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Am I Going Mad: A Reflection on Mental Health in Kenya

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While the public debate on mental health is welcome, as a person recovering from a mental disorder, there is need to push a wholesome discussion on the reality of the state of mental health in Kenya beyond depression.

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Am I Going Mad: A Reflection on Mental Health in Kenya
Photo: Olu Famule on Unsplash
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Monday, 17th December 2018 was a normal day that stubbornly refused to conform to my expectations. An impulsive decision made at 3:30 PM in a 46 Matatu heading to the Nairobi city centre dramatically altered the direction of my life.

I was on my way from Inuka Kenya offices, when a gut feeling nudged me towards the Doctor’s plaza at Nairobi Hospital. I wanted to see a psychiatrist who could recommend some sleeping pills.

When I arrived at the Nairobi Hospital, the two psychiatric consultants had both closed their offices for the Christmas holidays. Feeling unsettled, I decide to seek help at the adjacent Upper Hill Medical Centre where I quickly scanned the directory board on the first floor desperately trying to locate a psychiatrist before closing time.

Too impatient to wait for the lift, I bolted up the staircase, arrived at the reception on the third floor, and to my relief, I found other patients waiting in turn.

I walked up to the receptionist who would not accept my Jubilee Medical Insurance card: “Your insurer hasn’t installed glade which should be used to raise a claim for your card. Sorry we can’t serve you,” she said bluntly while handing it over.

I was adamant and decided to press on. “Is there any other way? Can you call the insurance company so that I can be treated and you deal with the claims later?” My persistence paid off. A few minutes later, as if fate was moving mountains, I was on the phone with my insurer who found a way to resolve the challenge.

I had seen celebrated psychiatrist Dr Frank Njenga on TV. His analysis fascinated me. Only this day, I was not arriving in my capacity as a journalist to get expert opinion on a story. I was a patient.

My sleep patterns had gradually deteriorated to their worst state as far as I could recall. It had been weeks of violent nightmares. Bad people with crude weapons wanting to kill me and rogue Ikolomani Bulls chasing me through the night.

I could not outrun death and when I tried to scream for help, I found my voice frozen. I felt helpless and trapped in the nightmares. I would wake up in panic, breathless and sweaty. I wanted to see a psychiatrist who could recommend some sleeping pills just like one had done in 2014 when I had a similar experience.

Frank Njenga was wearing a clean white shirt with a blue-stripped tie. His smile and calm demeanor disarmed me on the spot. “Tell me more about yourself,” he asked after exchanging a few pleasantries.

I went on and on about my family’s history, and myself while his head was glued on my file taking notes. Sometimes he would lift his head when I said something that sounded like a trigger. “Tell me more about incident, what happened?” he would ask when I explained some of the darkest seasons I had gone through recently.

He gave me a piece of paper, which had about 30 questions and told me to tick statements that closely represented how I had lived my life. While he had hoped that I would only tick about 10 when he looked at the paper, I had ticked 25 out of 30 and that’s how he partly discovered what had been eating me. To ascertain his preliminary findings, he sent me for a cognitive test to corroborate what he was suspecting.

What I thought was just a simple sleep issue turned out to a symptom of something deeper.

“I’m glad you came here, we are going to help you,” he reassured me as we chatted for about an hour, the longest I have been in a doctor’s office.

“Odongo, we may need to take you to a place so that we can monitor your sleep and find out if there are other underlying issues,” he advised as there was sufficient evidence that I needed to be monitored.

I knew the weight of inadequate sleep and was desperate for a solution. I accepted his suggestion.

“Mental health is like an onion, we peel it from the outer layer as we dig in. That’s the only way we can find out the core of the problem,” he added.

When we arrived at the gate of Chiromo Lane Medical Centre in Lavington, I saw a disturbing sign: Visiting hours is between 9-11 am and 3-6 PM. My panic buttons went off. I was not suicidal and I did not have the urge to harm other people. I just had migraines, nightmares and an anxious mind. Why was I being admitted into a restrictive hospital?

Begrudgingly, I agreed to check in for a night. The bungalow house that sat on a lush green serene environment complimented by the friendly staff all disarmed me.

In hindsight, this was one of the best decisions, I made in my life. For the next six days, I would go through an overwhelming journey of self discovery that I was hardly prepared for.

At the end of the first day, I was diagnosed with clinical depression, mild Attention Deficiency Hyperactivity Disorder (ADHD) and trauma. Though I was predisposed to some of the disorders, a toxic work environment for five years, an emotionally abusive relationship and front row coverage of the 2017 traumatic elections as a reporter played a key role in triggering the sleeping demons that landed me in a hospital.

After I was done with a two-hour therapy session, I slowly dragged my exhausted body back to my admission room. As I sat on my bed while listening to music, a wave of emotions descended and I broke down and wept. I slowly moved from the bed and sat on the floor with my back against the wall and legs straightened. For the next three hours, I wept until I felt weak.

Kenya Mental Health Policy (2015-2030) indicates that mental disorder cases have risen exponentially in Kenya. Estimates point that 20-25 percent of outpatients seeking primary healthcare present symptoms of mental illness at any one time. There are no sufficient qualified medical personnel and facilities to take care of this lot of patients.

