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(D)Evolved Healthcare: Makueni’s Trailblazing Experiment in Providing Universal Health Coverage

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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.

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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

Business as Usual: The Kasese Massacre and Power Politics in Uganda

The patterns of state violence in Uganda are sadly repetitive as the ruling party obstructs burgeoning criticism to President Yoweri Museveni’s decades-long grip on power.

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Business as Usual: The Kasese Massacre and Power Politics in Uganda
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Baluku Bismark was 14 years old when he sat for his school exams in early November 2016 with the goal of becoming a health worker in Kasese, western Uganda. A few weeks later, Baluku was among those killed by the Ugandan army during an attack on the region’s cultural institution, known as the Obusinga Bwa Rwenzururu (OBR).

By the end of a two-day assault on 26 and 27 November 2016 the military had killed 155 people using live ammunition and intentional fires; images of raging infernos and piles of bodies circulated on social media. Community members had killed at least 14 policemen. It was eight months after that year’s presidential and primary elections.

Baluku is one of many Ugandan citizens whose fate was sealed by state agents in the name of “restoring order”. In each instance, those agents “take orders from above” and are shielded from any accountability. Dig deeper and it is about power and votes.

Uganda is scheduled to hold elections on 14 January 2021. Ten opposition candidates, including former musician and member of parliament, Hon. Robert Kyagulanyi, popularly known as Bobi Wine, are challenging President Museveni who has controlled nearly every aspect of government in Uganda since 1986.

As expected, the presidential campaign, which officially began on 9 November 2020, has been marred by partisan law enforcement. Already, but unsurprisingly, state violence is defining the campaigns. Like previous presidential rival Dr Kizza Besigye, prominent opposition candidates Kyagulanyi and Patrick Amuriat have faced harassment, beatings, and various criminal charges. On 18 November police arrested Kyagulanyi during a rally in Eastern Uganda; Amuriat was arrested in Gulu. The arrests sparked spontaneous demonstrations in several towns, with the youth demanding their release. News reports indicate that security forces shot at least 45 people and hundreds more were injured.

For people in Kasese, these events are occurring as they prepare to vote in the first election since the horrific bloodshed that took place exactly four years ago this week. Unpacking the power politics behind the Kasese massacres is critical to understanding Uganda’s elections and the President’s stranglehold on power. It also tells a dismal story of total impunity no matter the scale of the killing.

Obusinga Bwa Rwenzururu and cultural institutions in Uganda

The Obusinga Bwa Rwenzururu is the cultural institution, or kingdom, of people that traditionally live in the western Rwenzori Mountains along Uganda’s border with Congo. The institution itself is headquartered in Kasese district.

Political recognition of cultural institutions in Uganda is part of the complex path that led to President Museveni’s ascension to power in 1986. For example, as a way of soliciting the support of the predominantly Baganda people of the central region, Museveni agreed to restore the region’s Buganda Kingdom which had been abolished in 1966 under the first post-colonial government.

But President Museveni, a master of political compromise, understood the delicate balance required. Buganda’s cultural leader was permitted to formally exist but he wasn’t allowed any actual political power. Over the years, as a form of bargaining for allegiance, Museveni has slowly accepted the restoration of other cultural institutions, such as the Bunyoro-Kitara in the west, and the Busoga and Tooro Kingdoms in the east and southwest, respectively. In a country as ethnically and linguistically diverse as post-colonial Uganda, these cultural institutions and their leaders can command significant loyalty and community support.

Such devotion was on full display in September 2009 when Museveni, seeking to curtail the influence of the Buganda Kingdom, sought to limit the freedom of movement of the kingdom’s leadership. Loyalists quickly took to the streets in protest. By the end of two days, security forces had killed at least 45 people to quell the uprising and the Luganda-speaking radios had been taken off the air.

Shortly thereafter, and despite criticism from those who deemed it unconstitutional, Uganda passed a law barring cultural leaders from participating in partisan politics or providing a platform for any politician. However, most cultural institutions have often remained influential, if constrained, despite efforts to rein in their influence using this law or attempts to co-opt them into the ruling party.

In 2006, Uganda held the first multiparty elections since Museveni first came to power through a military takeover. Already in power for 20 years, Museveni suffered what some felt was a humiliating political defeat in Kasese, with the opposition presidential candidate Dr Besigye garnering 56 per cent of the total votes to Museveni’s 45 per cent.

Some pundits interpreted the result as a rebuke to Museveni for ignoring the grievances of the Rwenzururu cultural institution in its plea for official recognition. In an attempt at political expediency, Museveni finally acquiesced in October 2009 – a few weeks after the violent suppression of the Buganda kingdom supporters. The Omusinga, or King in the Bakonzo language, was coronated and the Rwenzururu cultural institution was restored just in time for the campaign for the February 2011 elections. Museveni won the area vote and secured two seats for his party in parliament. But the recognition wasn’t without its critics, and clashes between pro- and anti-Obusinga forces escalated. Intercommunal fighting led to the displacement of both the ethnic Bakonzo and the Bamba, another ethnic group in the region. The government stepped in but was increasingly perceived to be siding with those opposed to the King.

Five years later, the opposition Forum for Democratic Change fared well in the Rwenzori region. All parliamentary and local posts in Kasese went to the opposition. National Resistance Movement (NRM) strongmen, such as Defense Minister Crispus Kiyonga, lost their parliamentary posts.

The relationship between the President and the King had been rocky for a few years prior to the election but the election results clearly indicated that the ruling party was losing traction in the region. Ruling party mobilisers started working harder to co-opt the king’s support base, sowing the seeds of instability.

Kasese in November 2016

Four years later, the full story of the horrific killings that took place in Kasese in November 2016 remains shrouded in secrecy. The government has never published the names of those killed or allowed independent investigations into why its army massacred almost 150 of its own citizens over two days. Spokespeople have only indicated that those who died were “terrorists” who sought to “take over Uganda”. Despite arresting and imprisoning over 180 people, the government has never presented any evidence in court and never proceeded to trial. The people arrested in November 2016 languish in prison to this day

Sporadic conflicts between communities, at times involving security forces, flared up after the 2016 elections. In one incident, the Police Flying Squad shot and killed a suspected Omusinga loyalist in a market as he bought food. A government soldier was later killed by machete, allegedly for spying on the King near the palace compound.

