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KENYA ELECTIONS 2017: A massive fraud by the genius of evil, with international participation

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Mural of PAWA254
Never in my life, did I imagine that in the name of democracy, a massive fraud would be committed against the Kenyan people with the participation of the international community. The Kenyatta oligarchy, having bought the complicity of the international community through inviting them to buy into the privatization of our schools and hospitals, turned against the Kenyan people and made international players like UNDP, John Kerry and the Carter Center cheer them along. Never has the victory of racism been so complete in Kenya. It has made the world expect so little of Africans that they do not care whether the freedom we have is genuine, or whether the elections are fairly done.

I trace the build up to international complicity in this massive fraud to 2015, when the governments of France, Netherlands and Norway, together with the Gates Foundation, plotted with the Government of Kenya to collapse public healthcare by denying public hospitals of staff, and making their working conditions so unbearable, that the private hospitals could harvest medical workers that had been trained by taxpayers. The private hospitals, in turn, received massive investments from European countries whose citizens would never have accepted such a defrauding of the people. From then on, it became impossible for the international community to really critique what the Kenyatta oligarchy was doing to Kenya.

The collapse of public healthcare was a harvest for private insurance. Bliss Pharmaceuticals, through AON Kenya that is reputed to have top politicians among its shareholders, received a KES 11bn contract to provide healthcare for government paid teachers and police officers. Meanwhile, NHIF – the health fund that is compulsory for Kenyan employees – was paying record amounts of money to private hospitals. As billboards for political campaigns went up around Nairobi, so did the billboards of insurance companies. To add insult to injury, the fast rising billionaire Peter Nduati rubbed salt in our wounds by gloating that Raila could not be president because he could not govern a majority Jubilee government. According to him, Kenya needs to get on with business.

The so-called victory of Jubilee is a victory of private business, and in the next few years, Kenyans should expect the collapse of public institutions and an increase in militarization to keep the people of Kenya in perpetual fear.

Peacemongering and violence in the national and international media

The stage was set for the Uhuru usurpation by a blitz of local and international media articles that prepared Kenya for an inevitable Uhuru victory based on the tribal numbers. Local and international media published data that said that Kenyans never choose their presidential candidate for a reason other than tribe, essentially saying that all Kikuyus would vote for Uhuru and he would win because they were the largest ethnic group. To make this purported inevitability acceptable, local businesses and the UN, with the voices of prominent media personalities, fueled a parallel message that Kenyans must keep the peace.

But as we all know, numbers do lie. Like Cathy O’Neil reminds us in Weapons of Math Destruction, numbers reflect the social biases of those who generate them. In the Kenyan case, it should be fairly obvious by now that Kenyans who live in metropolitan areas, who are in inter-ethnic families and who have a certain level of education are likely to choose presidential candidates on reasons other than tribe. However, these factors are never accounted for in research. Even locally, the polls would have kept on feeding us with the inevitability of an Uhuru win, until NASA chose to carry out their own poll. It was only then that the local media conceded that polls are not gospel truth.

The other local driver of the inevitable Uhuru win based on numbers has been the ideologies of the tyranny of numbers and of Uthamakism. As Mutemi wa Kiama explains, these ideologies stem from a concerted effort to exploit Kenya without the possibility of an uprising, since Kenyans would feel Uhuru has already won on the strength of ethnic numbers.

One must also add that the Kenyan media did not invest enough in analyzing the issues that Kenyans should have voted. The much hyped presidential debate ended up being a series of sound bytes from the lesser known candidates and an interview of Raila Odinga, because Uhuru Kenyatta refused to attend the debate. Before that, the media barely discussed the party manifestos, and attempts of Anne Kiguta and Yvonne Okwara to interview David Ndii on the NASA manifesto literally collapsed. In the case of Anne Kiguta, she had clearly not read the manifesto, and it didn’t help when Ndii asked her if she had read the Constitution as well.

For as long as we do not provide opportunities for Kenyans to discuss politics on any other basis, the tribalism influencing the elections is a self fulfilling prophecy . I did try my best to provide an alternative narrative with doing a review of the manifestos with the hashtag #ManifestosKE on facebook, but they were much too little and very much late. But more than that, an interesting discovery I made was that actually, the manifestos barely delved into the social issues besides employment and health, and health could have been largely a product of the doctors’ strike that sparked a serious public awareness on public healthcare. Indeed, I concluded, Kenyans still define politics almost solely from a business perspective.

