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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
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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.

Politics

‘You’re Not Welcome Here’: How Europe Is Paying Millions to Stop Migration From Africa

8 min read. Instead of addressing the root causes if illegal migration to Europe – including the exploitation of the Global South by the Global North – EU countries are evading the problem by paying off African countries to intercept the migrants before they reach European shores.

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‘You’re not welcome here’: How Europe Is Paying Millions To Stop Migration From Africa
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It is a known fact that Europe has been struggling with a serious migrant crisis in the last ten years. What is less known is that the ghost of a tremendous accusation is hovering over the plans established by the European authorities to contain the apparently unstoppable flow of immigrants. According to some sources, the funds that have been allocated to control the migratory flows have been diverted to support paramilitary forces or other nefarious organisations involved in human trafficking.

These forces allegedly act as a buffer that prevent people from reaching Europe by all means (even the most violent ones) rather than addressing the root causes of irregular migration. The European Union (EU) authorities denied all the accusations, and even suspended some of these funds, a move that has been seen by some as an admission of guilt. Although cutting the proverbial Gordian knot and finding the truth may be impossible right now, let’s try to clarify what is happening today by providing a better overview of the current scenario.

Europe and the 2015 migrant crisis

Every year, hundreds of thousands of displaced people and refugees from Africa, Eastern Europe, and the Middle East flee complex emergencies, natural disasters, and wars. They join the already immense river of humans who try to escape poverty and desperation by immigrating to the Old Continent. The reasons for this huge flow of humans are many, ranging from the recent political turbulence following the Arab Spring, to the evolution of the many conflict theatres and the harsh consequences of climate change.

Even if a solution could be found to stop each one of these different scenarios, it would require many years before it could bring any tangible change or impact. A lot of rhetoric ensued until a huge divide split the cacophonous political debate into two entrenched factions whose opinions cannot seem to be reconciled anytime soon. For some, these people are an invaluable resource that can rejuvenate a dying continent suffering from a chronic lack of a fresh young unspecialised workforce. For others, they are just parasites who can undermine the very roots of the Christian-based European culture, endangering the entire social fabric of a society that has based its wealth upon slavery, colonialism, and the exploitation of people for centuries.

However, an indisputable problem still had to be dealt with – the number of irregular immigrants reaching Europe was way too high to be managed. With over 2 million illegal crossings detected between 2015 and 2016, it was clear that the old containment policies were desperately failing in so many ways that they held no water whatsoever. Extremist and right wing political forces took advantage of this crisis to pull the whole continent into a populist drift, with racism and segregation running rampant to fuel hate, fear, and ancient religious rivalries. For the first time in decades, the European Union (EU) was facing the risk of having to deal with a widespread social crisis that could destabilise the entire political and economic asset. A plan that could address the different root causes of these never-ending migratory flows could hardly be imagined.

But the EU authorities had to find a rapid solution. They didn’t have the time (nor the interest) to tackle the reasons why these people were desperate and poor. Rather than caring about the lives of these masses of destitute individuals who were immigrating to Europe, they decided to stop them in their tracks before they could cross the borders. To put it bluntly, desperate and poor people from Africa, Eastern Europe, and the Middle East were still left desperate and poor – they only had to be desperate and poor somewhere else.

Turning a blind eye to the massive human crisis

The measures taken to manage the migrant crisis have been incredibly effective, and in less than five years, the number of migrant arrivals to Europe dropped by 90 per cent, from over 2 million to just 150,000. But at what price?

In a nutshell, the overall plan was quite simple: the EU authorities would ask other countries to “keep the migrants away” while they turned a blind eye on the methods used to achieve this goal. In theory, they were distributing hefty amounts of money to African and Middle Eastern countries to counter “human trafficking and smuggling” by breaking their “business model” in order to “offer migrants an alternative to putting their lives at risk”. In practice, these funds often ended in the hands of unscrupulous militia forces and shady organisations that prevented the most vulnerable people from reaching the borders of the EU member states with any means necessary – including the most inhumane ones.

One of the most important steps of this plan to “contain irregular migrants” was making arrangements with Turkey and Libya to prevent refugees from reaching the Old Continent’s borders by blocking all their land or sea routes. On top of that, whenever a migrant was caught crossing the Mediterranean to the nearby Greek islands, Spain or Italy, he or she would be sent back to Turkey or Libya to be “temporarily” locked in some prison. But the scenario that originated from these pacts was less than ideal at best, and eventually forced thousands of refugees to endure months of detainment in inhumane conditions in dilapidated detention centres.