Rumours began to spread in Kasese at this time that the government would be handing over a demobilisation fee to the Omusinga’s “royal guards” – volunteers who are loyal to the Kingdom and work on its behalf. In a very low-income part of the country, such enticements inflated the ranks of the royal guards as people waited for handouts to support their families.

Eventually, word spread that the payout was imminent. But as people gathered in the palace compound on November 25, the military arrived and Kasese was brought to a standstill. Under the command of General Peter Elwelu, Uganda People’s Defence Force (UPDF) soldiers, encircled the palace and told the people inside that they could not leave. Tensions escalated and, eventually, soldiers shot and killed eight royal guards at the kingdom’s office in town. The rumour that the kingdom was under attack spread into the outlying sub-counties. Community members attacked some police posts and 14 police officers and 32 civilians were killed in the conflicts. The next day, the UPDF made its biggest move, allegedly ordering royal guards to disband or face attack.

At 1 p.m. the UDPF launched an assault on the palace, shooting live ammunition and setting thatched roofing alight. The king was removed by force and transferred to Kampala. Photos of piles of bodies, some with their arms tied behind their backs, circulated on social media. Some of the dead were buried in a mass grave near a military barrack. Some people were never found. At least 15 children last seen inside the palace are missing to this day; 180 people were charged with murder, terrorism and treason. Those who managed to escape went into hiding and to this day, the palace remains closed.

Two months after the attack General Elwelu told a local newspaper that the “place had lost its legitimacy. It was no longer a palace. It became a legitimate military target because it had become a command post for all that was happening in Rwenzori.”

There is no doubt that the events of November 2016 ended any pretense that the right to freedom of expression existed in the region. Many believe that Museveni would most likely have tolerated the Rwenzururu king had he not shown open support for the opposition. No one could seriously believe the government’s line that the king posed any meaningful security threat to the country or that he would be able to orchestrate any secession. But, clearly, cultural leaders needed to be shown that they could not behave like the Rwenzururu king. What if other kingdoms followed suit?

Since 2016, the Omusinga’s movements have been largely restricted to his house in Kampala. He was barred from travelling to the Rwenzoris, even after seeking the court’s permission to attend the June 2019 burial of his mother. Security officials say that since the attack on the palace in 2016, the region is now peaceful. The region nurses its wounds and struggles to care for an estimated 300 widows and 600 orphans left behind by the massacre.

Despite some condemnatory statements from foreign embassies and civil society, the government has not been pressured to show any real evidence of why that scale of bloodshed was lawful or proportionate. In a classic case of co-option, President Museveni appointed the king’s brother as a minister in his government.

What happened in November 2016 in Kasese can only be viewed as a stark reminder to all cultural leaders – and frankly to any critic of the regime – that they should stay away from candid engagement in politics or consider supporting Uganda’s political opposition.

Those arrested were left to rot in jail, far from their families. But as the 2021 elections approach, perhaps they are suddenly again useful to the electoral landscape?

Uganda’s upcoming elections 

As Bobi Wine ignites imaginations about new approaches to governance in Uganda, the government’s paranoia is at an all-time high and one can only imagine that there is significant work being done to ensure that the Rwenzori votes go to the ruling party. Word is already trickling out that the government is going to release those who have spent four years in prison without trial. But they will never be exonerated. It is likely that they are under significant pressure to admit some wrongdoing, to grovel and seek forgiveness from Museveni despite no clear evidence of their crimes having been presented. When Museveni releases the detainees just in time for the anniversary (and the voting,) he will demand blind loyalty. Even though his soldiers killed their families.

The patterns of state violence in Uganda are sadly repetitive; the ruling party obstructs burgeoning criticism to Museveni’s long stay in power. Organised dissent – Uganda’s cultural institutions, opposition members, civic groups, or just an outspoken citizen – is met with co-option, pressure and intimidation. A bank account is frozen, a cultural leader is coronated, a brown envelop of cash arrives. But at times, these efforts fail to silence the critics. Defiant voices rise up.

In that flashpoint, the state unleashes overwhelming violence against its own citizens and people like Baluku and many others die under the bullets of the state security agents. No previous military or police training supported by Uganda’s Western “partners in democracy” like the United States or United Kingdom prevents the blatant drive for political expediency.

In each incident – the Kayunga demonstration in 2009, the Walk to Work protests of 2011, the Kasese killings of 2016, the Free Bobi Wine demonstrations in November 2020, and countless other similar events – citizens, often innocent bystanders, or youth demonstrating against state actions are killed or arrested. Each time, the pro-government pundits quickly go on the attack, demonising those killed as terrorists or hooligans and then calling for peace.

Behind the scenes, those in jail will continue to suffer without being brought to trial, and with no credible evidence of their wrongdoing being produced. But no member of the security forces will face any questions to justify the bloodshed. International donors to Uganda’s ample security sector will momentarily issue condemnations and then return to the humdrum of diplomatic life in Kampala’s leafy suburbs. The graves of the dead, of people like Baluku from Kasese, are quickly forgotten.

If the government’s explanation of the reasons behind these horrific episodes is ever to be believed, it will need to hold both sides to account and be willing to allow for criticism, dissent and, most importantly, electoral loss. Military commanders, including generals like Elwelu, who allowed the killings of unarmed civilians, who allowed the bullets to fly, will need to be brought to open court, to answer tough questions from lawyers who don’t fear reprisals. As long as men like General Elwelu are promoted for killing civilians, as he was, the unabashed reliance on state violence as a political weapon in Uganda will continue. And horrific images of bloodied bodies – like those of November 2020 and November 2016 – will increase.