Essentially, the point here is to say that if ALL Kenyans did vote on tribe alone, which I find difficult to believe is universally applicable, it is because we were set up to vote on nothing else. And that paradigm has a distinct political advantage for Jubilee or any other Kikuyu-centric political party: it sets up Kenyans to believe that a Kikuyu presidency is inevitable. And democratic.

It is on this point that the peace message becomes necessary. Where numbers do not work, the Kenyan people are fed with an ideology that equates peace with accepting Uhuru as president, and equates questioning the Uhuru regime with violence. Sparked off by the glamorous Julie Gichuru, a darling with global capital who has done moderation gigs at Davos, the peace narrative shook the Kenyan population and distracted intellectuals into addressing the problems with the peace narrative. A few days before Julie Gichuru released the controversial video, I was part of a group of bloggers who were called to the US Embassy to find out how we can push the peace narrative, and other forums were organized by foreign embassies and NGOs to lobby for the same as well.

The peace narrative got another spooky boost from the Kenya Private Sector Alliance that sponsored a video advert in which the post-election violence victims arise from coffins as zombies and urge people, ironically, to shun inciters and instead choose peace. Essentially, the ad said, the people to blame for 2007-8 violence were not those who organizing the violence, but ordinary Kenyans who accepted to be organized to commit violence. The twisted logic of the ad has made a number of us call on KEPSA to withdraw the ad because it is a form of psychological violence, but the calls have fallen on deaf ears.

Meanwhile, Safaricom – Kenya’s largest firm – kept off the word “peace” but numbed us with videos of a diversity of Kenyan celebrities going over the great virtues of Kenya. Another peace message that told us “the law works for us,” and that the courts were the only option for addressing electoral disputes, was sponsored by Uwiano initiative, which brought together UNDP and various organs of the government.

Essentially, Kenyans were coerced into accepting the dichotomy of peace and justice, and the branding of anyone who raises questions as advocates of violence. It is simply stupid for the international community to expect that a vote carried out among a people so beaten down with psychological manipulation can be genuinely called credible. The only reason that such a message becomes acceptable is because of a deeply racist belief that Africans cannot think, and only act on instinct.

Praise singing by international observers

Yesterday, it was mind blowing as watching successive groups of international observers praising the election process. Speaking from Radisson Blu, one of the upscale hotels of Nairobi, international observers, which included the European Union and the Carter Center, all restricted their observations to the long queues and the counting of votes, when the rigging was done before and after the actual casting and counting of ballots. And to supposedly capture the quaint Kenyan flavor of the process, they all joked about election ink being put on babies to prevent different women from using the same baby to jump the queue to vote.

The more explicit positions were inherent in their platitudes about Kenya being more than elections, and about accepting the result. But as former US Secretary of State John Kerry inadvertently revealed, this was a message that they gave to Raila Odinga but not to Uhuru Kenyatta. The stage managed press-conferences conveniently avoided the pertinent questions about the credibility of the tallies and their posting on the IEBC portal. They were very quiet and polite, but when NASA gave its presser later, the press literally shouted at Musalia Mudavadi. The contrast between the press conferences is a lesson in the anti-African bias of the media.

I also found it amusing to hear the EU and Carter Center observers say that the independence of the judiciary was a concern of “both” the main political parties. They essentially walked into Jubilee’s trap, which I flagged many weeks ago when I said that Jubilee’s criticism of the judiciary was a performance meant to fool the international community that Jubilee did not have home advantage in this election. Anyone with a decent knowledge of history could see that coming, except that the Kenyatta family has successfully alienated history from the school curriculum, and with the horror of a new education system it wants to impose on Kenya, our collective ignorance will only get worse.

Why Africans must care 

Essentially, what will now be praised as a “peaceful” election was the connivance of international racist global capital against the Kenyan people. The praises of Kenya being an icon in the African continent are all lies meant to make Africans accept Eurocentric dominance as the model for freedom. But worse, the narrative of this Kenyan democratic monster has been constructed on a Euro-centric, racist ideology that does not believe that Africans are capable, or even worth, a genuine nation that does not marginalize the majority to line the pockets of a minority. The international community did not have time to waste on understanding the complexity of African life, African thought and how we interact with institutions. It has better things to do, like attending cocktails and ranting about Donald Trump.

