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Reflections

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
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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

The Enemy Within

Death hangs heavily over people with cancer – it is always there, reminding you of your mortality.

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The Enemy Within
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So, this is what happens when a doctor tells you that you have cancer. The first response is disbelief (how can this be true?), followed by anger (I don’t deserve this, I never hurt anyone), and then a deep sense of grief and loss (what will I miss when I die, and how will my loved ones cope without me?)

They say cancer is the result of pent-up anger and resentment. Apparently, years of holding on to these emotions make your cells misbehave and become toxic. Cancer cells end up eating up healthy cells, leaving the body so full of poison that it collapses from lack of vitality. The jury is still out on whether lifestyle choices generate cancer in the body because people who lead healthy lives seem to be as prone to cancer as those who don’t. Nonetheless, when you find out you have cancer, your first reaction is to blame yourself. It is sort of like being told you have HIV. (Was I responsible for this? Was I reckless? Should I have used a condom?)

Friends and relatives will tell you that breast cancer is beatable, that they know so many women who had breast cancer and lived healthy lives years after treatment. What they don’t tell you is that all the literature points to a short life expectancy after the discovery of cancer. The chances of recurrence are high, even with chemotherapy, mastectomy or radiation, the traditional methods to “cure” breast cancer. I have read studies where women who had chemotherapy had an equal chance of recurrence as those who didn’t. So, death hangs heavily over people with cancer – it is always there, constantly reminding you of your mortality.

Most people are so afraid of cancer that they can’t even say the word. The receptionist at an oncologist’s office actually asked me what kind of “C” I had – never used the word cancer. Yet she deals with cancer patients every day.  Another oncologist I consulted couldn’t even make eye contact with me and rushed me through a diagnosis I couldn’t understand, perhaps believing that my cancer was contagious?

The thing is that cancer is not like any other disease that can be cured through surgery or drugs. It requires months of treatment and constant monitoring. It’s not like having malaria or a broken bone. It is like having an enemy residing in your body, hostile, predatory, waiting to pounce at any moment.

It seems a positive frame of mind is critical in recovering from cancer. I got calls from women who told me they bounced right back into their lives after months of treatment as if nothing had happened, that I mustn’t believe all the literature, that I should get all the treatments done and go back to living a normal life. They didn’t explain to me why they have been working from home since their treatment started and since their so-called “recovery”. Others are more honest about their experiences. A South African women called to tell me that her experience with chemotherapy had damaged her heart, and she is on life-long medication that makes her urinate every few minutes, which means she can no longer work in an office. Instead of destroying the cancer, the chemo destroyed healthy cells in her heart. She is cancer-free but now disabled in other ways. Another friend told me her aunt died not from the cancer, but from the chemo.

What the doctors and the optimists don’t tell you is that both chemotherapy and radiation have debilitating impacts on your body. They literally are poisons injected into your body to kill another poison. Sort of like a vaccine but not quite because they do not boost your immunity. Both chemotherapy and radiation therapies involve weeks of hospital visits that cost an arm and leg. Nausea, burns on your body, fatigue are common side effects.

A friend from Boston who has studied alternative ways of healing from cancer (including not getting any treatment at all) tells me that each woman with breast cancer has to make an individual choice about what kind of treatment she should get. Doctors trained in Western medicine will be quick to put you on chemotherapy and the other treatments without giving you other options. Desperate and eager to cling onto life, the patient with cancer readily accepts any treatment, not realising that not only is it a very long process, but very costly as well. Mental preparation and psychological support are also necessary before embarking on the long and arduous journey called cancer treatment. People become life-long patients; some recover well, others not so well. Some women opt for no treatment, preferring to lead a good quality of life before the disease ravages the body.

I am looking at alternative methods of healing, including Pranic healing that works on your energy fields and chakras. So far it seems to be helping me, but only time will tell if I will be a success story. I have certainly started eating more, and those dizzy spells in the morning seem to be getting rarer.