A 2015 performance audit report from the Office of the Auditor General (OAG) on the state of mental health paints a grim picture. As at 2015, there were only 92 psychiatrists in the country instead of the 1,533 required. 327 psychiatrist nurses instead of 7,666. The report stated that “While it’s expected that a psychiatrist should serve 30,000 citizens, currently a psychiatrist is serving about half a million citizens”.

I still count myself privileged to have gotten medical attention. The ability to afford private insurance cover, know where to go when symptoms arise and get treated by Dr. Njenga is privilege.

Millions of Kenyans who struggle to meet basic needs are exposed to mental disorder triggers stemming from their environment and cannot afford this privilege. For the poor masses in Kenya, quality primary health care is a mirage. Add the lack of specialized mental healthcare and you condemn a whole section of the population to destitution.

Mathari Hospital, which is an affordable public facility and the only hospital in the country offering specialized psychiatric services and training is in a sorry state according to the OAG. For the three financial years, 2013/14, 2014/15 and 2015/16 Mathari hospital was provided only about 30% of the funds allocated under the recurrent expenditure and nothing under the development expenditure.

As government policy, all mentally ill law offenders who require in-patient services can only be admitted in Mathari Hospital under the Maximum Security Unit regardless of severity of their condition. They make up 35 percent of the inpatients in the hospital yet there is no cost sharing to take care of them thereby straining the already limited resources.

Low funding means that apart from inadequate equipments, the wards are also insufficient with the hospital being reported to have an average bed occupancy rate of 115 percent. The low stock of critical drugs, inadequate skilled and qualified personnel to handle the patients are some of the issues plaguing Mathari as raised by the OAG report.

On the receiving end are the patients who are dependent on the hospital receive poor services including delayed diagnosis that can make the condition worse. While National referral hospitals should provide specialized healthcare services and should operate with a defined level of autonomy including a Board and a Chief Executive Officer, Mathari hospital is the only psychiatric hospital of its caliber in Kenya that operates under a department in the Ministry of Health.

The national statistics do not offer any reprieve either. County managed hospitals where the bulk of the nation relies on for mental health care is stuff of horror.

In the 47 counties, only 25 have psychiatric units. Even in the 25 counties where the services are available, they are pledged with the challenge of outdated equipment, inadequate stocks for essential drugs and insufficient personnel to treat mentally ill patients.

According to the OAG, besides Mathari national referral hospital, mental healthcare services are only available at 29 of the 284 hospitals in Level 4 and above of the referral chain. “This represents just 10% of the total facilities in Level 4 and above and 0.7% of the 3,956 government-owned health facilities,” notes the report.

A month before I walked into the hospital, I hardly thought that my relationship challenges could compound my psychological well-being. The revelations from a text message that came from my ex took me to the brink. That night, the thought of going to bed haunted me. I stayed on my couch writing until 4 am. I tried to pray but I could not. My heart was heavy.

My head was never the same after that night. It started to sound like the world’s busiest construction site. Constant hammering, grinders cutting through metal, welding machines and all sorts of construction chaos formed an unholy symphony in my head.

During the day, migraines became the norm and at night, insomnia took over. When I closed my eyes, I was battling anxiety unable to focus my attention on anything. I experienced anger, bitterness and a heavy dark cloud hovered above. I had never felt like this before.

While the public debate on mental health is welcome, as a person recovering from a mental disorder, there is need to push a wholesome discussion on the reality of the state of mental health in Kenya beyond depression.

We need to broaden the discussion to talk about different conditions and their symptoms, different medication and management of disorders. According to the World Health Organisation (WHO), there are over 10 mental health disorders affecting human beings including borderline personality disorder, anxiety and panic attacks, bipolar disorder attention-deficit/hyperactivity disorder (ADHD) among others. Depression is just one of them.

We also need to talk about inadequate mental health facilities and the few stretched mental health professionals. By solely pushing the message of depression, we downplay the reality of mental health challenges in Kenya and the manifest consequences.

Stigma and lack of accurate information continues to cost the global economy about $1 trillion every year in productivity due to depression and anxiety. WHO data, reveals that mental illness accounts for 30 percent of non-fatal disease burden worldwide and 10 percent of overall disease burden, including death and disability.

In 2016, the grim reality necessitated the World Bank Group (WBG), the World Health Organization (WHO) and other partners to kick start a call to action to governments, international partners, health professionals among others to find solutions to what is fast becoming a global mental health problem.

Leaving the hospital on 24th December, I was informed that Jubilee Insurance Company had rejected my claim for two reasons: The condition I was diagnosed with is not covered in my policy I was holding (Never mind that ADHD predisposes one to other mental illnesses like depression which they claim to cover).

For trauma and depression, which is covered under the policy, they said I needed a one-year waiting period (I took the cover in September 2018 after leaving formal employment) despite the fact that I was a previous policyholder with the same company for three years and my claim history was generally low and it didn’t have any mental illness.

I was furious because while signing the form, nobody informed me that I was entitled to a waiver. While I took time (2 weeks) to read the policy document, I didn’t notice that ADHD (I knew this condition when I was diagnosed in December) was not covered. The agent who signed me on was either too concerned with the commission or the corporate culture of the organization encourages ambiguity for profit gain.

