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Reflections

Medical Malpractice and Patient Advocacy in Kenya

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Medical Malpractice and Patient Advocacy in Kenya
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In December 2010, my mother was admitted to an established private hospital in Nairobi for what we considered a routine surgery. This surgical procedure was the culmination of a series of medical tests that begun in July that year in Kisumu where she lived and ended up in a referral to a sister hospital in Nairobi. After several tests and doctor consultations, the second doctor confirmed that she was in the early stages of cervical cancer and the best course of action for a woman her age – 64 years – was a hysterectomy.

It all seemed straightforward really. Armed with health insurance, we accompanied my mother through hospital admission procedures a day before her surgery. What was intended as a three-hour surgery ended up with my mother being wheeled out of recovery at 11 p.m. It turned out that the surgeons had found a hernia, chose to repair it and then conduct the hysterectomy. On the third-day post operation – the day she begun to eat solid foods – my mother developed complications in the night. These complications included difficulty breathing, reduction in urine output, low blood pressure for a high blood pressure patient. All of these symptoms were red flags.

Thirty-six hours later, my mother died of an acute bacterial infection. The doctors told us they did not know the cause of the bacterial infection. We were told infections can be picked up anywhere, we were after all in a hospital. When we asked for a post-mortem, it was suggested that it was unnecessary. To cite one doctor – we would find nothing except a missing uterus. We went ahead and conducted a post-mortem. A relative had the presence of mind to encourage us to get an independent pathologist to observe the procedure. It is the results of the post-mortem that pointed us to the cause of the bacterial infection (septicaemia) tiny punctures to her large intestines that occurred during surgery. In essence the minute she started eating food, the contents of her large intestines leaked into her bloodstream and poisoned her.

The admitting doctor quickly vacated the scene and left us in the hands of the ICU doctors, only offering a full medical report in mid-January 2011, despite our requests for said report in December 2010. She went on holiday. It is both treatment and responses we received to our questions about whether anything could have been done to avoid my mother’s death that set us on a six-year-long process of looking for accountability.

In 2011, we returned to demand answers from the hospital management. At this stage, we were slightly more than angered by the callous treatment we were receiving from the hospital. Yet, even in this anger, all we wanted was an admission that they had failed in their duty of care and an apology. We had proof of the cause of death. We wanted an apology that would for us acknowledge my mother as a person whose life mattered. She was not simply a 64-year-old African woman in bed X. We wanted my mother to be seen and our grief acknowledged.

Instead, we met a management team that was preparing for the possibility of legal action. In that meeting, the two surgeons who had operated on my mother were missing. We were told they were busy. The head of obstetrics confirmed that the case was internally investigated and the outcome of said investigation revealed that a crucial window had been missed. The window being the moment between the observation of changes in my mother’s vitals by the nurses and the time the doctors offered a proper medical response, which was mid-morning the next day. I am familiar with the missed opportunity referred to because I became intimately acquainted with my mother’s hospital records in the months that followed.

By the time the doctors begun accelerating their medical response, the opportunity to take her back into theatre had passed and no surgeon would have risked such a move because she would have died on the table. They made her comfortable and waited for her to die. He also hinted at my mother’s weight and pre-existing medical conditions such as high blood pressure and old age onset of diabetes as factors that did not help her situation. They were not fully to blame, the now deceased patient had to take responsibility for being “unhealthy”. The hospital after discussion agreed to transfer a copy of the medical file to a doctor in a sister hospital in Kisumu for review. They would not hand over a copy of the file to us without a court order. It is the outcome of that review that led us to the Kenya Medical Practitioners and Dental Board (KMPDB) to file a malpractice case.

Pursuing Accountability: Some Lessons

There is often that one case that hits the Kenyan media that reignites public concern about the state of medical care in Kenya. In the recent past, most of these cases have been located at Kenyatta National Hospital (KNH), such as the case of Alex Madaga[1], the rape allegations at KNH[2] which are about institutional care and most recently the patient who had brain surgery for no apparent reason[3]. These cases have occurred in the largest referral public hospital in Kenya, which often leads to the assumption that medical malpractice is a problem confined to public hospitals and that this is a class question. It is not.

