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Reflections

When the System is Unwell, Everyone Falls Sick

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Counting People in a Broken Health System
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Mwalimu Henry was a respected man of my little village of Genga stuck deep in the valleys of South Nyanza, where the rolling Gusii hills meet the plains that extend from Kanyada to the shores of Lake Victoria. Genga village folk still epitomize the traditional ideal of communality. You are the son of every granny in Genga, each one insists on feeding you if you so much as stray into their homestead.

Mwalimu Henry was a wise fatherly figure with a missionary education teaching background. He was pious, disciplined and a bit of a colonial relic from the good old days when success in life was directly attributed to academic meritocracy. I knew Mwalimu Henry long after his retirement from the civil service back in the 90’s. I literally grew up under his wings and patronage.

Mwalimu Henry earned a reputation as a vocal proponent of education as the primary means of uplifting a community. He was a constant fixture at fundraisers for students joining the university. It did not ever matter whose child it was that needed funding for higher education, or how many times a school was fundraising for one classroom. He believed in the principle of education as a human right for all.

For his zeal, Mwalimu got elected as chairman of the local secondary school, leading the Parents and Teachers’ Association (PTA) and he championed the interests of poor parents of the village.

I remember a fundraising committee meeting I once attended. The child’s mother was dirt poor and could not raise the mere basics for her boy’s upkeep, leave alone school fees after admission into a university in western Kenya.

That afternoon, a huge rainstorm kept members of the committee marooned in their homes, except one. Mwalimu Andrew showed up, saddled up in gumboots and clutching a broken umbrella ravaged by the storm. The chilly conditions began taking a toll on him the very moment he arrived at the venue. His legs were swollen and he could not take the tea offered to wade off the cold. He did not look well.

For all his enthusiasm, the good teacher was just a stubborn invalid who had lived with diabetes since early the 1980s. His resilience had kept him going through the decades. Sometimes he would collapse while walking, fall ill and get bedridden for days but he always bounced back to his feet.

Mwalimu Henry was diagnosed as diabetic only a few years before retirement from the teaching service. I had been accustomed to seeing him on insulin medication literally my whole life. In his house, he maintained a mini-pharmacy of bottles of medicine, tablets, needles, syringes and cotton wool.

Despite his diabetic condition, he always wore a brave face, with intermittent periods in between hospitals and doctors. His adherence to discipline extended to his diabetes medication regimen.

I had checked on him while home in the village in the month of October, 2016 to announce my upcoming graduation. He exuded his usual confidence and we reminisced how far we had come. It was a sunny afternoon and as we posed for pictures, he confided that his immobility was becoming a concern. He could no longer attend meetings and church on Sundays as he grew extremely tired and his legs would swell after a long walk.

“I am not sure if this disease would be merciful enough to let me see you graduate.” I dismissed his concerns.

In November, a month after our talk, I received information that he was not doing well. I was very worried since it coincided with a protracted doctor’s strike that had brought the public health sector down to its knees. This meant that Mwalimu faced the dire prospect of a daily commute to far-flung private hospitals for treatment.

As fate would have it, the medication he badly needed was suddenly unavailable. That meant he had to travel 20 kilometers to Kisii town to see a medic only to find long queues at the District hospital and empty doctor’s parlors. Then he would be forced to try his chances in different Kisii town pharmacies. Too many times, insulin supplements and complementary medication on which he had survived on over the years were not issued and there was no doctor at hand to write a prescription or conduct a clinical examination.

The irony was that a man who had spent his entire life trying to supplement the broken public education system had become a statistic of a dysfunctional public health system. Mwalimu was the unlikely victim of his own generosity.

The long trips and queues at public hospitals in Kisii town became unsustainable. Growing concerned, the community fundraised for Mwalimu Henry to relocate him for medical care in Kisumu in late December 2016, where it would be affordable.

His health deteriorated fast and the intervention to private hospitals was a little too late. The damage had been done in two straight months of a lapsed treatment regime. On January 29, 2017, I received the heartbreaking news of Mwalimu Henry’s death and my disbelief quickly degenerated into bitterness.

A generous man, who spent his entire life mobilizing funds to educate young minds for a better society, had suffered at the hands of a broken system. A government on a warpath with its healthcare givers was taking casualties of its own in collateral damage. Mwalimu Henry died at the hands of a healthcare system defined by economic profiling, inequality, greed and prejudice.

Little did I know that I would become a victim of the same system preceding the birth of my son. I came to face to face with the viciousness of economic profiling and prejudice when two Eldoret private hospitals flatly refused to admit my heavily pregnant wife a couple of months after we laid Mwalimu Henry to rest. She was categorically denied outpatient examination twice on account that my health cover paid for by a private company was not of the public service category even though she had been allowed a choice of those hospitals for inpatient services.

Both of these hospital facilities did not even bother to inquire if we could settle the bill by other means, other than the insurance cover the moment we mentioned that we did not work in the public sector.

