Victor Rago 23, is a tall lanky fellow, who every inch looks like an IT geek. He is not far from that description: he will be graduating with honours from the University of Nairobi on September 6, 2019, with a degree in industrial and analytical chemistry. His pastime is crunching numbers, and, as he told me, is looking to enter into the word of global financial trading.
But Rago has another pastime, a more lucrative one –farming. “I’ve been farming potatoes in Narok County on a one-acre plot of land,” said Rago. “I cracked the numbers and realized I could be making some tidy sum of surplus cash from the hired piece of land, after I’ve deducted all my expenses.”Rago’s rented potato plot is in Erongitok, five kilometres from Narok town.
“I rent my one-acre land at between Ksh40,000-50,000 per year. When the season is excellent, I’ll reap sack of potatoes every three months, in a good year. It’s a profitable undertaking provided you do your math well,” said the science student. “When its harvest time, I don’t have to go looking for buyers – they will come with their Mitsubishi Fuso trucks straight to the farm and collect the potatoes at the source.” That, he observed, saves him and his buyers from the crafty middlemen and potato crop brokers. “They are a necessary nuisance, but a menace, nonetheless.” This is the one time he must physically be at the farm. “Harvest time happens to be the busiest period, so you don’t want to leave all that work to your employee, or even hired hands. These people are human beings and they are prone to temptations.”
Rago told me the black alluvial soil, the flat land and the sunshine weather in Erongitok is good for potato crop cultivation. “The rains are also dependable, although they can be erratic, but just good enough to grow my potatoes.” His expenses include: hiring a farmhand, equipping him a feature phone (‘mulikamwizi’) and erecting a makeshift structure at the farm for his farmhand to live in during the season. “Labour is cheap, the farmhands are paid between KSh2000–3000, depending on the size of the land and what crop he is looking after. I pay mine KSh2000.”
Ever the ambitious university student, Rago, who has dreams of pursuing a master degree in analytical chemistry, has come to define your archetypal millennial “farmer”: adventure-seeking, entrepreneurial, a little ‘bougie’, techy-savvy, a terribly young man, who when talking about his farming, makes it sound like such a sexy undertaking. Telephone farming may not have started with the millennial, but this generation has sexed-up traditional farming as we know it.
“Modern day farming is today a social enterprise engagement that is being done by (college) students and young corporate types from the confines of their lecture halls and offices,” said Rago. “The friend who introduced and interested me in this side hustle is a financial consultant with an office in Nairobi CBD, who has been farming hay and potatoes on a large scale in Erongitok.” Rago said his friend was now even thinking of diversifying his telephone farming into keeping livestock – cows, goats and sheep. “Ërongitok and Ntulele(an area just before you reach Narok town from Nairobi city), are good for livestock keeping because there’s a lot of fodder and expansive land for the animals to graze,” Rago’s said his friend.
Rago has come to define your archetypal millennial “farmer”: adventure-seeking, entrepreneurial, a little ‘bougie’, techy-savvy, a terribly young man, who, when talking about his farming, makes it sound like such a sexy undertaking.
According to Rago, his friend told him that traditional farming as practised by our parents is waning – with the advancement in technology– you need not always be physically present at the farm. “Just invest in the right technological tools and personnel and you can engage in farming activities from wherever you are.’” In the coming years, the next big money to be made in this country is in the food production, said Rago’s friend. “But in the meantime, what’s wrong in making hay while the sun shines?”
Rago told me he has never thought of himself strictly as a farmer, “I wouldn’t say farming is my passion – it is not – but as an up and coming social entrepreneur, I’m always looking for opportunities to make a fast buck: this potato farming has been affording me some extra cash, while at the same time contributing to the country’s food production. I would like to think of myself as a patriotic Kenyan who’s playing his dutiful role as a food producer.”
Unlike Rago, Susan Wanjiku 32, has a full-time job, working for a local NGO in Nairobi. Wanjiku took me to her farm in Kamulu, 25 km east of Nairobi’s CBD. From Kamulu, a fast-growing trading centre, we rode a boda boda that took us eight kilometres, deep into the farmland area, which borders Ukambani on the northern side. “I grow watermelons on my half an acre plot. As you might be aware, watermelon is a succulent fruit that does not need lots of water. So, apart from investing in irrigation drips, the black cotton soil is good because, when it rains, the soils become water-logged, hence, can retain moisture and water for as long as the dry spell persists.”
“I consider my farming as an extra-curricular activity: it pre-occupies me over the weekend and any other time when I’m not going to the office,” said Wanjiku, who considers herself a millennial in every sense of the word. “I grew up in the rural area and my parents were subsistence farmers. Today when I tell them that I’m a farmer who doesn’t need to tend to the farm personally, they really get amused.”
Wanjiku says that farming is a good income earner that supplements her wages. “These December holidays, I’ll be going to Kikambala beach, thanks to my fruit farming.”This is her fourth year growing watermelons, “and I can tell you that watermelon farmers cannot satiate the market – the fruit is one of the most popular among the fruit-thirsty Kenyans – if only I could find more land to grow them,” she mused.