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Pan-Ethiopianists vs Ethno-Nationalists: The Narrative Elite War in Ethiopia

It is not an accident that much of the narrative war is being fought on social media. Social media is fertile ground for having one sided debate. For the elites, it is a place where captured attention can be exchanged for dollars and because of it, careful analysis, and nuance—arguably the most important characteristics of intellectuals—are disincentivised.

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Pan-Ethiopianists vs Ethno-Nationalists: The Narrative Elite War in Ethiopia
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The current political conflict, now a civil war, in Ethiopia partly has its roots in disagreement among elites on how to narrativise Ethiopian history.

There is an enduring disunity among Ethiopian elites regarding the country’s history and future. Informed by its long, and contentious multi-ethnic history, and fueled by recent shifts in the political landscape in the country, a war of narratives has been reignited. The narrative war is fought between adherents of what we have termed “Pan-Ethiopianists” and “Ethno-nationalists.” The spillover effect of this increasingly toxic debate has had a negative impact on the lives of everyday Ethiopians and continues to destabilise the country. Indeed, narratives surrounding ethnic identities and ethnic politics in Ethiopia is the one thing that demands the most attention. As it stands today, the way and environment in which the debate is occurring, and the actors involved in it indicates we may be approaching a threshold that cannot be uncrossed.

How the Ethiopian state evolved

Nation-building is a contested process of narrative construction. In his book, Imagined Communities, political scientist Benedict Anderson reminds us that nations are “imagined political communities.” Common to all political communities is a set of beliefs in unifying narratives about community special characteristics. These narratives provide explanations to the participating individuals and their leaders about what makes their community unique, especially when compared to others. Nation-building in the Ethiopian context follows a similar pattern.

Faced with the burden of justifying maintenance of the Ethiopian state and their place at the top, Ethiopian rulers of the past relied on religious texts and edicts of the Ethiopian Orthodox Church. Written in the 14th century, the Kibre Negest, or “Glory of the Kings,” provided detailed accounts of the lineage of the Solomonic dynasty—the former ruling dynasty of the Ethiopian Empire—according to which Ethiopia’s rulers were descendants of King Solomon and the Queen of Sheba. It told the story of Ethiopia and Ethiopians as God’s people, a chosen people.

The narrative war is fought between adherents of what we have termed “Pan-Ethiopianists” and “Ethno-nationalists.” The spillover effect of this increasingly toxic debate has had a negative impact on the lives of everyday Ethiopians and continues to destabilise the country

This narrative of Ethiopia as a chosen place endures to this day. It was in display when many Ethiopians woke up on October 24, 2020 and learned that US President Donald Trump had suggested “[Egypt] will end up blowing up the [Grand Ethiopian Renaissance Dam (GERD)] dam.” Many Ethiopian citizens and politicians responded with the assertion that Ethiopia will prevail, not least of which because it has God on its side. Prime Minister Abiy Ahmed’s office released a statement that echoed the same sentiment.

Similarly, the 12th century text Fitiha Negest, or “Laws of the Kings,” served as the country’s oldest traditional legal code. The Fitiha Negest insisted that kings must receive obedience and reverence. It justified the Kings’ power using scripture, specifically the words of Moses in Deuteronomy 17:15:

Thou shalt in any wise set him king over thee, whom the Lord thy God shall choose: one from among thy brethren shalt thou set king over thee: thou mayest not set a stranger over thee, which is not thy brother.

Ethiopia’s rulers used these texts to justify the state’s existence and their own power. But more importantly, as much as Americans take the Declaration of Independence as their founding moment, the Kebre Negest provided a similar “origins” story, albeit a contested one, while Fitiha Negest served as a constitution of sorts by laying out a minimal set of rules that bound the Kings and their subjects. As such, the Kebre Negest and the Fitiha Negest could arguably be taken as the most important founding texts of the Ethiopian state.

The 1700s witnessed the emergence of a new political structure where disparate noblemen usurped power away from emperors of the Solomonic dynasty and began ruling over their own regions, a period known among Ethiopian historians as Zemene Mesafint, or Age of the Princes, named after the Book of Judges. In 1855, Emperor Tewodros II, born Kassa Hailu, rose to the throne after defeating regional noblemen. He recognised the need for a newer narrative that was closely aligned to his vision of Ethiopia as a modern, forward thinking nation. In line with that vision, his first step was to separate church and state, shift its narrative and establish the state on a more secular foundation. To do so, he needed better educated Ethiopians, and thus began an elite-led nation building process. His efforts however did not bear fruit due to fierce internal opposition driven largely by disgruntled clergy, who, fearful of losing their own privilege and power, were unappreciative of his radical ideas.

Nation-building is a contested process and the path to consensus is neither linear nor guaranteed. Consensus is especially difficult to achieve in a nation as ethnically, culturally, and linguistically diverse as Ethiopia.

Subsequent rulers of Ethiopia mended the “glitch” and followed the path that almost was dismantled by Emperor Tewodros II, and, as a result, the Ethiopian Orthodox Church remained inseparable from the Ethiopian state, and, with that, the state narrative. That, however, changed with Emperor Menelik II assuming the throne in 1889. Although historical Ethiopia dates back to millennia, Emperor Menelik is widely considered as an architect of the modern Ethiopian state. His epic defeat of Italian colonial power at the Battle of Adwa added another, if not stronger, element to the myth of God’s-chosen-people identity to Ethiopians and the Ethiopian state. As the Ethiopian historian Bahru Zewde recounts in his book, Pioneers of Change, Menelik, eager to modernise Ethiopia, sent Ethiopians to Europe and the US for higher education. Unlike the church-educated elites that preceded them, these early Western-educated Ethiopians broke with tradition and became critics of the state. It may be argued as such that Emperor Menelik could be credited with spearheading the creation of a new intellectual-elite class and with bringing the same to the center of state politics. With that he laid the groundwork for the creation of a new elite class that would later challenge the very essence of Ethiopia as a nation state.

