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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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By

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

Stealth Game: The Proverbial Has Hit the Fan

The report of the Oakland Institute is simply saying what I have been saying since 2016. That “Community” Conservancies Devastate Land and Lives in Northern Kenya.

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Stealth Game: The Proverbial Has Hit the Fan
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Many of my friends, particularly those from outside the conservation sector have been puzzled by the silence that has followed the release of the Stealth Game report by the Oakland institute.

This, my friends, is because you people mistakenly imagine that conservationists in Kenya are normal, functional human beings. They are NOT, and the rational ones are fewer than five per cent, the scientific threshold for statistical significance. For those of us who know them well, we can read and interpret this silence to a high level of accuracy.

First of all, rest assured that everyone who needs to see the report has seen it, including government officials at both county and national level. I personally forwarded it to an official at the highest levels of government, and the response I received was “thank you”—at least an admission of having seen the report. Interestingly, two senior county government officers also forwarded the report to me, leaving me wondering what exactly they see as their role in the whole scandal, as opposed to mine as an individual. The silence is only in the public sphere. I have direct contacts in a lot of private spaces where the Oakland report is causing a lot of wailing, gnashing of teeth and breaking of wind.

The key point we all need to understand here is that people are in trouble—bringing to mind that uniquely American expression about faecal matter hitting the fan and splattering everyone in its vicinity. Here’s why: A couple of years ago, a few colleagues and I visited the US House of Representatives in Washington DC to present a memorandum on human rights abuses in central Africa committed by the WWF under the guise of conservation, an issue we also brought to the attention of various European legislatures. It has taken time, but the cosh has come down on the WWF, culminating in a Senate hearing earlier this year, which has severely tightened the screws on them. Therefore, the consternation that has greeted the report is disingenuous, because none of this information is new—it is simply saying the same things that a few colleagues and I have been saying since 2016.

The conservation sector in Kenya routinely dismisses any questions from black Africans and the consternation is because the report is coming from an American institution, and cannot be dismissed on racial grounds. An amusing anecdote I’ve heard from one of the conservation groups is, “This is just the usual noise from Mordecai Ogada. . .” But when another member says, “No, it’s from the Oakland institute in the US,” all hell breaks loose with people crying “Oh my God! What are we going to do?”  In another forum, a senior participant (who obviously hadn’t read the report) dismissed it as lacking credibility, “Since the only source of such information is Mordecai Ogada (again!!??). When another participant pointed out the report was the result of over two years’ research she changed tack, attacking the author Anuradha Mittal based on her racial and family background. The strange thing is that this woman is also of the same racial background as Mittal! Many people will find this bizarre, but I don’t. Our conservation sector is so steeped in racial and ethnic prejudice that it is shameful. Apart from dealing with people who don’t want to hear me because I am black, I’ve had to deal with indigenous Kenyans who routinely tell me to keep off wildlife issues in northern Kenya because I am a Luo from western Kenya!

The key issue of rights violations is studiously avoided by conservationists to a ridiculous degree. I’ve seen conversations where The Nature Conservancy’s communications director is asking a whole group of conservation professionals how they can “counter Mordecai Ogada’s narrative”. A couple of years ago, the Northern Rangelands Trust hired Dr Elizabeth Leitoro as “Director of Programmes” and one of the key expectations was that she would somehow “control” Mordecai Ogada (yes, again) since over 20 years earlier I had been her intern when she was the warden at the Nairobi National Park. Dr Leitoro asked to meet me, and my son was patient enough to sit with us as we talked. She later launched a racial attack against me and my family on social media in defence of the NRT (she deleted the tweet and blocked me, but I still have a screenshot; the NRT got rid of her). This shows the neurosis bedevilling conservation in Kenya.

These conservationists will scream, shout and make personal attacks and noise about everything EXCEPT the problem at hand. Secondly, they are obsessed with appearances, so you will never hear a word said by any of the foreigners who run the show. It is always the ill-advised, ill-prepared but well paid locals who come out in robust (if somewhat foolish) defence of their captors. Right now the national government, the county governments, and conservation organizations are all tongue-tied because they don’t know how to dismiss criticism from the US, where their lifeblood funding comes from. USAID is the biggest conservation funder in Kenya, and the biggest grantee is the NRT, which confers on them God-like status here. All the other conservation voices like the Kenya Wildlife Conservancies Association (KWCA) or the Conservation Alliance of Kenya (CAK) that receive small-change grants cannot say a word against their “leader”, the NRT. That is why five days later, the CAK claims to be “still reading the report”. They are waiting to see which way the wind is blowing before they make any noise or break any wind in defence of their fellow Kenyans.