Wanjiku lives in South B and she can afford to visit her farm every so often, especially on weekends and when she gets a day or two away from the office.“Mobile telephony is the greatest thing that happened in this millennium, all I need to do is pick up my phone, call my farm-worker to get updates or pass information on what I need done on the farm, without interrupting my day-to-day work.”
Wanjiku, who is employed as a personal secretary, says she has a passion for farming: “I love everything to do with the earth and what germinates from it, I love the soil, I like the fact that when I visit my farm, I wear my gumboots and wade in the muddy clay soil.” When you get it right farming is very profitable. To this end, every Saturday, she never misses her Saturday Nation newspaper pullout – Seeds of Gold – that chronicles, farming “success” stories that have been apparently glamourized and hyped modern-day agriculture; from breeding exotic goats for milk production, to urban farming done on rooftops. She reads the magazine, aptly, on her excursions to the farm every Saturday morning.
“But what really gave me the impetus to pursue my passion in farming are the seminars that I’ve been attending at the Latia Resource Centre Farm,” said Wanjiku. “The 60-acre demonstration farm in Isinya in Kajiado County, has a big lecture room, fully equipped with chairs and an erasure board and runs short courses for “urban” farmers and people who would like to invest in agri-business.”
“I love everything to do with the earth and what germinates from it, I love the soil, I like the fact that when I visit my farm, I wear my gumboots and wade in the muddy clay soil.”
The farm, which grows different types of crops, some grown organically – from carrots to cucumbers, from lemons to lettuce and from potatoes to tomatoes, has the latest demonstration farming techniques and information on technology-driven agriculture. When I visited the farm recently, the farm had just installed state-of-the-art greenhouses from The Netherlands. It was also host to some South African farmers from Orange Free State province.
For Anthony Namodi, remote farming came to him by default: “I inherited a two-acre farm from my parents, part of a larger farm that they had been farming in Nzoia scheme in Kakamega County.”The 34-year-old dairy farming consultant, based in Nakuru, said he decided to continue growing maize, which his parents had been doing for ages. “I couldn’t go wrong with maize farming because, I understood all the motions of growing the crop. I was walking a well-worn path. The one challenge that I faced though, was that I was going to be a telephone farmer, since I wasn’t available to look after the farm myself,” said Namodi.
So, using his smartphone, Namodi goes through the motions of telephone farming, by giving instructions to his workers on how he wants the farm tended every new season. “Once my supervisor alerts me on the impending rain, I begin putting together resources for tilling the land with a tractor, buying the required amount of fertilizer and the necessary amount of seed, then send the money to him. It is really telephone farming, because my supervisor must also spend considerable time on the phone, as we discuss back and forth on the farming process.”
Four years into telephone farming, Namodi points out that this type of farming has its own challenges. “Since most of the time you’re not there to oversee your own farming, a telephone farmer has always to cross his fingers and pray that his instructions are followed to the letter.” Many times, workers have a way of ignoring instructions given by the owner of the farm, observes Namodi. They presume they know better since they are ‘on the ground’ and therefore they know what ought to be done. It is always a big tussle, especially for someone like me, who is an agriculturalist, and knowledgeable in the dynamics of farming techniques.”
Frequently, many farm workers want to cut corners, says Namodi, which ends up compromising quality. “If, for example, you send them money to buy a dozen bags of fertilizer and a specific type of seed, they will shortchange you on the number of fertilizer bags –meaning they will buy less bags and compromise on the quality of the seed – by buying an inferior prototype.” The dairy farming consultant said it is always a constant struggle to ensure that his instructions are properly adhered to and the workers are not stealing from him. “I came to realize that my workers always inflate prices of farm inputs because I’m not there to ascertain those prices. Every time I have the time to be on the ground, I always negotiate better prices for my farming inputs.”
Namodi’s three biggest challenges in telephone farming are therefore: cost, uncertainty of whether his instructions have been implemented properly, and quality control. “This is not to say that I’m not eternally grateful for the invention of the smart mobile phone. My workers will always take pictures of the farm, to capture and record the progress for me on WhatsApp, as they keep me abreast of what’s happening to the farm constantly. I don’t have to be present to remit their payments or indeed any payments that maybe needed urgently.” Technology has made farming as a real-time activity, he added.
Namodi concluded his telephone farming has been a mixed bag of success: “I usually harvest 15 bags of maize per acre, for which I sell KSh2000 per bag. But I must warn profitability depends on the season – if for some reason, there wasn’t enough rain, the harvest suffers. That notwithstanding, I will tell you without a doubt, farming is the business of the future.”
Yet, telephone farming is not a preserve of the odd adventurer millennial. George Mukoya, 64, has been engaging in remote farming for 20 years, since 1999. A consultant in the energy sector, Mukoya is a farmer by choice and has been farming his six-acre farm in Ndalu scheme through the telephone for those many years. “I farm maize and beans.I’m amused by these young people who wonder how telephone farming used to take place before the advent of the mobile phone. In 1999, mobile phone was still a novelty in Kenya, a preserve of the plutocrats, I don’t remember any of my friends owning a mobile phone.”
Namodi’s three biggest challenges in telephone farming are therefore: cost, uncertainty of whether his instructions have been implemented properly, and quality control.
