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, the rape allegations at KNH which are about institutional care and most recently the patient who had brain surgery for no apparent reason. 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. 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.
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 or Mugo wa Wairimu, 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.
 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
THE DAYS OF SITUATION: Reflecting on the Reflections Series ‘Beyond The Numbers’
I was ten years old in 1996 when my parents separated. It seems to me that I had never really noticed them before it happened. Until that tumultuous December my parents were like the air around us – crucial to life, and you would notice when they shifted around, but otherwise somewhat unremarkable. I always thought my extended relatives were much more interesting than my parents – my aunt, who lived with us for a while, laughed loudly, spoke excitedly, and let us watch Indian movies late into the night when my mother was away working the housekeeping night shift at the New Stanley. My mother’s (step)father, my Guka, always brought us halua and kaimati every time he visited. We were fascinated bulging veins on his hand, wondering why they popped back up no matter how hard we tried to push them down.
And then, it happened. My father spoke a lot at this time, more than I had ever heard him speak, it seems, and he would say things like – “your mother is using you as a conduit to get to me.” At the end of his long speeches, I would go to my blue and red Oxford English Dictionary and look up the word conduit. And my mother became more quiet, I think, transfigured into glass that was dangerously on the verge of shattering at a moment’s notice. I was terrified at the thought of this. How does one pick up those kinds of shards?
But what none of us siblings could have known at the time – I am one of three – was that our family’s troubles were not ours alone, and that the intensity of our struggle to remain afloat was not entirely the fault of my mother and father. It was, (objectively?), the wrong time to get divorced – they were walking right into an economic blizzard, with the three of us in reluctant tow.
Kenya was in the midst of an economic recession, the fallout of implementation of the infamous Bretton Woods structural adjustment programs (SAPs), which led to a slash in government expenditure, especially on public servants’ salaries, administration, economic and social services. To make matters worse, the architects of the Goldenberg scandal had promptly drained an equivalent of 10 per cent of Kenya’s GDP from the Central Bank, just like that. Neglect and dilapidation were all around us, and in my ten-year-old mind, I connected the dots and concluded that this is actually what happens when your parents split up – the world goes to literal ruin. Garbage starts flowing in the streets. Potholes eat the road in front of your house.
Which is why I was not prepared for how painful this month’s Reflections series at The Elephant would be to read, edit and curate. They remind me, in the words of @tjjullu on Twitter, ‘ndalo situation’, days of situation, when the folks would say, “you know the situation…. We’re in a tight situation…”
Twenty-odd years later, state theft, poor fiscal management and an exorbitant debt appetite has ushered in a new season of austerity measures. Ndalo situation.
This Reflections series was intended to go ‘Beyond The Numbers’ of macro-economic policy and excavate the memories of those tough times, and connect that with what’s going on today. How did families cope? How did it affect social arrangements, like people having to live with relatives, or the stress that it put on marriages? How are millennials being affected by its iteration today – frustrating unemployment, and the unspoken angst of not being able to achieve dreams? How do we connect the brunt of the hustle to the dysfunction in national economics? How does society react to this culturally – chanelling frustration through music, sports, the arts and so on? And what are the untold stories of those traumas that were never discussed?
The series began with Lutivini Majanja’s extensive piece on how tea – its availability, quantity and quality – marked her family’s turbulent economic fortunes and domestic disruptions.
Then came Gloria Mari on the ‘extreme sport’ that is job searching today, where beyond skills, qualifications, work ethic and experience, it seems like you have to have guardian angels, good luck charms and even the occasional visit to the mganga to have hopes of finding a well-paying job.
We published Carey Baraka reflecting on how disconnected younger millennials are even from the memory or understanding of the 1990s ‘ndalo situation,’ and what that lack of memory does to a generation grappling with through similar challenges – but without a historical anchor to ground the struggle.
Filmmaker Amina Bint Mohamed explored the concerns and challenges of the so-called ‘middle class’ in a short documentary film, a demographic whose definition is contested and whose security is precarious.
There was Wanjeri Gakuru’s reflection on “flying out” as a way for families to cope with a depressed economy and diminished opportunities in the 1990s, but that is no longer an option today, with increasing xenophobia in the traditional ‘greener pastures’ – US, UK, Australia, and the like.