The said private facilities in Eldoret did not care that doctors in public hospitals were on strike. The need to grant a clinical check-up for my pregnant wife was secondary to financial guidelines that ensure non-public servants do not get out-patient services on the National Hospital Insurance Fund (NHIF).

Such a money-first-life-later approach to provision of healthcare services by private hospitals who are key players in provision of healthcare services in the country is clearly one of the reasons so many lives were lost during the doctor’s strike. The 100-day nightmare came to bear on me the morning my son was born mid-April 2017.

On Easter Monday morning, I had travelled back to work in Nairobi and an emergency scenario was the last thing on my mind. My wife had slept very well, only reporting the usual occasional and slight abdominal contractions of pregnancy.

We had not anticipated she would go into labour so soon. The doctor’s estimation had placed birth at three weeks ahead so when it happened unexpectedly at the height of the doctor’s strike, our first instinct was private facilities, in event of any unfortunate birth-related complications.

This time we opted to try a different private facility. By the time my wife arrived via a taxi ride through bumpy and potholed roads of suburban Eldoret, her condition was aggravated, the waters broken and in no position to listen leave alone negotiate financial details and payment modes.

One private facility laid down multiple terms and conditions including down payments before admission that we did not object. They came up with loads of paperwork, to be signed, beforehand by the spouse. The papers contained financial agreement terms and conditions and medical consent forms running into tens of pages.

No amount of pleading would grant my wife the option of signing and filling in the details later since her husband was stuck in Nairobi trying to catch a flight. This point worked me up immensely. Fortunately, a relation in the medical industry suggested an alternative facility and we rushed her to the Moi Teaching and Referral Hospital (MTRH), well aware that it was a dicey prospect with the doctors on strike. The gods were kind and my wife delivered a healthy boy through normal birth in the MTRH maternity wing

Lady luck was clearly on our side for the conditions of the maternity ward left me bewildered when I finally arrived a few hours after the birth of my child. In the hallway comprised 8 beds, each shared by two new mothers, lying side by side, facing away from each other on a two by six inches bed.

The newly-borns were lying precariously on the edges of those beds either feeding or asleep, as their worn out mothers struggled to keep them from falling off the edges of the tiny beds.

The ward was congested. Imagine new mothers coughing right into the face of the other and trying to shield a newborn from any possible mishap. No doctor was on site. The only single nurse doing rounds kept reprimanding new mothers whose babies would not stop crying. I still recall what my wife said the moment she saw me: “Am either coming home with you right now or if they won’t release me, be sure to take us home first thing in the morning when it’s daylight.”

Our healthcare system in Kenya is akin to a war-zone, where the sick pay the ultimate price in collateral damage due to government negligence, corruption and the greed of health profiteers. In our public healthcare system, to be poor is like a punishment for a crime you did not commit. Health care should not be a privilege enjoyed by the upper classes. It should be a right that is as fundamental as giving every child a chance to a good education. But what we have in Kenya is not even a system. It is a gamble with life.

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Gor Ogutu is a journalist based in Nairobi.

Reflections

Life on the COVID-19 Frontline: The Use and Abuse of Kenyan Nurses

Nancy’s cohort was not trained in the care of COVID-19 patients. They were dropped in at the deep end – the deep waters in which they outnumbered their colleagues of long standing who have permanent and pensionable contracts.

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Life on the COVID-19 Frontline: The Use and Abuse of Kenyan Nurses
Photo: Marcelo Leal on Unsplash
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As the novel coronavirus traversed central China and made its way across the seas to wreak havoc in Europe and the Americas, there were those in Kenya who wished the calamity would also befall us. My cousin Lyn, who works for a medical charity, was appalled to hear an official of the Ministry of Health express the hope that SARS-CoV-2 would arrive on Kenyan shores “tupewe pesa” — so that we can be given money. That was in February 2020; less than a month later, that maleficent official’s prayers had been answered and the funds soon followed in COVID-19’s wake, to be swiftly embezzled by Ministry of Health officials in cahoots with the directors of hastily incorporated tenderpreneurial companies. It can be safely assumed that the avaricious official was well positioned to be a prime beneficiary of the windfall.

It seems a long time ago now, when a wave of indignation swept through the nation as the news broke that funds and equipment meant to help Kenyans weather the COVID-19 storm had been stolen. Here in the Nyandarua County countryside, hawkers of hastily tailored cloth masks selling at a hundred shillings apiece soon exchanged them for the now ubiquitous sky-blue face masks once they became more readily available on the market, selling the prophylactics at ten shillings each.

The initial anxiety brought on by news of the sudden death of a middle-aged woman in May from COVID-19 two dozen kilometres further down the road from us gradually abated as it became evident that her death did not augur a hecatomb. Little by little, as the year wore on, life returned to a semblance of normal; the masks slipped off, the soap and water dispensers in front of the shops stood unused, market days returned and the police retreated to their usual occupation of extorting matatus and boda bodas. Pandemic fatigue had set in.