Walleligne and the birth of ethno-nationalism

When Emperor Haile Selassie rose to the throne in 1930, he was acutely aware of the shortage of educated Ethiopians to build Ethiopia’s nascent civil service and bureaucracy. In order to fill in this gap, like his predecessor, he sent many Ethiopians to Europe and the US for higher education that in the words of historian Jon Abbink produced “a generation of daring, innovative intellectual leaders and thinkers.” However, sadly many of these intellectuals were annihilated by the Italian colonial power in the late 1930s. This loss of its brightest left post-war Ethiopia with deep psychological scars and decades of stagnation, devoid of social and political change. With the founding of the University College of Addis Ababa in 1950, the future Haile Selassie University (now, Addis Ababa University), Emperor Haile Selassie’s dream of producing educated Ethiopians en masse finally came true.

The 1960’s was when the role of Ethiopian intellectuals in the country’s politics probably experienced its most consequential phase. Starting in the 1960’s, with the backdrop of broader social unrest, university students started to oppose Haile Selassie’s single-man authoritarian rule and the oppressive socio-economic and cultural structures within which the students said the imperial government and its predecessors functioned. They demanded rights and freedom. It was until a more radical wing of the movement, concurrent with the more mundane demand for reform, started to question the equating of the Ethiopian state with the nation. Compared to the reformist intellectuals of the previous generation, Ethiopia’s newly minted intellectuals displayed impatience and lacked foresight in their calls for radical social and political reformJon Abbink might not be far from the truth when he observed these intellectuals’ “wholesale adoption of unmediated Western ideologies and abandonment of Ethiopian values” had had “quite disastrous consequences.”

On the Question of Nationalities in Ethiopia,” an influential short essay written by Walleligne Mekonnen—who at the time was a second-year political science student at the university, and who was later was shot and killed along with fellow activists while attempting to hijack an Ethiopian Airlines flight—became a founding text of the radical wing of the student movement. In his essay, Walleligne argued that “Ethiopia is not really a nation” but rather “made up of a dozen nationalities with their own languages, ways of dressing, history, social organization and territorial entity.” However, this reality, according to him, was suppressed by the ruling class. Instead, a “fake Ethiopian nationalism” that is based on the linguistic and cultural superiority of the Amhara and, to a certain extent, the Amhara-Tigre, was imposed on the other peoples of Ethiopia, resulting in asymmetrical relations among the “nations” of Ethiopia. Therefore, according to Walleligne, the Ethiopian state came to be through the linguistic and cultural assimilation of the peoples of the wider South by the North—the Amhara and their junior-partner-in-assimilation, the Tigre. And, that this project of constructing Ethiopia was aided by the trinity of (the Amharic) language, (Amhara-Tigre) culture and religion (the Ethiopian Orthodox Church). He was, of course, echoing arguments that Joseph Stalin, Rosa Luxemburg and others made about nations, nationalism, and self-determination. (Stalin, for example, lays out his thesis in Marxism and the National Question, as does Luxemburg in The Right of Nations to Self-Determination.)

Walleligne thus called for the dismantling and replacement of this “fake [Ethiopian] nationalism” with a “genuine Nationalist Socialist State” that he argued could only be achieved “through violence [and,] through revolutionary armed struggle.” To be sure, Walleligne did not see “succession” as an end in and of itself; nonetheless, he propagated it as a means to building the future egalitarian Ethiopian state, with the caveat that such succession should be rooted in and guided by “progressivism” and “Socialist internationalism.” He closed his essay with what may be considered prophetic:

A regime [Haile Selassie’s government] like ours harassed from corners is bound to collapse in a relatively short period of time. But when the degree of consciousness of the various nationalities is at different levels, it is not only the right, but the duty, of the most conscious nationality to first liberate itself and then assist in the struggle for total liberation.

Haile Selassie’s government did collapse in 1974.

The constitutionalizing of ethno-nationalism

The movement that Walleligne imagined, spearheaded by the intelligentsia as it were, was hijacked by the Dergue—a collective of disgruntled low-ranking military officers in the imperial army—that not only succeeded in overthrowing Haile Selassie’s government, but also in ruling Ethiopia with an iron-fist for the next 17 years. But the political and armed struggle for “liberation” continued. It was in this atmosphere of radicalisation of the intellectual-elite class that discourses like “liberation” and the “oppressor-oppressed” took hold in the Ethiopian body politic and a plethora of liberation fronts mushroomed or revived: the Eritrean Peoples’ Liberation Front (EPLF, 1962)—that succeeded in seceding Eritrea from Ethiopia in 1991—the Oromo Liberation Front (OLF, 1966), and the Tigray People’s Liberation Front (TPLF, 1975) to name but the most important ones. The Dergue’s 17 years in power was marred by the bloodiest times in Ethiopian modern history: the Red Terror, a border war with Somalia (1977-1978) and, more importantly, the protracted civil wars with TPLF, EPLF and OLF.

After 17 years of armed struggle, the Ethiopian Peoples’ Revolutionary Front (EPRDF) defeated the Dergue and controlled Ethiopian state power in 1991. The EPRDF was a coalition composed of the TPLF, The Amhara National Democratic Movement (ANDM), the Oromo Peoples Democratic Organization (OPDO) and the Southern Ethiopia Peoples Democratic Front (SEPDF). It should, however, be noted that it was only with victory in sight against the Dergue and a desire to expand its sphere of influence beyond Tigray, that the TPLF formed the EPRDF in 1988. Otherwise, the actual power holder within the coalition remained TPLF. Consequently, the EPRDF introduced the 1995 constitution. Adopted in the immediate context of the post-Cold War, in a way that reflects the politics of constitutionalism and especially the shrewdness and pragmatism of the man behind it, Meles Zenawi, the constitution was a compromise between TPLF’s deep-rooted Marxist-Leninist ideological moorings and the post-Cold War euphoric triumphalism of liberal constitutionalism and human rights. So much so that the constitution declares the inviolability and alienability of human rights and freedoms emanating from the nature of mankind. However, as his building a de facto one-party state would later reveal, this was a move that seems to have been motivated more by placating the West than a genuine desire on the part of Zenawi’s EPRDF to champion the causes of human rights and democratic values.