Mukoya said in those pre-mobile phone days, he conducted his remote farming by writing letters to his workers, sending someone to the farm and travelling by himself to supervise the farming process. “There was indeed a lot of pre-planning.” When he compares those days and now, Mukoya, who got the “farming bug” from his uncle, today truly appreciates where he has come from with his remote farming: “farming can now be done in real-time by the smartphone, it is amazing how technology can alter our livelihoods and lifestyles for the better.”
With the smartphone technology, Mukoya says he can check on the weather patterns, research on the latest types of seeds, and get real-time updates from his farm workers. The telephone farming for him has been profitable, but of course, just like any other engagement run remotely, it has had its challenges. “The biggest challenge is of course trust issues from your workers: they will cheat and steal from you, all the time.” Therefore the two times that he must ensure he is present at the farm is during the sowing and harvesting time.
For the millennial who may falsely believe that telephone farming is their “invention” because mobile telephony happened in their time, they would be shocked to learn that remote farming preceded their generation.
As far back as in the mid-1980s – when the term millennial had not even been coined – Samuel Onsango, now fully retired, was already engaging in telephone farming. Then a full-time employee of the British American Tobacco (BAT) company, the company contracted him to be running their tobacco farms in Migori and Sirare, in Migori County, then referred to as South Nyanza.
“It was my duty to organize the farmers, ensure they have been supplied with all the farm inputs that they need, prepare their farms in good time during the sowing period and most importantly, always remit their payments on time without delay. All this, I did on my own time, not on the company’s time,” said the 74-year-old Osango. “I travelled a lot then. Every other weekend, I was on the move, to check on the farmers, to ensure they were maintaining the strict quality control demanded of them by the contracting company.”
The telephone farming for him has been profitable, but of course, just like any other engagement run remotely, it has had it challenges. “The biggest challenge is of course trust issues from your workers: they will cheat and steal from you, all the time.”
This was telephone farming by any other name, said Onsango, because I ran the farms from Nairobi, which then was seen as very far away. The best means to travel then to Migoriwas by the overnight bus. Onsango said every trip he made to Migori and Sirare had to be accounted for and add value – both to him and the farmers. And as long as everybody played their roles and delivered results, everyone was happy.
The success of Onsango’s tobacco remote farming did not go unnoticed: “Word got around to East African Breweries Limited (EABL), that I was the force behind the successfully organized tobacco farms of South Nyanza,” said the retired cigarette maker. “Soon the beer company contracted me to be overseeing their barley and wheat farms of Narok. I used the same techniques I employed to handle the tobacco farmers: visit them regularly, listen to their demands, inspect the farms, deliver farm inputs on time, as I also paid them on time.
As Onsango managed BAT and EABL farms, from Nairobi, he reckoned he could also manage his own remote farming. In the late 1980s, he bought a 100-acres in Cherangani scheme in Kitale and was soon planting maize. “It was enjoyable and an adrenaline-driven activity as long as I was young and energetic,” said the mzee. “You can only do so much telephone farming. In 2000, I retired from everything.”
Written and published with the support of the Route to Food Initiative (RTFI) (www.routetofood.org). Views expressed in the article are not necessarily those of the RTFI.
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Lagos From Its Margins: Everyday Experiences in a Migrant Haven
From its beginnings as a fishing village, Lagos has grown into a large metropolis that attracts migrants seeking opportunity or Internally Displaced Persons fleeing violence.
Lagos, City of Migrants
From its origins as a fishing village in the 1600s, Lagos has urbanised stealthily into a vast metropolis, wielding extensive economic, political and cultural influence on Nigeria and beyond. Migration in search of opportunities has been the major factor responsible for the demographic and spatial growth of the city as Lagos has grown from 60,221 in 1872 to over 23 million people today. The expansion of the city also comes with tensions around indigene-settler dynamics, especially in accessing land, political influence and urban resources. There are also categories of migrants whose status determines if they can lay hold of the “urban advantage” that relocating to a large city offers.
A major impetus to the evolution of modern Lagos is the migration of diverse groups of people from Nigeria’s hinterland and beyond. By the 1800s, waves of migrants (freed slaves) from Brazil and Freetown had made their way to Lagos, while many from Nigeria’s hinterland including the Ekiti, Nupes, Egbas and Ijebus began to settle in ethnic enclaves across the city. In the 1900s, migrant enclaves were based on socio-economic and/or ethnicity status. Hausas (including returnees from the Burma war) settled in Obalende and Agege, while the Ijaw and Itsekiri settled in waterfront communities around Ajegunle and Ijora. International migrant communities include the Togolese, Beninoise and Ghanaian, as well as large communities of Lebanese and Indian migrants. The names and socio-cultural mix in most Lagos communities derive from these historical migrant trajectories.
A study on coordinated migrations found that, as a destination city, Lagos grew 18.6 per cent between 2000 and 2012, with about 96 per cent of the migrants coming from within Nigeria. While migration to Lagos has traditionally been in search of economic opportunities, new classes of migrants have emerged over the last few decades. These are itinerant migrants and internally displaced persons.