The measures taken to manage the migrant crisis have been incredibly effective, and in less than five years, the number of migrant arrivals to Europe dropped by 90 per cent, from over 2 million to just 150,000. But at what price?

Several organisations, such as Amnesty International, Human Rights Watch, the United Nations Human Rights Council, and the European Council on Refugees and Exiles have alreay denounced the “degrading” conditions suffered by the detainees in Libya. Men and women are raped, abused, and beaten on a daily basis; some have spent months or years locked up. People are exposed to contagious diseases, such as tuberculosis, and often die from sickness, malnourishment, or neglect while in detention. The UNHRC went so far as to determine that the conditions in some of these detention centers may even “amount to torture”.

Despite being fully aware of the inhuman conditions faced by these migrants, the EU keeps contributing to this massive process of human exploitation in many ways. The Libyan authorities have been provided with the necessary funds and resources to intercept men, women, and children at sea. Italy donated several patrol boats to the Libyan coastguard and the training required to operate them as efficiently as possible during Operation Sophia. Even the Visegrad Group countries (Hungary, Poland, Slovakia, and the Czech Republic) provided an additional 35 million euros on top of the 10 million handed over by the EU. It comes as no surprise since their borders are constantly under the pressure of the thousands of immigrants who hope to escape poverty and find a chance for a better life.

One word – interception – has become the answer to the whole migrant crisis rather than reception. What happens to these people once they are stopped from reaching the borders of the richer First World countries doesn’t matter anymore. One may wonder whether this choice was just the result of a somewhat short-sighted strategy that only cared about reducing the death toll of people drowning in the Mediterranean sea. Maybe it is a component of a more complex (and inhumane) plan of externalising border control to Northern African countries. A strategy to keep poor people from escaping the poor countries where they live.

The Khartoum Process

Another action taken by the EU to stem the number of people reaching their coasts and borders was establishing the so-called “Khartoum Process”. Amidst the 2015 crisis, African and European leaders met in Malta during the Valletta Summit on Migration to discuss a common plan to address the problem. After the summit was over, the EU agreed to provide the African countries who accepted to help out in the crisis with an Emergency Trust Fund that was worth billions of euros. The fund was set up “to foster stability and to contribute to better migration management, including by addressing the root causes of destabilisation, forced displacement and irregular migration.”

Many projects eventually fell under the banner of the Emergency Trust Fund, such as the Operation Sophia mentioned above, as well as the less known but no less opaque Khartoum Process. Once again, this initiative consists of a series of financial incentives provided by the EU member states to African countries who can help in the fight against human trafficking and people smuggling. The only difference is that these funds are provided to prevent exploitation along the migration route between the Horn of Africa and Europe. The countries involved include Djibouti, Eritrea, Ethiopia, Kenya, Somalia, Sudan, South, Sudan, Uganda, and Tanzania.

One word – interception – has become the answer to the whole migrant crisis rather than reception. What happens to these people once they are stopped from reaching the borders of the richer First World countries doesn’t matter anymore.

Sudan, in particular, has been used as a buffer zone to exert effective extraterritorial control of the migration routes used by people who want to reach Europe from across Africa. Just like Italy did with Libya, Germany started a project to train Sudanese police officers and border guards, and an intelligence centre was founded in the capital Khartoum.

So, why did the EU announced the suspension of these projects in July, some of which were halted at least since March?

This time, some Sudanese and Eritrean rights groups accused Donald Tusk, the president of the European Council, of cooperating with “regimes and militia forces that are entirely unaccountable” and are “known for systematic abuses”. The funds have been, in fact, used to deploy the infamous Rapid Support Forces (RSF) – the heirs of the brutal Janjaweed led by Mohamed Hamdan “Hemeti” Dagolo. We already talked about the violence that the Janjaweed unleashed upon Sudanese civilians during the recent uprising, as well as the war crimes and genocide they committed in Darfur back in 2003. The RSF fighters found their own solution to stop migrants – they tortured them, forced them to pay bribes, and in some instances, even smuggled them (possibly if they paid enough).

So, in a nutshell, the EU paid smugglers to stop human smuggling and traffic – and they were fully aware of that. It was even noted that the RSF could divert resources “for repressive aims”. Just like in Libya and Turkey, Europe knew what was happening, but preferred to simply look the other way.