Meanwhile, the international community has left Kenya with a festering wound, a people groaning under the yoke of indignity and madharau, with few prospects of a national reconciliation that rights the injustices of the past and the present. And if, God forbid, the situation explodes, the same international community will feed us platitudes about peace in a situation whose deterioration it supported and celebrated.

By Wandia Njoya
Article originally posted here. 
Photo courtesy of PAWA254

Wandia Njoya is a scholar, social and political and commentator and blogger based in Nairobi, Kenya.

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Reflections

Obviously They Are Fine With Mugabe

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When A Coup Is Not A Coup: Why The Removal Of Mugabe Will Not Change Zimbabwe

My identity straddles African borders.

I was born in Zambia to a Zimbabwean mother and a South Africa father.

Of the three countries, I carry South African citizenship.

On social occasions I have often been at loggerheads with my compatriots who self-identify as pan-African. There are, you see, African politicians they will not brook criticism of. And one of them is one Robert Gabriel Mugabe: truth-speaker to the West, the man who had enough gumption to take land back from the whites and whose truth-telling videos, in this age of social media, they shared every year after the United Nations General Assembly. Any attempts at telling these, my fellow ‘woke’ South Africans how rhetoric did not match action and how the man, his family and his political party had often treated Zimbabwe and its citizens with contempt was always met with disbelief and what my friend and writer Petina Gappah calls Zimsplaining from my fellow South Africans. Why, they would ask, was I taking aspirin for someone else’s headache? Obviously Zimbabweans are fine with Mugabe. If they weren’t, surely they would object, toyi-toyi and overthrow him? This was the criticism that brooked no comeback as it was something that I wondered secretly sometimes. I had grown up in a Zimbabwe that protested: not just university students full of pent-up early adult hormones but notably, the teachers’ strike of 1990. What had happened to that fire? And then last year I decided to have my 40th birthday party in my mother’s country en route to South Africa by road from the country I now call home, Kenya.

In Zimbabwe in the days after my birthday, I found out that the two currencies which had created some sort of stability, the US dollar and the South African rand, were now going to be scrapped. In their place would be bond notes which, on being brought in, would be valued one to one with the US dollar. The Minister of Finance, Patrick Chinamasa and John Mangudya, Governor of the Reserve Bank of Zimbabwe had decided that the bond notes would be back in circulation in October 2016.

Already, while I was there, people had started hoarding their dollars and some shops were refusing to accept South African rands.

It was in this context that on the evening of August 2, 2016 I got a poster via WhatsApp from a friend reading:

Do you want to destroy your business that you have worked for all these years? SAY NO TO BOND NOTES. Join hands and march against Bond Notes.

Date: 03 August 2016

Time: 10AM

From: Cnr Julius Nyerere/Jason Moyo

To: Ministry of Finance

#pullingtogether #notobondnote #Tajamuka/Sesjikile

I had already dealt with a cash crisis in the week that I had been there. My cash crisis meant I could not go and see a lot of aunts and uncles as one cannot use a Visa or Mastercard on public transport. But my inability to visit relatives seemed minor when I heard some heartbreaking stories from people who live in Zimbabwe. I was, after all, just a guest in Zimbabwe and had other places to go. What of those who stayed there on a regular basis?

I thought of the unemployed university graduates working as vendors because of unavailability of jobs. I was thinking of a conversation with my friend Tapiwa who told me he interviewed five graduates, one of whom had twenty years teaching experience and another who had a degree in Architecture – married with children – to tutor his nine-year old twins for $200 a month. What would happen to the prospective tutor in a city where a reasonably neat two bedroom flat in the low density areas cost $500 a month? What would happen to the cab driver I met who had a car and wanted to survive with his four children but could only charge three dollars because no-one was willing to pay more than that for a five kilometer trip, essentially making his cab rides cheaper than Uber in Nairobi, Lagos or Johannesburg without cheaper foodstuffs? I was thinking too of my cousin Abisai telling me that because of a lack of cash, if business people needed a thousand dollars to do transactions, they had to do a transfer to illegal cash traders by the bus station for $1,200 so that they could get the $1,000 they wanted. And this was when the dollar was still circulating in the Zimbabwean economy but people were hogging it because of fear of the threatened bond notes.