Over in Laikipia West, in Marmanet, my friends Patrick and Dorothy had been fanatical about sanitising ever since the news broke that the pandemic had reached Kenya. You were met with soap, water and sanitiser at the gate, a good hundred yards from their house, and the exchange of news about the weather and the state of the crops took place on the veranda under the shade of the creeping jasmine and honeysuckle.

Then early this January Dorothy called to tell me that Patrick had been hospitalised with acute pneumonia and I feared the worst. Patrick wouldn’t go to hospital when he first felt unwell and by the time it became obvious that he needed urgent medical attention, he couldn’t walk. He’s a very big man, overweight, and so Dorothy put a mattress down in the back of their pick-up truck, laid Patrick on it with the help of neighbours and drove through the night to a private hospital 30 kilometres away. Updates from the hospital were not reassuring; Patrick had contracted COVID-19 and his lungs were in pretty bad shape so he was put on oxygen. Tests also found his heart deficient and his liver malfunctioning. Miraculously, ten days later, Patrick was discharged from hospital with strict instructions to drop weight.

I was relieved to hear the good news and selfishly thankful that Patrick and Dorothy are an hour away from me; to my knowledge, no neighbour of mine had yet contracted the deadly disease. Then in mid-March my friend Isaac fell ill. Aches and pains all over the body, shortness of breath, dry cough, raging headache, no appetite. All COVID-19 symptoms. Isaac is an ordained pastor and missionary, bringing help and succor to the least among us, his days filled with meeting people and finding solutions. A week of treatment did not improve his condition and Isaac was hospitalised at a private clinic in Nyahururu. I feared for him and I feared for all of us who have been cozily ensconced in our personal cocoons that have given us a false sense of security that we shall be spared the COVID-19 scourge.

The small private hospital where Isaac was admitted is not testing for COVID-19. Patients also have to go to a private facility in Nyahururu town for chest x-rays. But the level of care is beyond reproach and the medical staff attentive. The young woman doctor treating Isaac seemed experienced beyond her years, explaining Isaac’s prognostic profile with clarity and taking critical decisions with authority, all the while imparting a sense of hope that Isaac would make a full recovery.

Hearing that Isaac had been taken ill and hospitalised, a young woman who had been a beneficiary of Isaac’s sustained efforts to uplift the lives of the poor of Ngobit and give their children a fighting chance by supporting their education, came running to his bedside. Nancy* had successfully completed her nursing course and was now stationed at the Nyahururu County Referral Hospital, a stone’s throw away from where Isaac was laying on a hospital bed fighting for every breath. She arranged for Isaac to be tested for COVID-19 at the government facility and insisted on paying for the cost herself.

That Nancy offered to pay for the cost of the test is testament to the regard with which she holds Isaac. Nancy has not been paid since early December 2020 when she received five months’ salary arrears. She is one of a cohort of nurses that was hired by the Ministry of Health in June 2020 in the face of the pressures brought on the medical sector by the COVID-19 pandemic. A Zoom interview was quickly followed by a job offer and Nancy arrived at the Nyahururu County Referral Hospital in early July to find that the Kenya Medical Training School lecture rooms had been converted into COVID-19 wards. But they were soon closed down and COVID-19 cases returned to the general wards once the KMTC students resumed classes in January.

Nancy tells me that there is no isolation ward at Nyahururu County Referral Hospital; surgical and medical cases are housed under one roof in the male ward and the same goes for the female ward, where female patients with gynaecological issues are also admitted. Patients with COVID-19 are “put in beds in a corner of the ward”, as Nancy heartbreakingly put it. There they wait until a doctor with Personal Protective Equipment can attend to them, administering the care that the nurses daren’t, for fear of contracting the virus. There is not enough PPE for the nursing staff; the county surveillance officer doles them out as parsimoniously as he does the COVID-19 test which is reserved for patients displaying symptoms and those with whom they have been in close contact. Nancy says that their only protection is “prayers, masks and sanitising”. Nancy says that “we are not doing things the right way but it is the management that is failing us.”

There is no critical care unit at Nyahururu County Referral Hospital. In fact, there is no critical care unit in the whole of Laikipia County. Not in the public hospitals. Not if CCU is understood to mean the availability of life support equipment and medication, and highly trained physicians, nurses and respiratory therapists specialised in caring for critically ill patients.

At the Nanyuki Teaching and Referral Hospital — the only other major public hospital in Laikipia County — there is a building whose façade bears the name Critical Care Unit but that is all the building is, a façade. Speaking at the facility on the 23rd of June 2020, Laikipia Governor Ndiritu Mureithi announced to the press that “we are preparing a 6-bed ICU and a 12-bed HDU”, adding that “the most important issue is ventilators, five of which were already at the Nanyuki hospital while another five were foreseen for the Nyahururu facility. Well, Nancy says that between June and December 2020, the only ventilators in use in the temporary isolation wards set up at the Nyahururu County Referral Hospital had been borrowed — together with the beds — from other public medical facilities in Laikipia County. The beds and ventilators were to be returned whence they came when the isolation wards were shut down in January.