Darius Okolla detailed the decline of his hometown Kitale during those years, where the earth and rust seemed to swallow everything, and how the town never really recovered.
And Silas Nyanchwani’s devastating article on how he was making more money as a student a few years ago, than as an adult today with a family to support (and with a Masters degree from one of the most prestigious universities in the world), was almost too much to bear.
But could anything good come from all this distress? At a different time in my life, I would have written something clever about how economic turmoil allows innovation to emerge.
Like the way M-Pesa’s success may be partly because after the pervasive joblessness of the 1990s and early 2000s, there was a whole group of people who were willing to do the dreary work of being M-Pesa agents.
Much of the talk around M-Pesa has been why it worked so well in Kenya, and not so well in other places, and various reasons have been advanced – Kenya had a huge unbanked population, a lenient regulator, and a culture of sending money to relatives and friends.
But on the agent network, Safaricom had envisaged that agents would bolt on to already-existing businesses, like pharmacies, kiosks and convenience stores, which would then just do the M-Pesa transactions in a corner somewhere, the company’s corporate communications head told me in a past interview.
But the rapid rollout of the agent network was possible because of the very high informality in the Kenyan economy. In fact, the company was surprised at how there was a whole cohort of people willing to be M-Pesa agents as a stand-alone job, basically self-employed, sitting in a small stall, with no salary, benefits, or retirement package, earning a small percentage of every transaction.
Today, I can only make that argument intellectually, and even so, not completely sincerely. I am much more sensitive to the suffering that we tend to gloss over when we neatly tuck such losses into grand narratives of progress – that it all ‘worked out’ in the end, look at M-Pesa!
As philosopher Walter Benjamin argued, narratives of progress render history coherent and harmonious by resolving the traumatic dimensions of history, incorporating them into affirmative accounts that underwrite the positions of those in power.
It means that memory is always in danger of becoming a tool of the ruling classes, a situation that “threatens to murder the dead twice, to erase and eliminate the dissonant quality of past suffering, injustice, struggle and loss.”
Mine is a melancholic hope today, a “hope draped in black” in the words of writer Joseph Winters. It is the kind of hope that refuses to peddle in fantasies of a coherent, harmonious world unscathed by painful events, conditions and memories, in the name of the gospel of innovation. Sometimes suffering produces innovation. But it always produces pain, and the cheerful silver linings obscure this.
This series is our attempt, in the words of author Ralph Ellison, “to keep the painful details and episodes of a brutal experience alive in one’s aching consciousness, to finger its jagged grain…in the hope that we might transcend it, not by the consolation of philosophy but by squeezing from it a near-tragic, near-comic lyricism.”
Like Winters, I see melancholy gesturing towards a better, more promising hope, which must entail contemplation, remembrance, and critical encounter with vulnerability, cruelty, and death, rather than endeavours to resolve or deflect them through reassuring images of progress.
It is a blues sensibility, “unhopeful but not hopeless”, offering no solutions, only a way of responding to, working through, and coping with painful incongruities.
Perhaps the next M-Pesa will come out of all this. Perhaps not. But we at The Elephant will be a witness to ndalo situation.
EARTH AND RUST: The decline of a Kenyan town
Once in late 1996, a neighbour’s clothes were stolen from the hanging line when she went to work, a theft that fascinated the neighborhood to no end. Who would do such a thing? Why – for heaven’s sake? Our version of burglary was the smell of despondency with a tinge of crude survival, pain and hunger pangs. By DARIUS OKOLLA
I grew up in Kitale. The story of the deterioration of my hometown in the 1990s mirrored the tumultuous decline of just about every factory-dependent town in the country; it was subtle, gradual, almost imperceptible, and forever disguised as the typical wear and tear of urban spaces – but it was more than that. It was thievery, corruption, and disenfranchisement, shoving it down the path of visible decline; a depreciative spectacle masked by rural docility and the often-accepted rural poverty.
First came the increasing cases of theft. These were often acts of burglary that surprised us in their desperation as much as they exasperated the victims by their sheer banality. We had an outhouse in our compound measuring about 8 feet by 11 feet, where we stored farm equipment, tree seedlings, charcoal sacks – pretty much everything that was bulky and intended for outdoor use. At first the break-ins at this outhouse were infrequent, then they happened about once every few months.