To be clear medical malpractice is not unique to Kenya. The scale is accelerated by weaknesses in accountability channels that limit remedial measures taken to address gaps in medical procedures and implementing personnel. Of course, medical malpractice cannot be understood outside the larger training and labour issues associated with the health sector in Kenya. Nonetheless, I want to focus on accountability as a critical pillar to medical practice that does not necessarily disappear or reduce when better labour conditions are put in place. There is a general “utado” attitude that sits at the heart of accountability questions everywhere. It is that daring people to act – a dare that is located in an acknowledgement of structural powerlessness – that must be dealt with.

This is Kenya

When we arrived at the decision to file a malpractice case, we received many responses from friends, the most common being “this is Kenya nothing will come of it”; “she is dead, this will not bring her back”. However, the most disturbing in my view, were the litany of medical malpractice examples recalled with ease, as though they were describing the decision to use Vaseline and not spirit on a wound. The casualness with which people spoke about patients who were given wrong medicine thus ending up dead, surgical items left in patient’s bodies and misdiagnosis was disturbing to say the least. In all the cases I heard, no one took any action, because either the patient had survived or they were dead. Beyond the costs – both emotional and financial – associated with pursuing accountability for medical malpractice, we are resigned to the fact that systems will fail us and if “you don’t know someone” why put yourself through the process of looking for justice. The number of medical malpractice cases that go unreported are anecdotally high, the number of cases reported at the board with limited response is equally high[4]. However, the failure to address these cases and therefore improve the system is deeply reliant on an unholy alliance between our silence and the collusion of legal and health systems to protect “their own”. Our experience with the KMPDB points to this unholy alliance.

Professional Accountability

In the KMPDB, the body charged with the responsibility of holding medical professionals accountable to the highest standards of service, we find a manifestation of all weaknesses of the medical sector in Kenya. The slow responses by KMPDB to cases filed before it is indicative of the lethargy that accompanies a real commitment to hold medical professionals ethically accountable. This lethargy is evident in the speed with which KMPDB will deal with cases that attract public attention such as the death of former IEBC commissioner Letangule’s wife[5] or Mugo wa Wairimu,[6] while keeping non-high profile cases waiting for six months to a year for a hearing date, if you are lucky.

Second, in most jurisdictions outside Kenya, institutions such as KMPDB are considered independent professional bodies. This means that legal orders cannot be used to stop proceedings within the board. However, if someone is dissatisfied with the outcome of the board’s process, they can file a civil suit. Even if there is a concurrent matter before a court of law, the two processes are considered independent. This is not the case in Kenya. The medical malpractice case we filed at the medical board was stopped twice by the hospital asking to be de-linked from the case, yet they were the admitting hospital. My mother did not have her surgery on the highway. Every time the hearing was stopped it meant that we spent time and financial resources fighting court orders that went unchallenged by the very hospital that had filed them. It also meant that we went into a longer waiting period for another hearing date at the KMPDB.

It is clear this was a tactic used by the hospital to frustrate us. Most disturbing though was what appeared to be a collusion between the hospital and the board. This was apparent on one occasion when the director of the board, shouted into the corridor where we sat: “the case of the woman who died at X hospital. We will not hear your case today because there is a court order on the way to stop the proceedings”. Our hearing was being halted by a court order that had not been served to anyone. The board members then took an extended tea break ostensibly to buy time for this court order to arrive so that they did not have to begin hearing the case. When we questioned board officials about this apparent collusion, they as would be expected denied that they had engaged in a stalling game designed to benefit the hospital and ostensibly the doctor.

Third, procedures at KMPDB remain opaque, which means that for families who do not have the requisite understanding of evidence collection and most importantly the resources to do so, most cases will not see light of day. On one occasion as I sat outside the KMPDB hearing venue, I spoke to a family whose case involved a deceased family member’s organs being harvested. This case was eight years in the making. I knew that case was not going anywhere because they were predictably asked for evidence. The family member had long since been buried, no post-mortem was ever conducted and all they had was a story.

Finally, the opacity surrounding institutional procedures is aided by the unwillingness of medical practitioners to hold each other accountable. Where malpractice cases require expert witnesses, finding doctors willing to offer evidence remains difficult. In our case, we found a doctor who agreed to provide an expert opinion not because his own medical record is squeaky clean because the assumption is that those testifying have never made any errors. He recognised that there was a major lapse in the duty of care and he knew the deceased – my mother. His motivation was therefore personal.

On collective accountability

Ours is not a tale that ends in triumph. After six years of running through the courts, lawyers and poring over medical evidence we chose to halt the process. As a family, we were suspended in grief for six years. Every time there was a court or board hearing, we were transported to those traumatic two days in December 2010 when we watched our mother’s body shut down one organ after the next. We decided that sending the message had been important and we stood up for her.