Itinerant migrants are those from other areas of Nigeria and West Africa who travel to work in Lagos while keeping their families back home. Mobility cycles can be weekly, monthly or seasonal. Such migrants have no address in Lagos as they often sleep at their work premises or in mosques, saving all their earned income for remittance. They include construction artisans from Benin and Togo who come to Lagos only when they have jobs, farmers from Nigeria’s northern states who come to Lagos to work as casual labourers in between farming seasons (see box), as well as junior staff in government and corporate offices whose income is simply too small to cover the high cost of living in Lagos.
While people from Nigeria’s hinterland continue to arrive in the city in droves, the wave of West African in-migration has ebbed significantly. This is mostly because of the economic challenges Nigeria is currently facing that have crashed the Naira-to-CFA exchange rates. As a result, young men from Togo, Ghana and Benin are finding cities like Dakar and Banjul more attractive than Lagos.
Aliu* aka Mr Bushman, from Sokoto, Age 28
Aliu came to Lagos in 2009 on the back of a cattle truck. His first job was in the market carrying goods for market patrons. He slept in the neighbourhood mosque with other young boys. Over the years, he has done a number of odd jobs including construction work. In 2014, he started to work as a commercial motorcyclist (okada) and later got the opportunity to learn how to repair them. He calls himself an engineer and for the past four years has earned his income exclusively from riding and repairing okada. Even though he can afford to rent a room, he currently lives in a shared shack with seven other migrants.
He makes between N5000 and N8000 weekly and sends most of it to his family through a local transport operator who goes to Sokoto weekly. His wife and three children are in the village, but he would rather send them money than bring them to Lagos. According to him, “The life in Lagos is too hard for women”.
Since he came to Lagos thirteen years ago, Aliu has never spent more than four months away from Sokoto at a time. He stays in Sokoto during the rainy season to farm rice, maize and guinea corn, and has travelled back home to vote every time since he came to Lagos.
The second category of migrants are those who have been displaced from their homesteads in Northern Nigeria by conflict, either Boko Haram insurgency or invasions by Fulani herdsmen. The crises have resulted in the violent destruction of many communities, with hundreds of thousands killed and many more forced to flee. With many who initially settled in camps for Internally Displaced Persons (IDP) dissatisfied with camp conditions, the burden of protracted displacement is now spurring a new wave of IDP migration to urban areas. Even though empirical data on the exact number of displaced persons migrating out of camps to cities is difficult to ascertain, it is obvious that this category of migrants are negotiating their access to the city and its resources in circumstances quite different from those of other categories of migrants.
IDPs as the emerging migrant class in Lagos
According to the United Nations High Commission for Refugees, two of every three internally displaced persons globally are now living in cities. Evidence from Nigeria suggests that many IDPs are migrating to urban areas in search of relative safety and resettlement opportunities, with Lagos estimated to host the highest number of independent IDP migrants in the country. In moving to Lagos, IDPs are shaping the city in a number of ways including appropriating public spaces and accelerating the formation of new settlements.
There are three government-supported IDP camps in the city, with anecdotal evidence pointing to about eighteen informal IDP shack communities across the city’s peri-urban axis. This correlates with studies from other cities that highlight how this category of habitations (as initial shelter solutions for self-settled IDPs) accelerate the formation of new urban informal settlements and spatial agglomerations of poverty and vulnerability.
While people from Nigeria’s hinterland continue to arrive in the city in droves, the wave of West African in-migration has ebbed significantly.
IDPs in Lagos move around a lot. Adamu, who currently lives in Owode Mango—a shack community near the Lagos Free Trade zone—and has been a victim of forced eviction four times said, “As they [government or land owners] get ready to demolish this place and render us homeless again, we will move to another area and live there until they catch up with us.”
In the last ten years, there has been an increase in the number of homeless people on the streets of Lagos—either living under bridges, in public parks or incomplete buildings. Many of them are IDPs who are new migrants, and unable to access the support necessary to ease their entry into the city’s established slums or government IDP camps. Marcus, who came from Adamawa State in 2017 and has been living under the Obalende Bridge for five years, said, “I am still managing, living under the bridge. I won’t do this forever, my life will not end like this under a bridge. I hope to one day return to my home and continue my life”.
Blending in or not: Urban integration strategies
Urban integration can be a real challenge for IDP migrants. Whereas voluntary migrants are often perceived to be legal entrants to the city and so can lay claim to urban resources, the same cannot be said about IDPs. Despite being citizens, and despite Nigeria being a federation, IDPs do not have the same rights as other citizens in many Nigerian cities and constantly face stigmatisation and harassment, which reinforces their penchant for enclaving.
The lack of appropriate documentation and skillsets also denies migrants full entry into the socio-economic system. For example, Rebekah said: “I had my WAEC [Senior Secondary school leaving certificate] results and when Boko Haram burnt our village, our family lost everything including my certificates. But how can I continue my education when I have not been able to get it? I have to do handwork [informal labour] now”. IDP children make up a significant proportion of out-of-school children in Lagos as many are unable to get registered in school simply because of a lack of address.
Most IDPs survive by deploying social capital—especially ethnic and religious ties. IDP ethnic groupings are quite organized; most belong to an ethnic-affiliated group and consider this as particularly beneficial to their resettlement and sense of identity in Lagos. Adamu from Chibok said, “When I come to Lagos in 2017, I come straight to Eleko. My brother [kinsman] help me with house, and he buy food for my family. As I no get work, he teach me okada work wey he dey do.”