The biopsy results are not yet out, so I am still not sure what the oncologist will prescribe, but in Kenya, the modus operandi seems to follow the same script: mastectomy, followed by chemotherapy or radiation and some kind of hormone treatment. Am I ready to go there? Not sure. Women who lose their breasts speak of feeling like an amputee; the loss of an organ that defines their femininity impacts their identity and self-esteem. Others are more casual about losing their breasts, (“It’s just fat,” one woman told me). `

The other thing about cancer is that when you have it, you think of nothing else. Everything is a blur. Someone wants to make small talk, and all you want to do is look the other way or scream. (Can’t you see I have cancer? Do you really want to discuss the weather?) You think about your life in vivid film shots. Your past suddenly comes into sharp focus, both the happy and sad days. You begin questioning the meaning of life in ways you never did before. Cancer prepares you for death the way a fatal car accident doesn’t. Is sudden death preferable to dying slowly because you can’t see it coming? Not sure.

But let me not be the purveyor of doom and gloom. The reason I am writing this article is that I have learned wonderful things about myself and other people. One of the things I have learned is that people can be kind and generous when they know you are in pain. People I don’t even know and have never met have sent me good wishes, prayers and even money for my treatment. Friends and family have sent food and offered accommodation. An Indian friend called to say that if I opted to go to India for treatment, I could stay in his home for as long as I needed. These generous and kind offers have literally brought tears to my eyes.

What I also learned is that my life’s work has not been a waste, and that my readers love and admire me for my writing. I didn’t realise I had inspired so many people, not just in Kenya but around the world, through words I have penned. That is a really important things for me to know and hold onto right now – to realise that I had a gift that I used well, and which helped others. And to know that when I go, my writing will live on.

I also learned that life is very, very short. So, we must not postpone the things we need to do. If your job makes you unhappy, quit. If a relationship is toxic, leave it. If people around you are making you feel bad about yourself, walk away. Surround yourself with people who love and cherish you. Love is very important for human survival, so distribute it freely. Be kind and generous. This thing called life is temporary, so enjoy every moment and live it as if every day is your last.

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Reflections

Someone’s Grandmother Just Died!

It is painful to always have to consider the feelings of others while legitimate calls for acknowledgement of racial injustice and reparations are consistently ignored and dismissed.

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Someone's Grandmother Just Died!
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Following the death of Queen Elizabeth II, I watched the televised service at St. Giles’ Cathedral in Edinburgh attended by the royals and various Scottish dignitaries, as well as the many hundreds who came out to pay their respects or to be a part of this historical event.

As I watched the outpouring of public emotion, I couldn’t help but wonder what emotions the queen’s death would invoke in those whose lives have been blighted because of the British colonial policies that killed millions and left a legacy of misery and disenfranchisement in countries far too many to name.  

At first I was saddened by the news. But then came the reactions of global figures the world over, with some proclaiming outright that Queen Elizabeth had been a guiding light, a symbol of hope and stability in the world. One broadcaster went so far as to say “She was everybody’s grandmother.” My problem was that she wasn’t mine.

My grandmother, born in 1923, was just three years old when the Queen was born, my 81-year-old mother told me when I called to get her reaction to the news that the Queen had died. “She would’ve been 99 years old today if she had she lived,” my mom said. I could hear the emotion in her voice as she remembered her mother. My grandmother died in 1983; she was 59 years old. I was then just 18 years old.  I said, “Mom with all the things we know about the racist systems that have kept Black and Brown people oppressed, I really don’t know how I want to feel about the death of the British Queen.” Never one to mince her words, my mom replied, “She was a human being, and we, well you know, we mourn the loss of any life.”

Yes. She may have been a grandmother to many but to me she was a symbol of institutionalized racism in its clearest form. Images of British dynasty have been present in the education of every American who has gone through the public school system since the Second World War during which the United States allied with Britain in their quest for global power and dominance. Yet here was the evil of the Crown being portrayed in the media—as it’s always been portrayed—as providence, something divine. As I listened to a special broadcast by the popular British talk show host James Corden talking to an American audience about the Queen’s passing, his tone struck me as odd: “She will be missed, she was everybody’s grandmother,” he said, going on to tell us how well she had served the country and the world.

