region.

It is significant to note that “the name Kalenjin came into use as a group of designation in Kenya among World War (II) servicemen and ex-servicemen and students in the elite East Africa high schools in Nairobi and Kampala in the 1940s. “This ethnic consciousness of being Kalenjin was rooted in the native-stranger distinction. In very part, it was produced by the land tenure regime. The form of ethnic consciousness and mobilization that developed in Kenya was not the consciousness of all the people.

“When (former President Daniel arap) Moi led the efforts to amalgamate the political organization of the state-recognized tribes of the western Rift Valley in early 1960, he called the umbrella group the Kalenjin Political Association (KPA).” Boone adds that when the colonial government lifted the ban on indigenous politics, Kenya African Democratic Union (KADU) took over the interests of KPA.

“By the time of the February 1962 Lancaster House constitutional negotiations, “the rifts between Kanu and Kadu were…deep and deeply felt…During the talks, Moi would repeat that the people of Kalenjin were prepared to fight and die for their land.” Boone reminds us all, that “Kalenjin first appeared as an official ethnicity on the Kenyan census in 1979, Moi’s first year as a president. Moi promoted Kalenjin identity in the 1980s and 1990s as an ethnic designation to transcend the narrower, older colonial-era identities of Nandi, Kipsigis, Elgeyo, Tugen, and so on.” These ethnic consciousness of being a Kalenjin, says Boone was driven by the sensitive land politics of the Rift.

This consciousness has had the effect of creating a peculiar “tribalism,” in the Rift Valley land politics “namely that in it was almost wholly a consciousness of being, either a Kikuyu or not-Kikuyu.”

If the 1960s and 1970s were decades of consolidation of the Kenyatta regime which sidelined those claiming ancestral land rights in the Rift Valley and “inserted” African settlers into Rift Valley farming districts, the 1980s and 1990s were a reversal of these settlements. Forced to accept plural politics in 1991, by the West, his erstwhile allies in the Cold War era, Moi mobilized the Rift Valley constituencies, “along an axis of competition that pitted indigenes of the Rift Valley against settlers who had been implanted by the Kenyatta regime.”

Boone observes that the Rift Valley politicians tapped into existing land-related tensions in which the central state was directly implicated as the author and enforcer of a contested distribution of land rights. “This conflict found direct expression in electoral politics at the national level. Political rhetoric that pervaded Nandi, Nakuru, Uasin Gishu and Trans Nzoia districts dwelled on how land was lost to the Europeans was never recovered and how under Kenyatta ‘black colonialists’had been allowed to buy up land that rightfully should have belonged to indigenous communities.”

Prof Boone gives the example of Likia location, in Molo division, Nakuru District, “where most land belonged to Kikuyus in the early 1990s, local Kalenjin politicians reminded the people of the past ownership of the land and encouraged them to reclaim it.”

On January 10, 2019, a former Molo MP, Joseph Kiuna held a press conference in Likia area of Molo and reminded the Kalenjin that they had not forgotten what they had done to the Kikuyus in 2007/2008post-election violence (PEV). “All this time the Kikuyus have been pretending that they had forgotten and moved on,” said Kip. “We Kalenjin are very much aware they have not forgotten anything.” Even though thousands of Kikuyus were internally displaced – up to 600,000 people were dislocated from their homesteads in the greater Rift Valley during PEV, by the marauding Kalenjin warriors – many a Kikuyu nevertheless returned to Rift Valley. The allure of fertile soils, the armistice arrived at between Ruto and Uhuru Kenyatta and a desire to go back to their lands, which they had occupied for many years, was greater than the ominous existential threat of a repeat “ethnic” attack on their farms.