The crises have resulted in the violent destruction of many communities, with hundreds of thousands killed and many more forced to flee.
Interestingly, migration to the city can also be good for women as many who were hitherto unemployed due to cultural barriers are now able to work. Mary who fled Benue with her family due to farmer-herder clashes explained, “When we were at home [in Benue], I was assisting my husband with farming, but here in Lagos, I have my own small shop where I sell food. Now I have my own money and my own work.”
Need for targeted interventions for vulnerable Lagosians
“Survival of the fittest” is an everyday maxim in the city of Lagos. For migrants, this is especially true as they are not entitled to any form of structured support from the government. Self-settlement is therefore daunting, especially in light of systemic limiting factors.
Migrants are attracted to big cities based on perceived economic opportunities, and with limited integration, their survival strategies are inevitably changing the spatial configurations of Lagos. While the city government is actively promoting urban renewal, IDP enclaving is creating new slums. Therefore, addressing the contextualised needs of urban migrant groups is a sine qua non for inclusive and sustainable urban development.
“I am still managing, living under the bridge. I won’t do this forever, my life will not end like this under a bridge. I hope to one day return to my home and continue my life”.
There is an established protocol for supporting international refugees. However, the same cannot be said for IDPs who are Nigerian citizens. They do not enjoy structured support outside of camps, and we have seen that camps are not an effective long-term solution to displacement. There is a high rate of IDP mobility to cities like Lagos, which establishes the fact that cities are an integral part of the future of humanitarian crisis. Their current survival strategies are not necessarily harnessing the urban advantage, especially due to lack of official recognition and documentation. It is therefore imperative that humanitarian frameworks take into account the role of cities and also the peculiarities of IDP migrations to them.
Lagos remains a choice destination city and there is therefore need to pay more attention to understanding the patterns, processes and implications of migration into the city. The paucity of migration-related empirical data no doubt inhibits effective planning for economic and social development. Availability of disaggregated migration data will assist the state to develop targeted interventions for the various categories of vulnerable Lagosians. Furthermore, targeted support for migrant groups must leverage existing social networks, especially the organised ethnic and religious groups that migrants lean on for entry into the city and for urban integration.
*All names used in this article are pseudonyms
It’s a Nurses’ Market Out There, and Kenyans Are Going For It
Nurses are central to primary healthcare and unless Kenya makes investments in a well-trained, well supported and well-paid nursing workforce, nurses will continue to leave and the country is unlikely to achieve its Sustainable Development Goals in the area of health and wellbeing for all.
Nancy* is planning to leave Kenya. She wants to go to the United States where the nursing pastures are supposedly greener. I first met Nancy when the country was in the throes of the COVID-19 pandemic that tested Kenya’s healthcare system to breaking point. She was one of a cohort of recently graduated nurses that were hastily recruited by the Ministry of Health and thrown in at the deep end of the pandemic. Nancy earns KSh41,000 net with no other benefits whatsoever, unlike her permanent and pensionable colleagues.
When the then Labour and Social Protection Cabinet Secretary Simon Chelugui announced in early September 2021 that the government would be sending 20,000 nurses to the United Kingdom to help address the nursing shortage in that country, Nancy saw her chance. But her hopes were dashed when she failed to raise the KSh90,000 she needed to prepare and sit for the English language and nursing exams that are mandatory for foreign-trained nurses. Nancy would also have needed to pay the Nursing Council of Kenya KSh12,000 for the verification of her documents, pay the Kenya Medical Training College she attended KSh1,000 in order to get her exam transcripts, and apply for a passport, the minimum cost of which is KSh4,550 excluding the administrative fee. Nancy says that, contrary to then Health Cabinet Secretary Mutahi Kagwe’s disputed claims that a majority of applicants to the programme had failed the English language test, most nurses simply could not afford the cost of applying.
Of the targeted 20,000 nurses, the first 19 left Kenya for the UK in June 2022. But even that paltry figure represents a significant loss for Kenya, a country where the ratio of practicing nurses to the population is 11.66 per 10,000. The WHO considers countries with less than 40 nurses and midwives for every 10,000 people to not have enough healthcare professionals. Nearly 60 per cent of all healthcare professionals (medical physicians, nursing staff, midwives, dentists, and pharmacists) in the world are nurses, making them by far the most prevalent professional category within the health workforce. Nurses offer a wide range of crucial public health and care services at all levels of healthcare facilities as well as within the community, frequently serving as the first and perhaps the only healthcare provider that people see.
The growing shortage of nurses in the UK has been blamed on the government’s decision to abolish bursaries and maintenance grants for nursing students in 2016, leading to a significant drop in the number of those applying to train as nurses. Consequently, the annual number of graduate nurses plummeted, reaching the current low of 31 nurses per 100,000 people, below the European average of 36.6 and half as many as in countries like Romania (96), Albania (82) and Finland (82). Facing pressure to recruit 50,000 nurses amid collapsing services and closures of Accident & Emergency, maternity and chemotherapy units across the country, the UK government decided to once again cast its net overseas. Established in 1948, the UK’s National Health Service (NHS) has relied on foreign healthcare workers ever since staff from the Commonwealth were first brought in to nurse back to health a nation fresh out of the Second World War.