The January to March 2021 issue of the Nanyuki Teaching and Referral Hospital Quarterly  publication reports that “we now have also completed at 17-bed critical care unit with 6 beds reserved for intensive care unit (ICU) and now have just obtained an anaesthesiologist to get the service set up and running. A nurse has been sponsored by the hospital to specialise in critical care, and more will continue to be developed in this manner.” It is unclear which “ultramodern intensive care unit” was “unveiled” by Governor Muriithi in June 2020.

Nancy tells me that, because the Nanyuki hospital does not have the facilities, critical COVID-19 cases at the Nyahururu hospital are referred to Nakuru Level 6 Hospital in Nakuru County. If there is no room there, patients are pointed in the direction of the Kenyatta University Teaching, Referral and Research Hospital. But relatives must first deposit KSh200,000 with KUTRRH before the patient can be admitted there. The elderly mother of a colleague of Nancy’s who contracted COVID-19 last November could find no help beyond being put on oxygen at the Nanyuki hospital and so the family raised money and had her treated at a private facility in Thika. She survived.

Nancy’s cohort was not trained in the care of COVID-19 patients. They were dropped in at the deep end – the deep waters in which they outnumbered their colleagues of long standing who have permanent and pensionable contracts. Nancy and her colleagues were offered 3-year contracts with a basic salary and no benefits take it or leave it. They took it.

Last December Nancy’s cohort was split in two and she found herself in the Universal Healthcare group (UHC), falling directly under the Ministry of Health. She has not been paid since, while her colleagues who fall under the responsibility of the Laikipia County Government have been receiving their salaries every 27th day of the month like clockwork. Nancy says she doesn’t know the criteria that was used to split the group. She says that she and her UHC colleagues often call on the understanding of their colleagues who are on the county government payroll for financial help. Which is why her offering to pay for Isaac’s COVID-19 test is so significant.

Now it seems that the Ministry of Health has lost their paperwork. Their files have “disappeared” and so they cannot be paid. Nancy and her UHC group have been asked to resubmit all their diplomas, certificates and all other supporting documents. Each document must be certified by a magistrate as conforming to the original. The magistrate at Nanyuki charged 50 shillings the copy, a small enough sum until you take into account the number of documents that must be submitted and the number of nurses submitting them. And the fact that none of them have been paid since the 4th of December 2020. The county government took possession of the resubmitted documentation for onward transmission to Afya House but could not tell Nancy and her colleagues when they might expect their salary arrears to be paid.

Thankfully, Isaac tested negative for COVID-19. He had suffered a particularly nasty bout of pneumonia. He is out of the woods and back home where he haltingly (talking still makes him breathless) admitted to his wife that in the dark hours of a particularly difficult and frightening night he had yielded to his God, leaving his family in the care of the Almighty.

* Name has been changed.

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Reflections

The Paradox of Choice: Just Another Family Tale

I am thinking about the miracle of being born, a one in 400 trillion chance. Even without this statistic it is hard for me to consider that my birth might have no meaning beyond the self-constructed value I give to my experiences of life through you; the fact that your death was not the end of your life, that you continue to live through me.

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The Paradox of Choice: Just Another Family Tale
Photo: Unsplash/Aditya Romansa
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Say something to me
What does one who grants you the kindness of a living body
want from you in return but an understanding of what it means to feel alive?

~ Forough Farrokhzad

I was told that I was born a healthy baby at Consolata Hospital in Nyeri. My father, who is of the Kuria people of southwestern Kenya, was working on a project in central Kenya as an agricultural engineer. I was named Boke after his mother. In Kuria tradition girls were not as celebrated as boys, but my father looked at me as keenly, with that same sense of indebtedness, as he would at his own mother. 

We thank our parents for the gift of life. Our parents expect us to thank them. Each and every day you should demonstrate gratitude for this special gift; no matter your experiences, you owe it to the givers of life – for better and for worse.

We lived in Nyeri for two years. And then I was taken to my maternal grandmother in Russia, where I spent two, three years with her in Krasnodarsky krai in that southern part of Russia that borders Crimea to the west and Georgia to the south. Krasnodarsky krai is in the Caucasus, a popular getaway because of the warmer climate, the ski resorts and the seaside. But I didn’t get to visit any of these places then; only later in my life did I spend time on the Black Sea while living there as a teenager.

While everything before this time remains with the custodians of the stories, my first memory is that of abandonment, my mother taking me away from Nyeri at only two and leaving me with my grandmother. Her soft long fingers slip away from mine and I realise that I am not going with her. I break into a cry but it is too late; the tram is moving away and we are separated.