This was a protest I would sign up toyi-toyi for.

With the Zimbabwean courts having ruled against the police and the government in their quest to ban people from marching against the return of the painful notes into the economy, taking part in the protest was the right thing to do. Half of my family is, after all, Zimbabwean and the bond notes would impact them.

I had no idea who was organizing the event but whoever they were, I agreed with the reason for their demonstration and I wanted to do more than verbally support it.

On August 3rd 2016 as my fellow South Africans went to the ballot box to vote in the municipal elections. I was north of the border at a march against bond notes.

I arrived at the march just before it began. After a prayer and the singing of the old Zimbabwean anthem Ishe Komborera Africa whose lyrics and tune were taken from the late South African Enoch Sontonga, the organisers informed us of the route we would be taking. I asked one of the fellow marchers why we were not singing the current Zimbabwean national anthem and the wit responded, “it would be like listening to a speech by Grace after reading one by Sallie Mugabe.”

Until he was forced to resign on 21st of November 2017, when talking to many Zimbabweans, it was never quite clear who they resented more: their then senior citizen President, Robert Mugabe who stubbornly held on to power way past his sell-by date or his flamboyant and vituperative wife, Grace. Further, I sometimes wonder whether the affection that is given to the late Sallie by Zimbabweans who talk of her fondly would still be there if she were still alive. I also wonder whether Mugabe would have retired gracefully if she were alive. Random musings.

But back to the protest.

The organisers informed us of the route we would be using and we proceeded to march.

I noted that the face of protests had changed drastically. Prior to 2016, most protests consisted of either members of the opposition party or employees of non-governmental organizations who sometimes were both. While many people my age felt the pinch, they were members of what I dub The Sandwich Parents. When asked to boycott bread because it had become overpriced, for instance, their response would be something akin to, “Ah manje, my children need sandwiches. If I boycott bread for a week, what will my children take to school?”

But now, knowing how this may hurt them, they were among those who were taking part in the protest. A friend in the banking industry called in sick so she could take part in the protest. I encountered some high school friends during the march, among them a former classmate who, not only had actively spoken of the abuse of power by the Mugabe administration but who got thrown in jail together with her partner and others for daring to screen the Arab Spring when they took place. For her actions, Tafadzwa and her comrades were charged with attempts to overthrow the government. They received a suspended sentence “if they do not repeat it” by a court system that was largely state-captured.

Another high school friend was at the march because her brother-in-law, a former Zimbabwean liberation war veteran, was arrested and charged for speaking out against abuse of power by the political leadership of the governing party. Saner minds in Zimbabwe’s High Court, which now seemed keen to no longer be puppets to the puppet-masters that are ZANU government, prevailed and the case was struck off the roll. I saw friends who had returned from the diaspora with their savings hoping to invest in the country. Among those in the crowd too were unemployed university graduates in their gowns and grandmothers. There was something about this particular demographic that I had not seen in previous marches in Zimbabwe. There was a certain unity of purpose across age, gender and class that seemed to highlight that people were fed up. I did not know it then but I had just witnessed the beginning of the end for the Mugabe leadership which would topple a little over a year later.

The government had attempted to ban the march. The organisers went to court and the courts allowed it. Knowing that despite the court ruling, the law will not always act lawfully towards protestors, flyers were handed to the police reading:

OPEN LETTER TO THE POLICE

We are not your enemies, but we are your brothers and sisters, fathers and mothers. All we want from life is to be able to feed our families and to be able to send our children to school so that they can get jobs and do the same for their children. We want them to work in Zimbabwe, not outside the country as it is now. We want doctors and medicines in our hospitals. When we stand up to ask our government for these basic human rights, do not beat us, rather stand with us as we want the same basic human rights. Above all, we are all Zimbabwean, let us unite in demanding these rights from our government.

It was doubtful that the police would really care. They were there to do the bidding of their masters but it was good to see an attempt by the organisers to wake them up.

In Zimbabwe, there seemed to be questions about the government’s relationship with China as heard from the popular song on the march:

Bobo, watengesa nyika kumaChina

Usazokanganwa

Tisu takakuisa, tichakubvisa

A song that accused Bob, the President of having sold the country to the Chinese and reminding him that they were the ones who put him in power and had the power to remove him. It was an entertaining song but I wondered just how much power these people with their energy had, to remove Uncle Bob from power.