The stories from neighborhood increased. In nearly all the incidences there were no guns used, often no attacks, not even violent break-ins – just missing farm tools, stolen livestock, and pilfered homes when the owners had briefly travelled out of town. Once in late 1996, a neighbour’s clothes were stolen from the hanging line when she went to work, a theft that fascinated the neighborhood to no end. Who would do such a thing? Why – for heaven’s sake? Then there were the stories of food stolen alongside a burning charcoal jiko as someone cooked outside the house, a story told with awkward hilarity.
John Kirimaiti, Wanugu, Wacucu and the elite cadre of fascinating gun-toting gangsters were the stuff of distant cities told with near-legend flair that we knew we’d never have to worry about. Our version of burglary was the smell of despondency with a tinge of crude survival, pain and hunger pangs, which drove able-bodied humans to steal anything they deemed to be of market value.
When we first moved to Kitale in the early 1990s we lived at Section Five, a row of patterned townhouses with hedged compounds of cypress, flowers, worldliness and tranquility. Nearby was Matano, consisting of dozens of two storied homes with large balconies, cream walls and wooden doors named in alphabetical order. Bondeni, where we would go ride the swings at the children’s playground, was not far either.
My folks were somewhat too extraverted for the austere life of hedged picket fences in that neighborhood, so we moved to Section 21, a well tarmacked, more concrete-y neighborhood lying to the west of the town. The streetlights worked, the town matatus ran the transit service with an efficiency that we, for the longest time, took for granted. We moved again just when private landowners started buying property in Section 21 and setting up unplanned developments.
As Section 21 began to sprawl, it is perhaps not a coincidence that the locals transliterated its name to Tuwani (two-one-i), betraying its deterioration, imbuing it with a villagized name, vibe and life.
Our next neighborhood, Mitume, for the better part of the 1990s was a large piece of land with few houses and lot of grassy fields. Mitume (Kiswahili for apostles) a name likely derived from Christ The King Catholic church parish nearby, was far different from the organized suburb life of Section 21, though it offered a stronger sense of community. Mitume wasn’t spared either as slowly, random developments popped up on what was once sprawling grassy fields.
Chipped paint, dirt, and dilapidation slowly ravaged the children play area at the swings at Bondeni estate that we had left behind. The swings grew rusty, then bare-boned and dangerous for kids to play on. Then they got vandalized and whatever remained of them was run into the ground by neglect, swallowed by the earth and rust. Beside it, where dusty paths met collapsing hedges, garbage strewed onto the road from what were once neat, well-ordered homes.
I attended a public school and so did most of our neighbors, and most of our parents were either in the informal sector or worked as civil servants. It’s still intriguing how the elders seemed so unaware of just how vulnerable they were to downward mobility given their faithfulness in following every single news item on the radio. How come they didn’t see what was coming?
Baba Silas, my friend’s dad worked the Kenya Cooperative Creameries (KCC) and so did most of my friend’s dads who worked in various parastatals, like Baba Wycliffe, Baba Jaredi and on and on. Somehow our parents’ names were hallowed, so they were just ‘Baba nani’ and ‘Mama nani’. Baba Silas – I never got to know his name – carried himself with an air of officiousness, always in a leather jacket, with a slow walk; his neck seemed stiff as he walked, with a slight swagger and a polythene bag at hand. He always carried a polythene bag, I’m not sure why.
He’d lose his job during retrenchment as the parastatals got downsized and then collapsed in the mid-1990s. But I didn’t see him for a while, as we moved from Mitume estate to Lessos, where our parents had bought some land. Lessos estate is named after the Lessos farm in Eldoret, given that the Kalenjin owners who gave the place its name had moved to Kitale from Eldoret.
Set on a ridge overlooking a forest, you could always see the factories in Section 6 and Section 19 on the opposite ridge about four kilometres away, across from Lessos forest in the valley below.
From Lessos, the few remaining factories including a leather tanning factory, Kenya Seed, Western Seed and a dozen other factories let out a low dull hum that on a quiet afternoon reached all the way to our home. Slowly by slowly, the hum grew fainter as the firms collapsed until the sound was no more. But quickly, the silence as it was quickly replaced by the cacophony of human activity, especially a construction boom that hit the estate in the 2000s. The town’s population was rising, properties were becoming smaller and more sub-divided, and unplanned developments were everywhere.