In his essay, Walleligne argued that “Ethiopia is not really a nation” but rather “made up of a dozen nationalities with their own languages, ways of dressing, history, social organization and territorial entity.

The constitution divided Ethiopia into nine ethnic states that—with the exception of what is called the Southern Nations and Nationalities Regional State—are based on the ethnic identities of residents of those states. Most importantly, the constitution grants the “Nations, Nationalities and Peoples” within those states the unconditional “right to self-determination, including secession.” In other words, rather than with a people, sovereignty resides in a plurality of peoples of Ethiopia. It is these peoples that came together to form Ethiopia and they are the custodians of Ethiopia, from which they have the absolute right to secede if they so wish. That way, the constitution replaced the age-old notion of Ethiopia as a nation with an Ethiopia as a “nation of nations.” Walleligne predicted this almost a quarter of a century earlier: “What are the Ethiopian people composed of? I stress the word peoples because sociologically speaking at this stage Ethiopia is not really a nation.”

From then on ethnicity became a determinant factor and dominant political currency in Ethiopian politics, bringing with it, in the words of the late sociologist Donald Levine (who taught at the University of Chicago and became a key figure in Ethiopian Studies), an “epidemic of ethnic and regional hostilities.” In addition to changing the way the country organised itself politically, EPRDF also sought to reframe the very foundation of what it means to be an Ethiopian and how Ethiopia itself came to be. Not unexpectedly, EPRDF targeted schools and educational institutions in particular as spaces where new narratives of Ethiopian history could be inculcated, so much so that Ethiopian universities became flashpoints of ethnic conflicts among students. Walleligne’s abstract and—as he himself admitted in his writing—incomplete idea found a home in the curriculum.

With this entrenchment of a “new” history of Ethiopia and a generation educated in the new curriculum and the alienation of “pan-Ethiopianism” from the Ethiopian body politic, it seemed that the “old Ethiopia” had died and been buried. But, as the 2005 Ethiopian election showed, a pan-Ethiopian party called the Coalition for Unity and Democracy (CUD) almost clinched power in major cities and rural areas if it had not been suppressed and finally expelled from Ethiopian political landscape. In fact, it was that election that gave the close to two decades-long ethnic politics championed by Meles Zenawi, a real challenge and, more importantly, sowed the earliest seeds of the revival of pan-Ethiopian politics.

Abiy Ahmed and the re-emergence of pan-Ethiopianism?

Zenawi—the ex-guerrilla fighter who, as a prime minister, was reported to have made authoritarianism respectable—died in a Belgian hospital in 2012. Although political pundits thought that in his absence Ethiopia would plunge into crisis immediately, his successors managed to stave off social unrest until protest rallies started to emerge in the Oromia region following the unveiling of the so-called Addis Ababa Master Plan (a plan to expand the federal capital, mostly into Oromia) in April 2014. Months of sustained protests resulted in hundreds of deaths and even more people being imprisoned.

However, the draconian measures did little to slow the protests. The EPRDF government eventually backed off from its aggressive actions against protestors and shelved its ambitious master plan, but it was too late. The protest had picked up steam and expanded to several other regions, including the Amhara region. Protestors demanded rights, representation, and economic justice. Tellingly, these protests erupted less than a year after EPRDF claimed to have won 100% of the 2015 election and only months after US President Obama praised the government as being “democratically elected.”

The TPLF-led EPRDF government could not sustain its political power. In the backdrop of a fierce intra-party scuffle, in April 2018, Abiy Ahmed, an ethnic Oromo and member of the OPDO, ascended to power. With his promise of leading Ethiopia through transition to democracy, Abiy immediately began introducing a plethora of reforms, including releasing political prisoners, inviting home all opposition parties, and appointing some prominent public figures to key positions within his government. These and many other earlier reforms won him almost universal support from Ethiopians and the international community. In 2019 he won the Nobel Peace Prize for brokering a peace-deal with neighboring Eritrea, ending a two-decades long stalemate, following the 1998 border war between the two countries that claimed more than a hundred thousand lives.

Despite the indisputably positive changes he introduced and results achieved, Abiy’s Ethiopia also saw its most turbulent years in recent Ethiopian history, including internal displacements, violence that claimed the lives of hundreds—high-profile assassinations, including an attempted assassination on the premier himself, targeted ethnic killings, and ongoing violence perpetrated by a splinter military wing of the OLF in western Oromia region. Abiy’s decision to indefinitely postpone the August general election due to COVID-19 has further destabilized the country and put in tatters his promise of transitioning Ethiopia to democracy.

There also is the ongoing tension with the TPLF that governs the Tigray region—that recently held its own regional election in defiance of the central government’s ban on all elections due to the pandemic. As a result, the Ethiopian parliament voted to cut ties with Tigray region leaders, which has the potential to erupt into a full-blown war with the federal government. Further complicating Abiy’s agenda of stabilizing the East African nation is the tension with Egypt in relation to the Grand Ethiopian Renaissance Dam (the GERD) and broader geopolitical issues.

It was amid this ongoing turmoil Abiy established the Prosperity Party at the end of 2019, which brought together three of the four ethnic-based parties that constituted the EPRDF coalition and other smaller parties, considered within party circles as “allies” to the EPRDF. Based on his vision of national unity among Ethiopians that he calls medemer, which literally means “coming together,” this re-branding of EPRDF was meant to stave off the ethnically divisive politics and address ethnically motivated conflicts that engulfed the country during EPRDF’s 27 years in power. This seemingly mundane action, however, did not sit well with everyone and it brought to the surface an issue dormant for the last 25 years in the Ethiopian formal political scene, namely: how to historicize Ethiopia. There is now an all-out war of narratives among Ethiopian elites on the history of Ethiopia.