There is something about knowing that you have no choice that leaves more room for acceptance. How that acceptance, or rebellion, manifests itself is a different story. Days went by and I settled into a routine in my grandmother’s home. In the winter we would light firewood to keep warm and in the summer we would eat strawberries and crimson cherries, and pickle cucumbers for the coming winter. I had no real sense of time other than day, night and seasons, and I do not remember thinking as much about being left behind as I did about what would be happening in my day to day life – fighting with my twin boy cousins, their mother bringing us hot dog treats overflowing with tomato sauce and mustard, taking a bath in a bucket, picking walnuts (fallen from a tree I still miss as my connection to the roots it held), running to the river, walking to fetch water from a nearby well, my tattooed uncle getting me out of the cupboard where I hid when I was upset, his golden teeth shimmering back at me. “Katyusha”, dearest Katya, he’d say.

Every so long, babushka would announce the arrival of a letter and she’d read out words that came from the heart of my “real” family in Kenya: my father, mother, older sister and newborn brother. But of my family, I remembered only my mother, so potent was that first memory living a life of its own somewhere at the bottom of my soul’s well: an unprocessed flashback of her hand slipping away from mine.

Whatever else, I cannot say it was a dull childhood.

This taught me that I did not find places but places found me.

My life was stable. Days, seasons, letters. Until one day, the strangest looking man walked into my grandmother’s house. He was black. I could not hide the shock on my face. Living in a neighbourhood where I only saw white people, I fell prey to the thought that all people were white. Ironically, I did not acknowledge my own difference from those around me – the honey-coloured skin, brown almond-shaped eyes and unruly hair. “Your papa has come for you,” babushka said. The four-year-old me could not fathom how this alien looking person could be my father and want to take me away. Deeper than that, though unable to name it, I felt a sense of betrayal from my grandmother, who seemed so ready to give me away. I hid behind her and refused to approach this stranger, who interestingly enough, spoke “our” language so fluently. In an effort to persuade me to approach him, she tried to bribe me with my favourite treats, “You can have as many pickled cucumbers as you like and more sugar in your porridge.” When that did not work, babushka said that if I left with this man, I would meet my mother who was waiting for me on the other end, where it was always summer. That triggered something in me and I felt the need to touch my mother’s hand again and mend the separation. I planted that seed in my mind and it held me together for what would turn out to be a longer trip than I had imagined.

This taught me that my life was choosing me rather than me choosing my life.

The journey back to the land of my birth started with a long train ride. The longest trip I remember ever taking was from my grandmother’s home to the Christmas show children attended at a theatre in the city centre and this took no more than 30 minutes. The one day on which we dressed up. After the show, the Russian version of Santa, who wore blue (not red) and whom we called Ded Moroz, Father Frost, would give us a bag. In it was an orange (a special fruit in that part of the world at that time) and chocolates. I reflected on this memory on the train, my only source of comparison as I embarked on another long journey that filled me with anticipation. The ride from Krasnodar to Moscow, which today takes 18 hours on the fastest route, was a very long ride indeed.

When we reached Moscow, we spent the night at an old couple’s home. Merry making over dinner revealed an awkwardly jovial side to my father. He was laughing and speaking loudly. I noticed white teeth as a distinct feature for the first time in my life; they sparkle in contrast to his dark complexion. And even though he spoke Russian, my language, all I could do was stare as I tried to fathom that this was my father and that suddenly, my life had completely changed.

I am in a strange place, with strange people, and when I wake up the next morning, the first sound will not be that of my grandmother at the stove yelling that we should all get up and be useful, bellowing a-ya-yai ya-yai! if we didn’t move.

A sofa bed is pulled out for my father and I. We sleep side by side in this open space. He quickly falls asleep as I cuddle myself on the other side thinking about what’s to come. Will I really meet my mother? Will I be safe? When will we arrive? Is this a dream I am about to wake up from?… My thoughts are abruptly interrupted as my father, having made too much merry for our own good, vomits all over me. It’s putrid, lukewarm and slimy but he continues to sleep, unperturbed. I get up and walk down the corridor not knowing what to do. The old lady hears the movement and finds me in the corridor. She cleans me up and takes me to sleep somewhere else. I do not recall if she woke my dad up or what happened next but it took me 25 years to get rid of that pungent smell that it seemed would follow me around for the rest of my life, until someone told me that I had a choice, and I listened.

This taught me that sometimes the world expects too much of humanity.

There was nothing memorable about this trip, and certainly not the nausea I experienced from flying. Perhaps this should have served as a premonition. I most vividly recall my first impression: arriving at the Jomo Kenyatta International Airport in Nairobi made this long uncomfortable journey seem like it had been the road to heaven. First it was the black and white striped animals by the roadside as we left the airport; magical creatures. I thought only dogs and cats existed in this world. Then the sun hits you, it is all green and lush, and further out into the busier roads are trees shaped like umbrellas and huge birds with prominent beaks comfortably perched on the slender branches, making sounds that could almost pass for frogs croaking. But mainly it was the sun, it felt so close that I could hold a portion of it in my hand, and I instantly fell in love with this country, forgetting for a moment that my main goal was to mend my separation. We ride in the car with the windows open, the warm breeze kissing my face.