The UK government’s press release announcing the signing of the Bilateral Agreement with Kenya states that the two countries have committed “to explore working together to build capacity in Kenya’s health workforce through managed exchange and training” and goes as far as to claim that “with around only 900 Kenyan staff currently in the NHS, the country has an ambition to be the ‘Philippines of Africa’ — with Filipino staff one of the highest represented overseas countries in the health service — due to the positive economic impact that well-managed migration can have on low to middle income countries.”
It is a dubious ambition, if indeed it has been expressed. The people of the Philippines do not appear to be benefiting from the supposed increase in capacity that the exchange and training is expected to bring. While 40,000 of their nurses worked in the UK’s National Health Service last year, back home, according to Filipino Senator Sonny Angara, “around 7 of 10 Filipinos die without ever seeing a health professional and the nurse to patient ratio in our hospitals remains high at 1:50 up to 1:802”.
Since 2003 when the UK and the government of the Philippines signed a Memorandum of Understanding on the recruitment of Filipino healthcare professionals, an export-led industry has grown around the training of nurses in the Philippines that has attracted the increased involvement of the private sector. More nursing institutions — that have in reality become migrant institutions — are training nurses specifically for the overseas market, with the result that skills are matched to Western diseases and illnesses, leaving the country critically short of healthcare personnel. Already, in 1999, Filipino doctors had started retraining as nurses and leaving the country in search of better pay.
It is difficult, then, to see how the Philippines is an example to emulate. Unless, of course, beneath the veneer of “partnership and collaboration in health”, lies the objective of exporting Kenyan nurses with increased diaspora remittances in mind – Kenyans in the UK sent KSh28.75 billion in the first nine months of 2022, or nearly half what the government has budgeted for the provision of universal health care to all Kenyans. If that is the case, how that care is to be provided without nurses is a complete mystery.
Already in 1999, Filipino doctors had started retraining as nurses and leaving the country in search of better pay.
For the UK, on the other hand, importing nurses trained in Kenya is a very profitable deal. Whereas the UK government “typically spends at least £26,000, and sometimes far more, on a single nurse training post”, it costs only £10,000 to £12,000 to recruit a nurse from overseas, an externalization of costs that commodifies nurses, treating them like goods to be bought and sold.
However, in agreeing to the terms of the trade in Kenyan nurses, the two governments are merely formalizing the reality that a shortage of nurses in high-income countries has been driving the migration of nurses from low-income countries for over two decades now. Along with Ghana, Nigeria, South Africa and Zimbabwe, Kenya is one of the top 20 countries of origin of foreign-born or foreign-trained nurses working in the countries of the OECD, of which the UK is a member state.
Faced with this reality, and in an attempt to regulate the migration of healthcare workers, the World Health Assembly adopted the WHO Global Code of Practice on the Recruitment of Health Personnel in May 2010. The code, the adherence to which is voluntary, “provides ethical principles applicable to the international recruitment of health personnel in a manner that strengthens the health systems of developing countries, countries with economies in transition and small island states.”
Article 5 of the code encourages recruiting countries to collaborate with the sending countries in the development and training of healthcare workers and discourages recruitment from developing countries facing acute shortages. Given the non-binding nature of the code, however, and “the severe global shortage of nurses”, resource-poor countries, which carry the greatest disease burden globally, will continue to lose nurses to affluent countries. Wealthy nations will inevitably continue luring from even the poorest countries nurses in search of better terms of employment and better opportunities for themselves and their families; Haiti is on the list of the top 20 countries supplying the OECD region.
“Member States should discourage active recruitment of health personnel from developing countries facing critical shortages of health workers.”
Indeed, an empirical evaluation of the code four years after its adoption found that the recruitment of health workers has not undergone any substantial policy or regulatory changes as a direct result of its introduction. Countries had no incentive to apply the code and given that it was non-binding, conflicting domestic healthcare concerns were given the priority.
The UK’s Department of Health and Social Care (DHSC) has developed its own code of practice under which the country is no longer recruiting nurses from countries that the WHO recognizes as facing health workforce challenges. Kenya was placed on the UK code’s amber list on 11 November 2021, and active recruitment of health workers to the UK was stopped “with immediate effect” unless employers had already made conditional offers to nurses from Kenya on or before that date. Presumably, the Kenyan nurses who left for the UK in June 2022 fall into this category.
In explaining its decision, the DHSC states that “while Kenya is not on the WHO Health Workforce Support & Safeguards List, it remains a country with significant health workforce challenges. Adding Kenya to the amber list in the Code will protect Kenya from unmanaged international recruitment which could exacerbate existing health and social care workforce shortages.”
