Two days to the third Sagana State Lodge meeting, called by President Uhuru Kenyatta in the absence of his deputy William Ruto on 30 January 2021, 41 central Kenya MPs sent a no-holds-barred letter to Uhuru. The Sagana meeting came hot on the heels of a “state of the nation address to the Kikuyu people” at State House, Nairobi, on 18 January.
The 51-minute question and answer session — in reality a monologue from President Uhuru — was broadcast live on all the Kikuyu-language radio stations. The president was for the umpteenth time beseeching the Kikuyu voter to unquestioningly and unequivocally accept the logic of the Building Bridges Initiative (BBI), whose latest moniker is Building Billionaires Initiative.
The Building Bridges Initiative was birthed immediately after President Uhuru and Raila Odinga shook hands on 18 March 2018. Three years into the handshake, President Uhuru’s backyard has shunned the document and basically ignored the President’s pleas to support it. The exclusively ethnic meeting with the Kikuyu radio and television presenters and the Sagana State Lodge baraza were a concerted effort to bring the Kikuyu rank and file to his side.
Among the salient issues that were contained in the MPs’ 12-page letter, four stood out for me:
“In Nyamakima, Gikomba, Kamukunji and on Taveta and Kirinyaga Roads, businesses have closed as besieged traders relocate to the rural areas to dress their wounds.”
“In the bitter cold of a freezing July [sic] at the height of the deadly COVID-19 pandemic, hardworking Kenyans in Ruai and Kariobangi were woken up in the terrible turmoil of heavy machinery pulverising their homes, businesses and little hustles.”
“It has also been noted that you’ve never visited any part of Mt Kenya region to say thank you.”
“For eight years, between 2011–2018, you consistently and persistently cautioned us that Raila Odinga was Kenya’s foremost problem and pleaded with us to send him home for the country to move forward. The successful effort you made to persuade the people to render Raila Odinga unacceptable in Mt Kenya cannot be undone in your lifetime.”
That letter specifically addressed the Kikuyu people’s economic problems after the 2017 presidential elections that saw Uhuru’s win on 8 August 2017 cancelled by the Supreme Court of Kenya on 1 September only for him to win a pyrrhic victory 56 days later, on 26 October. Sworn-in on 28 November, Uhuru’s victory could not hold – hence the handshake just three months later. President Uhuru would later tell his Jubilee Party members that he could not have effectively ruled the country with Raila still in the opposition.
Kikuyus are the largest ethnic community conducting business in Gikomba, Kamukunji and Nyamakima and on Taveta and Kirinyaga Roads. The “hardworking Kenyans in Ruai and Kariobangi” referred to in the letter to Uhuru are Kikuyus. The “you cautioned us” statement also refers to the Kikuyu. But did not the president himself address an ethnic matter in an ethnic language, couched as a national question? The MPs might as well have written their letter in Kikuyu.
Three years into the handshake, President Uhuru’s backyard has shunned the document and basically ignored the President’s pleas to support it.
The Nyamakima debacle was reported in The Elephant in 2019. In July 2020, The Elephant published a piece about the Kariobangi North evictions. The brutal, state-sanctioned demolitions – the letter speaks of a “freezing July” but the evictions actually took place during a very cold month of May — were visited on the hapless impoverished ghetto dwellers. Thoroughly embarrassed, the government asked the Internal Security Principal Secretary’s office to identify all the victims of the evictions and indemnify them quietly away from the glare of the public and the press.
The 41 MPs were not invited to Sagana because they do not belong to President Uhuru Kenyatta’s wing of the Jubilee Party, dubbed Kieleweke, but belong to Tanga Tanga, a tag that connotes a loiterer. The MPs’ letter was a deft move by politicians who have detected dissent from rebellious peasants against President Uhuru and smelt a rat on a waddling president who is serving his lame-duck years and could therefore afford to tell him off without fear of recrimination. (In October 2019, The Elephant published a story titled The Rebels Within: The politics of Kieleweke and Tanga Tanga in Central Kenya.)