And there she is. Mother. The glorious delicate being I wanted to attach myself back to. I notice that the sense of familiarity embedded in my mind has faded and I have to find her again. While I mend this separation, a new one is born, as I try to get further away from the scent spreading distance between my father and I.

Years went by and in them father remained a source of … interruption … between my mother’s wholeness and I, even if the gift he gave us – Kenya – was something none of us could afford to take for granted.

This taught me that one separation leads to another; like a chain necklace.

Mother

I write this on a warm morning in March. I wake up to the beautiful Kenyan landscape luring me out of bed. I stare out of the window; the crescent moon presents itself just slightly behind a tall old tree on the left, and on the bottom right the sun is slowly awakening and beginning to brim its rays subtly into my day. I watch them both and I am thinking of you. I am thinking how much you would have savoured this morning. I am thinking that it has been two decades since you left. I am thinking I was thirteen. I am looking at my thirteen-year-old daughter and I am seeing a child who needs her mother next to her, and I am feeling empathy for my younger self. I am thinking how father left nine months before you did and I am realising that we were both delusional in our thinking – that the interruption was gone and life would give us a second chance to truly mend that separation. I am thinking, you did not deserve that cancer, yet it was your lot. The lot that your genes gave you. I am thinking I had to grow up to understand that inheritance was not a choice. I am thinking of the time the doctor told me that if I test positive for the gene, it is not a matter of “if” but a matter of “when”. Boom!!! I am looking at your grandchild, this our daughter, who has her mother and I wonder – how will I make her understand that I can save her from a rainy day with shelter, I can save her from hunger by the work of my hands, but I cannot save her from our inheritance. I cannot promise to stay, I cannot, like a sculptor, reshape her genes.

This taught me that this life had to be enough.

Father

What I really have been wanting to say is, I am sorry. Sorry I never learnt to love you like a daughter should love her father. Then I passed that on to my daughter by raising her alone. I am sorry you could not give me a safe space to grow in love. Or maybe you could? You know, there were always the remnants of that scent and your small dark eyes like darts, staring at me accusingly. I reflect on what I did not understand about you then. You were happy but you did not have happiness. That is why your eyes seemed hollow. Why it was hard to find a photograph of you smiling or laughing. Why merry making was your way of leaving yourself but the failure to do so was your source of anger.

The end was not only physical pain but the intangible pain of knowing you messed us all up, that your PhD ultimately did not get to live up to the glory it aspired to. Still, I thank you for this country. What more can you really give someone than a whole country! So that when you both left, I still found a nurturer in its landscapes. The warm breeze kissing my face, the sun holding me at its centre, the croaking birds reminding me that I am never alone.

This taught me there is more than one way to be left; many forms of abandonment.

Epilogue

I am thinking about the miracle of being born, a one in 400 trillion chance. Even without this statistic it is hard for me to consider that my birth might have no meaning beyond the self-constructed value I give to my experiences of life through you; the fact that your death was not the end of your life, that you continue to live through me. That I perpetuate your education, that I display mama’s sensibilities. That which I inherit and that which I pass on. The miracle itself.

Everybody wants somebody to be their own piece of clay
~ Marvin Gaye

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Reflections

The Night Watchmen: Hustling in a Time of Coronavirus

In this legendary city of chestnut trees, gabled rooftops, fairy tale bridges and winding canals, the nights belong to the young and the restless.

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The Night Watchmen: Hustling in a Time of Coronavirus
Photo: Wikipedia/A. Bakker
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“Big man, they killed our little brother.”

“Who?”

“Amanuel.”

“Who is, Amanuel?”

“Your friend. They killed him.”

“Who, are you talking about?”

“Amanuel-Maantje!”

“You mean Little Man? The little light-skinned guy?” I asked now, linking the messenger to a fresh-faced kid I had met at the beginning of the first coronavirus lockdown some nine months ago in March 2020.

“Yes My brother! They killed our little brother. I knew I had to come by here and let you know. You know I always saw he liked to talk to you.”

All of a sudden I felt my heart drop, I didn’t want to accept that he was gone. I didn’t even know his name.  All I knew was that he was a really nice guy.

So reading the news report literally broke my heart.

“Between late night Tuesday the 18th and the morning of Wednesday 19th November 2020, a 30-year-old man was severely wounded in a shooting incident on the Krugerplein in Amsterdam’s eastside. The victim was rushed to hospital. His outlook is said to be ‘critical’.  ‘He had to be resuscitated before they took him,’ said a witness at the scene.”

I called him “Little Man”.

It had been weeks since I had seen him. Our first meeting was purely by chance. I was doing a job providing security in the heart of Amsterdam’s red light district when our paths crossed.

My task was to position myself in front of the establishment at around 1.40 a.m. and provide a physical deterrent for loiterers, vandals and robbers.

“It’s a breeze, all you got to do is stand here. Make sure no one messes up the place. You don’t have to fight with anyone.  All you have to do is let them see you.”