Accountability for medical malpractice is fundamentally a question of attitude. An attitude that recognises patients as human beings whose lives matter and that one mistake is a mistake too many. From my experience, the cycle of collusion that surrounds hospitals and medical personnel doing what is no doubt a difficult job, does not build any confidence in health institutions. There is need for collective accountability for medical malpractice in Kenya that goes beyond looking at individual hospitals and cases. There is a larger system based question that should generate a change process that targets all the actors responsible for medical care and ethics. A critical actor in this conversation is the patient. No one files a medical complaint because they are out to get doctors. Grief is too painful a process to prolong by choice.

[1] https://www.nation.co.ke/news/Ambulance-patient-Alex-Madaga-dies-at-KNH/1056-2906238-4pr29bz/index.html

[2] https://www.nation.co.ke/news/Outrage-on-Facebook-over-rape-allegations-at-KNH/1056-4270106-g9u9x2/index.html

[3] https://www.standardmedia.co.ke/article/2001271660/knh-on-the-spot-after-brain-surgery-is-performed-on-wrong-patient

[4] https://africahealth.wordpress.com/2012/07/02/medical-negligence-and-malpractice-is-rife-in-kenyas-health-facilities-a-public-inquiry-reports/

[5] https://www.nation.co.ke/news/Thomas-Letangule-Wife-Death-Family-Care-Medical-Centre/1056-2371320-bxxihlz/index.html

[6] http://allafrica.com/view/group/main/main/id/00038738.html. See also https://www.the-star.co.ke/news/2018/02/19/doctor-accused-of-rape-and-murder-attempt-still-at-work_c1716525

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Awino Okech has been involved in social justice work in East Africa, the Great Lakes region and South Africa over the last twelve years, focusing on women’s rights in conflict and post-conflict societies and security sector governance. She is a lecturer at the Centre for Gender Studies at the School of Oriental and African Studies.

Reflections

Naming the Sins of our Fathers

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Naming the Sins of our Fathers
Photo: Shutterstock

On June 8, 2015, I stood in a labour ward waiting for our bundle of joy. When she arrived, shortly after 10.30 a.m., I was beside myself with joy, totally overwhelmed.

Those of a religious disposition know the kind of emotions one goes through when God answers prayers. For the longest time, I prayed to God for a daughter to name after my late mother. The first glance at her, revealed a double stroke of luck; she was not only a girl, but she took after my mother.

I stood in the corridors overjoyed, painfully aware that in under two months I would leave the young one to go for my graduate studies in the United States. I was torn. I wanted to spend every waking moments with the girl for two reasons: Biologically she is my daughter and culturally, she is my mother too. Secondly, I never had a father, and to me, this was a divine chance to try and be the best father she would ever want. Sure, against my will, going for grad school proved to be most stressful experience, I was so depressed in New York Streets that I barely coped with the class room pressure. Upon graduation, I boarded the next plane home and spent the next 10 months bonding with my little girl. It was the most fulfilling thing in the world.

Kids are so sweet. Makes me wonder why men run away from them.

***

I have never seen my father. I do not know if he knows that I exist. I do not know if he is still around or he died a long time ago. Whether he is still in active employment or long retired. I do not know if I have other stepbrothers and sisters, and God-forbid, if our paths have ever crossed, without recognising our common bond.

As a reckless teenager, I once angered and offended one of my guardian aunts. Minutes later she fished some photo of the purported father for a reason I have never known. He was tall, wearing those greenish-blueish suits. I do not remember the face, for I was angry and teary, but I remember a benign smile that revealed nothing.

I have managed to numb any feelings towards the old man. I decided to live with the fact that I will never know my paternal heritage. Whether they had murderers in the family, a history of suicide, or any genetical disorder that shows up every third generation, that I somehow escaped, but may recur in my children or grand-children is something time will tell.

If not for that photo, I will never have bothered with the thought of my father. But that photograph planted an element of doubt, and every other day I dream of some demon possessing me to pay for a want-ad in a newspaper or embarking on search for him.

Indeed, those wakeful nights, when my insomnia gets in the way, which is far too often, I do think about him.

Why did he leave? I want to assume that I tick all the boxes. I am everything an African father would have been proud of: My report form was always impressive, I made it to the best university in Kenya and a top Ivy League university in America. I married in good time and there is a granddaughter to parade. Stuff that most parents cherish. Why did he leave?