Mark my words, these people have colossal reach; that’s why even the government has said nothing. There was a major press conference in Nairobi on 17th November 2021 about the Oakland report, and all the major media houses in Kenya were present, but the story has been “killed”. They have a huge PR machine, and if anything in the report were untrue, they would have torn it to shreds. Their bogeyman, Mordecai Ogada (frankly I’m a bit flattered!), is not in the picture, so they cannot point fingers at me anymore, and must now address the ISSUES. I am informed that some heads have already rolled. They are big, but not big enough to kill the story in the US public policy space. The WWF learned that the hard way. There shall be wailing, there will be hypertension, some hyperacidity, diarrhoea and other stress-related illnesses, but it looks (and smells) like change is coming.

This silence isn’t of the golden kind, it’s the silence of sick, trembling cowards caught in a big lie. I have nothing to add to the Stealth Game report, but wherever and whenever I will be asked to say something about it, I will not let anyone get away with trying to look shocked. I will always state just how I told them about this injustice five years ago, but it never mattered then. Because I am black, if truth be told.

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Reflections

I Know Why God Created Makeup

I am an economic migrant without the luxury of choice. I am not ready for Kenya yet so I must wake up, put my makeup on and take up my station by the dialysis machines.

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I Know Why God Created Makeup
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It is half past five in the morning and your eyes are heavy with sleep. It is fascinating that they should be this lethargic, yet they would not close for a wink or two in the past eleven or so hours of the night. Lately your body seems to be operating on a paradoxical circadian rhythm– sleep when you shouldn’t and stay awake when you ought to be sleeping. You are a nurse and constantly tired. Translated, it means that you are one patient away from a mortal accident. You slap the alarm clock into silence, eyes half open set another alarm for half past six on your mobile phone, which has permanent residency under your three pillows.

You have been using three pillows for a while now. There does not seem to be one single shop in the world that sells decent pillows. The pillows in this city are as thin as a tongue. The lowlife of pillows. They smell of dying hope and unhappy thoughts. They are the sopranos in the pillow choir. Irritating but necessary. We therefore use three of them to allow them to accord each other some moral support. You miss fluffy pillows. Pillows like the ones you lay on at that posh hotel in Naivasha during your disastrous honeymoon a few years ago. Nostalgically, you go back to Naivasha in your sleepy mind.

There is a hazy recollection of that honeymoon. It was not meant to be because the wedding was not to be either. But they both happened. You know they did because you can hear yourself screaming in agony as another harsh word lands on your soul. But despite the honeymoon’s calamitous ending, you miss the pillows. They took to your torrential tears like a babe to its mother’s breast. They soaked the tears up perfectly and left no traces. He never once stirred. He was so drunk he could have been half dead. You had wished for the latter before you met Jesus. We do not think such thoughts nowadays and if we ever do, we will blame it on these scandalously uncomfortable pillows.

The summer morning’s sun tears precisely through your curtains like a surgeon’s blade. You love summer but you don’t like the glare of the morning sun. It is too bright. Accusatorily bright. Like it came to remind you what a slob you are for snoozing your alarm. It stands there, hovering over you like your mum when you wouldn’t complete your homework but wanted to read a Harry Potter novel instead. Mum would not go away, nor will the sun. Begrudgingly you wake up. Legs dangling onto the side of the bed, you will the rest of the body to join them on the peach-coloured bedroom rug on the floor. You miss the days when peach was just some fruit.

Eyes still closed, you head to the bathroom. You are startled into alertness by the girl staring at you in the mirror. She is as hopelessly worn out as a politician’s promise after campaigns. She looks like a thousand trucks ran over her and a group of snow-white owls perched on her hair. The wild hair tendrils falling on your face are a pasta disaster. My God, the lint from those pillows! You whisper. It is however more than just lint. Your eyes are red and puffed up. Like you hid two baby donuts under the eyelids and now the world can see your secret eating habits.