This time, some Sudanese and Eritrean rights groups accused Donald Tusk, the president of the European Council, of cooperating with “regimes and militia forces that are entirely unaccountable” and are “known for systematic abuses”.

Even if the project is now suspended, and the EU maintains that the RSF forces have never been funded or equipped, the Sudanese police received training and significant financial resources (40 million euros). This is the same Sudanese police that brutally repressed the pro-democracy, anti-government demonstrators during the last months of protest. Once again, all the projects that fall under the Khartoum Process umbrella do not address any of the “root causes” of uncontrolled migration and human trafficking. Without going so far as to say these projects are a true travesty, it can’t be denied that right now they’re nothing but extraterritorial disguised control of the borders.

Not my brother’s keeper

Today, Europe is simply turning a blind eye to one of the largest humanitarian crieis of this century. But hoping that desperate people will bring their misfortune somewhere else is not just a cowardly policy, it is a downright cruel choice made by people with no traces of humanity. It is highly hypocritical for Western countries to claim that they want to address the “root causes” of the tremendous strife that brings so many people to leave their homelands. In fact, most of these “root causes” originate from the endless exploitation of lands and resources of the Global South that seemingly sustains the whole capitalist system. In fact, when over 37,000 people are being forced to flee their homes every day, it doesn’t look like the situation has improved in any way. Today, the developed countries host just 16 per cent of these refugees, while the vast majority of them are found in Turkey, Pakistan, Uganda, and Sudan.

When the Roman Empire had to deal with the massive migrations that occurred during the fourth century A.C., the Emperors simply preferred to close their borders, leaving countless displaced people to die of sickness and starvation in front of their doors. Open revolt ensued, however, when those masses of destitute people became so desperate as to kill Emperor Valen, eventually causing the fall of the entire Roman Empire.

History teaches us that everything that happened once may happen again – especially if so many people are driven up the wall for so long.

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The Fire Next Time: ‘Bedroom’ Politics in the Kibra By-Election

11 min read. The Kibra by-election was not so much about the 24 contestants that took part in the race, but was more about a competition between the two biggest political parties, and between two bitter rivals, Raila Odinga and William Ruto. It was also a dress rehearsal for the 2022 elections, which, if this by-election is anything to go by, promises to be highly contentious.

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The Fire Next Time: ‘Bedroom’ Politics in the Kibra By-Election
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Something startled where I thought I was safest. – Walt Whitman

My Dungeons Shook – The Fire Next Time by James Baldwin

On Saturday 9, 2019, two days after the hotly contested Kibra by-election had taken place and the dust had settled, Raila Odinga, aka Baba, was in an ecstatic mood: he gathered around some of his closest associates that had helped him campaign to retain the Kibra seat by hook or crook for a toast-up at his Karen home.

The ODM party candidate had triumphed over an onslaught that had threatened to torpedo Raila’s iron-grip stranglehold over a constituency that had, over time, become synonymous with his name and political career. But it was a victory that been won with “blood”: Bernard Otieno Okoth, aka Imran, took 24,636 votes while his closest nemesis, McDonald Mariga Wanyama, an international footballer-turned-betting-billboard-face, had carted away 11,230 votes. Although there were no casualties, voters had been roughed up and beaten.

As one of ODM’s foot soldiers from Ololo (Kaloleni estate, off Jogoo Road in Makadara constituency) later confided in me, “There was no way those rural folks (referring to William Ruto’s gang of MPs, mainly from western Kenya, and their supporters) were going to storm our grounds. Hii tao ni yetu, tumekuwa na mzae tangu 90s, na tumepingana vita nyingi sana…hao watu walikuwa wanacheza na nare.” This is our turf and we’ve been with Raila ever since the 90s, and we’ve fought many bloody wars, those people were stoking a war and playing with fire.

As a diehard supporter of Raila Odinga, the stocky foot soldier, now in his late 30s (he is a former bantamweight boxer)m said he had not slept for three consecutive days: “Kibra ni bedroom ya mbuyu na wewe unaleta mbulu pale…utatembea buda.” Kibra is the old man’s bedroom and you want to desecrate it…you’ll pay for it.

He said in those three days, all the foot soldiers’ work was to screen all “foreigners” entering Kibra. This was evident to me because I had also been forewarned by my minders that I should now be extremely careful when going to Kibra for my journalistic work.