As the hum of factories faded to whimpers, informal businesses in the neighborhoods rose sharply as retrenched workers desperately tried their hands in business, trying to secure an income for their families. Most of them collapsed within months or a few years after inception.
The 1997 elections carried with it a strange sense of camaraderie and hope in the town, partly because multi-party politics had expanded the democratic space and increased a sense of political freedom. Men (and they were mostly men) stood atop old Peugeots and Mazdas, flashing two-finger salutes and yelling in the air, drowning the silent scream of a town choking under the stranglehold of Structural Adjustment Programs.
In 1998 my mum sent me to call over a relative who lived about 40 kilometers away for a job opportunity at a local company – this was before cellphones were a thing. I must have been 10 years old. This relative had already unsuccessfully applied for the job dozens of times. I arrived late in the evening as he worked on his shamba, weeding his sukuma wiki and cassava.
‘‘Hii kazi bwana nimeapply, fare nimetumia mingi na mimi nimechoka, wacha tu nilime.’ (I’ve applied for this job many times and used so much fare; I’m tired, let me just farm). I was taken aback by the vulnerability on display, his frustration breaking through into an involuntary rant to a 10-year-old.
This time though, he got the three-month gig, which still only paid peanuts and barely provided him with meaningful cash. He’d leave for Kisumu afterwards, then Eldoret, then Nairobi and back to Kitale then Eldoret again.
I would run into Baba Silas in the late 1990s, a few years after he’d been fired from KCC. He looked haggard, tired, his trouser torn at the knees. He was working at a brick-making factory, and I ran into him taking a break under a makeshift grass thatched shade, eating the mjengo githeri at lunch time. His sagged chin reflected dignity under assault, he looked shaken to see me, and a bit sad.
Then came the early 2000s and the town broke into a palpable air of difficult-to-justify yet hard-to-dismiss optimism. When Narc luminaries came to Kitale stadium for what would be their only visit to the town before the 2002 elections, I sneaked from home to go watch the revolution happen. I was 13 years old.
“Hii movement bwana! It will last for at least 30 years,” my relative would tell me matter-of-factly after the momentous event. His life certainly changed. He landed a better paying gig, then got married. His wedding, albeit later in life than was expected, reflected his changing fortunes, much more than anything. We often take for granted how the frequency of social functions such as weddings, birthday parties, cookouts, and get-togethers reflect a rising society.
He’d secure better fortunes across the country, marry, settle down, buy a plot of land, build his home and essentially hit all the markers of adulthood that had eluded him for most of his life, all in a span of eight years in the 2000s.
Unfortunately for Kitale, the town never got to deftly negotiate with the colonial state in ways that could secure it enough resources to help it fully recover. It didn’t help that the town’s patriarch, Kijana Wamalwa, would pass away a few months into the Narc wave.
Still Kitale continued to grow, the population growing exponentially in the 2000s. During the 2007 post-election violence, given its cosmopolitan makeup, Kitale provided a somewhat safe harbor for those kicked out of their homes in the outlying regions. The population soared but the infrastructure and the vitality of its urban life didn’t. I see all that every time I go home.
Your Dreams Are Not Valid Here
I came back to Kenya immediately after my studies, armed with a master’s degree from one of the world’s most prestigious universities – and two years later, I am worse off than I have ever been in my short adult life. I used to earn more as a student than I do as a grown-up adult, with a family and a daughter about to join school. By SILAS NYANCHWANI
This time of year, October/ November, is the season when the United States runs their Electronic Diversity Visa Lottery, commonly known as the green card.
Globally, 20 million people fill it, with the hope of becoming part of the tight short list of the 50,000 people who eventually receive the American Permanent Resident Card, and a ticket to pursue the fabled American Dream (sometimes a nightmare).
In my early 20s, I used to nurse dreams of living in America. Most of my friends who never qualified for university used various means, dubious and straight, to enter America. And soon they were building mansions and buying plots around Nairobi as I chased my bachelor’s degree. I remember one friend in particular who had been jobless in Nairobi and when the opportunity came, he left in such a huff, leaving with his small worldly possessions; a bag with three or four clothes, old shoes and nothing else. He has never stepped back 14 years down the line.