Immediately after his December holidays in his Murang’a County, on 30 December 2020, Senator Irungu Kang’ata penned “a letter to my president”. The long winding letter was just about one thing: “Mr President, you’re unpopular and not wanted in Mt Kenya region. And you know why. Period.” A month and a half after the letter was leaked to the press, Kang’ata was replaced as Senate Majority Whip by Kiambu County Senator Kimani Wamatangi on 9 February 2021. Kang’ata had replaced Nakuru County Senator Susan Kihika in May 2020; she was removed because she belongs to the Tanga Tanga team.
The address to the Kikuyu nation boomeranged on the beleaguered President, even as he hoped to frame his monologue as an “us vs them”, “us” being the Kikuyu and “them” being the Kalenjin. “How could the President have the audacity to tell the Kikuyu poverty stricken fellow that the government loses KSh2 billion every single day?” posed Stanislaus Njogu of the Kĩama Kĩa Ma (the Truth Council).
“The Kikuyus were very furious; if Uhuru thought he was impressing them, he had scored zero points,” Njogu, an elder from Kiambu County said after listening to the president calling them andũ aitũ (our people), Kikuyus decided that “Uhuru nĩ kwĩyarĩria ekũĩyaragĩria na kũoguo ecokeria.” President Uhuru had been talking to himself, therefore, he can as well answer himself. Njogu said many Kikuyus wanted President Uhuru to desist from using the royal “we” when referring to them, “we are no longer together”. The mzee said that is what some of the council members had told him.
The MPs’ letter was a deft move by politicians who have detected dissent from rebellious peasants against President Uhuru.
Kĩama Kĩa Ma, which is led by engineer Patrick Mwiru from Gatundu South, is a much bigger and more credible organisation than the Wachira Kiago-led Kikuyu Council of Elders. It is more active, more broad-based, has both a youthful and an older membership, the majority from Kiambu County.
The statement on the daily theft of KSh2 billion had particularly infuriated ordinary Kikuyus: “Gũtirĩ mũici na mũcũthĩrĩria,” there is no thief and onlooker, said a middle-aged man who had just paid his dues – a sacrificial lamb – to the Truth Council in order to be initiated as a junior elder. “So, Uhuru’s aware of the exact cash that is being pilfered daily from the state coffers? Therefore, he knows who does it? What has he had done about it? That money is probably stolen by himself and his cronies. He can’t keep telling us Ruto is a thief – did we elect Ruto or Uhuru?”
Mũtahi Ngunyi, nowadays a State House operative, recently told me that Ruto being referred to as a thief by Kikuyu political barons was a shot in the dark: “Kikuyus grew up being called thieves, big deal, the word thief to a Kikuyu is not an abomination, to tell them that Ruto is a thief is to remind them that, indeed, he’s one of them. Try something else.”
The junior elder said President Uhuru had failed the Kikuyus miserably and for that they were hell-bent on punishing him. “Gĩathĩ kĩa ngũha gĩthiragĩra gũtũ.” The resolve of a tick (a parasite) to draw blood from a cow ends up at the ear. “It seems the Kikuyus’ resolve to seek revenge on Uhuru is total,” said Njogu. “Right now, they are behaving like the proverbial tick: they won’t rest until they draw blood.” Njogu said the leadership of the Truth Council will not publicly voice their dissent against the BBI, but it is not happy. It doesn’t want to pick a fight with Uhuru, not now, but the followership which is mostly made up of middle-aged men was taking no prisoners.
“After ruining our lives, Uhuru now wants to impose Raila on us,” said the junior elder. “The hatred for Raila among the Kikuyus is total: we’ll never accept him. I’m a true Kikuyu and will never vote for him. If Raila is such a fanciful idea to [Uhuru], how come he has yet to bring him to us? It is because he is unsellable – now more than ever before. Ruto’s a thief, uh huh? We like thieves. Kaba gũciara mũici gũkira kĩrimũ.” It is better to sire a thief than an idiot, said the junior elder.