And that is all that mattered. The rest of other 22 contestants were neither here nor there, including ANC’s Eliud Owalo, a one-time Raila’s confidante who collected 5,275 votes.

According to IEBC (Independent Electoral and Boundaries Commission)’s 2017 figures, Kibra has 118,658 registered voters and 24 polling stations. In the just-concluded by-election, a paltry 41,984 people voted, constituting 35 per cent of the electorate. In the 2017 presidential election, 18,000 people voted for Uhuru Kenyatta, the Jubilee Party’s presidential candidate. The Jubilee Party candidate Doreen Wasike got 12,000 votes. The 6,000 extra votes that increased Uhuru’s number to 18,000 came from the Nubian community resident in Kibra.

As Raila and his friends were sipping champagne on a sunny Saturday afternoon, Ruto was gnashing his teeth, furious to the point where he refused to meet with the buddies he had campaigned with, according to media reports. However, his chief noisemaker, the rabblerouser Dennis Itumbi, denied that his boss was in a foul mood after the by-election.

Kibra constituency, formerly part of Langata constituency, has been a hotbed of political contests ever since Raila opted to stand in the constituency in 1992, the year the country returned to multiparty politics. Two years before that, in 1990, Raila, who had been exiled in Norway, had come back to Kenya to be part of the “Young Turks” who agitated and pushed for political reforms. He had stood in what was then known as Kibera constituency in the first multiparty general election and from then on Kibera became his enclave. That is why, in the run-up to the by-election, Raila “privatised” the constituency and called it his bedroom, in a (desperate) effort to rally around his troops to vote for Imran and to affirm to his current biggest political rival, William S Ruto, that Kibra was impenetrable to the latter’s political whims.

According to IEBC (Independent Electoral and Boundaries Commission)’s 2017 figures, Kibra has 118,658 registered voters and 24 polling stations. In the just-concluded by-election, a paltry 41,984 people voted, constituting 35 per cent of the electorate.

That is why the Kibra by-election was not so much about the 24 contestants that took part in the race, but was more of a competition between the two biggest political parties, the ruling party Jubilee and ODM, and between Raila Odinga and William Ruto. Imran and Mariga were just pawns in a much bigger and wider plot linked to the 2022 presidential succession political chess game in which the two have staked their ambitions and claim.

Three weeks to the by-election, I met with one of Ruto’s bosom buddies who was coordinating the campaign behind the scenes. “If we wrestle the Kibra seat from the kitendawili (riddles) man, we’ll have completely changed the political map of not only Nairobi County, but of the country,” he had said to me. “We will configure national politics and consign Raila to a corner. And then relish to face him in 2022.”

The Ruto man told me that in the lead-up to 2022, their chief tactic is to draw Raila into a two-horse race, in which case, “I can assure you, we’ll pulverise the enigma [one of the monikers used to describe Raila] once and for all”.

It understandable, hence, for Ruto to have taken the defeat personally and Raila to have gloated – but for how long?

In many ways, the by-election was a curtain raiser, a preamble and a showdown of what to expect in 2022, the year Kenyans once again go to the polls to elect a new president. The violence witnessed in Kibra will be multiplied at the national level. The money that was thrown at the electorate in little Kibra will seem like cash for an afternoon picnic as the chief contestants in 2022 open their war chests to woo an even hungrier electorate, ready to settle scores and be manipulated. The shadow line-ups that we saw falling respectively behind the protagonists will be reshaped many times over before 2022.

The by-election was also about the “big boys” (Raila and Ruto) settling scores and about cementing the burial rites of the already dead NASA (National Super Alliance), the fledgling and motley coalition that brought together Raila Odinga, Kalonzo Musyoka, Moses Wetangula, and Musalia Mudavadi. In addition, it was about the extension of the supremacy battles being fought between the Jubilee Party wing of President Uhuru Kenyatta and its rival that is being led by his deputy – in essence, the trooping of colours between #Kieleweke group and the #Tanga Tanga brigade.

Could this by-election also have signalled the death knell of the Jubilee Party as currently constituted?

The Ken Okoth factor

The by-election was a function of several variables, including what can be referred to as the Ken Okoth factor. Okoth, who died from colon cancer at the age of 41, was the Kibra MP when he succumbed to the killer disease on July 26, 2019.