In those idle moments, like when stuck in Mombasa Road traffic with a dead phone, I imagine tracking him down to a village, maybe he is in a drinking den, maybe he found Jesus and is now a church elder…Or he died long time ago, and in that eventuality, I will have closure. Chances of making that resolve are closer to nil and zero.

***

My father was a baby boomer. Kenyan baby boomers, have been a spectacular failure. Certainly, there are decent and noble men from that generation, but if they were a class, they would be D-grade. And this is not because my father took off.

Despite the gift of formal education, exposure, travel, and interactions with the outside world beyond their ethnic enclosures, the men from this generation have been underwhelming. Nobody summed up who they are better than Laureen Wesonga, a Chevening Scholar,

I call them(the) independence generation, they are petty, they are greedy, they are insecure. Woe unto you if you are younger, smarter (and female), am like who traumatized this lot? And it doesn’t help that they are running the country at the moment. That’s why our country is an orgy of pettiness, incompetence, general mediocrity. That’s why there is a hostility to intellectual investment and output.”

My father’s generation has contributed virtually nothing meaningful to the country, whether politically, intellectually or economically, other than pillage, obnoxious if primitively grabbing and accumulation of wealth. Young people now have arrested development because the elders ate the food even made for babies.

Most of them still hold positions of power and influence in various institutions, which they run like their personal fiefdoms, giving young people no chance whatsoever to prosper. It is this generation that imposes a fine Sh 5,000 to graduate job seekers who are yet to start their Higher Education Loans Board payments. It is the generation that requires young job seekers to spend KSh 5,000 in useless paper work as a perquisite when seeking government employment. The generation that is likely to deny a woman a job or a promotion because she said NO to their advances, and just as quick to unethically promote an undeserving one who cooperated. And this is the same attitude they approach fatherhood. Some were reckless drunks. Some married two or three wives when they could not sustain the one.

Amoral. Unethical. Disgusting.

In the circa 1980s, men could scatter their wild oats and disappear. Today, you will not run away from Child Support, however far or fast you run. Courts, tabloids, bloggers and social media will hold you accountable. Absentee fathers live in mortal fear of the law catching up with them.

Some of us were unlucky to have grown up without our fathers, even though we turned up fine. Or did we?

What was worse, was having a father who was absent emotionally. As a bare minimum, children expected of their fathers: the provision of the basic life needs like school fees, being present and the occasional pat on the shoulder. Visiting us in school, buying a gift was more than enough. All we needed.

The generation of our fathers came in three shades: The loving, generous and kind (a few and far between). Secondly, were the patriarchal tyrants who respected neither their wives nor their children (their daughters eloped at the earliest opportunity, if only to be safe and sons ran away from to the nearby town for menial jobs) And thirdly, were the colourless and incompetent, who left their wives to do all the parenting (quite a pathetic lot, mostly married a second wife, or kept a mistress abandoning their first family).

There is nothing to say about cool and responsible fathers.

But the latter two, let’s unpack them.

I have talked to a good number of friends on how the relationship with their fathers is shaping or has shaped their attitude to life and especially towards parenting.

It is surprising how dissatisfied most people are towards their fathers (I have two rare cases where people are dissatisfied with their mothers, but that is for another day). I know a few who have had to physically confront their fathers for continuously being abusive, disrespectful and violent towards their mothers. They drew the line, curses notwithstanding, and held their old men by the collars and gave them a piece of their mind.

There are fathers who did bad things because of ignorance. But more annoyingly were those who knew better but still run away, or those who stayed, but were abusive and the only memories we can conjure of them are the dark days they put us through. Most of my peers never quite forgave their fathers or are very ambivalent towards them.

Women who grew up with abusive fathers are very skeptical of men and can be unduly cautious. Men, either chose to be the exact opposite of their fathers, or the trauma of the abuse leads them into alcoholism, violent behaviour and seeking cheap sex to fill the void left by the father’s folly.

But to decide to chart a different path from your father’s requires a higher cognitive ability to forgive the old man and to learn from his wrongs.

My peers, those with a basic university degree and those who aspire to a quiet middle-class life are doing things differently: Most are opposed to violence against women. Most love their children and lately, the sex of the child is not an issue, unlike in the past where giving birth to a daughter was deemed a sign of weakness in some cultures, like where I come from.