The junior elder said President Uhuru’s association with David Mũrathe leaves a sour taste in the mouths of many Kikuyus. “Murathe is a scam, he’s a loudmouth and no sane Kikuyu pays attention to his utterances.” He alleged that Murathe had sold the Gatanga seat to Kanu in 1997, and for that, Kikuyus, especially those from Murang’a County, had not forgiven him. Kanu – then led by President Daniel Moi – is anathema to Kikuyus.
One June evening last year at the height of the coronavirus pandemic, Murathe went for a drink at Castle Inn in Garden estate. Some Murang’a moguls who patronise the club found him seated at the counter alone. Once ensconced in their corner, they summoned the manager and told him to evict Murathe. These tycoons are the kings of downtown Nairobi, overseeing multi-million shilling businesses that include real estate and major distributorships of both alcoholic and soft beverages, among others. The moguls, who on a quiet evening, in a single sitting, can write a cheque for tens of thousands of shillings, call the shots at the club. Murathe was asked to leave immediately, his unpaid bill notwithstanding.
Maina Kamanda, a nominated MP and a vocal BBI proponent who has accompanied Raila several times as he tries to make inroads into the hearts and minds of the Kikuyu, is also held in contempt, especially by Kikuyu traders in Nairobi. “They consider him selfish and a sectionalist,” said Njogu. Although he hails from the greater Murang’a, Kamanda’s home is today in Nyandarua County, near Ol Kalou town, where he bought land and where he is mostly to be found when not engaged in politics.
“Kamanda is a spent force, he neither speaks for Kikuyus in Nairobi nor Murang’a,” said a street vendor from Murang’a County. “If he is still interested in politics, he should run in Nyandarua. We’ll never elect him here in Nairobi, and he can’t be voted in Murang’a after dissing his ancestral home.” Njogu said it was odious that President Uhuru should ask Kamanda to accompany Raila to address Kikuyu rallies: “Kamanda draws only scorn and distaste from Kikuyus.”
President Uhuru had treated Merus recklessly and shabbily, said a Kĩama Kĩa Ma Meru elder. “I’ll tell you this, Merus are very annoyed with Uhuru for taking us for granted. Even after some of us voted for him thrice, he hasn’t found it fitting to at least say thank you. He hasn’t visited the area, he just moved on with his life after getting the Meru votes.” He could not but be nostalgic about President Mwai Kibaki’s days. Kibaki was Kenya’s third president between 2003 and 2013. “Kibaki was an honourable old man, he knew how to say thank you and we loved him. How we miss the days he was President.”
The notion that President Uhuru had “neglected” the Mt Kenya region, especially the region occupied by Embu, Meru and Mbeere people, was also echoed by Joseph Nyagah in a conversation we had weeks before he died on 11 December 2020.
If President Uhuru’s radio interview was a “car crash”, the outcome of the Sagana State Lodge meeting was even less soothing to struggling Kikuyus. “You mean Uhuru has just acquiesced to the greedy MCAs?” said Muchiri, a Nairobi businessman. “He can find KSh4 billion to give to politicians to buy cars, but he can’t find money to stock medicine in hospitals? We’ll be waiting for these MCAs next year, 2022 is not a century away and for Uhuru and his BBI, he can bribe the MCAs all he wants, we’ll not pass the damn document.”
Njogu said Kikuyu hatred for President Uhuru had gone grassroots. “The angriest are those that voted for him twice in 2017. They cannot now believe that he’s wining and dining with Raila.” The mzee said that Kikuyus consider this to be the ultimate insult. “After poisoning them against Raila for such a long time and to now tell them that he’s the man they should work with was just mindboggling.”
Faced with the threat of being taken to the International Criminal Court (ICC) in 2012, Uhuru Kenyatta whipped up ethnic Kikuyus in a well-choreographed tribal mobilisation the likes of which had not been witnessed in modern Kenya. By election day on 4 March 2013, Kikuyus were so filled with anti-Raila venom that they could have died or killed for Uhuru. “Uhuru succeeded in dangerously balkanising the Kikuyus, telling them that Raila was planning to send him to the ICC once he takes over as President of Kenya,” said a lawyer from Kiambu County that I interviewed in 2012. That lawyer is one of the writers of the BBI (II) document that proposes a powerful presidency.