I joined University in the mid-2000s, when the Kibaki economy was booming. Sectors like higher education had expanded massively, opening doors to hundreds of thousands to access university education and creating employment and business opportunities such as never witnessed before. Local banks, hitherto operating as cooperative societies or community chamas, had become serious players in the industry. M-PESA had just been launched and Nairobi was being noticed in Africa and indeed in the world finance markets. Real estate was booming. The media was flourishing, both mainstream platforms and lifestyle magazines were making stupendous profits. There was money to be made if you had the right skills.
For my first ever newspaper column (aged 21, no less), I was given a cheque of KSh7,500, inspiring me to pursue journalism. In my four years in campus, I supplemented the Higher Education Loans Board (HELB) money with the wages from writing for local newspapers.
There was an air of optimism everywhere.
Then came the 2007 elections, followed by the post-election violence, coinciding with the 2008 global financial crisis, from which the world has never really recovered. In Kenya, we had barely started picking up the pieces from the post-election violence when a youthful duo came into office, who promised heaven and but have delivered hell, to the point where our economy is now in the doldrums.
But I remember that through college and the ensuing years, we were proud of our country. The roads became better, Internet connectivity improved immensely, mobile technology grew, and Nairobi could afford anyone the best things in the world, barring traffic and pollution. Those of us in university hoped after graduation, we would get the six-figure salaries that our predecessors (classes of 2004-2008) were getting.
At the time, few of my friends had any ambition of leaving Kenya, save for those who were headed to graduate school. There were many reasons to stay. Many among those who traveled for further studies, or for whatever reason, did come back. And my Kenyan-American friends, advised me, “If you make at least KSh80,000 as net income, then you don’t need to come and struggle in America.”
It was a piece of advice we heeded, and after college, we were all looking for jobs that will guarantee KSh100,000. That was during the post-college euphoria, and by this time my obsession with “flying out” had diminished significantly. I started to believe I could ‘make it’ here in Kenya.
As a single young man, I enjoyed good income from my newspaper columns, and ultimately I got a permanent job with a local media organisation and decent pay nearly two and half years after graduation. People around me had more mixed fortunes. My spouse got a job after waiting for nearly three years after graduation. Most of my college friends waited longer, some in between jobs, more underemployed, others dropped through the cracks. The devolved government did rescue a few with jobs in the counties, but in my estimation only about half of the graduates in my year have been in steady employment or business.
Two years into my employment, the company I was working for laid off 300 workers, nearly a quarter of the workforce, in a purge that spared no one, from the young, to the middle-aged to the older folks. It was devastating. I only escaped the axe because I won a scholarship to graduate school that saw me spend a year in New York.
When I left for America, my entire clan accompanied me to the airport, knowing that the path to prosperity had just been opened. Their palpable excitement was understandable.
“Don’t ever come back, fetch your family and stay there,” they insisted. There were many more people who asked me to stay in America than those who advised me to come back – unlike just a few years before.
While in America, even with the telltale signs of a diseased and decaying economy, my acquaintances in US were all of the idea that I should play the system (basically marry my way into citizenship), or use whatever trick to stay there. But I was determined to come back, armed with youthful chutzpah and the idealism that my master’s degree from one of the world’s most premium universities will guarantee me a better life.
I came back immediately after my studies – and two years later, I am worse off than I have ever been in my short adult life.
There are no jobs in the media, and or in my Plan B, academia – that has been ruined too.
The other day, for the first time since 2010, I went to a cybercafé. I hadn’t gone to browse – who does that anymore? I had gone to take the quality photo necessary filing in the DV-lottery, and I sat down and applied for the green card. And in the last few months, along with other friends, I have been visiting placement agencies that advise skilled adults on how to settle in countries like Canada or Australia.
When was the last time you passed near Nyayo House? You have probably seen the impossible crowds. One can safely assume that those looking for passports want out of the country for various reasons.
I happen to have worked with a few agencies that send Kenyans abroad, from low-skilled workers (to Dubai, Doha and other places in the Middle East), to high skilled labour (to Western countries mostly). So many of my folks, given the limited farming opportunities in the village, have moved to the Middle East and America, where most of them work on low-end, but better paying jobs that anything the country can offer.