Certainly, my generation has been gifted with hindsight, unlike our fathers who grew up under the worst possible circumstances. Women of our generation are enlightened, know better and hardly want to settle for less. We are almost equal and many actually bring the bacon home.

Most women I have spoken to who grew up with abusive fathers always sympathise with what their mothers had to go through. And want to lead different lives: they are assertive, ambitious, keen to have their money and property, just in case a man goes beast mode on them. They expect us men to provide in the traditional sense, but they are not entirely dependent on men. They have backups in chamas, in churches as well as private and secret investments. Their ability to pull resources quickly, means they acquire a head start over their male counterparts.

Women learnt from the tribulations of their mothers and took charge of their lives. Many men never received guidance or the security of inheritance from our fathers and we stumble and falter a lot. We have hardly any role models to look up. Religious leaders lost their moral voice. Politicians have nothing to teach us, but to steal, grab and be stupid, generally.

******

Our fathers were born somewhere between the Second World War and during the struggle for independence from the British colonialist. They were too young to be victims of the British brutality but growing up with absentee parents took its toll on them. They went to school in the independent Kenya. School was designed to prime them up to work in factories and the corporate sector, a drastic change from the agrarian way of life, that they grew up under.

They grew up knowing that the place of women was in the kitchen. They grew up knowing that children were merely a source of labour.

After the independence of Kenya, the world was gripped in a meaningless Cold War that consumed another 30 years of neo colonialism with different actors. The Cold War period gave birth mediocre and cognitively challenged dictators, propped up to oversee several countries. They suppressed freedoms, especially academic freedom. Anyone who subscribed to a contra ideology to that of the paymasters’ paid the ultimate price. In late 70s and early 1980s, a collective of university intellectuals were forced into exile. They included reputable scholars like Ngugi wa Thiong’o (ironically settling in the Capitalist West, when he was accused of being a socialist), Micere-Mugo, Korwa Adar, James Ogude, Nixon Kariithi, Job Kibii among others. They left a huge intellectual gap that was filled with cowardly conformists.

So, our fathers grew up suppressed and repressed. By the time they were coming of age, President Moi had taken over and an attempted coup had turned him into him a dictator who ushered in a totalitarian chapter. The impact of living in a one-party regime turned our fathers into cowardly, insular and extremely selfish individuals with self-enrichment as the only goal. They have a zero sense of accountability and responsibility whatsoever. They are guided by base instincts, hardly proactive but very reactive to any perceived threat to their dominance. They want to grab all the land, even riparian zones. They have mismanaged public institutions raiding coffers and channeling the loot to private facilities they own, to profit from the provision of essential services such as education, health and security. They lack is a sense of the future, which defies logic.

Why do they steal so much?

Why the common excuse of “ni watoto tunatafutia.”( I steal for my children)?

I am not mad at the generation. For they are blind and severely handicapped due to the circumstances they grew up under. But I still habour some resentment. They fouled and soiled their children who inherited the bad habit of greed and cast aside the brilliant ideas capable of transforming Kenya.

Their time at the top of the food chain has been nothing but disastrous and the ramifications will affect us, at least for the next three decades. Think of the foreign debt, the unprecedented level of corruption that make the Moi and the Kibaki regime seem incompetent in their corruption. Look at what they are doing to higher education (lecturers have been on strike for 10 months in the last one year). The health sector is in shambles. The main referral public hospital Kenyatta is always in the news for all wrong reasons. Hospitals in the rural parts of Kenya no longer stock basic medical supplies like anti-venom. The agriculture sector has no remedy in sight for the armyworm invasion ravaging maize fields around the country. Farmers no longer receive subsidized fertilizers yet well-connected individuals can always import maize from Mexico overnight. Need I mention the pain and agony of sugar cane farmers.

***

I see young people embracing their responsibilities differently. Men from the 1980s, aided by the power of social media to reunite friends are forming high school WhatsApp groups and visiting their former schools, organizing to donate books, build facilities and give back in whatever way they can.

We understand the importance of philanthropy and the value of altruism. We recognize there is something bigger than ourselves, or our families. The need to leave the world, a better place. We are planting trees where the baby boomers cut them down for development or settlement.

We question things. We do not blindly support regimes. When we think our political leader has erred we tell him off, such as we did with Raila Odinga recently. His latest handshake moment has met a lot of hostility. When Moses Kuria’s loose mouth utters something vile, we clap back.