Thiya ndĩthũire mũmĩũragi ta mũmeanĩrĩri. An antelope hates those who expose it to danger more than it does its predators. “Kikuyus have always been wary of Raila’s intentions if he ever took state power,” said Njogu, quoting to me the above Kikuyu idiom, “They have a lot of misgiving about him: from truly believing that he will revenge against them for the sins committed against his father [Jaramogi Oginga Odinga] by [Jomo] Kenyatta to weirdly believing that when he says he will fight institutional corruption, he actually means that he will ensure they are cut to size, that is, crash their businesses and riches.”
If President Uhuru’s radio interview was a “car crash”, the outcome of the Sagana State Lodge meeting was even less soothing to struggling Kikuyus.
Njogu said Kikuyus like reminding themselves how Raila crafted the narrative of “‘41 [tribes] against one’, inordinately exposing his malicious intentions against the Kikuyu people.” In the lead-up to the hotly contested 2007 presidential election that pitted President Kibaki, running on a Party of National Unity (PNU) ticket, to Raila who was running on an Orange Democratic Party (ODM) ticket — with Ruto as Raila’s de facto running mate — the 41 vs 1 came to be viewed as the opposition’s official mantra.
During Raila’s recent meet-the-Kikuyu-people Githurai Market tour, the wary Kikuyus could be heard saying “tũramuonera eitini,” meaning, “we are aware of Raila’s dubious intentions”. Raila arrived at the Market at 10.30 a.m. on 28 January 2021 and went straight to the Migingo area. The market is divided into several areas such as Posta and Family Bank. Migingo is now ring-fenced because it had encroached on railway land, but it is still expansive and it can hold a meeting.
At Migingo Raila was welcomed by the market leaders led by Joseph Wanyoike and Peter Kamau. They told him about the need to construct a bridge to connect to the railway line area that was separated by the fence. Ever since the fence was erected, people have to walk a long distance to cross over to the other side. Raila promised that the government would build the bridge. It was a short meeting and he moved on to the roundabout area where the masses was waiting.
Raila spoke to the crowd atop his vehicle, cautioning them not to be confused by the “wheelbarrow” narrative as he extolled the virtues of BBI. “Will you allow that man of the wheelbarrow to sow his retrogressive politics here?” Raila upped his rhetoric. The waiting crowds answered him by chanting Ruto’s name interspersed with shouts of “wheelbarrow”. The crowd did not allow him to continue speaking, with some yelling, “you cannot feed on rhetoric.”
The crowd exasperated Raila and he accused Jubilee Party-nominated Senator Isaac Mwaura of inciting them. On 9 February Mwaura was demoted and stripped off his senatorial position by the party. Mwaura had indeed visited the market area on the eve of Raila’s visit and incited the people. “Nĩmwakĩmenya rũciũ nĩagoka, mũkĩmenye ũrĩa mũkamwĩra.” You are aware (Raila) is coming here tomorrow. I hope you’ve planned what to tell him.
Mwaura, whose entry into the political limelight was through the opposition ranks when he was nominated as ODM MP in 2013, was to shift gears and join the ruling Jubilee Party in 2016, where he was rewarded with yet another nomination in 2017. Keen to enter elective politics, Mwaura seems to be preparing to contest the Ruiru constituency seat in Kiambu County. He has defected once more – this time within the Jubilee Party ranks – and thrown in his lot with the Tanga Tanga team. His bashing of the BBI has greatly displeased the president, who must have sanctioned his sacking.
In October 2020, Ruto too had gone to Githurai Market. The market is a catchment area, which represents a cache of votes because of its huge population that straddles Nairobi and Kiambu counties. The deputy president came along with 500 wheelbarrows and 100 mkokotenis (push carts). He had certainly done his “market survey” (pun intended). The wheelbarrow is the most sought-after piece of equipment at the bustling market. Because of this, it is also the most stolen item. Traders who do not have their own wheelbarrows hire them for KSh50 a day and in the evening, they pay an extra KSh20 for storage overnight. Each of the wheelbarrows that Ruto delivered came with an umbrella to protect the trader from the vagaries of the weather.