You are expected to be at work by half past seven, nursing patients. The COVID-19 pandemic rages on and you are not sure how much longer you can keep it together. Take that lovely patient yesterday, for example. She stood out from the first time you met her. She allowed you to needle her dialysis fistula as a new nurse. She was welcoming. Showed you pictures of May, her cat. Always had a joke for everyone. She entertained the unit with great panache. She had perfectly manicured nails which put your grooming routine to shame.

For fifteen years, kidney failure never took her life. But she died yesterday. She contracted COVID-19 and passed away. This is not an isolated case. The story keeps repeating itself. Like a repetitive bad dream, the carrousel of mortality keeps coursing through the hospital.  Too many dialysis patients have been lost to the coronavirus.

Nobody acknowledges it but your colleagues are gutted by her death. Their demeanour is typically British though, they are long suffering. They wear resilience on their faces and spot plastic smiles to hide the pain. British nurses are averse to complaining. They take it all in their stride. Either that or quit. What would you not give to be able to quit nursing right now!

On the other hand, you are an economic migrant in the United Kingdom. Your life in the UK is governed by the terms and conditions of your visa. The terms say you are to be a nurse for the remaining period on your visa. You cannot leave. You risk being deported to Kenya if you exit nursing at the moment. You are not ready for Kenya yet. You envy Amy and Moraine. Two highly skilled kidney nurses from Scotland. They recently quit nursing altogether. Amy went back to university to study accounting while Moraine has started a coffee shop. The luxury of choice.

You take a quick shower, scrub your hair so hard as if you were shaking your brain from a lingering nightmare that it half hurts. Six and a half minutes later, you are staring at yourself in the dressing mirror. You have been in this flat for a year now and have never once used the dressing mirror like you want to use it today. To glam up the top half of your face.

Following a YouTube tutorial, you start applying acres of ridiculously expensive products on your exhausted face. Your patients are expecting a buoyed-up nurse; that is what they must get. This is why God created makeup. You pay close attention to your eyes. The windows to the soul. These windows needs some maintenance. The eyebrows are up first.

Your eyebrows are a strange phenomenon. The hairs are few and far between. You can never shape them perfectly to save your life. You scribble and doodle with some eye pencil YouTube influencers swore by and finally manage to draw two diagrams of West African evil spirits chasing after one another. Your signature mismatched eyebrow look.  Feeling accomplished, you open your eyes wide and, stroke after stroke, you apply mascara on your eyelashes. The damage is then covered in some dark eye shadow. Only the top half of the face matters. The face masks and visors worn at work have rendered the lower half of the face irrelevant. Who wants lipstick smears on their face mask? Not you, you conclude.

At twenty minutes past seven, you are at work already. You are helping prepare the dialysis machines. Jean, your nurse colleague streams in. She has had her eyes done too. She is wearing some glittering eyeshadow. Her eyebrows look like what yours would be like when they grow up. You can see a hint of foundation on her forehead. You let out a sigh of relief. God created makeup for tired nurses, you surmise.

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Reflections

The Charles Mugane Njonjo I Knew

Much will be said and written about Charles Njonjo. The Charles Njonjo I knew was a steadfast friend and a man of his word without hesitation.

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A lot has been written and a lot more will be written about the late Charles Mugane Njonjo who has passed away. I would like to tell my own personal story. I never knew him as a bureaucrat or politician. Indeed, our paths crossed immediately I left high school in 1983. Together with colleagues, we had written a play and planned to perform it for the public. We searched our minds for a public figure who would agree to come as guest of honour on opening night. We sought someone who would attract public attention to what we were doing, but more importantly for us 17-year-olds, someone who would agree to show up. Charles Njonjo’s name was all over the news at the time. His political career had just been truncated amid the prolonged political drama of the “traitor affair”. He was a figure of great public fascination for a variety of colourful reasons. We also had the names of other public figures on our list and I was tasked with reaching out to them.

Frankly, I wrote to Charles Njonjo not expecting to hear from him. He replied immediately, though, and accepted the invitation to be guest of honour at the opening night of our play, The Human Encounter, at Saint Mary’s School in Nairobi. Once he accepted the invitation, we excitedly proceeded with preparations for the opening night. A few days later, however, we were informed that, unfortunately, the authorities had deemed Mr Njonjo’s presence at our event unacceptable and the decision was not negotiable. I informed my colleagues and we decided that since we had worked hard on the production we would obey the orders from above and proceed with our play without Mr Njonjo. There was no need for a fuss. I then had the embarrassing duty of disinviting Mr Njonjo when he had already accepted to be our guest of honour.