Okoth was elected in 2013 in the newly created Kibra constituency, which was hived off from the larger Langata constituency to Raila’s chagrin. (This is a public secret.) Even though Okoth was elected on an ODM ticket, he was not Raila’s first choice. Okoth was an independent-minded politician and a popular and well-liked local boy. Home-grown and well-educated, he understood the problems of the infamous Kibera slum like the back of his hand. He was suave, well-spoken and a terribly likeable man.

When he became the MP, he charted an even more independent path: he decided he was not going to be anybody’s protégé. So he cultivated his political friendships across party divisions. As a man who understood the power of education (he was the recipient of a sound education from Starehe Boys’ Centre, where he was educated on a full bursary), he invested heavily in education in Kibra. A good secondary education, like he used to say, had saved him from the clutches of poverty.

Okoth built eight secondary schools in Kibra and expanded many of the primary schools to have a secondary school wing. He rightly argued that since many Kibra parents could not afford to take their children to boarding schools, he would lighten their burden by constructing local secondary schools. He also gave out lots of bursaries to parents who struggled with fees. Any pupil who got 350 points or more in his or her KCPE (Kenya Certificate of Primary Education) exam got full bursary to transition to high school.

Even though Okoth was elected on an ODM ticket, he was not Raila’s first choice. Okoth was an independent-minded politician and a popular and well-liked local boy. Home-grown and well-educated, he understood the problems of the infamous Kibera slum like the back of his hand.

Juliet Atellah, a Kibra resident from Gatwekera village in Sarang’ombe and a double maths and statistics major from the University of Nairobi can attest to this. “When Okoth become MP, he told us education was the key to success. He implored us to work hard in school as he also worked hard to ensure Kibra youth interested in education benefitted from a bursary.” It is something that Okoth continually preached till his death.

Okoth, also, through his Jubilee Party networks, tapped into the National Youth Service (NYS) resources to create some employment opportunities for the youth of Kibra. This cross-cutting political parties’ engagement would land him into trouble with ODM mandarins who accused and suspected him of cavorting with the enemy. “By opting to work with Jubilee Party functionaries, Okoth looked at the bigger picture: what mattered most, according to him, was how best to improve the quality of lives of Kibrans. If the help would come from his presumed ‘political antagonists’ so be it,” said a friend of the late MP.

He relegated the work of managing the bursaries through the Constituency Development Fund (CDF) to his brother Imran. Little wonder then that his brother clinched the ODM ticket, but not without loud grievances. According to my sources within the ODM party, Peter Orero (popularly known as mwalimu), the Principal of Dagoretti High School, and also the former principal of Upper Hill High School, had won the ticket, but to stem the fallout that was going to befall the party as it faced its greatest onslaught from Ruto, a man who was staking his all to capture the seat, Raila opted to hand the ticket to the former CDF manager.

Disgruntled followers

Kibra constituency residents are some of the most politically “woke” electorate that this country has ever produced. Their political consciousness is high and battle-hardened from their brutal fights with the Kanu regime in the 1990s. The people of Kibra know their politics well. This is courtesy of Raila Odinga, who for a long time championed the political struggle for equity and social justice in the country. As their MP, Raila encouraged Kibra voters to fight for their rights and to demand no less than his rightful representation.

But the burden of the “handshake” between Raila and Uhuru Kenyatta had reared its ugly head and it was evident that Raila struggled when campaigning in his former constituency. “With the handshake, Raila commercialised the struggle,” said a politician who has known him since the multiparty struggles of the 90s. “The handshake had confused his base, angering many and disillusioning a great deal of people who had stood with him all the way. Until, the death of Okoth, Raila had not stepped in Kibra to explain the handshake. Instead, when he shook Uhuru’s hand, he headed to Kondele in Kisumu to appease his other equally fanatical base, 300 kilometres away.”

The politician said that Kibra people have yet to enjoy the handshake’s dividends. “Many of the youths who were shot at by police when defending Raila were from Kibra, yet the handshake projects have all been taken to Kisumu. Although the Kibra electorate is still fanatically loyal to Raila, they were also passing a subtle message to him – it about time you re-evaluated your politics with us.”

Kibra constituency residents are some of the most politically “woke” electorate that this country has ever produced. Their political consciousness is high and battle-hardened from their brutal fights with the Kanu regime in the 1990s.