My review of the mental health policy and the relevant laws including the Mental Health Act of 1978 and the Mental Health (Amendment) Act 2018, showed that the same clause they used to decline my claim is potentially discriminatory. The policy states in part “Ensuring that the health insurance system does not discriminate against persons with Mental, Neurological and Substance use (MNS) disorders in accessing insurance policies,”

Though not yet enacted, clause 3D(3) of the Mental health amendment bill of 2018 amplifies the 1978 Act more expressly: “A person with mental illness shall have the right of access to medical Insurance for the treatment from public or private health insurance providers. An insurance company or person providing health insurance services shall not discriminate against a person with mental illness or subject a person with mental illness to unfair treatment in obtaining the necessary insurance cover.”

As a good citizen, I appealed their decision using internal mechanism but I still hit a dead wall. I am now preparing to take the dispute before the Insurance Regulatory Authority (IRA) with a view to not only settle my bills but also to amend the discriminatory clause for personal policy holders.

Kenya grapples with a low insurance penetration rate at 2.68 percent. The 2017’s Insurance Industry Annual Report 2017 by IRA flags mistrust among the reasons listed for the cause of low rate of insurance penetration in Kenya.

As I began to investigate the nature of insurance claims for mental health cases, I have encountered numerous patients who have suffered mental health challenges and the stories are similar: A clever refusal to pay claims using technicality.

In developing countries like Kenya, the mental health landscape is often plagued with insufficient data to show the economic impact of mental illnesses. However, the effects are wide-ranging and long-lasting including the impact on the families’ and care-givers’ resources; the expenses related to crimes caused by the mental disorders; the productivity losses due to debility, morbidity and premature death; and the psychological pain borne by the patients and their family members.

There is also a correlation between the state of mental health and rise of the Sexual and Gender Based Violence (SGBV). Evidence shows that mental health has a crucial role in the primary prevention of sexual and gender-based violence (SGBV) even though most standard practice has focused on the role of mental health post-violence, and primary prevention relying on public health models that do not explicitly include mental health.

For example, research shows that empathy, self-esteem, compassion, emotional regulation and resilience, stress management, relationship building, and challenging problematic social norms are crucial for primary prevention of SGBV.

A 2016 report by the National Gender and Equality Commission estimated that the cost of GBV stood at KES 46 billion, which translated to about 1.1 percent of Kenya’s GDP due to medical related expenses, litigation costs, productivity losses among others.

More needs to be done to create awareness about mental health and its economic cost. Also, there is need for an immediate taskforce to collect data about mental health in Kenya to advise policy decisions.

In the words of Owen Arthur, former Prime Minister of Barbados: “For he who has health has hope; and he who has hope, has everything.”

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Dannish Odongo is a writer, journalist & researcher based in Nairobi. He's interested in the Nexus between mental health & governance. Follow him on Twitter @dannishodongo

Reflections

Reflections of Githeriman in the Age of Coronavirus

There is a world of githeri people living at the bottom of Nairobi’s urban existence, homeless or living in squalor. But the existential threat posed by the COVID-19 crisis has revealed that all our fates are intertwined, we are one, and the world has to acknowledge their existence as people, as human beings and not simply as labour, voters or markets.

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Reflections of Githeriman in the Age of Coronavirus
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The Government of Kenya’s hollow but public relations-savvy response to the coronavirus crisis has been wanting. The control initiative began following the appointment Cabinet Secretary Mutahi Kagwe to the Health Ministry in late February 2020. As the growing number of confirmed COVID-19 cases resulted in a worldwide pandemic, hysteria and public restrictions, the Health CS issued sterner directives that included fines and the threat of a jail sentence against those who failed to adhere to self-quarantine.

On the ground, however, there are signs of disorder. There have been reports of healthcare workers, unable to secure even the most basic face masks, judiciously scampering to safety at the sight of potentially infected patients. Nurses at the Mbagathi Hospital, which is serving as one of the designated national isolation centres, staged go-slows protesting lack of adequate training and protective equipment.

On 25 March the government announced a dusk-to-dawn curfew as a public control measure. On the first day of the curfew, on Friday 27 March, Kenyan citizens caught in the disruption of public transport as they tried to make their way home, met with police violence. Given an opportunity to show heroism, the administration was instead overwhelmed by its true nature, revealing its malevolent villainy. Two hours before curfew, police officers pounced on the unsuspecting public at the Likoni Ferry landing, unleashing indiscriminate brutal violence on women, old men, children and labourers trying to get home. This was only the beginning.

As the night wore on, video footage of the violence meted out on the public by the police—including footage taken by the police themselves—flooded social media. Public floggings of even those workers providing vital services that the government had exempted from the curfew—such as food delivery—were rampant all across Kenya. On the fourth night, a 13-year-old boy, Yassin Hussein Moyo, was shot dead by a police officer while standing on the balcony of his family’s apartment.

The bungling and ineptitude of the COVID-19 response by the Kenyan government has revealed that that which we are socially conditioned to call “our government”—that presumes a complex, omniscient and omnipotent establishment—is in reality dysfunctional. The coronavirus is revealing the truths of all levels of our incorporeal reality: our ideological system, our hegemon, our economics, our institutions and even our individual beliefs.

Sitting in Nairobi’s Eastlands, social distancing has turned out to be a cruel joke during this entire fiasco. It is an attack on the last human community we have. The one we were compelled to form after British colonialism took away our clans, our villages and our land; dumping us on that concrete public transport intersection called the city. The last human front is our neighbour.