By the time we got to Treasury, many had joined and there were now thousands in a march that began with a few hundreds. It was then that I realized that perhaps something had changed. Zimbabweans were not only talking in private about being fed up with Mugabe, they were coming out in the street and publicly declaring it.

And so, on 18 November this year, although I was at a literary festival in Nigeria, I locked myself up in my room for a major part of the day to root for and follow the #MugabeMustGo protest through updates on social media. Zimbabweans were showing, this time in the glare of international media, that they were done with their geriatric leader.

Mugabe is now gone. I heard this announcement in an anti-climactic moment while in Nairobi making dinner.

Mnangagwa is in the driver’s seat.

And I.

I am cautiously optimistic for my mother’s country as I reflect on the coup that was not a coup from my father’s country. I like to think that Zimbabweans have realized the power they have and will not surrender it easily now to any politician.

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Reflections

A Healthy Serving of Reality

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A Healthy Serving of Reality
Photo: Shutterstock

I never thought I would be on the receiving end of gratitude until cancer happened. This show of kindness has kept me on the other side of Kenya’s health care system. I consider myself lucky. I am able to afford chemotherapy drugs, monthly tests and doctor’s visits and supplements.

It is common knowledge that cancer is not cheap and this is universal. At the height of my treatment, I was spending 140,000 shillings a month on treatment, the cost of my bone marrow transplant has more zeros and commas. It is thanks to family, friends, colleagues and strangers that I was and still am able to afford my treatment. Acknowledging this fills me with a sense of humility. I struggled with the kindness that was showered my way. My therapist who helped me grapple with the many twists and turns of this journey told me to be ‘open to kindness’. Pride stood in my way, but the bitter truth was that I could not have done this alone. We as a family, could not afford this alone.

Our healthcare system is us! It will be us, the people, holding one another until we have a public healthcare system that will be able to provide universal, affordable and quality healthcare services. My diagnosis gave me new eyes to accompany this new normal. I was hugely aware of the shortcomings of our public healthcare system and once you experience it, it scares you. And if you have private medical insurance, you will appreciate the cover. But these health covers are not bottomless pits. If anything, they cushion and if it’s excellent, it offers restful nights. During the two weeks of my hospitalisation, I spent over six hundred thousand shillings of my one-million-shilling in-patient cover. Thankfully, NHIF, knocked off another 100k. My outpatient cover was going to be blown in sixty seconds and I was tapping into my savings.

Alice Membao Tawa, was my nyanya, my grandmother. Sometime in 1999, she was admitted to the burns unit of the Kenyatta National Hospital (KNH). She spent many weeks there until she passed away. The burns unit is not pretty, but we made our visits to the hospital hoping nyanya would get better. That period introduced me to the harshness of our public health system.

It is functional, though not wholly efficient. Kindness doesn’t come easily for some members of staff. There is a tough-love, ji-sort, hii-ni-kazi and uta-do attitude that is harboured by some of the staff.   I witnessed patients lying on mattresses on the floor, and there were patients sharing single beds. Beds were currency. There were no three-course meals like the Nairobi Hospitals, Maters or Aga Khans, the food was bland, stodgy and uninviting. It provided the most basic of nutrition. The hospital and the wards had a beaten and drab feel to them. They didn’t offer comfort or healing. I’ve been to Kenyatta many times after that, for several reasons, and there have been vast improvements, but it is far from perfect.

We work hard to able to afford private healthcare, but sadly not everyone in Kenya can access this. I don’t take this for granted. I was saddened by the many stories of patients being turned away or dying due to the lack of medical personnel during the doctor and nurses strike. I heard medics being described as selfish for downing their tools. I bet these critics made sure their health premiums were up to date nor had they slept or walked into a public health facility.

Let us not deceive ourselves, as we live in Kenya, we are not too far from experiencing the ‘other side’ of our health care. I keep on imagining what if I was to have an accident in public either in Nairobi or elsewhere? I would probably be rushed to public health hospital before my insurance provider is notified. I have thought about it constantly. What if the only place that I would have been able to afford or receive treatment for my cancer would have been from a public health facility? If I had to receive chemotherapy intravenously and not orally, I’d be making an early morning pilgrimage to KNH and camping on the hospital grounds as I wait my turn. It would be a process of waiting hours to see a doctor for minutes and hoping that on that day they would show up.