The WHO clarifies that nothing in its Code of Practice should be interpreted as curtailing the freedom of health workers to move to countries that are willing to allow them in and offer them employment. So, even as the UK suspends the recruitment of Kenyan nurses, they will continue to find opportunities abroad as long as Western countries continue to face nurse shortages. Kenyan nurses will go to the US where 203,000 nurses will be needed each year up to 2026, and to Australia where the supply of nursing school graduates is in decline, and to Canada where the shortage is expected to reach 117,600 by 2030, and to the Republic of Ireland which is now totally dependent on nurses recruited from overseas and where working conditions have been described as “horrendous”.
“Adding Kenya to the amber list in the Code will protect Kenya from unmanaged international recruitment which could exacerbate existing health and social care workforce shortages.”
Like hundreds of other Kenyan-trained nurses then, Nancy will take her skills overseas. She has found a recruitment agency through which to apply for a position abroad and is saving money towards the cost. She is not seeking to move to the UK, however; Nancy has been doing her research and has concluded that the United States is a much better destination given the more competitive salaries compared to the UK where nurses have voted to go strike over pay and working conditions. When she finally gets to the US, Nancy will join Diana*, a member of the over 90,000-strong Kenyan diaspora, more than one in four of whom are in the nursing profession.
Now in her early 50s, Diana had worked for one of the largest and oldest private hospitals in Nairobi for more than 20 years before moving to the US in 2017. She had on a whim presented her training certificates to a visiting recruitment agency that had set up shop in one of Nairobi’s high-end hotels and had been shortlisted. There followed a lengthy verification process for which the recruiting agency paid all the costs, requiring Diana to only sign a contract binding her to her future US employer for a period of two years once she had passed the vetting process.
Speaking from her home in Virginia last week, Diana told me that working as a nurse in the US “is not a bed of roses”, that although the position is well paying, it comes with a lot of stress. “The nurse-to-patient ratio is too high and the job is all about ticking boxes and finishing tasks, with no time for the patients,” she says, adding that in such an environment fatal mistakes are easily made. Like the sword of Damocles, the threat of losing her nursing licence hangs over Diana’s head every day that she takes up her position at the nursing station.
“The nurse-to-patient ratio is too high and the job is all about ticking boxes and finishing tasks, with no time for the patients.”
Starting out as an Enrolled Nurse in rural Kenya, Diana had over the years improved her skills, graduating as a Registered Nurse before acquiring a Batchelor of Science in Nursing from a top private university in Kenya, the tuition for which was partially covered by her employer.
Once in the US, however, her 20 years of experience counted for nothing and she was employed on the same footing as a new graduate nurse, as is the case for all overseas nurses moving to the US to work. Diana says that, on balance, she would have been better off had she remained at her old job in Kenya where the care is better, the opportunities for professional growth are greater and the work environment well controlled. But like many who have gone before her, Diana is not likely to be returning to Kenya any time soon.
*Names have been changed.
Why Azimio’s Presidential Petition Stood No Chance
In so far as the court had nullified the 2017 elections, the evidential threshold required for any subsequent electoral nullification was going to be substantially high for any petitioner.
Even before the 9 August general election, it was expected that the loser of the Kenyan presidential contest would petition the Supreme Court to arbitrate over the outcome. Predictably, the losing party, Azimio La Umoja-One Kenya Coalition, petitioned the court to have William Ruto’s win nullified on various procedural and technical grounds. Azimio’s case was predicated on, among others, three key allegations. First, that William Ruto failed to garner the requisite 50 per cent plus one vote. Second, that the Independent Electoral and Boundaries Commission (IEBC) chairman Wafula Chebukati had announced the outcome without tallying and verifying results from seven constituencies. Finally, that the commission could not account for 250,000 votes that were cast electronically.
As we know, Azimio lost the case as the judges dismissed all the nine petitions that the party had filed, unanimously finding that William Ruto had won fairly.
Adjudicating electoral fallouts
Since its inception in 2010, the Supreme Court has played a decisive role in adjudicating fallouts linked to contentious presidential politics in Kenya, with the court deliberating on the outcome of three out of the four presidential elections held after its inauguration. Prior to this, the losing party had no credible institutional mechanism of redress and electoral disputes were generally resolved through mass political action (as in 2007) or consistent questioning of the legitimacy of the winner (as in 1992 and 1997).
The Supreme Court’s presence has, therefore, been crucial in providing losers with an institutionalised mechanism to channel dissent, with the court operating as a “safety valve” to diffuse political tensions linked to presidential elections. It is, hence, impossible to conceive of the relatively peaceful elections held in 2013, 2017 and 2022 without the Supreme Court whose mere presence has been key in discouraging some of the more deadly forms of political rivalry previously witnessed in Kenya.
While the Azimio leadership were right to petition the court in the recent election, first because this successfully diffused the political tensions among their supporters, and second because the court was expected to provide directions on IEBC conduct in future elections, it was clear that Raila Odinga’s relentless petitioning of the court in the previous two elections, and the nullification of the 2017 elections, was in essence going to be a barrier to a successful petition in 2022.
In so far as the court had nullified the 2017 elections, the evidential threshold required for any subsequent electoral nullification was going to be substantially high for any petitioner. The relentless petitioning of the court and the nullification of the 2017 elections had in essence raised the bar for the burden of proof, which lay with the petitioner(s) and, therefore, reduced the probability of a successful petition.
The Supreme Court’s presence has been crucial in providing losers with an institutionalised mechanism to channel dissent.