The success of the British colonial enterprise in atomising our African societies in order to dominate us, by secularising our values and inculcating individualism into us, left us completely unable to defend ourselves against not only European aggression and plunder, but also against all predation. We have no defences, not just against economic predators like China but now apparently also against non-human threats like pandemics. “United we stand, divided we fall” is not a saying, it is an aphorism.

The colonial administrative infrastructure that was implanted by imperialism, disrupted and replaced our nuclear and extended families, our clans, our villages and our tribes through the systematic erasure of all avenues of communal bonding. Tribal social rituals were banned and children were separated from their families and herded into “Church Missionary Society”-run schools for re-education. Entire villages were condemned to concentration camps during the years of emergency. The colonial government, under whose auspices these violations took place, revealed itself to be nothing more than a policing infrastructure. The ideals of nationhood, property, healthcare, education all polydactyly, dysfunctional malformations masquerading as fingers. The Government of Kenya does not have a clenched fist, for a clenched fist could one day hopefully open into a gentle palm; it has a bludgeon.

We do not know our neighbours. Well, at least not intimately. We form extended families of convenience, to survive the harsh economic edge of these concrete jungles, but now capitalism has come for even that relationship.

Now everyone, including my neighbour, is a potential threat to my survival and that of my family. We are being compelled to teach suspicion and mistrust of even our neighbour’s children to our children, because how do you explain “social distancing” to a six-year-old boy? Children comprehend absolutes, not relative relations.

Meanwhile Twitterati elites with refrigerators choking with supplies frothed at the mouth, endlessly calling for lockdown. It is “us”, the hoi polloi who live in the bowels of the city—in Dandora, Mathare, Kawangware, Kibra—that the Twitterati elites are demanding that the government lock down.

Us, the Twenty-shilling Githerimen

As I read their tweets, I remembered a moment two years ago when an old man walked up to my friend’s food stall outside a Mosque in Dandora, a working class residential neighbourhood located next to Nairobi City’s garbage dump site. He politely asked for 20 shillings. What for? To buy githeri (a mix of boiled maize and beans). He had not eaten in two days. A plate of githeri was all he needed to get him through the day and night, and he could not afford it. From a position of privilege, many cannot perceive the economic value of 20 shillings nor imagine the economic microcosm in which it can have value, let alone how a man can be incapable of raising it. The Twenty-shilling coin is one of those irritating bits of loose change that we dump in the cup holders of our cars and use to pay parking boys or get rid of persistent beggars. Many do not consider the actual value of the coins; they are only good for handing out as small tips around the city.

Where was his family? His brother? His sister? His children? It is much easier to profile him as a drunkard. The only feasible rationale for not possessing 20 shillings is that he must have drank it all. Or that he must be a loser who he didn’t work hard, didn’t save, didn’t invest in his future, didn’t apply Robert Kiyosaki’s Rich-Dad Poor-Dad Cash-Flow Quadrant. Alternatively, he is profiled as a wife beater who terrorises his children. A man with no source of livelihood, no land title loses his identity. When he can no longer work, he loses his worth in an individualistic capitalist society and is reduced to begging for survival.

During the 2017 general elections, a man queuing to vote while eating his githeri from a polythene bag had the Kenyan middle class tickled no end. Plucked from obscurity, Martin Kamotho (The Githeriman) became an overnight sensation in a bizarre reality-show complete with media coverage. A few months later, he fell from grace, shamed as a man who had returned to his old alcoholic ways.

The old man who came looking for help at the food stall didn’t have the good fortune of random events conspiring to turn him into an overnight national sensation. He and millions of other githerimen, women, children and families remain unseen, invisible to the middle class. There is a world of githeri people living at the bottom of Nairobi’s urban existence. They are homeless or living in squalor. At night they sleep on the pavements outside buildings along River Road and Juja Road, along the hidden river beds of Ruiru, under bridges in the city, any nook or cranny that a man can fit into to shelter from the rain. They are invisible only because their humanity has been denied.

The world may be deliberately blind to what it owes them but it sees them very clearly when it has something it wants to take from them. Politicians rally them to harvest public opinion, corporate CEOs reiterate their value, echoing C.K. Prahalad’s The Fortune at the Bottom of the Pyramid: Eradicating Poverty Through Profits. Safaricom PLC, a leader in mining this fortune, it is said, experienced a 400 per cent leap in traffic when it introduced the twenty-shilling scratch card. Therefore, capitalism’s blindness is not congenital; it conveniently perceives only what is profitable unless compelled otherwise.

But those were “normal” difficult economic times, when 20 shillings was hard to come by, compared to the present reality of a society careening uncontrollably towards political and economic devastation. We are all hurtling towards our nadir at a sustained pace, oblivious to the oncoming apocalyptic rapture. This existential threat has revealed that our fates are intertwined, we are one, and the world has to acknowledge our existence as people, as human beings, and not simply as labour, voters or markets.

Public intellectual David Ndii has proposed that, in the wake of the restriction of movement, the socio-eonomically vulnerable should be allowed to flee the urban jungle to their rural areas as a means of decongesting the city. But many cannot even exercise that option. Capitalism in Kenya has now evolved into the dystopic future described by H. G. Well’s 1895 classic, The Time Machine. We now have a steadily growing population of Morlocks, generations of parents and children born in the bowels of the city who know no other home and have nowhere to run.