And the Kikuyus have had big group farms ranging between 1000 and 3000 acres in Trans Nzoia and Uasin Gishu Counties. 35 kilometers from Kitale town are the better known Gitwamba and Munyaka Farms located at the foothills of Mt Elgon, bordering Mt Elgon Forest. Most of the Kikuyus who settled here were from Nyeri and its environs. Endowed with black alluvial soils, the farms are very fertile. Since settling there, decades ago, the Kikuyus have grown beans, cabbages, carrots, potatoes, tomatoes amongst a host of other horticultural crops. Markets days in Iten, Kitale, Matunda, Moi’s Bridge and Soy are filled with fresh produce from these farms. As fate would have it, in Trans Nzoia, it is Gitwamba – which in Kikuyu language means a flat, rich plateau with fertile soils and Munyaka which means to be lucky – that were the first flashpoints of ethnic upheavals in 1991. They have remained so to date.

The 1991 ethnic clashes were instigated, organized and executed by Moi’s Kanu regime which suddenly felt under siege from the multi-party advocates. Hoping to tap into their age-old grievances of land ownership and aware he had kept mum as land in the Rift Valley was being parceled to Kikuyus and other communities, by the Kenyatta government in the 1970s, Moi allegedly encouraged the Kalenjins to “reclaim” their land from foreigners, in exchange for their support to further cement and consolidate his grip on state power. By foreigners, he meant the Kikuyu people.

The other Kikuyu farms in TransNzoia are: Wamuini Farm A, the 1,000 agricultural land near St Joseph High School on the Kitale-Ndalu Road. Wamuini Farm B, formerly Mabonde Farm that was called mabonde – Kiswahili for denes, because of its ridges and valleys. There is also Meru Farm bought in the early 1970s. It is near Kitale showground, adjacent to the posh Milimani Estate. The other big farms owned by Kikuyus are Kiirita, Makui and Weteithie Farms. Weteithie, which in Kikuyu means self-help. All these farms were bought through land-buying companies with loans from Agricultural Finance Corporation (AFC). They include Mwihoko, which means hope in Kikuyu, Ngwataniro-Mutukanio, Nakuru District Ex-Freedom Fighters Organization (NDEFFO) and Nyakinyua, which was President Kenyatta’s favourite cultural dancing troupe made up of women.

The 1991 ethnic clashes were instigated, organized and executed by Moi’s Kanu regime which suddenly felt under siege from the multi-party advocates. Hoping to tap into their age-old grievances of land ownership and aware he had kept mum as land in the Rift Valley was being parceled to Kikuyus and other communities, by the Kenyatta government in the 1970s, Moi allegedly encouraged the Kalenjins to “reclaim” their land from foreigners, in exchange for their support to further cement and consolidate his grip on state power. By foreigners, he meant the Kikuyu people.

In Trans Nzoia, other Kikuyus acquired land through SFTs, formerly white farms, given ostensibly to “landless people” by Jomo Kenyatta government. In Uasin Gishu County which borders Trans Nzoia, there is a replica of Munyaka Farm, today referred to as Kimumu-Munyaka Farm, located on the Eldoret-Iten Road. The more famous Ya-Mumbi Farm is on the Eldoret-Kapsabet-Kisumu Road. Rukuini and Kondoo Farms are near Burnt Forest. Kimuri and Kiambaa Farms are not far from Eldoret town. Rukuini and Kondoo, just like Gitwamba and Munyaka in Kitale, have remained focal points of “ethnic wars” since 1991.

After the violent uproar that took place in Eldoret North following the controversial 2007 general election, many Kikuyus living in Uasin Gishu County, abandoned their farms in Turbo 30 km from Eldoret town and went to live in town, at Langas estate, the sprawling Kangemi-type ghetto located on the Eldoret-Kisumu highway, just after the Eldoret Polytechnic. Kangemi is a slum on Waiyaki Way, seven kilometres from Nairobi city centre. Stephen Kiplagat, who was born and bred in and whose family still lives in Langas told me that it is today estimated to be 85 per cent populated by Kikuyus. “My family is one of the very few Nandi families that still reside at Langas, the rest are Kikuyus.”

Five Nandi families originally owned Langas. Many of them started parcelling the land and selling it mostly to Kikuyus from the 1980s. Two factors drove this sale: the Kikuyu desire for a plot of land and the fact that they had ready cash to buy the land. With the money, the departing Kalenjin bought land in Kitale, Soy, Turbo and Ziwa so that they could engage in agricultural and livestock farming.