“Detractors of the wheelbarrow can say all they want,” said 30-year-old trader Peter Mungai. “For all the 10 years I’ve lived in Nairobi, I’ve earned my keep from this wheelbarrow.” Mungai started hawking watermelons on a pavement next to the market. Then in 2019, a brutal eviction by Nairobi County askaris led to the loss of goods and equipment including wheelbarrows and push carts. Mungai bought a new wheelbarrow and now hawks sugarcane.
“Hawking sugarcane has a much wider radius than melons,” explained Mungai. “I’ll tell you this: I voted Uhuru two times in 2017, but look at his gratitude. I don’t want to know about BBI, its promises and lies, I’ve no need for it. Make no assumptions, I went to school, I can read and comprehend. In the 10 years I’ve lived in Nairobi, I started a family, all because of this wheelbarrow. In 2022, I’ll be voting for Ruto, because I’m a wheelbarrow hustler.”
“Uhuru and Raila and indeed anybody else can criminalise the wheelbarrow. What have they ever given? I don’t want to speak much, some of my friends were lucky to get a wheelbarrow from ‘thief Ruto’. They can hustle and deliver something to their families in the evenings. Meanwhile ‘thieves Uhuru and Raila’ can continue selling BBI, telling us it will bring us [Kikuyus] goodies. It is good because our children will feed on something called promises hidden somewhere in the BBI, which must wait to be passed by a referendum.”
The story of the wheelbarrow, in the words of Mungai, indeed cannot be spoken about much here. It is a story for another day. Suffice it to say that at Githurai Market I met a 27-year-old Kenyatta University BA graduate. From an impoverished peasant family, he did not waste time looking for a non-existent job after graduating with an upper second in economics. He landed at Githurai Market and started carrying the market women’s goods as a kua, a man who carries a load on his shoulders.
“Look at me, I’m a lanky fellow, but was I going to further burden my mother with my survival problems? She had already done much and I’ll be eternally grateful for ensuring I got some education. At the market, the women call him Ka-Waithira, son of Waithira, because that is how he calls himself. From kua, Ka-Waithira graduated to a wheelbarrow owner and made his work easier. “I’m now looking to investing in a push cart, because it carries much bigger and heavier loads.”
Ka-Waithira told me he had expanded his skills to include balancing accounts for the market women: “You’d be shocked to learn the kind of money these women handle. I was.” In his spare time he also explains simple economics to the women – supply and demand theory, economies of scale, the difference between macro- and microeconomies. “I really have no time for Uhuru and BBI. He has hugely let my mother down. She believed in him and it nearly killed her because of depression. Githurai, as you’ve seen for yourself is a ‘hustler nation’. Uhuru has only been interested in advancing his family’s fortunes and the Kikuyus have become the wiser. Do you think I’d be languishing here at Githurai Market if I came from a well-connected family or I schooled at St Mary’s?”
As President Uhuru Kenyatta plots how to woo the recalcitrant Kikuyus back into his political fold, it is evident that his work for in the next 16 months is cut out him. For now, he has to contend with a gleeful Deputy President William Ruto who seems to have effortlessly taken over his backyard.
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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.
GMOs Are Not the Only Answer
In a country where agricultural production is dominated by smallholders, the decision to allow genetically modified crops and animal feeds into Kenya as a means of combatting perennial hunger ignores other safer and more accessible alternatives such as Conservation Agriculture.
Newly elected President William Ruto has, to use a much abused expression, hit the ground running. I am, however, not certain that he is running in the right direction. On 3 October 2022, during the second meeting of his recently (and unconstitutionally) constituted cabinet, Ruto announced that his government had authorized the cultivation and importation of genetically modified crops and animal feeds, sweeping aside the grave concerns raised by Kenyans and lifting a ten-year ban with the stroke of a pen.