This narrative war is fought between adherents of what we have termed “Pan-Ethiopianism” and “Ethno-nationalism.” The ethno-nationalist camp takes Walleligne’s thesis as accurate representation of Ethiopia as a nation of nations. As we have noted, in mainstream Ethiopian history, Emperor Menelik is considered the architect of the modern Ethiopian state. He is especially credited with expanding the Ethiopian empire to the south from his northern stronghold of Shoa. To the outside world and to Ethiopians alike, his epic victory over the Italian colonial force in the Battle of Adwa is widely celebrated as a key moment in Black anticolonial consciousness. In stark contrast to this picture, in the ethno-nationalist discourse, Emperor Menelik figures as the archenemy. To the ethno-nationalists Menelik’s supposedly mundane “state-building” endeavors were marked by violence, forced assimilation and suppression of cultures of peoples of the South, especially the Oromo. Echoing Walleligne’s thesis, they insist that rather than a nation built on the consent of the “nations, nationalities and peoples” of Ethiopia, Ethiopia is imposed on the wider South through conquest, violence and assimilation by Ethiopian rulers of Amhara, and to a certain extent, Tigre extraction. In their view, rather than an inclusive multicultural state, Ethiopia is made in the image of the Amhara and the Tigre.

This narrative of Ethiopia as a chosen place endures to this day. It was in display when many Ethiopians woke up on October 24, 2020 and learned that US President Donald Trump had suggested “[Egypt] will end up blowing up the [Grand Ethiopian Renaissance Dam (GERD)] dam.”

Quite to the contrary, those in the Pan-Ethiopianist camp embrace the historical Ethiopia and adhere to the idea of Ethiopia as a nation-state. While not ruling out the presence of violence, they reject the “empire thesis” of the ethno-nationalists and hold that Emperor Menelik was just engaging in state-building when he conquered and brought the wider South under his Imperial rulership. In the Pan-Ethiopianist narrative of Ethiopia, the supposed assimilationist and imperialist expansion of Emperor Menelik and his predecessors to the South is a normal historical process inherent to state building. There are also some within the Pan-Ethiopianist camp that insist that Emperor Menelik did not actually conquer and control “new” territories, but only “re-claimed” territories that hitherto were parts of the historical Ethiopia. There are still those in this camp that argue that it is in the nature of an empire to conquer peoples and rule over lands, and hence there is nothing anomalous about Emperor Menelik’s deeds.

Not surprisingly, many in the Pan-Ethiopianist camp saw, at least in the beginning, Abiy’s formation of the Prosperity Party as a move in the right direction with a potential to dismantle the current ethnic-federalism—that adherents of this camp hold is the root cause of the cycles of ethnic conflicts and other problems that the country faces—and eventually realise a unified Ethiopia, albeit federalist. Quite to the contrary, the move did not sit well with the ethno-nationalist camp, the TPLF in particular openly opposing this merger as “illegal” on the grounds that all constituent parties of the EPRDF should have consented to the dissolution of EPRDF and the merger. The Oromo activists see in this merger and Abiy’s other reform agenda a return to the old Ethiopia, in which they argue Oromos were culturally and linguistically alienated by the Amhara-Tigre elites that in the past had a monopoly on state power.

Social media and narratives of hate

The elites’ reach and impact has expanded as the means of information sharing and consumption has expanded. It is no more the traditional intellectual-elite class that engages in the production and dissemination of information that advances knowledge. Unlike the closely-knit intellectual class of earlier times, the debate now has a diverse body of actors: activists, political party operatives, and, as oxymoronic as it sounds, intellectual activists. The elites with the loudest voices use low-trust and high-reach communication mediums like Facebook, Twitter, and other social media to peddle their own facts and pursue their own agenda. Social media as it exists today rewards absolute claims, purity, good and evil binaries, and unequivocal declarations of truth that leave little room for compassion, reasoning, careful interpretation, and nuance. Fueled by algorithms that favor combustible content, social media companies orchestrate human interaction that lead individuals to maintain extreme positions and be adversarial towards one another.

The emerging Ethiopian elites in both camps have harnessed social media in ways that have yielded extraordinary influence and power over political discourse that directly and indirectly affects the lives of everyday Ethiopians. They recognize their charisma is more significant to their audience than the contents of their speech or the quality of their argument. Name calling and ad hominem attacks are their currency and they invoke current and historical grievances, and narratives of superiority, to stoke fear and anger. Unfortunately, the narratives these elites broadcast are not without consequences. There is a correlation between recent violence in Ethiopia and the supposed adherents of these narratives.

Nothing makes the dangers of the deep division between the two camps as the murder of the renowned Oromo singer, Hachalu Hundesa in June 2020. This incident has clearly shown their tendency to see and interpret any and every incident or issue in ways that support their respective narratives. Unfortunately, as is quite common in the post-truth social media age we live in, it is as though elites in each camp use different truth-filters, no matter what facts on the ground dictate. So much so that, immediately after the news of Hachalu’s death surfaced, elites in each camp took to social media and, with no evidence at their disposal, started to speculate who might have shot and killed the singer and began pointing fingers at each other. In the ethno-nationalist camp, a conspiracy started to circulate that claimed the killing was orchestrated and carried out by “neftegna” and statements like “They killed our hero” reverberated around social media, followed by wide-spread Oromo protests in Ethiopia, Europe, and North America. On the other hand, in what appears to be due to Hachalu’s pro-Oromo nationalistic political views, in the Pan-Ethiopianist camp there was either a deafening silence, or some suggesting that the killing was a result of intra power-struggle among the Oromo elite politicians who just “sacrificed” Hachalu for their own politically calculated ends. Amidst the confusion and unsubstantiated claims floating around—with even some media outlets broadcasting hate-filled messages—violence  erupted in the Oromia region claiming the lives of more than 200 individuals, the displacement of thousands, and property damage. The killings were reported to be gruesome and targeted.

If anyone in either camp is insensitive enough to bring havoc to Ethiopia, or even worse, to sacrifice precious human lives in pursuit of political ends or to prove a particular narrative of Ethiopia, then the debate is not so much about liberation and freedom as it is about ideology or some other ends. As Edward Said chastises us:

the standards of truth about human misery and oppression [are] to be held despite the individual intellectual’s party affiliation, national background, and primeval loyalties. Nothing disfigures the intellectual’s public performances as much as trimming, careful silence, patriotic bluster, and retrospective and self-dramatizing apostasy.