Motivated by an immediate financial need, I agreed to give the job a shot.

To be honest, I just didn’t have the luxury of saying no; the offer was a godsend given we were entering a lockdown.  Upon accepting the job, the most wonderful things began to unfold.

He was a “hustler”, a “kid from the streets”, but I didn’t know that at the time, or really what a hustler or kid from the streets really meant. All I knew was that he was a nice guy who confessed to me that his “gangster” persona was just an act.

I had spied him coming down the street. It was already well after 2 a.m. but the streets were still busy with the throngs from the pubs, bars, cafes that were now closing. I heard him shouting as he walked, parting the crowds.

It was during that random encounter that I realised the importance of not condemning the young.

“I’m famous in these streets, nobody messes with me around here, not even the cops. They all know me around here, Opa.”

I wanted to know what he was doing out in the streets knowing we were suffering a pandemic.

“You either play football or you hustle Opa. You know how it is!” he said with a big cheeky grin on his face. I could only manage a forced smile, understanding the struggle to survive.

Thirty-year-old Amanuel Nelson Cornelio was a cheerful young man who grew up in one of Amsterdam’s poorer neighbourhoods.

“Americans say soccer, right Opa?  But we here in Dutch, say football. You know, I played in a league for ten years”, he said before adding earnestly, “I call you Opa from respect. You are my elder, I could be your son,” he said, and this unsolicited admission made me feel good.

“I used to be real good, I was fast,” he continued. “Look at my legs, they’re strong,” he said and I had to smile.  This exchange between strangers under the lamps on the Plein in the wee hours of the night felt like it was the middle of the day.

“But I messed up Opa.  See, I come from these streets, I was born here. These streets raised me”, he said, then he paused, causing me to wonder if his last statement was an excuse or an indictment on society. I suspect it was the latter.

When he first called me Opa I had to laugh not to feel insulted. I am only fifty-five years old. It seemed like only yesterday that I was out there running the streets carefree like he was, filled with fire and wonder for everything new.

I was 28 years old. Back then life was so different. For a while I thought the parties would never end. It was heaven on earth and I was as free as the breeze. Every day was an adventure. Everyone was an artist or a visionary and we all had big, big dreams for the future.

There was no European Union. The Dutch had their own currency. People were happy and connected in what was truly the most tolerant city in the world. It was truly unreal. A mother’s love reigned over the land, a stark contrast to the patriarchal system I had escaped from in America.

I remember when we danced all night in the streets. When peeing in the canals was a rite of passage. You hadn’t really lived until you sent one downstream.  Today, it will cost you a 90-euro fine if you’re caught.

When the Dutch became a part of the union, switched to the single currency and opened their borders, life changed. A global economic crisis that left five of the 17 member-nations in need of financial aid and a mass influx of migrants to European shores in 2015 kept jobs and progress at a slow pace.

Coincidentally, that same year I hit two milestones in my personal life. I turned 50 and I was made redundant and seemingly unemployable, forcing me to face the fact that my time had come and gone.

Which is why I was standing out in the night air at 2 a.m., working as a night watchman surrounded by sex workers and the traffic that visits the infamous red light zone.

In this new, unique position as a casual observer I learned that no matter their position, everyone is only trying to be their full complete self. Straight across from the Royal Amsterdam Palace adjacent to the Bijenkhof building on the Damstraat is a quote placed on a street tile that marks the beginning of the red light district.  The quote is from John Locke, and it states, “Inside every person, is a part of himself that is only his property and belongs only to him”.

“It’s an easy gig, all you got to do is stand there and watch the place.  You don’t have to engage anyone. You are not there for that. if something happens call me. You have the police station right across the Plein but they usually ride by every 15 minutes to check.”

I had to admit I was a little nervous, performing a job that until then I thought was beneath my previous social status.

After leaving a military career spanning over a decade and relocating to Amsterdam in 1993 with a small severance package, I was able to carve out a pretty successful life for myself here in the Netherlands.

Things began to fall into place almost immediately upon my arrival. I had an advantage in the workforce; I was a native English speaker in a new Europe, a more united Europe that was beginning to raise its head. I was able to jump from one opportunity to the next until the economic crisis that swept across the globe in 2008 hit, changing everything as jobs became harder to find.

In the Netherlands, one is employed on a contractual basis that ensures that the rights of the worker are at all times respected. If an employer takes you on, they cannot break the agreement without respecting the law. Now, the downside to this system is that employers are less likely to take on new senior staff whose contracts are more expensive and harder to break than those of younger, inexperienced workers.

This dynamic has left many senior professionals marooned on the island of ageism, forcing them to find new avenues to earn a living.

“No sleeping, eating, drinking or gathering in front of the shop. Don’t engage with them. If they come under the awning just direct them to keep it moving. Don’t argue with them, if something happens, call me but you have the police station right in front of you. You can go just across the Plein.”

Those were the instructions.

“Ok, I’ll try it,” I said with only one thought in my mind: I needed the money.