Where the baby boomers and Gen Xers choose silence, we raise our voice, even as police brutality has become increasingly sanctioned. I remain hopeful that our generations and young people will get it right as the baby boomers and Gen Xers age and leave us alone.

Good riddance.

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Reflections

maWinnie: Lessons in Feminist Approaches to Storymaking

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maWinnie: Lessons in Feminist Approaches to Storymaking
Photo: Felix Dlangamandla

It was a gathering of women. Mothers, sisters, daughters and wives of black male ex political prisoners. They had been gathered at Cowley House, Cape Town by the Robben Island Museum to share and document memories and stories of their Journeys to Robben Island Maximum Security Prison.

Cowley House, became a remarkable haven for those, whom under very difficult and often brutal circumstance were granted permission to travel and be in Cape Town for the sole purpose of visiting loved ones on the island. An arduous journey. It required bureaucratic application processes; permissions from various authorities including Prison Services, permission from Homelands authorities to travel, permission to be in Cape Town or the Western Cape, accumulating the funds to take a bus or train of some means of transport to the Cape…and finding accommodation in which to stay overnight. Many of the women had themselves served under house arrest and detention, been brutalised by the apartheid state in its attempt to break the spirits of those who chose the path of resistance and or, whose family members had done so.

(I recall so vividly tata S, an ex political prisoner and survivor of the Lesotho massacre, with heartbreak laced in each of his words and silences, explaining just how it shattered him to see his wife in the prison visitor space after many years of separation. She had been starving as he, the main breadwinner was no longer able to support the family. And so emaciated and skeletal she had somehow found a way to visit him and reassure him of her support.)

maWinnie agreed to participate at the gathering on one condition. On arrival at Cowley House for the Women’s Reference Group, she drew us aside and requested a quiet private meeting space. She said that, as her story was already very well documented, recorded and shared within the public domain, she wanted the day to be about the other women who were present, not her. She impressed upon us that the women had stories which were layered with hurt and humiliation and that possibly, the greatest hurt was being ignored by history.

And for the duration of that day’s exchange, I observed maWinnie, gently and compassionately deflecting attempts to defer to her. Calmly prodding and reminding each of the women gathered of a particular incident or event which had taken place on their journeys. And most of all, I observed how she kept silent, attentively listening.

There are a number of lessons and affirmations which remain invaluable to me to draw on and reflect in practice as a feminist ‘memory maker’.

Firstly, how disciplined and comfortable silence grants permission for others to speak and share intimate stories of pain and hardship. That even though the Listener or Observer may have book knowledge or an idea of ‘the Story’, it was important to remain silent and have the Speaker albeit slowly, painstakingly tell their own story. This takes great discipline. The ability to be quiet and trust that the process of storytelling will unfold as it should. And on that day, it most certainly did.

Secondly, that ‘standing down’ from power and influence vested in one as an individual, institutionally or historically, for whatever reason, is a necessary step in putting together the intricate narratives of the collective. That merely ‘saying’ that one is there to listen and understand is not enough, it needs to be a conscious practice. And requires the ability to recognise the power vested in one as an authority or knowledgeable one. And I continue to wonder about this as we see standoffs between groups, the creeping in of that nefarious combination of power+judgement into discourse and relationship. And the discomfort of living within contradictions and questions, as opposed to answers found within ideology alone. As the day progressed, and the stories unravelled, it became clear that the individual stories made up significant parts of a whole. That what appeared to be quite ordinary was in fact rather extraordinary. And that what appeared contradictory was complementary.

Thirdly, I was struck by just how much maWinnie was an Archive and clearly consciously so. She was a formidable memory bank of stories, places, people, events and emotions. And that her ‘paying attention’, being wholly ‘present’ requires a certain kind of Listening for and in between words and silences.She was able to gently remind someone of an incident and a reaction to an incident as if it was not a decade or two past. I still wonder whether in the poverty of our her-story making process as a nation, is this absence of the emotive or visceral or rather, an inability to read it when it is present. And that the damage done by the exclusion of women’s stories is more harmful because of history’s form which attempts to erase feeling and emotion.

Fourth, that being kind, gentle and compassionate are parts of maWinnie’s whole. That the formidable, fiery and sassy is not a juxtaposition or contradiction thereof. That living in the landscape of the ‘whole’ story, whether the individual or collective requires an ability to hold opposites in unison, and thus to include the seemingly irreconcilable. She suggests to me, that living life whole requires living within contradictions and finding a space for the unresolved. I cannot imagine what the “not knowing” when her husband, partner, comrade would be released did to her soul. I do know, that when 27th April 1994 came around, many of us walked to the polling stations as if in a daydream. The reality or realness of something which was spoken of in hope fuelling slogans such as ;”Freedom in our Lifetime” too overwhelming to comprehend on any rational level.