We shouldn’t also lose sight of the fact that, while not denying that there are genuinely invested individuals and groups of actors in each camp, there are still many in this “war” owing to other factors that have little or nothing to do with a genuine concern for Ethiopia and everyday Ethiopians. The harsh truth is that this is not just a debate about history, identity, or self-governance, but more so about elites’ drive for resource monopolization, the prestige that comes with power, and other factors external to the debate.

Abiy’s government, like the EPRDF before it, is attempting to limit internet access, especially to social media, to quell recent unrest. The government’s desperate act to avoid future incidents like these are understandable. Expanded internet access to all, in theory, at least, is a positive development in the right hands. And it would be misguided to argue that the broadening of access to free speech that has been made possible through social media is wrong or detrimental. The detriment, actually, is with the unchecked nature of social media. As well, the absence of meaningful fact checking and understanding of local knowledge among social media companies make it possible for misinformation to spread easily.

Whither Ethiopia? The way forward

As we noted initially, nation-building is a contested process and the path to consensus is neither linear nor guaranteed. Consensus is especially difficult to achieve in a nation as ethnically, culturally, and linguistically diverse as Ethiopia. This has become a singularly arduous task especially now that a generation of Ethiopians who have grown up under the EPRDF are increasingly alienated from actual inter-ethnic-lived experiences of Ethiopians of present and past generations. It is also naive to expect the debate to remain even-tempered. Emotions can run high as communities attempt to reconcile their ethnic identity and group status as they negotiate the meaning of their shared history with others. However, prerequisites to making meaningful progress are highly credible communication mediums, shared facts, and shared goals. At the moment, the opposite appears to be true.

There is a glaring absence of willingness on both sides to engage in reasoned debates, leaving no room to explore the authenticity and truthfulness of alternative narratives. It is not an accident that much of the narrative war is being fought on social media. Social media is fertile ground for having one sided debate. For the elites, it is a place where captured attention can be exchanged for dollars and because of it, careful analysis, and nuance—arguably the most important characteristics of intellectuals—are disincentivised.

Even if we disagree on where we started and how we got here, we could at least agree on where we are heading. Denialism, lack of empathy, and cancel-culture are the last traits we should carry into this debate, not only because people’s lives are at stake, but also the future of Ethiopia as a state. Good faith debate based on shared facts and shared goals are required if the historical Ethiopia is to survive another century.

This post is from a new partnership between Africa Is a Country and The Elephant. We will be publishing a series of posts from their site once a week.

Editor’s note: Please note that the piece was first published on September 30. While the authors updated it over the past month, the conflict in Ethiopia has now accelerated to a civil war. We plan to provide more up-to-date coverage. Meanwhile, we recommend this statement by a group of scholars and researchers from the Horn of Africa.

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Politics

The Winter of Our Discontent: What Next After Biden Victory?

The incoming Biden administration will find monumental setbacks that are almost insurmountable in the age of COVID-19. Everyday, whether the stock market or unemployment figures reflect it or not, the economic reality for tens of thousands of Americans grows harsher.

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The Winter of Our Discontent: What Next After Biden Victory?
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It has been more than two weeks since former Vice President Joe Biden was able to scrap and claw his way to a damaged and awkwardly narrow victory over Donald J. Trump. Despite the margins becoming clearer, the win is still ringing out hollow and empty as Trump muddies the US presidential election with claims of electoral fraud.

Biden has repeatedly come out and called for calm and reconciliation – principles of the Democratic Party that almost seem laughably archaic when viewed through the lens of Trumpism. In the bare-knuckle brawl that is modern American politics, the Democratic Party seems to have shown up wearing woolen mittens, not wanting to draw any blood from its opponent.

And what an opponent the Republican Party has proved to be! Despite everything, it managed to seemingly hold the Senate (pending crucial run-off elections in Georgia in January of 2021) and actually decreased the Democratic lead in the US House of Representatives. The big prize – the White House –  was won (due to our strangely outdated system) by a factor of 200,000 votes in four key states (Georgia, Pennsylvania, Arizona and Nevada). It was entirely within the realm of possibility that Trump would have won the electoral college and massively lost the popular vote yet again – a black mark against the strategy of the Democratic Party.

So the lingering question in the air remains: what now? For something so “certain”, a great many things seem to be up for debate. Many political insiders are wringing their hands on network TV channels over whether Trump will leave the White House at all, but this may be overblown. Unless there’s an outright electoral college coup when the electors meet to vote in mid-December of this year, Trump doesn’t’ really have much of a choice.  It looks as though he’ll have to retreat into a gilded cage of media-driven anger and of riling up supporters, never truly conceding that he lost, the bitterness clanging back and forth in his head beneath a sweaty mop of hair plugs and spray tan.

If the coronavirus response can be nothing else than a sort of a political bellwether, then this outcome is objectively the best. The response has been nothing short of a day-by-day horror show, the bar being drenched in petrol, set alight and then thrown rudely from a cliff.

Whether Trump goes willingly or not is not a concern, as it isn’t really his choice; what is of concern is what he will do with his powers in his remaining 60 days in office. The next couple of months could well be the deciding factor in the future of global power dynamics, all playing out on the whims of a petulant moron who can’t accept his own shortcomings and instead will sit on his tiny thumbs.

As has been said before, Rome wasn’t built in a day, but it was destroyed in a much shorter timeline. The incoming Biden administration will find monumental setbacks that are almost insurmountable in the age of COVID-19. Everyday, whether the stock market or unemployment figures reflect it or not, the economic reality for tens of thousands of Americans grows harsher. Moratoriums and stop gaps are expiring or have long since run their stimulus bill-guided course. All too many could be kicked out of their houses in short order. Businesses that relied on economic assistance during this bizarre period have already begun to close permanently. It is estimated that up to 40 per cent of all non-chain restaurants may never reopen their doors.