The reason for this is both legal and political. Legal in the sense that the IEBC is expected to conduct the elections under the law, which, among other issues, requires that the electoral process be credible and the results verifiable before any certification is made, otherwise the election is nullified, as was the case in 2017. It is political because the power to select the president is constitutionally, hence politically, delegated to the Kenyan people through the ballot, unless electoral fraud infringes on this, again as was the case in 2017.
The court in its deliberation must, therefore, balance the legal-political trade-off in its verdict in search of a plausible equilibrium. For instance, while the majority of Azimio supporters had anticipated a successful petition based on the public walkout and dissent by the four IEBC commissioners, it seems that the decision to uphold the results displayed the court’s deference to political interpretation of the law by issuing a ruling that did not undermine the Kenyan voters’ right to elect their president.
While the settlement of legal-political disputes by a Supreme/Constitutional court is a common feature across democracies, and continuously being embedded in emerging democracies like Kenya, it does seem that in this election, the political motivations for upholding the vote outweighed the legal motivations for nullifying it. In essence, the court demonstrated its institutional independence by ruling against the Kenyatta-backed Azimio candidate due to insufficient evidence.
Supreme Court power grab
A counterfactual outcome where the evidential threshold for the nullification of presidential results is low would foster a Supreme Court power grab, in lieu with the 2017 nullification, by marginalising the sovereign will of Kenyans to elect their president.
In many ways, nullification of the results would also have incentivised further adversarial political behaviour where every electoral outcome is contested in the Supreme Court even when the outcome is relatively clean, as in the case of the 2022 elections.
It is this reason (among others) that we think underlined the Supreme Court justices’ dismissal of Azimio’s recent petition. The justices ultimately dismissed the evidence presented by the petitioners as “hot air, outright forgeries, red herring, wild goose chase and unproven hypotheses”, setting a clear bar for the standard of evidence they expect in order to deliberate over such an important case in the future.
In essence, the court demonstrated its institutional independence by ruling against the Kenyatta-backed Azimio candidate due to insufficient evidence.
Since the earth-shaking nullification of the 2017 elections, the Supreme Court transcended an epoch, more political than legal by “invading” the sovereign space for Kenyans to elect their president, thereof setting a precedence that any future successful petition to contest a presidential election requires watertight evidence.
In a sense, Azimio were victims of Odinga’s judicial zealotry and especially the successful 2017 petition. In so far as the evidence submitted to the Supreme Court by Azimio in 2022 was at the same level or even lower than the 2017 base, their case at the Supreme Court was very likely to be dismissed and even ridiculed as the justices recently did.
The precedent set by the 2022 ruling will, actually, yield two positive political outcomes. First, it will in the future weed out unnecessary spam petitions that lack evidence and rather increase needless political tensions in the country. Second, it has signalled to future petitioners, that serious deliberations will only be given to petitions backed by rock-solid evidence.
From the recent ruling, it is evident that the judgement fell far below the precedent set in 2017. The 2017 Supreme Court ruling that the IEBC should make the servers containing Form 34A publicly available, was crucial in improving the credibility of the 2022 elections, by democratising the tallying process. At a minimum, the expectation was that the justices would provide a directive on the recent public fallout among the IEBC commissioners with regard to future national tallying and announcement of presidential results.
By dismissing the fallout as a mere corporate governance issue, the justices failed to understand the political ramifications of the “boardroom rupture”. What are we to do in the future if the IEBC Chair rejects the results and the other commissioners validate the results as credible?
Additionally, by ridiculing the petitioners as wild goose chasers and dismissing the evidence as “hot air”, the justices failed to maintain the amiable judicial tone necessary to decompress and assuage the bitter grievances among losers in Kenya high-octane political environment.
In a sense, Azimio were victims of Mr Odinga’s judicial zealotry and especially the 2017 successful petition.
The Supreme Court ought to resist the temptations of trivializing electoral petitions, as this has the potential of triggering democratic backsliding, where electoral losers might opt for extra-constitutional means of addressing their grievances as happened in December 2007. It is not in the petitioners’ place to ascertain whether their evidence is “hot air” or not, but for the court to do so, and in an amiable judicial tone that offers reconciliation in a febrile political environment.
The precedent set by the 2017 ruling that clarified the ambiguities related to the IEBC’s use of technology to conduct elections, set an incremental pathway towards making subsequent elections credible and fair, and increased public trust in the key electoral institutions in Kenya.
The justices, therefore, need to understand that their deliberations hold weight in the public eye and in the eyes of political leaders. Therefore, outlining recommendations to improve the IEBC’s conduct in future elections is a bare minimum expectation among Kenyans. In this case, while they provided some recommendations, they failed to comprehensively address the concerns around the walk-out by the four IEBC commissioners.
At the minimum, chastising the IEBC conduct was necessary to consolidate the electoral gains made thus far but also recalibrate institutional imperfections linked to how elections are to be conducted and, especially, contestations around the role of the commissioners in the national tallying of results in the future.
This article is part of our project on information and voter behaviour in the 2022 Kenyan elections. The project is funded by the Centre for Governance and Society, Department of Political Economy, King’s College London.
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