Capitalism and imperialism have hollowed us out completely. The destruction is almost irreparable. Capitalism has wreaked devastation on us all as a society in addition to the poverty of kinship brought about by the secular individualism of our social lives. Capitalism has pushed us into gaping chasms of economic disparity not only among the social classes but among members of a single family. I distinctly remember the collective gasp when the media revealed the poor dwellings in which the brother of the former President Kibaki’s lived before he died.

Individualism undermines, directly and indirectly, the purpose and synergy of every possible group formation: filial, commercial and political. And, therefore, it undermines the very existence of society. If man by nature is a social animal, individualism is not just directly antithetical to his nature but is also pernicious.

Capitalism, it is already apparent, is incapable of organising itself for the well-being of any living creature or ecosystem, let alone its primary host—man. The presumed most powerful man on earth, the President of the United States of America, was ineffectual in procuring basic medical equipment or in organising his government to respond to the pandemic. Democracy and it’s ruling class have been revealed to be nothing but enablers for capitalist extraction. Everything we have been taught about modern life and purpose has proven to be not just false, but insidiously detrimental to society and self.

There is global consensus that it is time to rethink both our social and economic system generally. But for Africa it is time to go even deeper and reconstruct our basic social structures, our bonds of kinship.

During the Ebola crisis in West Africa, afflicted and affected people were completely dependent on their families for care. The same happened throughout Africa at the height of the HIV/AIDS pandemic.

But in spite of our experience, we have allowed capitalism and individualism to corrode these bonds and units of social cohesion. We only recognise them in times of crisis, because Africa has not developed state institutional infrastructure to compensate for this loss. It is time to reconstruct them from the ground up. And not in some workshop-based imperialist-funded aid agency project, but through an organic socio-political indigenously-driven initiative.

On January 29 2020, Dr McFie argued on a local political TV show, NTV AM Live, that democracy as a political system has failed because it is fundamentally flawed. He asked quite pointedly, where, in what vital productive human enterprise has the democratic process been used to determine leadership? He explained the rigorous process used to recruit business leaders and asked why, in the more important domain of governance, such processes cannot be considered. He then went on to propose that Africa needs to look to its history, to explore for the purpose of adoption, the processes through which people rose to become elders and leaders, to find our way out of the mess we are in.

I would argue that this crisis compels us to go deeper, to reconstruct our families, clans and tribes from the ground up, complete with the layers of leadership at all levels—clan, tribe, nation—upon a cogent set of spiritual beliefs.

We now have no choice.

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Reflections

Coronavirus, Curfews, Corruption and Conspiracy Theories

Despite a curfew and the threat posed by COVID-19, it is business as usual in Kenya. Bribe-taking and beatings by the police have not stopped. And people have resorted to concocting conspiracy theories to make sense of their precarious situation.

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Coronavirus, Curfews, Corruption and Conspiracy Theories
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On Friday, 27 March 2020, the day the curfew took effect, I took a matatu ride to Zambezi, a distance of just about 20 kilometres from the Limuru-bound vehicles’ terminus on Kilome Road in downtown Nairobi. From this stage, you can board matatus going to Acre Ithano (Five Acres), Kiambaa, Limuru, Muguga, Rironi and Zambezi.

President Uhuru Kenyatta had, on 25 March 2019, decreed a 7 p.m. to 5 a.m. curfew countrywide – the government’s latest effort to combat the now really frightening coronavirus disease that could, in one fell swoop, easily send swathes of people to early graves. With a broken healthcare system countrywide, a government that treats its medics badly, the patient-bed ratio in its hundreds of thousands, and a demoralised corps of medical officers, the pandemic in Kenya, like in Italy, Spain and now the US, could be truly calamitous.

I was at the stage by 5.15 p.m. The rush to beat the curfew hours was evident: They were no matatus, so the people, who unusually go home at this hour, waited anxiously. That was already one worry too much, but more poignantly, the matatus had been ordered by the government to ferry half their carrying capacities. So, the 33-seater minibus was now allowing only 16 to 17 passengers, while the 14-seater Nissan shuttles only carried eight passengers. This added unforeseen problem was, to say the least, wrecking nerves.

With this new travel constraint, the matatu crew found a perfect excuse to inflate the fare and take advantage of an already precarious situation. A couple of days before, when the government had decreed that matatus should reduce their carrying capacity to create “social distance”, the matatus had, without flinching, more than doubled their fares. Now with the onset of the curfew, the fare is set to increase even further.

This extraordinary arrangement created a perfect state of anarchy: the rush to leave town, the shortage of matatus, which exacerbated passengers’ anxiety and despondency, and the fear that if by chance you were caught during the curfew hours you would be beaten up by the easily excitable paramilitary squad deployed by the state or by the overzealous police.

My tout friend reminded me, matter of factly, that it had been a long time since the General Service Unit (GSU) police had been unleashed on the streets, and they, therefore, were itching to break some ankles and elbows and trample on people’s heads with their boots. And perhaps even kill one or two Kenyans.