The coming harsh winter 

It seems far-fetched to many that any kind of brutal humanitarian crisis could ever play out in a country that is so excellent in marketing itself as the greatest nation on earth. However, many of those who believe that Americans cannot possibly experience suffering haven’t experienced the brutality of an American winter. It is hard to describe just how rough this four-month period can be for people during normal times. The temperature can fall to minus 10 degrees Celsius and remain there for two months. There can be 30 centimetres of snow in a single a night. Brutal ice storms entrench cars and encase entire buildings. All that happens during periods of normality, but this is far from normal and now global warming has made the weather patterns all the more strange and beyond accurate forecasting.

Without the benefit of foresight, the unfortunate equivalent of this coming winter seems to be that of 1932-1933. During this period, the Great Depression was in full swing, and an American President who had denied the extent of the economic damage had just been resoundingly defeated by Franklin D. Roosevelt. Herbert Hoover sat on his hands until the change of power, which led to untold deaths and poverty across the country.

Whether Trump goes willingly or not is not a concern, as it isn’t really his choice; what is of concern is what he will do with his powers in his remaining 60 days in office. The next couple of months could well be the deciding factor in the future of global power dynamics…

Trump just lost the election by the widest by an incumbent since that same election of 1932. Did he lose it by a frightfully small margin? Absolutely, but if any tea leaves can be read, had the election taken place in March 2021 instead of November 2020, he may have been electorally obliterated beyond recognition.

There is an essence of tragedy in America during this time – to have had all the power to do everything and all the misguided cheap instincts to do absolutely nothing. Both parties to date have sat back and have seemingly done nothing but bitch and snipe at one another since May of this year. Meanwhile, an entire generation has been doomed to a sort Sisyphus-style financial purgatory. As has happened in innumerable societies before it, within America, a reckoning could already be well on its way – much to the utter surprise of baby-boomer generational elites who have been calling for normalcy while padding up their retirement portfolios.

There has long been a cliff coming – an entire swathe of the younger generation with nothing to show for themselves financially, clinging on to dead-end jobs merely for the insurance as they eke out an existence while only being outwardly successful via posts on Instagram. The last several months have been a sort of rapids for them to negotiate, bouncing around corporations downsizing, fighting their way through unemployment websites that crash with regularity, racking up credit card debt to eat, then protesting for their future on weekends.

It is only so far that people can be pushed to survive. This is all without mentioning the spark to this tinder – the coronavirus pandemic itself, one that it burning out of control to an almost unfathomable degree, a continuous upwards tsunami that has never crested, and now looks to crash forth in perpetuity for the foreseeable future as the Thanksgiving holiday approaches. By mid-December, the absolute true extent of the crash will become apparent (as COVID-19 cases often take around two weeks to truly surface).

There has long been a cliff coming – an entire swathe of the younger generation with nothing to show for themselves financially, clinging on to dead-end jobs merely for the insurance as they eke out an existence while only being outwardly successful via posts on Instagram.

The medical system is already running well beyond the point of exhaustion that they ever thought to be possible. Many people, including the current administration, currently just isn’t listening. With a state of political deadlock seemingly certain, the safe bet would be to throw your money on nothing at all happening, and for such horrors to simply continue as they have. Despite the recent developments of two vaccines being rolled out, the question remains how they will be administered and distributed.

Meanwhile, Trump and his ilk have not acknowledged the incoming Biden administration, let alone started the transition process. In the last two weeks, every possible media talking head on the cable news left is screaming and hollering about norms and then turning around and being polite to complicit officials. The real human tragedies do not get mentioned: the bank accounts wiped out, the families shattered, the debts accrued, the suicides committed. It is a tired, bullshit charade that is now reaching the tentacles deeper into the lives of American homes by a rate of nearly 200,000 new COVID cases everyday.

As of November 17th, 2020, the total number of COVID cases in the US stood at over 11 million. The lines on the graph are essentially vertical and all people are burnt out on this weirdness. What the breaking point will be I cannot predict, but there certainly is no leadership or directive to correct it. Could the pandemic kill a million Americans by next April? That may be a stretch, but at the moment all things seem possible. Could more than a million people die as a direct or indirect result of the botched COVID-19 response and bungled economic assistance?

Take, for example, the incomplete patchwork facing Americans staring down the barrel of eviction notices; some will get respite, many, if not most, will not. Where will they go? Into crowded homes of distant family members or shelters with a multitude of strangers? Will they turn to robbing grocery stores? Will they languish and freeze in cities like Milwaukee, Detroit and Pittsburgh? Could there be an ugly wave of suicides, private deaths of lives that no one bothered to check in on?  Such notions of widespread systemic destitution and desperation used to be dismissed as socialistic musings; now they read as frightful premonitions. All of America’s dark underbellies have now been exposed, and the wolves are having a feast.

At least twenty million or more ugly little tales will play out this winter. These will not be necessarily deaths from COVID, but of families cast out into mourning and entire trajectories of lives forever altered. There is no rescuing many, and they’ll remain down in the cracks of society.

Such notions of widespread systemic destitution and desperation used to be dismissed as socialistic musings; now they read as frightful premonitions. All of America’s dark underbellies have now been exposed, and the wolves are having a feast.

In random states that are flown over and exploited for votes (places like my home state of Wisconsin), such situations are already in a full-blown tailspin. Despite Wisconsin only having a population of around five million, it has numbered in the top 10 states for new COVID cases for several consecutive weeks. This was already occurring when Trump held a large campaign rally on October 30th in the city of Green Bay just ahead of election day. It is that action of callously adding fuel to the fire that has raised eyebrows the highest. It is one thing to largely ignore a crisis, as the current government has done, it is another altogether to actively help the situation to deteriorate in states without large-scale public health capabilities. Make no mistake, this period will be referred to in textbooks as the “The Dark American Winter”. The only question is just how bleak it will become before the spring.

While many in the West are looking at the current state of the US teetering and gasping with shock and horror, most in East Africa simply shrug, knowing they are one bad leader away from reaching the same precipice. Maybe next time the US will listen. But holding one’s breath is not recommended.

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