The decision was made at a time when Kenya is facing the worst drought in four decades that has left over four million people facing starvation. According to President Ruto, the adoption of GMOs is the solution to the recurring cycles of drought and famine that Kenyans have been increasingly experiencing.
I shall not go into the merits and demerits of what some call Frankenfoods here. However, it seems to me that Ruto’s decision is driven solely by the political imperative to bring down the price of maize through cheap imports of GM maize following the withdrawal of the maize subsidy.
Already, back in November 2018, the Route to Food Initiative (RTFI), the Kenya Biodiversity Coalition (KBioC), the Africa Biodiversity Network (ABN) and Greenpeace Africa had issued a joint statement raising “concerns over recent disconcerting developments in the country, that [suggest] the Government has made [a] unilateral decision to adopt genetically modified crops”, and adding that “an all-inclusive nationwide discourse through public participation, which addresses whether the technology is appropriate for us, is being circumvented”.
The group also voiced their suspicion that the report of the Task Force to Review Matters Relating to Genetically Modified Foods and Food Safety that was set up by the Ministry of Health in 2013 was being withheld because it was against the adoption of GM foods. This suspicion may well be founded since, in making the announcement, State House said that the decision to lift the GMO ban was “made in accordance with the recommendation of the Task Force”, while failing to make the so-called Thairu report—which was submitted in 2014—available for public scrutiny.
The cabinet said that in reaching its decision to lift the ban it had also referred to reports of the European Food Safety Authority, among others.
The European Union’s policy on GMOs “respects the right-to-know by ensuring clear labelling and traceability of GMOs. This requires reliable methods for the detection, identification and quantification (for authorised GMO) in food, feed, and the environment”. There is zero tolerance for unapproved GMOs and stringent regulation of products originating from or containing GMOs.
A detailed risk analysis and the availability of a validated method for locating, identifying, and quantifying GMOs in food or feed are prerequisites for authorization. For any GM launch, biotech businesses that want to market their product in the EU must submit an application. A very precise way of detecting each unique GMO is included in the application dossier.
The terms of reference of the government’s GMO task force included, among others, assessing Kenya’s infrastructural capacities to monitor genetically modified products in the country; assessing the adequacy of qualified human resource capacity to monitor research, use and importation of genetically modified products into the country; and recommending approval procedures for imports of GM foods.
If we are to look only at the procedures established by the National Biosafety Authority for the importation of GM products into the country, then we may conclude that Kenya lacks the infrastructural and qualified human resource capacity to monitor their research, use and importation. In effect, an entity wishing to import a GM product into the country is merely required to provide the particulars of the supplier, the nomenclature of the GMO, proof that the GMO has been registered in the exporting country, its use in the country of origin, its intended use in Kenya, a summary risk assessment, methods and plans for safe handling, storage, transport and use, and the emergency response foreseen in the event of an accident with the GMO. The second of the two-page the application document is reserved for the applicant’s signature before a commissioner for oaths, a magistrate or a judge. Means of detection of GMOs are not mentioned.
It would seem then that Ruto’s government has fully devolved the responsibility for Kenya’s biosafety and biosecurity to the authorities of foreign nations. This is very frightening when you consider, for example, that the European Union Regulation EC304/2003 allows EU companies to produce and export to other countries pesticides that are banned or restricted in the EU. This double standard is the reason why active ingredients which have been withdrawn in the EU find their way to Kenya, poisoning our bodies and our environment, and destroying our biodiversity.
Maize is not the only ugali
The lifting of the ban on GMOs may have sounded the death knell for Kenyan small-scale maize growers; GM maize is to be found on the international markets at prices that defy all competition, which will now prove to be a boon for well-connected maize-importing cartels.
But maize, a staple in the majority of Kenyan households, is a relatively recent arrival on our national menu, becoming a major staple during the First World War when disease in millet led to famine.