I went to school in Kitale in the 1980s, then it was a one-street settler town and that is where I first heard the phrase “revisiting the issue.” A prominent Kalenjin businessman, (he later become an influential politician in President Moi’s inner circle and today he is retired), said in my presence: “We’ve only leased the land to them (Kikuyus), they should be knowing that…we’ll soon revisit that issue.” When the push for multiparty elections in 1991, appeared inevitable, Moi’s monolithic Kanu one-party dictatorship relented to political pluralism, but not before igniting “ethnic” skirmishes in the Rift Valley.

Kip told me, “resources are becoming scarcer by the day in the Rift Valley region and our people would like the land issue in the Rift Valley region prioritized as a matter of national political discourse.”

The first wave of Kikuyu settlers in Trans Nzoia district first appeared as colonial civil service workers in the mid-1940s after the World War II. The next group showed up in the mid-1950s. These were Kikuyus running away from the Mau Mau insurgency and capture by the British colonial police. Many of them converted to Islam and assumed new identities. Indeed the first Kikuyus to settle in Kitale town were Hamisi Saidi and Hussein Ramadhan. They had taken up Islamic names and soon became petty traders in town.

Resources are becoming scarcer by the day in the Rift Valley region and our people would like the land issue in the Rift Valley region prioritized as a matter of national political discourse

Kigotho Njuguna, Mbugua Gachani, Danson Kangonga Mbugwa, John Muchuri, Wanguhu Githiomi (who hailed from Kijabe) and Peter Kinyanjui – one time Democratic Party of Kenya (DP) point man in Trans Nzoia) formed part of the earliest pioneers of Kikuyu settlers in Kitale. DP was an opposition party once led by Mwai Kibaki, the third President of Kenya. The others were: Lawrence Waweru, Kirima Githaiga, David Kiberu, Waigi Mwangi (originally from Ngecha in Limuru) and Apollos Mwangi. All these men are dead and many of them hailed from Nyeri district.

As the theatre of the politics of succession leading to 2022, plays out in the expansive Rift Valley region, the spectre of the ever-simmering land question looms large. William Ruto, like his predecessor Moi, and not Seroney, finds himself in a dicey position of canvassing the entire Kalenjin vote, amid unsettled land ownership saga that remains an unresolved issue.

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The History Kenya Forgot: Untold World War II Stories

The sinking of SS Khedive Ismail suffers from the same historicity issues that World War II, in general, suffers from in former colonies. It was a war (mainly) away from home, driven by issues that most of the one million Africans who enlisted had little or nothing to do with, at least at a socio-cultural level.

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The History Kenya Forgot: Untold World War II Stories

Before 2:30 pm on 12th February 1944, everything on SS Khedive Ismail was as normal as things aboard a troopship could be. In the music room on the upper decks, someone was playing the Warsaw Concerto on the grand piano. In the lower decks and the cargo hold, which had been converted into barracks mainly for the black soldiers, it was hot and humid. Both spaces would become death traps within a matter of seconds, and the grand piano, a weapon.

A lookout, probably bored out of his mind, noticed a periscope peeking from the water. He raised the alarm, alerting the gunners to the position of the Japanese submarine deftly charging towards SS Khedive Ismail. The troopship was on a routine mission to deliver troops, mainly East Africans, from Mombasa to Colombo in Ceylon (now Sri Lanka) before their onward journey to Burma (now Myanmar). It was part of a convoy codenamed KR8, which had begun its journey from Kilindini port in Mombasa a week earlier.

The alarm was a little too late. Just as the gunners opened fire, the submarine fired four torpedoes. Two missed, but the other two found their target. The first struck the engine room. The second hit the boiler room. The troopship listed, and in less than two minutes, disappeared under the water. The other troopships and the destroyers in the convoy, codenamed KR8, barely had time to react or help. They fled to safety before two destroyers doubled back to face the Japanese submarine and to rescue survivors.