Hence, it was not lost to keen observers that for the first time since Raila began campaigning in Kibra in 1992, he had been forced to solicit for votes beyond Kamukunji in Sarang’ombe ward. “For the first time,” said a resident of Sarang’ombe, “Raila had been forced to campaign in Bukhungu in Makina, Laini Saba, and Joseph Kange’the in Woodley.” As the area MP, Raila would campaign only in Kamukunji grounds and with that he would seal his victory and close that chapter. The rest of the voters would fall in place.

Sarang’ombe ward has the largest number of voters, largely comprising Luos and Luhyas. The Luos are concentrated in Kisumu Ndogo village, while the Luhyas are to be found in Soweto and Bombolulu villages. There are about 6,000 registered Luhya voters in both the villages, while there could be about 20,000 Luos in Kisumu Ndogo. The other large concentrations of Luhyas are located in Lindi and Makina. Hence the reason why Raila went to campaign in Makina. He also campaigned in Woodley on Joseph Kange’the Road, because it has a large population of Kikuyu voters.

New alliances and 2022 politics

If campaigning on “virgin” territory was not too much of a stretch, Raila had to enlist the support of seven governors: Alfred Mutua of Machakos, Ann Mumbi Kamotho (previously known as Ann Waiguru) of Kirinyaga, Charity Ngilu of Kitui, Kivutha Kibwana of Makueni, James Ongwae of Kisii, John Nyagarama of Nyamira and Wycliffe Oparanya of Kakamega. “Ruto with his loads of money was piling pressure on Raila and he wasn’t going to take any chances,” explained one of Raila’s associates.

So, on October 30, 2019, nominated MP Maina Kamanda, Kigumo MP, Ruth Mwaniki and David Murathe (President Uhuru Kenyatta’s hatchet man) met with Raila to ostensibly pledge the Kikuyu electorate’s and President Uhuru’s support for the ODM candidate Bernard Otieno Okoth aka Imran. At the meeting, Mwaniki hinted that McDonald Mariga Wanyama, the Jubilee Party candidate, had been forced on the party leadership and President Uhuru: “I don’t know why some leaders [referring to Deputy President William Ruto] in Jubilee dragged Mariga into the race.”

In the spirit of the handshake, Kamanda said he would rally the Kikuyu voter to throw his lot with Imran: “When you see me here, know that President Uhuru Kenyatta is here.”

On the previous day, the former Starehe MP had told the Kikuyus in Kibra, “On November 7, please come out in large numbers to vote for Imran. Imran’s victory will be a big win for the unity of this country.” He was referring to the now mercurial political handshake that President Uhuru and Raila cemented on March 9, 2018. The handshake between the two bitterest rivals gave birth to the Building the Bridges Initiative (BBI). The acronym has been baptised many things, the latest one being Beba Baba Ikulu. Take Raila to State House.

On that same day (October 30), Raila had separately met with Kikuyu and Kisii opinion shapers from Kibra at his office in Upper Hill, before descending to Kibra again in the evening, three days after he had held a rally there on October 27, a Sunday. This same day, as Raila met with the respective community leaders, he confided in a mutual friend who he had lunch with at Nairobi Club that Ruto was breathing down his neck, and giving him a run for his money in his erstwhile constituency that he had represented for a quarter of a century.

During the time that Raila stood in Kibra, the Luhya community had also stood with him. They voted for him to the last man, “but when Okoth died, the Luhya nationalists in Kibra and elsewhere thought ‘it was their time to eat’”, a Luhya politician who stood as a senator in western Kenya said. “The Luhya felt the time was ripe to get paid for standing with Raila all these years since 1992.” The politician reminded me that even when Michael Wamalwa died in August, 2004, the Luhyas remained strong supporters of Raila.

Feeding on this Luhya nationalism, Ruto and his band of Luhya MPs from western Kenya landed in Kibra, and hoped to hype this reigning scepticism to maximum effect. So when Bernard Shinali, the MP for Ikolomani, was caught by the hawk-eyed ODM foot soldiers dishing out money to potential voters in Kisumu Ndogo three days before voting day, he, like the former Kakamega Senator, Bonny Khalwale, wanted to prove to their boss Ruto that they were ready to deliver the Kibra Luhya vote to him. The other Luhya MP from western who would be deployed to Kibra was Benjamin Washiali of Mumias and Didmus Barasa MP of Kimilili.

In all probability the Kibra by-election offered Kenyans a trailer of how the 2022 presidential elections will be and how they will will be fought. Will that election be a contest between Raila and Ruto? If the parading of the troops from both sides is anything to go by, the sneak preview of the troops’ formation promises many shifting alliances.