My shift started at 2 a.m. Travelling across town was surreal. It was as if this legendary city of chestnut trees, gabled rooftops, fairy tale bridges and winding canals belonged to only me. Until I learned who really owns the nights. The nights belong to the young and the restless.

It was just supposed to be me and my thoughts out in the open air when suddenly, from around every corner, every bend,  as if an alarm had gone off forcing them from out of their holding places, young people emerged from everywhere I looked, at a time when we had been instructed to maintain social distance. I thought no one else would be out.  It was the first weekend of the public restrictions to curb the pandemic.

I was supposed to be the only one on the streets, but when I arrived the scene was a circus. Bars and cafes with outside table service were jam-packed, my work station was right in the middle.

Everyone seemed to have ignored the warning to stay indoors; the young and the old, Black, White, Asians and Browns. Day-trippers, transients and party guests, hustlers and dealers all moving among streetwalkers and foolish hearts looking for a good time. It was a completely different eco-system.

Maantje means Little Moon, but the pronunciation is similar to Mannetje which literally means “Little man”. I gave him that name when we first spoke but what I learned after his death was that he was a street hero. I just hadn’t known it.  All I knew was he was a really nice guy.

“Where are you from, I mean, your people?”

“I was born here but my family comes from Curaçao. But they are all here now.  I stay not too far from here with my grandma. These are my streets, I’m telling you. You know what? My Uncle used to run these same streets back in the day. He was one of Amsterdam’s original gangsters. He died right there,” the young, talkative kid said, extending his arm out to show the spot where his uncle took his last breath, across the empty square close to Nam King, the iconic Chinese restaurant famous for its oysters.

“That’s sad,” I said.  As I stood there searching for what to say next, a darker, older man came cycling around the corner, an apparent acquaintance of Little Man.

Little Man waved him over.

“Tell him who my uncle was. Tell him he was killed right over there,” Little Man said to his friend who I had determined had Afro-Surinamese roots. The darker guy looked closer to my age than to Little Man’s.  He greeted me unceremoniously.

“Yes, my brother, he was a serious gangster,” he said, his voice thick.

“Really?” I said, which gave me away.

“Where are you from Big Man?” the darker man asked, but Little Man answered before I could.

“He’s American. Man, I would like to go there, not to live there but to see it, Opa.  I listen to a lot of music from America, rappers out of Baltimore. You know Baltimore?”

It just so happened that I did. “I used to live not too far from Baltimore, before moving here,” I said before adding, “Maybe one day, after this coronavirus is over and travelling begins again, you’ll get the chance to go?”

To which he replied, “Nah, Opa, they are never going to let me in. I have a record. I just got out [of prison]. I tell you I’m known in these streets, but I’ve been trying to turn that around. Now this lockdown.”

Listening to him and his story I knew how it felt being stuck, being trapped, your ambitions fading from you and you being unable to do anything about it. But I was pressed to know his age.

“Little Man, how old are you?”  I asked. To look at him you would have expected to find him kicking football around the Plein, or sitting under old trees with a pack of other kids, talking loudly at one another, just having fun.

I couldn’t see how a kid like him could have committed a crime that would warrant a prison sentence. Not here in the Netherlands. The Dutch have one of the most civilised judicial systems in the world.  When I first got here, you could kill someone and the most you would get behind bars was four years, but even that had changed over the years.

“I want you to know, because I saw you looking at me, what you saw, what I do out here is  just an act.”

The entire time we spoke, he wanted me to know he respected me ticking the box in the code of a thinking man, and if “Opa” was another form of that code of brotherly love, I wanted to encourage that because in all aspects he could have been my son. I was his elder and could imagine that all he really wanted, like everyone else, was better.

“I’m thirty.” He said smiling while handling his phone which must have showed an incoming call.

“I got to go now Opa,” Little Man said, jumping on his bike and waving as he rode away into the night, to which I could only offer, “Be careful out there.”

I watched him riding away and I imagined he was off to be with friends. Little did I know.

“To say that he will be missed is an understatement,” began the follow-up headlines. “The 30-year-old victim of the shooting on the Krugerplein in Amsterdam’s eastside has been identified as local street hero ‘Maantje’.”

The article went on to describe how much loved he was. “Maantje was known for his enthusiasm and his spirit. He was also loved on the sporting field having played ten years for an indoor club.” The article went on to say that Maantje had lived a street life which was first immortalised in 2011 when photographer Paul Blanca put him in front of the camera for a series of photos of Amsterdam’s street gangs. Blanca remembers Amanuel quite vividly and recalls one particular photo of a younger 20-year-old Maantje staring deeply into the lens of the camera with the most menacing look on his face. The series of photos was titled, “Mi Mattie,” a phrase borrowed from the Surinamese language which means “My Friends”.

To say he will be missed is a serious understatement. It’s a bloody shame. When I asked what actually happened, I was told that it was due to the many months of lockdown. The two assailants arrested for his killing were young people aged 21 and 24.

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