As Noel Vietmeyer observes in the foreword to the first volume of Lost Crops of Africa,
“Lacking the interest and support of the authorities (most of them non-African colonial authorities, missionaries, and agricultural researchers), the local grains could not keep pace with the up-to-the-minute foreign cereals, which were made especially convenient to consumers by the use of mills and processing. The old grains languished and remained principally as the foods of the poor and the rural areas. Eventually, they took on a stigma of being second-rate. Myths arose—that the local grains were not as nutritious, not as high yielding, not as flavorful, nor as easy to handle. As a result, the native grains were driven into internal exile. In their place, maize, a grain from across the Atlantic, became the main food from Senegal to South Africa.”
But with initiatives such as the Busia County Biodiversity Policy, which recognises the role that biodiversity can play in addressing food insecurity, the tide is turning and Kenyans are rediscovering and embracing the culinary habits of our forebears. You would think then that the GMO decision will not, in the main, affect the choices we make in the foods we consume. That those of us a tad squeamish about eating foods that have been genetically interfered with can opt out.
Were it that simple.
Many Kenyans are unaware that the Seed and Plant Varieties Act Cap 326 of 2012 prohibits farmers from sharing, exchanging or selling uncertified and unregistered seeds. Yet, to mitigate against the effects of perennial droughts and the escalating costs of hybrid seeds, community seed banks have been conserving indigenous seeds—that are demonstrably more climate-resilient—for sale during the planting season, in contravention of the law and at the risk of a one million shilling fine, or two years’ imprisonment, or both. Criminalising a system through which small-scale farmers acquire 90 per cent of their planting material does not augur well for Kenya’s food security, or for our biodiversity. Small-scale farmers are fighting back, however, with a group from Machakos recently going to court to challenge the legislation. It remains to be seen who between David and Goliath will prevail.
But maize, a staple in the majority of Kenyan households, is a relatively recent arrival on our national menu, becoming a major staple during the First World War when disease in millet led to famine.
What is clear is that Kenya’s David, while remaining impoverished over the decades since independence, is the mainstay of the country’s agriculture in terms of productivity. The Economic Survey (2021) of the Kenya National Bureau of Statistics reports that,
“The share of marketed agricultural output for small farms increased marginally to 73.3 per cent in 2020. This is a reflection of the continued dominance of the smallholder sector in the marketing of agricultural produce during the year under review. The value of sales through small farms increased by 9.4 per cent from KSh 341.4 billion in 2019 to KSh 373.6 billion in 2020. Similarly, the value of sales by large farms increased by 8.9 per cent from KSh 125.0 billion in 2019 to KSh 136.1 billion in 2020.”
The survey defines large farms as those above 20 hectares.
The small-holder has consistently outperformed the large-scale farmer despite government policies that have since the 70s viewed smallholders as without agency beyond adopting technologies that are presented as capable of transforming agriculture and building livelihoods. The adoption of GMOs is likely to be yet another of these technologies that, together with unjust seed legislation, will increase rather than decrease Kenya’s food insecurity.
President Ruto worries about food insecurity but fails to consider the very ready solution available to his administration and recommended in the Agricultural Policy (2021) of the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, namely, conservation agriculture.
The Food and Agriculture Organisation (FAO – also quoted in Ruto’s decision to lift the GMO ban) recommends conservation agriculture as it is a sustainable system of production that conserves and enhances natural resources; enhances biodiversity; assists in carbon sequestration; is less labour and fertilizer intensive; improves the health of soils; and increases yields over time.
Criminalising a system through which small-scale farmers acquire 90 per cent of their planting material does not augur well for Kenya’s food security, or for our biodiversity.
The very promising results obtained among the small-scale farmers that have adopted the system following training under the FAO beginning in 2015 show that the government would do well to promote conservation agriculture among smallholders as a means of mitigating both against food insecurity and the effects of climate change, rather than hastily reaching for GM technologies that the country is ill-equipped to safely handle.
But clearly, the president is not on the same page as his Ministry of Agriculture and so, like others, I can only conclude that Ruto’s lifting of the GMO ban is for the benefit of the seed multinationals and their clients, the large-scale farmers who have taken over most of the productive land to grow cash crops for export, leaving small-scale farmers to exploit marginal lands for the production of food crops for local consumption. And for the benefit of maize-importing cartels.
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