And in storytelling and memory making – being able to hold these unresolved questions and contradictions, however tentatively or tenuously – reveals the Truth in ways which awaken Hope and Imagination.The polar opposite to this would be a shutting down or closing off and stagnation which half – truths provide[1].

As I contemplate once again, how the very act of remembering and living the legacies of those, such as maWinnie requires us to gently and with respect, interrogate, investigate and possibly represent, the values and principles they lived by in our very rendering of their memory.

 

 

[1] We see this in countless exhibitions or memorialisation projects where half-truths about World War One and Two largely exclude the participation of people of the South and so the absence of stories; of the Mende, the deepening desire for Freedom from colonial rule, the place of women in science and technologies which aided the war efforts and so on, reiterates prejudice, racism and abject misogyny which at least parts of these war efforts was attempting to stop.

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Reflections

Now I Know That I Knew Nothing About Winnie Mandela

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Now I Know That I Knew Nothing About Winnie Mandela
Photo: Flickr/GovernmentZA

First of all, let’s dispel the myth that ignorance is bliss. It can be. States of unawareness can be a cushion, feathered down and fuss-free, when one needs a respite from the little annoyances of life. But ignorance is not a day-to-day frivolity that many of us, who have always lived on this continent and know the violent repercussions of one misstep, can afford. Clearly there was not a lot of bliss prancing about during the apartheid years and Black people just conveniently forgot to throw a celebratory parade. To call what happened to the majority population during this regime anything less than what it was – a brutalizing of human spirit – would be a supreme disservice.

So let’s rather call ignorance a journey. A series of stops and way-stations where, the passenger, draws ever nearer to something approaching the truth. Or a truth, whatever the case may be. You may, of course, decide to stay where you are. Never exploring, never wandering or wondering, and thus never knowing. There is a smug comfort in knowing that one day the world will come to you, because that is the pervasive and diffusive nature of all things human. The truth may one day find its way to you. But when you’re Black and female, it’s more likely to kick down your door than knock.

I met Mam’Winnie in stages.

Stations. Stops. Dilutions and exaggerations.

My earliest memory of hearing the name ‘Mandela’ was in the mid-eighties. My parents had a staggered bedroom, with a main bedroom that opened onto a dressing room-foyer where us children were sometimes allowed to play, listen to the radio and just watch our parents be parents in muted fascination. On a Liberian radio station is where I heard the song ‘Free Nelson Mandela’ by The Special A.K.A, which was quite a hit back then.

“Who is this Mandela man? Why is he…unfree?” I didn’t even know what to call the opposite of liberty. The concept was very contrary to an ideal that every African and we Liberians especially enjoyed, or so my young mind believed. The only opposite of freedom and joy I knew of was BellehYalla. BellehYalla was our nation’s worst prison, mythical and monolithic in the way it blocked out the sun in every child’s imagination. People sang songs for criminals who ended up in such places?

My father went on to explain some of what life was like under segregation in South Africa, how Mandela was a freedom fighter in jail for a long time for trying to level the playing field for the Black citizens. I fired a lot of questions. My father was one to joke if the rare mood took him so surely he was joking now, about an African country where people had so little and could do even less. Didn’t they own things, like land? Yes, apparently the country was theirs, but then White people came along and took it. But how could that be? Did White people often go around taking massive things like whole countries away and no one did anything to stop it? My father looked especially wry as he answered yes, it did happen all the time and when I was older and studying history, I would learn all the colourful ways how.

I remember one thing I could not wrap my head around: where was this Mandela’s wife, while he rotted away for a million years? What was she doing in the meantime? My father cleared his throat and adjusted his clothes and muttered something about minding the children and keeping the home and waiting.

My mother, who tended to silently watch these occasional educational exchanges between my father and any one of us five children with a mysterious wry smile of her own, came over when he left the room to busy himself with something else. “She’s helping in her own way,” my mother soothed me, knowing I had the tendency to overimagine and get overwrought. “She’s fighting how she can.”