Wavinya Ndeti, the former MP for Kathiani and a governor candidate for Machakos County in 2017 on a Wiper Democratic Movement (WPM) ticket – but nonetheless aligned to Raila – allegedly moaned loudly, after seeing Mutua in Kibra. Had Raila dumped her by inviting the Machakos governor into his “bedroom?” Kalonzo Musyoka, one of the four NASA co-principals is mum, but when he said he would be supporting the Ford Kenya candidate Ramadhan Butichi, he invited opprobrium from ODM mandarins. My friends in ODM hinted to me that Kivutha is the man to checkmate Kalonzo. What about Musalia Mudavadi, the other NASA co-principal principal? Is Oparanya being propped up to replace him?

The fact that President Uhuru Kenyatta has not made any comment on the by-election, and has not appeared anywhere near Kibra to campaign for the Jubilee Party candidate speaks volumes about whether indeed Mariga was a Jubilee Party candidate, I told a close associate of the deputy president that Ruto and Mariga had camped at State House for two days to get the president’s audience. It was only on the second day that Ruto showcased Mariga to the president, who fitted Mariga’s football head with a Jubilee cap. “That is all true,” agreed the associate, “but the president is a grown up, how do you force anything onto a grown up?”

What is clear, however, is that as 2022 fast approaches, the Kibra by-election of November 7 marked the unofficial commencement of the 2022 campaign season in Kenya with Ruto’s aggressive raid into Odinga’s “political bedroom”. Now, as pundits, political analysts, and the media try to explain what this political drama will mean for the future of Kenya’s politics, the central question that Kenyans need to ask is what role they will play in shaping a prosperous future.

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Kibra: The Face of Kenyan Politics to Come?

4 min read. What does the Kibra by-election portend for the future of Kenya’s politics? Renowned photographer CARL ODERA captures the sights.

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“The most painful state of being is remembering the future, particularly the one you’ll never have.”― Søren Kierkegaard

Located about 6.6 kilometres from Nairobi city centre, Kibra is a sprawling informal settlement with an estimated population of about 200,000 people. Majority of Kibra residents live in extreme poverty. Unemployment rates are high, persons living with HIV/AIDS are many, and cases of assault and rape common. Clean water is scarce. Diseases caused by this lack of water are common. The majority living in the informal settlement lack access to basic services including electricity, running water, and medical care.

But this photo essay is not about the peddled quintessential cliché narrative depiction of Kibra as Africa’s biggest slum’ – itself a false assertion. Rather, Kibra has historically been Nairobi’s most vibrant political constituency; its residents often at the forefront of agitation for expansion of political space in Kenya; and, the most enthusiastic demonstrators at political meetings where the opposition is pitched against an apparently recalcitrant ruling elite. The Kibra by-election is also the political backyard of Raila Odinga, leader of the Orange Democratic Movement and the most enduring fixture in opposition leadership since the early 1990s. Currently, in an alliance with the President Uhuru Kenyatta, the Kibra by-election was occasioned by the death on the 26th of July 2019 of Ken Okoth, 41, the area’s dynamic, popular and highly effective MP.

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The demise of Ken Okoth left the seat open for a contest directly between Raila Odinga, whose family has dominated the area for decades and the Deputy President William S. Ruto who is determined to entrench himself as the only viable successor to Kenyatta who is currently serving his last constitutionally mandated term. As such the Kibra by-election of November 7 marked the unofficial commencement of the 2022 campaign season in Kenya with Ruto’s aggressive raid into Odinga’s ‘political bedroom’.

Deputy President William Ruto and Jubilee candidate McDonald Mariga in Kibra's DC Grounds on Sunday.

Deputy President William Ruto and Jubilee candidate McDonald Mariga in Kibra’s DC Grounds on Sunday.

ODM leader Raila Odinga with party flag-bearer Bernard Imran Okoth (left) sings the national anthem at a rally on Kiambere Road.

ODM leader Raila Odinga with party flag-bearer Bernard Imran Okoth (left) sings the national anthem at a rally on Kiambere Road.

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The by-election to fill the position left vacant following the death of the area MP, Okoth, attracted 24 candidates, ODM candidate Imran Okoth, Jubilee’s McDonald Mariga and Eliud Owalo of Amani National Congress, were the dominant players.