My tout friend, who was once a street boy who grew up in the roughhewn of Nairobi’s central business district, where he had been beaten and harassed by the police, knew exactly what he was talking about. The GSU, it soon emerged, in their over-enthusiasm to follow and implement government orders, not only broke ankles and elbow bones, they beat people with sjamboks (blood-drawing whips used by the infamous Boer police on the black masses at the height of the anti-apartheid resistance). In the process, the police killed a boda boda rider and two other Kenyans.

Passing through Westlands, we met a mass of humanity trekking to Kangemi, Kihumbu-ini, Mountain View, Sodom, Uthiru and Waruku. The conductor told me the fare to any of these places from Westlands had shot up to Sh100. (On a normally day, it is Sh30.) The choice was with the commuters: to cough up the Sh100 or walk.

I looked up into the skies and saw that a storm was fast gathering. If by a dint of bad luck, the skies decided to open up then, the people would suffer a double tragedy: arrive home both drenched and tired.

The advent of the coronavirus pandemic in the country has not only threatened to exterminate a panic-stricken people, it has equally conspired to appear at a time of great economic turbulence in the country, which has threatened to wipe out even the little earnings that the people possess.

The trip was uneventful until we reached the makeshift police check that just sprouted in the middle of the road at Mountain View stage, between the Shell and Total petrol stations. The first thing that came to mind was that the police, in their usual style of collecting bribes, would at least pretend to check that the driver and his crew were actually obeying the government’s strict directive. But no. The cop went to the driver’s side where, without wasting time, he quickly “greeted” him (corruption does not recognise coronavirus).

Two thoughts immediately came to my mind: this looked like an illegal road block; the normal road block is usually erected just outside of the Kabete Police Station. Additionally, the recent directive by the government that traffic offences would be henceforth dealt with by the National Transport and Safety Authority (NTSA) meant that there should not be a road block manned by the police on the roads. That rule had not changed, even with the pandemonium over coronavirus.

So what were the police doing on this particular road? The conductor told me that the Kabete traffic police, allegedly one of the most notorious departments in the country, was now erecting the road block as soon as dusk set in. “Tuliwazoesha vibaya, wako na njaa saa yote, na usipowalambisha, hautafanya kazi.” We spoiled them completely (by giving them bribes), so they are always hungry, yet, (the bigger problem) is, if you don’t grease their hands, you will never work.

For work to be done, the police must eat. The conductor said that the police now took it as their right to be bribed. “Let us not kid each other – police corruption is not about to end in a hurry,” said the conductor. He said that the Kabete police, in particular, couldn’t care less if people were decimated by coronavirus: “What they are most interested in is how they will continue to line their pockets.”

On arriving at stage 87, just after Uthiru, all pretence of being extra vigilant on combating the deadly coronavirus was thrown out of the window. At the Nairobi terminus, the conductor had been carrying a disinfectant (basically a mixture of soap and water), which he had sprayed on our hands. Once here, he dumped the can and began looking for passengers.

Women with huge baskets scrambled to board the matatu and snap the remaining seats. “Ithue tutihaicaga ndege.” We don’t board aeroplanes. “Coronavirus iranyita itonga.” The coronavirus is afflicting only the rich, said one woman, who grabbed the seat next to me.

At Kinoo stage, more people boarded the matatu: “Andu no mohaka mainoke…ni turikirara guku”. We must find our way home…I mean we can’t spend the night here, said some drunken fellow.

When we reached the next stage in Muthiga, some passengers alighted. By this time, the exorbitant fare had dropped to its normal rate of between Sh30 and Sh50. The chitchat in the matatu was, of course, about coronavirus. Conspiracy theories spawned by know-it-all dudes kept us busy and momentarily took away our attention from the more serious issue of observing social distance inside the matatu.

Blame the Chinese

“It is the Americans and the Chinese who are engaged in a biological warfare and now we’ve become collateral,” said an obviously drunk passenger. He said that the Chinese were devious and secretive people “You’ve seen them here – short and bossy and will not talk to anyone, unless shouting commands”.

Another claimed that China hoped to conquer the world by unleashing of the viral disease into the now global society. “How come they now seem to have, suddenly, found the cure for it? Coronavirus is ravishing the rest of the world as China, which has gone back to its normal self, now watches gleefully from afar. They have even offered to help Italy and America.”

The Chinese are constructing the Nairobi-Nakuru Road, which has stalled because the government has delayed payments to owners of buildings that need to be demolished to pave way for the expansion of the highway. The highway serves as the transport corridor of goods, from the Mombasa port to Burundi, eastern Democratic Republic of Congo (DRC), Rwanda, South Sudan, Tanzania and Uganda.

After excavating the original dual highway two years ago in the hope of rebuilding the road, the section between Uthiru and Kiambaa seems to have been abandoned. And so it is in a terrible state. It has become the bane of the ever-complaining motorists who have no choice but to use the mangled road. The section just outside Uthiru Girls School is so bad that when last week there was a huge downpour, the 100-metre distance caused a five-hour traffic jam. The section has huge potholes in which small saloon cars disappear. This section not only causes traffic snarl-ups, it has become a dangerous point where muggers and thieves steal mobile phones and other valuables from cars stuck in the mud.