Over the last 24 months, I have met other cancer patients who have lived that experience of waiting, wondering and hoping. There was six-year-old Waithera who was scheduled for surgery on the day the doctors’ strike began. She was only able to get badly needed surgery when her father was informed about the Faraja Cancer Trust, but before this, the hospital in Nakuru had become a second home.

I learnt that it was faster and cheaper if you got admitted as an overnight patient at Kenyatta for chemotherapy treatment. I hope the new equipment at Kenyatta will reduce patient waiting times. I was told that it was faster for patients in the western part of the country to go to Uganda for radiotherapy treatment rather than coming to Nairobi. Yes, Uganda, whose only radiotherapy machine hit the global headlines when it broke down last year. Yet, there is a radiotherapy machine in Kisumu lying idle because there aren’t enough numbers to justify the cost of operating it. Apparently, there aren’t any oncologists in Kisumu. One must go to either Eldoret or Nairobi for treatment.

In rural medical centres, there are numerous stories of misdiagnosis because of some patients (some now deceased) were tested and treated for malaria or typhoid before the discovery of cancer or either a preventable or treatable malady.   I still get angry thinking about this. Early diagnosis of breast, cervical and prostate cancer make these three cancers treatable and affordable. Being diagnosed with cancer doesn’t necessarily mean death.

Our healthcare system is us. ‘Naomba serikali’ does not cut the mustard anymore. The mode of referrals for specialists, surgeons, pharmacies, and hospitals both in Kenya and abroad is word of mouth. I created a spreadsheet of the different outlets that I could source my medicine from and the phrase, ‘naenda kutafuta dawa‘ became real. There was one time I went to three hospitals looking for a drug because it was in short supply. That was when I realised that there are many of us on this journey. A journey to find the best possible healthcare that our money can afford to buy.

I followed the doctors and nurse strike keenly, read the Collective Bargaining Agreement (CBA) and cried tears of joy when an agreement was reached. We need to put more into our public health system. I am sure we know of cases of patients being transferred to KNH from private hospitals because it was cheaper cost wise. Remember those bottomless pits? They don’t exist. We have a cadre of men and women who are passionate about their work in public health. We can only reward their duty by making sure that they work under the best possible conditions. I have seen it work in the UK, through the National Hospital Service. It is not perfect, it has its critics, but it works. I look forward to the day when we will have a system that we too can boast of. One can dream, right?

But until then, our healthcare system will continue to be us. Where we look out for one another, attend medical harambees or give towards Mchanga campaigns, share a referral or WhatsApp messages on cancer, diabetes and blood pressure cures! We cannot afford to have a health system that ‘others’ individuals or provides care that is dependent on the size of one’s purse.

For we all know that death and disease do not discriminate.

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Reflections

Counting People in a Broken Health System

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Counting People in a Broken Health System
Photo: Shutterstock

I remember, a young woman, a freshly minted teacher named Leah- who was very fond of my father. I was a little boy then. She looked up to father as a senior teacher and a mentor to help her grow into the profession. My father and mother were fond of her and she was a common visitor to our house. In our young minds, age sets were binary: you were either nyithindo or jomadongo, children or adults. Children were the people you could play with, the people you called by their first names and complained about to your parents. Adults were a whole other matter, separated by a chasm that moved through time. They were people who even when informal in their manner, had to be treated with the formality that adulthood conferred.

Leah was confusing for my binary world. She was at a stage my elder siblings had not gotten to yet, somewhere in between a child and an adult. When she was around she cooked with us, referred to my mother as “mama”, and seemed more at ease with my teenage sisters and cousins. Yet she held adult conversations with my parents and could gently disagree with them in conversation. I probably had a little puppy crush on her. She straddled that space with some aplomb. My parents loved her. My elder brother’s eyes never left her swaying hips as she navigated the ten metres or so between our detached kitchen and the main house holding a tray of food or kettle of tea in her hands. My sisters could not wait to be her- she had all the big girl privileges: she could choose her own clothes, she wore jewellery, and she earned a salary at the end of the month!

Even after she moved to a different school further away, the warmth of her company whenever she returned to visit did not change.