Endorsed football star McDonald Mariga

Endorsed football star McDonald Mariga

 Rally to drum up support for Imran Okoth, ODM's candidate for Kibra by-election.

Rally to drum up support for Imran Okoth, ODM’s candidate for Kibra by-election.

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Days to the parliamentary by-election there were reports of fracas between warring factions. Rowdy residents, for instance, kicked former Kakamega senator Boni Khawale out of Kibra upon his arrival in Laini Saba ward, claiming it was ODM’s bedroom.

Destruction of property was also reported.

Milly Achieng, a tailor-resident of Kibra told the Elephant that supporters of an opposing candidate recently went and attacked one of her friends and fellow party member and demolished her house. She was forced to flee Kibra with her children.

A family house demolished in a political violence encounter in Kibra.

A family house demolished in a political violence encounter in Kibra.

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The Kibra by-election received wide support from leaders across the political divide. Governors Charity Ngilu, Alfred Mutua, Kivutha Kibwana and Anne Waiguru joined Raila Odinga and the ODM party in drumming up support for its candidate, Imran Okoth. The leaders announced that this by-election was the beginning of a new political movement that would drum up support for the Building Bridges Initiative (BBI) and ultimately forge an alliance for the 2022 General Election.

Charity Ngilu campaigning in Kibra to get the vote for ODM candidate Imran Okoth within the Kamba community

Charity Ngilu campaigning in Kibra to get the vote for ODM candidate Imran Okoth within the Kamba community

Governor Waiguru at Joseph Kangethe Grounds in Kibra on Sunday the 3rd of November to drum up support for the ODM candidate

Governor Waiguru at Joseph Kangethe Grounds in Kibra on Sunday the 3rd of November to drum up support for the ODM candidate

Raila Odinga and Machakos Governor Alfred Mutua arriving for a rally organised to woo Kamba voters to rally behind ODM candidate for Kibra constituency.

Raila Odinga and Machakos Governor Alfred Mutua arriving for a rally organised to woo Kamba voters to rally behind ODM candidate for Kibra constituency.

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On November 7, 2019, the polling stations across the constituency were opened by 6 am to a smooth start of voting throughout the day amidst a reportedly low voter turnout. The voting stations were closed immediately after the voting exercise was concluded and voter tallying began thereafter. Residents stood in groups waiting for the results.

A man carries his disabled friend to a polling station in Kibra's Laini Saba.

A man carries his disabled friend to a polling station in Kibra’s Laini Saba.

ODM leader Raila Odinga at Old Kibera Primary school polling station to cast his vote.

ODM leader Raila Odinga at Old Kibera Primary school polling station to cast his vote.

An election official marks an indelible ink stain on Amani Congress Party's candidate Eliud Owalo at Old Kibera.

An election official marks an indelible ink stain on Amani Congress Party’s candidate Eliud Owalo at Old Kibera.

Amani Party Congress party leader Musalia Mudavadi (right) accompanies party candidate Eliud Owalo at Old Kibera Primary school to cast his vote.

Amani Party Congress party leader Musalia Mudavadi (right) accompanies party candidate Eliud Owalo at Old Kibera Primary school to cast his vote.

A man shows his finger marked with phosphorous ink after voting

A man shows his finger marked with phosphorous ink after voting

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As counting of votes for Kibra by-election continued on the night of November the 7, Jubilee candidate McDonald Mariga conceded defeat to Orange Democratic Movement (ODM) party aspirant Imran Okoth.

In a Twitter post, Mariga called Okoth and congratulated him for his victory and promised to work together after the elections.

According to the results announced by the Independent Electoral Boundaries Commission (IEBC) on Friday, November 8, Imran Okoth garnered 24,636 votes beating Mariga by over half the total number of counted votes standing at 11,230 votes. ANC’s Eliud Owalo was a distant third, managing to garner a paltry 5,275 votes out of the 41,984 votes cast.

A child in Kibra celebrating Imran Okoth’s victory

A child in Kibra celebrating Imran Okoth’s victory

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Though the Kibra by-election has been deemed a win for Raila Odinga and the handshake and a loss for Ruto and the “tanga tanga” movement, these political battles have yet to translate into tangible benefits for the ordinary mwananchi whom they purport to fight for.

Nancy Akinyi, a resident of Sarang’ombe Ward, Kibra constituency

Nancy Akinyi, a resident of Sarang’ombe Ward, Kibra constituency

Written by Joe Kobuthi

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