“President Uhuru has taken too much debt from the Chinese, that’s why he couldn’t stop the plane from China from landing in the country,” ventured the drunkard, who now had taken to entertaining the passengers. “Agiruo arihe thire ucio na kiumia kimwe.” If he had tried (stopping the plane from landing), he would have been asked to pay that debt in a week’s time.

In February, a plane flying from China was allowed to land in Nairobi despite a government directive to not allow planes from China to enter the country. It is believed that the China Southern Airlines plane had several Chinese nationals in it who were allowed to disembark and mingle with the rest of Kenyans at the height of the coronavirus explosion in Africa. For some reason, many Kenyans believe that those unnamed Chinese (nobody knows where they “dissipated” to) could in the near future put the country at risk.

“Kiguoya kia mundu,” commented the noisy drunkard. “President Uhuru was the coward of the country,” he said. After mortgaging the country to the Chinese, he’s now beholden to them: he cannot do anything until he asks them. I don’t know who told him that coronavirus is most effective only at night. Should we now stop making love to our wives? Eno curfew nitukumenya uria tuku deal nayo. Just wait, we’ll a find way of dealing with this curfew.”

Another passenger said that President Uhuru Kenyatta had put the country on a semi-lockdown and now curfew “because he was targeting to reap billions of dollars that would apparently be disbursed by our benefactors, both from the East and West to combat the disease. He and his cronies have devised a plan to pocket the billions – for them, they are in business. All this scare-mongering is just that: tactics for them to make money. This is not a black man’s disease – have you heard any black person who has died of the disease? All the people who have died from coronavirus are all Caucasian. The black man’s body is not to be felled by a mere fever.”

One drunkard started singing the following chorus:

Mwihoko wakwa no we Jesu
Kuma miaraho nginya hwa-ini
Thayo wakwa no we Jesu
Kigeno giakwa no we Jesu
Gutire kindu kingi gwenda tiga we Jesu
My only hope is you Jesus
From early in the morning till late in the night
My only peace is you Jesus
My only joy is you Jesus
All that I need is you Jesus

“When it came to implementing the curfew, Uhuru suddenly discovers his mojo: he does not entertain nonsense, he is decisive, firm, tough talking and threatens fire and brimstone to anyone defying his order by sending the paramilitary police to roughen up people with their death-knell rungus (clubs). How is it that this decisiveness and firmness is often lacking when dealing with the thieves and robbers who are his cronies and friends?” posed the drunkard.

“Ask him to go after the looters, and he suddenly becomes exhausted, handicapped and helpless, throwing his hands in the air…‘murenda njike atia?’ What do you what me to do? Uhuru is fake…after messing our economy, he now purports to be fighting this monster invasion.”

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Reflections

Remembering Thandika Mkandawire, A Beloved Teacher

I have been lucky to meet many intellectual giants in my life. The truly great, like Louis Henkin-my Constitutional Law Professor in Graduate School – and Thandika Mkandawire, are those that teach you effortlessly and joyously, and without even a hint of condescension.

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Remembering Thandika Mkandawire, A Beloved Teacher
Photo: Flickr/Mo Ibrahim Foundation
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I am utterly distraught to learn that my favourite political economist and teacher, Thandika Mkandawire, has died. My intellectual development took a different direction when I found Thandika Mkandawire after Graduate School, first through his, edited, 1987 book “The State and Agriculture in Africa,” and subsequently through the brilliant work he did on Africa’s economic development, World Bank policies and the African state in the 1990s and throughout the 2000s. I am certain that if I had not come across Thandika when I did, my intellectual development would have veered off in a completely different, almost certainly less fulfilling direction.

I was – at the time- young, restless, and, intellectually, very adventurous. Graduate school had lit a spark in me. But it had left me somewhat jaded. I had suddenly realized that I did not care for legal doctrine. I liked – and still like- law’s forensic tools – but I found doctrine sterile: it was either noisily obvious or complicatedly trivial. This was especially so when lawyers launched into voluble disputations on some arcane point. True, jurisprudence had real insight but then jurisprudence is academic law. Most of the rest of law is applied, or to put it differently, law is to jurisprudence what accounting is to economics.

There I was then: June 1993, a newly-minted graduate bristling that my training till then had neither asked nor answered the questions that had taken me to graduate school. I wanted to know what to do when those sworn to implement the laws regularly ignored them. I did not know what incentives or disincentives to put in place to discourage dictators or corporate chiefs from stealing public money. Could such incentives and disincentives be legally designed? I wondered why theories of sovereignty did not address the ways in which economic prescriptions by multilateral agencies subverted people’s control over governments in debtor countries. I knew what the rule of law was and could speak and write with great eloquence about its characteristics. Yet if you asked how institutional design might help secure it, I could not answer you. This background is necessary to explain just what a profound effect Thandika had on me.

My journey towards acquiring the perspectives and tools that would eventually help me grapple with these questions begun in two places, with Thandika Mkandawire’s “The State and Agriculture in Africa” and with all-night, whisky-inspired debates and arguments with David Ndii at Invergara Club. (David won’t like these confidential disclosures!) Thandika gave me different perspectives on how to understand the state. In this book, I learnt to look into and to question the fiscal basis of the state, any state. That is to say, I learnt to ask how a state raised revenues because, it turned out, as I learnt still later, that revenues and where they came from, shape how a state treated its citizens. Does the state raise revenues from taxes or from mineral rents? States that live off taxes –called merchant states – must have some implicit understanding with the key tax-paying groups in society. For this reason, governance in such states is likely to be more inclusive. States that live off rents- called rentier states- rest on narrow, exclusionary bargains between politicians and the companies involved in extraction. Mineral economies are essentially off-shore economies: Governments in states with such economies don’t care for public support. They survive by repression or co-optation, that is, by buying-off opponents.