I spent a whole night drafting the letter and in the end, my late father told me not to agonise excessively, “Njonjo likes to be told the truth directly.” So I wrote the disinvitation letter as clearly and as respectfully as I could. I asked a friend of his to pass it on to him and did not expect to ever hear from him again. The message I received promptly back surprised me. Njonjo expressed his deepest appreciation for the invitation and explained that he fully understood why it had been withdrawn. He asked that we remain in touch. I was deeply relieved. Over the years, he would reach out to me through family and friends and we would interact jovially, remembering the letter I had written retracting his invitation as guest of honour. “No one has ever done that to me,” he would joke over tea.

In the early 1990s, as political pluralism was returning to Kenya, violence broke out in Nyanza, Western and Rift Valley provinces. At one point, hundreds of thousands of Kenyans were displaced as our elites arm-wrestled for power. I travelled to Laikipia and then to Burnt Forest and was aghast at the state of the internally displaced that had been forced from their homes by the violence. Together with Dr David Ndii and Mutahi Ngunyi we launched the “Kenyans in Need” appeal. The then chief editor of the Daily Nation, Wangethi Mwangi, gave us free advertising space to mobilise resources for the displaced – especially those in Ol Kalou who had been evicted from Ng’arua in Laikipia. The late Archbishop Nicodemus Kirima of the Archdiocese of Nyeri agreed to use the relief infrastructure of Catholic Church to distribute any donations that came our way. Laikipia fell under Kirima’s remit.

The response to the appeal was surprising in its scale. People donated second-hand clothes, books, shoes and cash to the appeal. We received around KSh1 million worth of donations over the following months. We delivered the first batch directly to the philosophical Archbishop Kirima at his official residence in Nyeri, unique because of its specially built library full of the books he clearly loved. Our biggest and most consistent donor throughout the entire enterprise was Charles Njonjo. He was not keen to have his name mentioned but we would sit at his home drinking tea and reflecting on the political situation in the country.

When I joined government in 2003, Njonjo remained one of my steadfast providers of moral support. When news broke that I had been moved from the Office of the President to the Ministry of Justice, the first call I received was from Charles Njonjo. “You’re going to resign immediately, aren’t you?” he asked in his typically direct way. In the end, I didn’t. I sometimes wistfully recall his advice at the time. We kept in close touch.

When my situation in the Kibaki government went belly up in 2005 – as he had predicted to me many times – and I found myself in exile, Charles Njonjo became an even more steadfast friend. He stayed in touch and whenever he called, he would always enquire about my personal circumstances. He was a most interesting person in that way, loyal to his friends to a fault. Once you were his friend, he stood by you no matter how atrocious the circumstances. He would call to tell me he was coming to London and we would spend the day together simply walking the city, chatting and drinking tea. Back home I found out he was in constant touch with my family, offering moral and any other kind of support that might be needed.

When I returned from exile, one of the very first people to invite me for tea and a catch-up was Charles Njonjo and we took up from where we had left off in 2005. His observations on politics and about certain politicians were often wryly hilarious. His capacity to read people accurately was something I learnt. We would sit in his Westlands office and I would seek his opinion on this or that political interlocutor and in typical fashion he was always direct – “solid fellow”; “believe only half so-and-so says”; “take that one seriously”, etc. He was particularly dismissive of ethnic chauvinists and insisted that they held Kenya back in fundamental ways.

Charles Njonjo and I kept our friendship quiet. In part, this was because some of his diehard enemies were also my very good friends – the late legal giant Achhroo Ram Kapila SC among others. So, we didn’t discuss his enemies; he advised me on mine. Much will be written about Charles Njonjo and even though there was much we totally disagreed on politically, the Njonjo I knew since I was a teenager was a man of his word. He was a dear friend in ways I have never been able to share. There is not a personal problem that I raised with Charles Njonjo that he didn’t immediately seek to solve in his no-nonsense style. Njonjo could be a very funny man, full of jokes and insightful observations without a taint of bitterness. To me he was funniest when he joked in Gikuyu, which some people thought he couldn’t speak.

As I have said, much will be said and a lot will be written about Charles Njonjo. The Charles Njonjo I knew was a steadfast friend and a man of his word. I have lost a dear friend and wish his family succour as they mourn him at this time.

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