As the troopship sank, survivors clutched onto whatever they could get their hands on. The Japanese submarine, I-27, hid beneath them as the destroyers in the convoy doubled back and tried to hit it with depth charges, killing even more of the survivors. The submarine was eventually forced to surface, and one of the destroyers, Palladin, rammed into it. The hit breached the destroyer’s hull, forcing it to retreat and leave the work to the other destroyer in the convoy, the HMS Petard. The Petard’s torpedoes hit the submarine at 5:30pm, three hours after SS Khedive Ismail had sunk. The sub broke into two and sank with everyone on board.

Aboard the SS Khedive Ismail before the sinking had been 1, 511 people, 996 of whom were members of the 301st Field Regiment, East African Artillery. Only 215 people would make it out alive. The survivors were rescued once the submarine had been sank and moved on to Ceylon, where they got survival leave for two weeks before rejoining the war effort.

Of the 1, 296 people who died that day, only four of them were given a proper sea burial. The rest were left in the shark-infested waters, far from home and virtually forgotten.

***

The sinking of SS Khedive Ismail is the subject of Brian J. Crabb’s 1997 book Passage to Destiny. In an email conversation, Crabb says his interest stems from his father, Percival Crabb, who “…was a fortunate survivor of the sinking, escaping through an open porthole with his leg still in plaster!”

In the book, Crabb includes an extensive appendix with all the names and ranks/roles of everyone, black and white, on board the doomed ship. The list of East Africans, mainly from Kenya, Uganda, and Tanzania, takes up several pages. The troops are ranked by names, rank, and number. That’s all we know about Warrant Officers Alfani Ndagile, Kathuka Ndajo, Mua Kilonzi, Muema Ileli, Selemani Mzee, Shabani Mbaraku and Siligwi Mwita. The seven of them were the highest ranking enlisted men among the hundreds of East African troops who died that day. Most of the East African casualties were gunners.

The sinking of SS Khedive Ismail suffers from the same historicity issues that World War II in general suffers from in former colonies. It was a war (mainly) away from home, driven by issues that most of the one million Africans who enlisted had little or nothing to do with, at least at a socio-cultural level.

When World War II began, there were only 2,900 men in the Kings African Rifles (KAR). The real threat of an Italian invasion from Ethiopia, and the entry of Japan into the war, drove the need for fast mobilisation.

Although the Great Depression (1929-1939) was a relatively prosperous time for Kenyan farmers, it gutted the settler economy and the colony’s budgets. Job opportunities in urban areas and farms dwindled, and crime levels in the former rose for a time. Combined with the crop failure of 1939, it meant that the best option for young men was to join the military. Any able-bodied man could enlist, although there had been restrictions as late as 1941 based on ethnicity. The Pioneer Corps, for example, were initially recruited from Western Kenya.

The sinking of SS Khedive Ismail suffers from the same historicity issues that World War II in general suffers from in former colonies. It was a war (mainly) away from home, driven by issues that most of the one million Africans who enlisted had little or nothing to do with, at least at a socio-cultural level.

In his memoirs, Fan to Flame, John G Gatu, the future Reverend and Moderator of the Presbyterian Church of East Africa, writes that he joined the armed forces because he was unemployed. Gatu joined the Signal Corps and served in Ethiopia and Somaliland. Like Gatu, Waruhiu Itote (General China) joined the military because he was unemployed and “to escape the boredom”.

For some, the economic benefits were a result, not a motivation, of being recruited. Kenya’s first four-star general, Jackson Mulinge, accidentally found himself in the military after he chose the wrong day to go to Machakos to sell a chicken. A recruitment officer grabbed the teenager and conscripted him, marking the beginning of a journey that would see him climb up the ranks over the next three decades.

The contracts the new recruits signed stated that they would be discharged “after the cessation of hostilities”. Most of them were in their early 20s, still single, and because of the education policies at the time, barely literate, if at all. By the end of the war, in 1945, there were nearly 100,000 Kenyans in the military either as members of the Kings African Rifles or the Pioneer Corps, a successor of the Carrier Corps.

Being a soldier meant a steady income and other benefits, such as being exempt from excruciating hut and poll taxes. It also gave the soldiers a common martial identity as well as exposed them to unprecedented trauma and horrors that would also go largely undocumented.