It is not just the manual labourers who want out of the country. Increasingly, people with university education are moving out of the country, reminiscent of the exodus witnessed in the 1980s and 1990s during the repressive regime of Moi, compounded by the Structural Adjustment Programs that saw the economy shrink so badly in the 1990s.
It is a quiet exodus.
One of the best things that come with age is the shattering of youthful idealism. You learn sooner than later that not all dreams are valid. You discover the ideal house you visualized, your dream car, and the neighbourhood you wanted to live in can be decidedly elusive. And as you grow older, you constantly adjust your expectations, adopting a cold-hearted selfishness, and pragmatism, for yourself and for your family.
I know at least six other friends who left the US and the UK, and at least four of them have had it so tough, the last I checked, they are at advanced stages of going back abroad to pursue a Ph.D. or looking for work as skilled immigrants. Never before I have ever been inundated with links for job applications and advice on how to emigrate to some of the better countries in the West; UK, Netherlands, Belgium, USA, Canada, New Zealand, Australia and the Scandinavian countries.
Yet the timing couldn’t be worse. In the West, the rise of right-wing governments spurred by collapsing or stagnating economies has inspired a wave of xenophobia targeting foreigners, and dark-skinned immigrants are especially not welcome.
But even so, we want to leave. Because the economic prospects for men and women of my generation look dim. According to a Pew Research Center study in March this year, 54 per cent of Kenyans wanted to relocate. They cited corruption, the high cost of living, poor living standards, and search for better housing, healthcare and education opportunities. Life has become unbearable.
And SAPs 2.0 are about to hit harder, as thousands of employees are set to lose jobs when the government sells 26 parastatals. With inflation, and the slow death of affordable public health care and education, the timing could not be worse.
I used to earn more as a student than I do as a grown-up adult, with a family and a daughter about to join school. Public schooling is in ruins, higher education in an irrecoverable mess, so much that middle-class and upper-class parents have totally lost all the hope in public schools and send their children to expensive private schools, the better if they run a different “international system”. But private education is so expensive that kindergarten annual tuition fees in some of the average schools is more than what a university student pays for their tuition. And many millennial parents are not going to afford it.
For healthcare, half of the WhatsApp groups we are in are for fundraising for sick or deceased folks since families cannot afford to pay for their relatives’ healthcare in decent hospitals.
We know the Kenyans in the diaspora are often homesick. Given a chance, many would return. Indeed, their remittances tell a story of unshakeable faith in their motherland – in 2017, Kenyans remitted over $1.9 billion from the diaspora – but the government hardly accords them any significance.
“Indian Prime Minister Narendra Modi spares time when he goes abroad to meet Indians living in that country. President Uhuru Kenyatta rarely does it. But this helps build a connection between migrants and the motherland,” says Mukurima Muriuki, a Kenyan conflict resolution expert based in California, USA.
The same can be said of countries like Lebanon that keeps a database of professionals abroad. Or Ireland that taps into the potential of its expansive diaspora network. Israel too.
Similarly, the growth in industrialization as well as the information and technology rapid growth of the Asian tigers has been credited to returning immigrants, and the sustained ties ensure that both the host country and the motherland benefits.
In Kenya’s case, it feels like contempt towards those in the diaspora is always on constant display. Like the recent launch of direct flights to America that hardly involved members of the diaspora who ordinarily would make the bulk of the users of the flight.
But because we mostly send low-skilled workers who end up in menial jobs, there is little exchange of skills that can transform the country. More individuals end up in middling jobs, with no way to really contribute back home, beyond building an ancestral home (essentially, dead capital) and buying more meaningless pieces of land for lack of alternatives.
High skilled individuals often gain citizenship to the host country, and their brains end up benefitting the host country more than the mother country. Think of the late Professor Calestous Juma, a celebrated international authority in the application of science and technology for sustainable development worldwide, who was at Harvard University at the time of his death last year. If he stayed in Kenya, he probably would never have risen through the ranks – and would never have ascended to the status that Harvard afforded him. One can think of the top Kenyan academics, thinkers and writers who spend their lives in the Western institutions because their country has spurned them.
This country loses so much in terms of skills and ideas. And worse because we are not creative enough to utilize the diaspora beyond just remittances. We could use more transfer of skills and ideas.
Still, I am starting to think that when your country does not love you, you have no obligation to love it back.
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