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Reflections

EMPTY ARMS: The story of Kenya’s broken maternal health system

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EMPTY ARMS: The story of Kenya’s broken maternal health system
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This ‘Brazen: Reflections’ series was born out of a desire to continue the conversations springing out of the ‘Too Early For Birds: Brazen’ theatre performance in Nairobi in July 2018. TEFB-Brazen was a mix of straight-up scripted theatre, narration, poetry, music and dance that featured the little-known stories of six fearless women in Kenya’s history – freedom fighters like Field Marshall Muthoni wa Kirima, Mekatilili wa Menza and Wangu wa Makeri; democracy activists Philomena Chelagat Mutai and Zarina Patel and even one iconoclastic yet nameless woman warrior who brought down Lwanda Magere, the legendary ‘Man of Stone’ in Kenyan folklore. The story of each hero was narrated by a corresponding mirror character on stage. The ‘Brazen: Reflections’ series seeks to explore the idea of brazenness, what it means in our daily lives, whom the idea of brazenness privileges or erases, and the place that brazenness has in imagining freedom. 

 

The pain

The morning of 3rd November 2013 is still so clear to me, almost five years later. I remember waking up at 2:11 a.m. in so much pain I could barely stand. I remember waking my husband who was sleeping next to me. I remember how calm his voice when he said, “dress up, let’s go to the hospital”. I remember what I wore – a green dress with black floral patterns. I remember touching my belly and wondering why it felt so hard. I remember my husband driving like a crazy person, ignoring every red light on the way to Nairobi Hospital. I remember how the emergency area of the hospital looked dreary and depressing. I remember the relief I felt when I heard my daughter’s heartbeat but then a twinge of anxiety when the sonographer said her heart rate was higher than it should. I remember the next nine hours clearly, up until noon, when my water broke and I pushed my baby girl into the world. I remember seeing her tiny body on a tray and hearing the doctor say “I am so sorry she didn’t make it”. Then everything from there is a blur.

The people that came to visit us in hospital were very kind, but for the life of me I cannot remember any of the conversations we had. A few pastor friends stopped by and prayed. I had trouble closing my eyes though. I was sure if I closed them, the darkness in my heart would overwhelm me. The only thing I remember about the days that followed is my first shower. I stepped out of my bed, legs shaking and eventually made it to the shower. And I touched my belly and there was nothing where my baby bump had been. And I sobbed in the shower, wishing I could die. But I didn’t. And at first, I was deeply disappointed with God for letting me live. But I went home and experienced so much love from friends and family. I remember Timo and Lo (a couple who lived near us) coming to our house with food. That was the first night I laughed since my daughter died. And my journey of healing began.

Seeing in colour

A month after coming from hospital I wrote about losing our daughter on my blog. I had resigned from my job. So here I was, unemployed, with no baby to look after. The blogpost was my way of trying to understand what had happened to me. Then, I felt, if I just wrote it down, it would stop having so much power over me. And the writing helped. I felt lighter – the kind you feel after a good cry. But soon after I received numerous calls, emails and messages from people who had lost a baby or knew someone who had. I don’t know why I did it but I reached out to these people. Here I was, still raw from pain, listening to other devastating stories of loss. For some reason, holding hands with these parents, crying together and encouraging each other started me on my healing journey. Somewhere along the way my heart was strengthened. At some point I started to see in colour again. And though some nights were long and teary, there was a new hope in my life.

I started Still A Mum officially in October of 2015. It is a not for profit that provides psychosocial support to parents who have gone through miscarriages, stillbirth and infant loss. In the three years I have been doing this I have met over 850 men and women beaten down by the death of their baby. Broken by the lack of support from their family. Angry because of the myths their neighbours have about why the baby died. I have met couples that have lost an eight-week pregnancy and people dismissed their loss and called their baby a “mass of cells” not knowing that they had been trying to get pregnant for six years. I have met university students who were terrified when they found out they were pregnant, and even considered abortion, but decided to keep the baby. Then sadly lost the baby. And this baby, not wanted at the beginning, but loved over time brought them such sadness when they were no more. Every year we plant trees to mark Pregnancy and Infant Loss Day in October and my heart is so full to hear a man tell me, “Thank you for giving us a chance to plant this tree in memory of our baby. This is the first we are speaking about our son since he died.”

For Women Who Are Difficult To Love

Read also: The Brazen Edition

Sure, my life took a detour I am so grateful for – from a career in tech to running Still A Mum. Half the time I feel like I have been thrown to the deep end because I am not a counsellor, yet I am here to offer comfort to grieving parents. Of course, I often feel boggled down by the high numbers of pregnancy and infant loss. We are barely scratching the surface and it breaks my heart to know there’s a woman who has lost a baby and has no one to walk with her. Yes, I have missed the glamour of employment life, and the security of a paycheck. But that passes when I meet a mother I have counselled and she’s laughing again. When I run into a mum who tells me that they have recovered from a loss and are even thinking of having a baby again, I get overwhelmed with joy. That’s being Brazen.