A few years later my own idyll was shattered, if indeed my country had ever truly been the beacon for Negritude and hope that it believed itself to be. The 1990 civil war had me exiled from home and confused about wars, politics and the courageously destructive statements men make. Several years and one too many new countries later, any political appetite I could have had was snuffed out. Coming to live in South Africa, Cape Town no less, as a postgraduate student perked up my interest somewhat. I got to look at a different sort of beast close up. Stories about apartheid came alive. I had learned in my many junior and secondary schools about Bantu homelands and the regularity with which children grew up without a constant imprint of their father because he was away somewhere. Swallowed by the mines, by the cities, by the struggle. I heard much of Robben Island; you had to, with the White tourists pouring in every summer and interrupting your delicious restaurant dinners with their typhoon of tears of how this lovely man had suffered so much and still he forgave. I did not visit that white rock prison until I had some years under my belt, until the Capetonian sunshine had properly baked the overindulgent Mother City into my skin. I wanted to really feel things when I went to Robben Island.

I did not, not much. It was interesting and educational, but not riveting and wrenching. Bear in mind, I considered myself a pretty jaded young woman by this point. Proximity dulls the knife even more. Robben Island was a major tourist attraction in my city and I had learned too much via osmosis to be well and truly, pearl-clutchingly shocked. I was going for the most part to treat my mother, who was visiting at the time. Most of all, it turned out that Robben Island was no BellehYalla. I expected dungeons and neck chains. But flushing toilets, separate cells, regular meals… My knowledge of the typical African prison had never evolved beyond “no mammal should be here”, and justifiably so. But from the looks of things, all prisons were not created equally. Troupe Nelson had suffered, yes, but they’d had some dignity. As I studied the commemorative plaques on the walls, photos of revolutionaries in action, the sacrifice is not lost on me. Still, I looked around and wondered: where were the wives? Where was The Wife?

Stops. Stations. Titrations of truth.

Sometime during my Cape Town years, in the mid-2000s, a biography of Winnie Mandela was foisted on me. It was ‘Winnie Mandela: A Life’ by Anne Marie du PreezBezdrob, a popular one during that time. I was going to read it without prompting, really I was, but other books of a more fiction-bent, galvanizing nature kept getting in the way. The jaded young woman considered the nature of non-fiction too invasive to be reading material she sought out willingly. Autobiographies and biographies were heavy work of the navel-gazing variety, the payoff often too slim for my liking. I tended to steer clear. But the look on my best friend Inonge’s face brooked no nonsense as she thrust it under my nose, after days of heavy hinting did not work. This was a book we as women, Black women, had to read. I could return to my silly crime and fantasy novels afterwards. Still, I did not immediately relent. Why did I need to know more about Winnie? I knew enough. She had done some important stuff, she was the ex-president’s ex-wife. Wasn’t she bitter now? Wasn’t there a short Google page I could read with just the highlights, some ANC cliff notes? This felt like homework.

So I did some preliminary digging. There was a wealth of intriguing archival memorabilia and articles just a mouse-click away. One online photograph in particular struck me. Winnie in the 1960s, toting a metal pail of water, of something, in the township. So this was where she had been. Gone was the girl in the iconic wedding picture giggling beside her new husband, a girl who, let’s face it, had no goddamn idea what she was getting into. No idea that a nation would start to look up to her in his absence. In her place was this woman forging herself under fire: raising kids alone, facing the daily grind of laundry and assembling meals and assorted etceteras, all whilst in the grip of a police state.

This was what being the satellite parent entailed. The power of notoriety and glory of mystique were never yours, not fully, not when national security perpetually kept your business in the street. You would never be a son of rebellion or sun around which revolutions revolved. The satellite stands vigil and waits. But satellites also absorb information and detonate strategically. The girl was a woman now, her body underneath her cheap polyester jersey softened by children, the stress of her day already shadowing her face. She looked so ordinary it was frightening, because I knew she was frightening. Any woman raising children alone and fielding threats on their behalf knows this reality too well.

She reminded me of my mother. That photo hit me hard.

So I read about the Nomzamo before the Winifred, and put the two together. The book was not without its flaws and omissions of nuance, but it gave flesh and breath and breadth to a woman I had not known, allowed myself to know, was in there. I read more, picked up information from her career over the years and blended colours to make a more complete picture. As I have matured, so have my empathy and understanding. My desire to be acceptable, to apologise like a good girl, to always have my interior world and motives understood are things I crush underfoot as many times as is required to keep my spirit intact.

I knew nothing of Nomzamo-Madikizela. But we journeyed out to meet each other, she and I.

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