In the heat of war, despite concerns from the settler community about everything from labour supply to the economic and security risks, thousands of Kenyans were trained, armed, and deployed to fight in Northern Kenya, North Africa, and Asia. They were all enlisted men, meaning they could never rise beyond the rank of Warrant Officer. That would be one of the challenges in the lead up to and immediate aftermath of independence two decades later.

Discipline was still enforced mainly with corporal punishment. Major infractions were punished with a kiboko, while cowardice was punished with execution. There were at least three incidents of retaliation, once when a sergeant shot and killed three officers, and then when two enlisted men were executed for shooting officers and wounding others with a grenade.

In 1945, a quarter of those who survived the war were discharged. The demobilisation went on for two more years, which meant that tens of thousands of young men who had seen war and death were expected to resume their pre-war status. The Kenya that the veterans returned to had barely changed, but they had. They had not only seen the perils of war but they had also been exposed to a new lifestyle, and had had a steady income and developed new habits. Gatu, in his book, offers that the war was the beginning of unparalleled drug use among the troops. Every week, the soldiers would be issued with matches, soap, and cigarettes.

But they were also liquid and most of them were still young, single and raring to go. Studies of the post-war period mention a rising discomfort with the power held by chiefs and elders, as well as inflation in the social scene as bride price was hiked.

In 1945, a quarter of those who survived the war were discharged. The demobilisation went on for two more years, which meant that tens of thousands of young men who had seen war and death were expected to resume their pre-war status. The Kenya that the veterans returned to had barely changed, but they had.

The money they had made could not last forever. Many of them applied for trade, shop and transport licences, only to be met by a racist bureaucracy that expected them to fall back to wage labour, primarily in agriculture. Some re-enlisted into the Kings African Rifles, while others struck out in new businesses. Others, like my grandfather, used the training they had obtained during the war to eke out a living as health officers and drivers.

A number of the former soldiers were involved in the political upheaval of the late 1940s and the 1950s, but not to as significant a level as one would imagine. Dedan Kimathi, the de facto leader of the Mau Mau, was only a soldier for a month in 1940 before he was dishonourably discharged for violence and drunkenness.

Some rejoined the KAR and other disciplined units, but a large number disappeared into the normalcy of reserve life.

What’s less acknowledged in our history books are the number of enlisted men who died or suffered during the war, and the trauma the survivors came home with. Because a large number of the survivors did not have any formal education, and there was little interest in chronicling their experiences, we can only glean aspects of them from scattered memoirs and academic studies. Several memorials and cemeteries in major towns celebrate their lives and sacrifice, but very few black soldiers are named.

The sinking of SS Khedive Ismail was also problematic because of its magnitude; it was the single largest loss of East African troops, and third worst Allied mercantile shipping disaster of World War II. Publicizing it in the immediate aftermath would have affected recruitment and morale as the sinking of SS Mendi during World War I had done with South African troops.

What’s lesser acknowledged in our history books are the number of enlisted men who died or suffered during the war, and the trauma the survivors came home with. Because a large number of the survivors did not have any formal education, and there was little interest in chronicling their experiences, we can only glean aspects of their experiences from scattered memoirs and academic studies.

Despite Kenya’s central role as the home of the East African force, the Eastern Fleet, and also as a war front with Italy, the war itself is merely a footnote in the events that followed in the next decade. Thousands of enlisted men who died for a cause they didn’t necessarily believe in remain mainly nameless and unacknowledged. The unit that suffered the heaviest losses, the 301st Field Regiment, had been formed just two years before and had already served in Madagascar. The only thing that remains in their memory is a plaque at the Nairobi War Cemetery. Few of the thousands of Kenyans who died on different fronts and missions are named, and their stories have all but disappeared. Even the wounds of war, such as the bombing of Malindi and the Italian excursion 100km into Kenya, are now mere footnotes in history.

It is a significant gap in our military history, and if the lacklustre coverage of our eight-year war in Somalia is anything to go by, a part of our national ethos.

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