***********

The broken health care system

That being said, every day I come face to face with Kenya’s broken health system. Perennially, I see how much more work needs to be done. Did you know that Kenya has 23 stillbirths for every 1000 live births (the rate is 10 for Mauritius and Seychelles, the safest places to have a baby in Africa, and just ten in the US and UK)? Did you know that in Kenya we define stillbirth as the loss of a pregnancy from 28 weeks while developed countries it is from 20 weeks? That means that in those countries a baby born at 21 weeks can make it?

Do you know how many hospitals in Kenya can handle a birth emergency? How many health centers have incubators? Or even a theatre for a basic caesarian section birth? Did you read about the mother who lost quintuplets in Kenya last year? I went to visit her in Oyugis and saw how devastated she was to bury five babies. Five babies! And why? Because she could not go for antenatal clinics because the nurses were on strike, and so assumed she was pregnant with only one baby. On the day when labour started she thought she could handle the birth at home, with a midwife. Until she delivered two babies and the midwife saw there were more. And she was rushed to a hospital in Oyugis where she delivered the other three. Who had to be moved to a hospital in Kisii because the first hospital did not have incubators for the preemies. Eventually because of the movement and the cold the three babies died. And just like that a woman lost five children! That is our health care system.

But that is not what riles me most. I am most angry about how Kenyan hospital staff treats mothers and fathers after the loss of their baby. During the support group sessions I have heard some of the most devastating stories I’ve heard in my life.

I went into labor when I was 23 weeks pregnant. The nurse that came to my bed said “mama, huyu mtoto akizaliwa atakufa tu”. She said that because the baby was too young their chances of survival are almost nil. All I could hear was that “atakufa tu” statement. It was so callous. I didn’t know I would be experiencing a lot worse. As soon as I pushed the baby out, the midwife lifted my son and threw him in the trash can as I watched. Soon after, I started to throw up because my blood pressure was really high. Without missing a beat, the midwife handed me the trash can she’d put my baby in so I “stop messing her floor”. Can you imagine how I felt throwing up on my baby?! I had nightmares for months. – Joan*

I lost my baby at 36 weeks of pregnancy. My daughter died in my womb about 24 hours before I came into hospital. “Mama, hapa hakuna heartbeat” The sonographer said while staring at the monitor. Then I was sent to the maternity ward and nobody explained anything. I just saw nurses setting up the drip and putting it in my hand. A few hours later I went into labor. After delivery when I asked if I could see my girl I was asked why I would want to see a dead child. Then I spent the night in the maternity ward – I could not sleep hearing all the babies crying yet mine was dead. It was the most traumatizing thing I’ve ever gone through. I demanded to be discharged the very next day. – Ruth*

I stayed in Newborn ICU (NICU) with my son for 6 weeks. Every day was fighting a new battle. Some days were good, some were tough. One day he’d be doing well the next he’d be fighting a new infection. Because of the bill that had already accumulated my husband and I had decided I would be commuting instead of sleeping in the ward. Most days I just slept in the car. Six weeks in I was exhausted both physically and mentally. I had cried until I didn’t think I had more tears. I had prayed, desperately asking God to take my life instead and spare my son. I didn’t know if I could take more bad news. Then on Thursday May 4th 2017 I walked into NICU and saw a group of doctors and nurses surrounding my baby trying to resuscitate him. Not more than five minutes after I walked in, the machine stopped beeping. Immediately they set my son aside and put another baby into the incubator. They didn’t even wrap him up. They just left him there naked and cold. – Cynthia*

I hear these stories so often and each time it breaks my heart. I meet women who doctors have ignored their calls for help, or the midwife disregarded information they gave that would have saved their baby’s life. I listen as fathers narrate how they paced the corridors outside the theatre only to be told their babies died. And how painful it was for them to break the news to their wives. Our bereavement care is almost non-existent. Our health care is totally devoid of compassion. Medical practitioners leave medical school knowing how to diagnose a patient’s illness and prescribe medicine. They know how to conduct difficult surgical operations. But they are caught flatfooted when they have to break bad news to a patient. They are devoid of empathy. And I understand that most are overworked and already doing more than is required, but a little compassion is required. Saying “I am so sorry for your loss” goes a long way.

I know we can do better. The situation definitely feels bleak but we can start to fix it. Every day we can change systems that don’t work and introduce some new ones that do. Every day we can get feedback from patients and see ways to improve. We don’t have to have world-class facilities to start seeing change – we can be more compassionate and humane and not belittle the loss of a baby. We can start where we are and visit a bereaved parent. And hug them. That’s Brazen.

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Wanjiru Kihusa is a family blogger, social media consultant, marriage supporter and a miscarriages activist.

Reflections

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

* Name has been changed.

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Reflections

The Paradox of Choice: Just Another Family Tale

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

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

~ Forough Farrokhzad

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mother

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

This taught me that this life had to be enough.

Father

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

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

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

Epilogue

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

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

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Reflections

The Night Watchmen: Hustling in a Time of Coronavirus

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

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

“Who?”

“Amanuel.”

“Who is, Amanuel?”

“Your friend. They killed him.”

“Who, are you talking about?”

“Amanuel-Maantje!”

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

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

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

So reading the news report literally broke my heart.

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

I called him “Little Man”.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Those were the instructions.

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

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

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

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

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

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

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

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

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

Little Man waved him over.

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

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

“Really?” I said, which gave me away.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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