One day, word arrived that Leah had died. The whole family was left reeling. My sisters cried. My brother went off to the simba- my second to last unmarried uncle’s house- lost in a daze of disbelief. Although my parents were stoic, they could not hide their pain. Nobody wanted to explain death to a little boy. Up until then death was an exciting and rare occurrence associated with screams tearing the bucolic night air from the direction of the home of an ailing elderly man. They were not people I knew. In my little sheltered, small town rural existence, I had never met anyone who later went off and died.

Leah died. She was the first person I had met, known, even loved, who died. She had died during childbirth. One moment she was full of life and carrying the promise of a brand-new life, the next moment she was dead. Cause of death. Maternal mortality. Leah had come up against maternal mortality and lost.

Maternal mortality is a sterile pair of words. It is impersonal and jarring. I did not know who the father of Leah’s child was but I felt for him. Maternal mortality is the sudden shot between the closed eyes, blissfully sucking on the lollipop of life. Maternal mortality is a rusty serrated knife piercing your back. One moment you are tingling with excitement and looking forward to holding a new life in your hands and looking at the incomparable poem of joy that is the face of a new mother. The next moment you are planning a funeral.

A woman went out, and two coffins came in. A big one and tiny little one.

I did not know these things then. But, I know them now. I became a pharmacist. Then I drifted, a journeyman into public health with a penchant for math. So I count things. I count ratios and rates, odds and people’s chances. I create pivot tables and run scripts. I find blips and upticks and trends. And to stay human I try not to think of counting Leahs and little babies who have not had the chance at a name. A simple name.

2017 has been a rough year for mothers, babies and families across the country. The year opened to a doctors’ strike that was a month old and would continue into March stretching for a 100 days. Public health facilities were on their knees. Clinical officers and nurses did what they could and sent those they could not handle to private health facilities, which sometimes is the same as being sent home to die. After a brief respite, the health system would once again go into the convulsions of massive labour unrest with the nurses’ strike. That strike would last 5 months before getting called off.

If doctors are the analytical mind of the health system, nurses are its beating heart. A formidable nurse-doctor team, with the backing of a working health system, is what makes maternal mortality quake in its shoes. For the better part of 2017, there has been no team. No team means that Caesarean sections and assisted deliveries are not happening. Blood transfusions and resuscitation are nowhere to be found. Incubators are not whirring; bleeding mothers are not stirring. Ambulances are running across the land blaring sirens of death.

One of the simplest pieces of health data that indicates the health of the health system is vaccination coverage rates. It is simple because vaccines are given at predetermined intervals and ages. When a baby is born they get BCG- the tuberculosis vaccine- and the polio vaccine. Kenyans have about 30 babies for every one thousand people every year. If there is a community of about 5000 people then we expect that a baby is born every two days or so and 12 children get birth vaccines every month. Vaccine coverage responds quickly, positively or negatively, to failures in the health system- when people cannot get to the health system for reasons such as flooding, when medicines or syringes are not available, when there is no energy supply for refrigeration and when staff are not at their posts because they are on strike.

Vaccine coverage has dropped precipitously in communities that rely primarily on the public health system. Less than 5% of Kenyans have private health insurance, so this means almost every mother who is not on Facebook. Vaccines protect children individually but also as a group in what is called herd immunity. The chances of a vaccinated child getting the infection they have been vaccinated against is lower than for an unvaccinated child and if they do get the infection it commonly runs a shorter course and is less severe and less likely to lead to death.

This means that they are less likely to spread it to other children who also, if vaccinated, are less likely to catch it. Vaccination is therefore equivalent to children locking arms and standing shoulder to shoulder against vaccine-preventable diseases. Unvaccinated children are a big hole in that wall- their own risk rises massively but they also increase the risk for vaccinated children.

More ominously still, falling vaccination coverage is an outward sign of an ailing health system. For four years of my working life, I kept verbal autopsy tables: Excel sheets where in a community the size of a small district it was my business to know who died, where, when, and why. I learnt what makes people die. In what seasons people killed one another and when people killed themselves. I got to know intimately how the health system fails babies, children, mothers, and other people and how the consequences are felt in communities are far removed from tables and graphs.

As the Kenyan health system convulses, children are dying from immunizable diseases. People are missing precious doses of chronic medications such as diabetes and HIV medicines. Women are bleeding to death in ambulances and that is one Leah, too many.

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