This analysis opened my eyes to much that I had missed in my education. It sent me scurrying in unfamiliar but exciting research directions. Now I could explain why so many mineral or oil rich countries were either so fragile or so dictatorial. I now knew why populations in those countries were often poor: Politicians would rather squirrel the money away to tax havens than invest in public services. They paid no political price if they did that.

Thandika was always brilliant: He had the uncanny ability to illuminate a subject or to upend received wisdom with a simple vignette. I remember being extremely impressed by Paul Collier’s and Nicholas Sambanis brilliant work on conflict. Collier and Sambanis had put to bed the old canard that African conflicts are caused by ancient ethnic hatreds and grievances through a series of empirical studies showing that most conflicts could actually be explained by greed. That is, they offered evidence that most conflicts were driven by the scramble for lootable resources. Thandika was not persuaded by this thesis and though I do not know whether he ever wrote an essay that specifically responding to this argument he wrote a number of penetrating essays that very cleverly chipped away at the argument. His 2002 deceptively low-key essay, “The Terrible toll of Post-Colonial ‘Rebel Movements’ in Africa: Towards an Explanation of the Violence against the Peasantry” is particularly on point. Thandika asked a simple question, “Why are African rebel movements so violent towards peasants?” He returned the answer, which felt so intuitively right to me, that it was because the rebels were invariably urban elites who had migrated their disputes to rural Africa. This was astonishingly obvious when I thought about it. Until the violence after the 2007 election, Kenyan elites squabbling over the presidency had always taken their blood letting to the rural areas.

Perhaps Thandika’s most influential work- with colleagues like Bayo Olukoshi – was his 20 year interrogation of the neo-liberal stipulations of the World Bank – sold to Africa first as Structural Adjustment Programmes and then as Poverty Reduction Strategies. The neoliberal agenda put forth by Ronald Reagan and Margaret Thatcher came to Africa and the developing countries dressed up as the Washington Consensus. First as Executive Secretary of CODESRIA and later as Director of United Nations Research Institute for Social Development, UNRISD, Thandika was in the thick of debates about the viability of the Washington Consensus as policy prescription. He was completely vindicated by the dramatic unraveling of the Washington Consensus -in its neoliberalism garb- in the 2008 financial crisis.

Thandika and a handful of African scholars fought long and hard to liberate Africa’s development debate from the stranglehold of the so-called North American Africanists. Throughout the 1990s and early 2000s these Africanists were extremely influential in policy circles in the West. Though their advice was regularly sought, Thandika was deeply disenchanted with their work. This research argued that under-development was as a result of neo-patrimonial politics: neopatrimonialism was itself defined in segmental and hierarchical terms. The standard model has the President and his ‘tribes-mates’ sitting as patrons atop the state, their hands on the public kitty, serving a web of grateful clients who repay him with loyalty and votes. On this view, Africa was under-developed because these neopatrimonial webs undermined or eroded rational policy making.

Thandika could not abide this empirically bankrupt argument. He felt that the Africanists were selling snake-oil to policy makers in Washington and London. He noticed – as did other African scholars – that Africanist circles were not only hermetically sealed against perspectives from scholars working in the field in the continent, they had also become intellectually incestuous – liberally quoting and cross-referencing each other. They were not promoting debate, they were more like congregants at a neo-liberal wake. Thandika thought that the neopatrimonial perspective – though highly privileged and valued in donor circles in western capitals –offered nothing useful analytically. And even worse, it had no predictive value.

Thandika’s interpretations of the possibilities of democracy in Africa were always original, cautiously optimistic and always refreshing. He had genuine flashes of insight. He made me question much that I thought self-evident. He hated complacency. I was privileged to participate in many fora with him. I remember, in particular, a discussion panel I shared with him and Prof. Anyang Ny’ongo in Accra Ghana in April 2014 during the “Pan-African Conference on Inequalities in the Context of Structural Transformation.” It was the first time that I got a really good chance to have a chat with him. What humility, what gentle persuasion and what intellectual charm. I have been lucky to meet many intellectual giants in my life. The truly great, like Louis Henkin-my Constitutional Law Professor in Graduate School – and Thandika Mkandawire, are those that teach you effortlessly and joyously, and without even a hint of condescension.

God speed you along, Beloved Teacher. Here is Laban Erapu’s ‘Elegy’ that you may not walk alone to underworld:

When he was here,
We planned each tomorrow
With him in mind
For we saw no parting
Looming beyond the horizon.

When he was here,
We joked and laughed together
And no fleeting shadow of a ghost
Ever crossed our paths.

Day by day we lived
On this side of the mist
And there was never a sign
That his hours were running fast.

When he was gone,
Through glazed eyes we searched
Beyond the mist and the shadows
For we couldn’t believe he was nowhere:
We couldn’t believe he was dead.

Adios Maestro.

I WILL MISS YOU.

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