As I was listening to Corden and wondering why I was so irritated by his outpouring of emotion, it dawned on me that racism moves from generation to generation, falling back on the old practices of how to colonize a nation:  You teach them to love you more than they love themselves. Racism survives because the symbols of racism never die. We carry the symbols in our hearts and in our minds and once we have identified with them, we seek to justify their existence. While I could empathise with those that felt a special connection to the Crown, what I realized and felt most immediately, was the insensitivity I received as an African American who bears the scars of the legacy of slavery that has made the British Empire one of the richest and most powerful nations in the world today.

The next day I watched the funeral procession move through the streets of Edinburgh, the commentators conveying the solemn mood of the people who came out to pay tribute to their Queen.  All the while I couldn’t see past the 1989 image of Princess Diana hugging a child suffering from HIV/AIDS. On her first unaccompanied trip overseas, Princess Diana spontaneously broke with protocol and showed compassion towards a suffering Black child with all the world watching, at a time when the stigma of HIV/AIDS was as bad as the disease, and  Blacks were being impacted the most and no one else seemed to care. Diana’s humanity helped solidify her reputation as the “People’s Princess” and it radically changed the way AIDS sufferers were perceived.

While the news played on I thought about two recent exchanges I had had in Amsterdam, just outside my front door.  The first exchange took place in a cafe.

I was sitting at the bar having a coffee. Another Black male of Surinamese origin was sitting a couple of tables away. It was midmorning and we were the only ones there. In an attempt to start a conversation, as men do, he asked my opinion on the war in Ukraine. I told him I thought it was crazy, all too unreal. The white Dutchman behind the counter leaned over and candidly shared, “I don’t give a shit about the war in Ukraine.”  I didn’t speak again and left the bar so abruptly the young brother asked, “You leaving?”  I was in no mood to have that conversation so early in the day, having experienced the backlash of the “Black Lives Matter” protest with the counter-narrative that All Lives Matter; I’ve learned that sometimes it’s better to just hold one’s peace and walk away. (It literally is your peace.)

Shortly after that incident, a couple of days later, I had another encounter that made me realize that we simply can’t afford not to care. I had wandered into a tool shop  on the corner of my street that looks more like a men’s gift shop inside than a hardware store selling nails, drills and plywood. Behind me walked in a man who apparently knew what he wanted because we reached the cash register at the same time, he with a power drill in his hand. I moved aside to let him be the first in line, not sure if I was done.

The Dutchman behind the counter seemed not to have noticed that the man with the drill wasn’t Dutch and didn’t speak the language. But to his credit, he did know what he wanted: the drill and a bag in which to put the canisters of spray paint he had already placed on the counter. Being familiar with Eastern Europeans, I assumed the man was Polish and asked “Polske?” “No! Ukraine!” he said, then, smiling, added, “Close.”

Hij wil een tas.” He wants a bag, I said to the clerk; bags are not automatically handed out after a purchase these days.  The clerk then understood and reached under the counter. I was pleased I could help and the Ukrainian was happy as well. To my surprise, as I placed my items on the counter, the Ukrainian tapped my shoulder and offered a fist bump.

I say all this to say of the human condition that people appreciate what they understand.  And sadly enough, we rarely think about injustice until it is visited upon us.

Whose permission do we now need to talk about racism and the policies that still impact us today? Africa and the African diaspora’s historical issues are and always have been about racism and this is why members of this group, my group, will always hold a contrarian view when the West attempts to compel us to join them in their moment of grief.  My grandmother died in 1983, at the young age of 59, in a small southern town next to a river; there was no horse and carriage, no media. The British Empire once covered the whole world, a dominance that was achieved through suppression and oppression. Many atrocities were committed and entire communities decimated under the authority of the Queen.  I was raised never to speak ill of the dead because they aren’t here to defend themselves but I will submit this:  it is painful to always have to consider the feelings of others while legitimate calls for acknowledgement of racial injustice and reparations are consistently ignored and dismissed.  Where is the same fervour and energy for those issues that matter to us? 

When we as Black people keep the peace, we empower the presence of the historical lie that we are inferior and thus require control. When we remain silent we allow the systems of the institutions and the prejudices that block our collective growth to thrive. Why should we care about the death of the Queen when the Queen has stood for the oppression of our people? Why should we be guilt-tripped into silence, into not speaking out about the dead, into not pursuing our freedom? When will our emergency, the issues that impact Black and Brown people, become a top concern for the White world? When will I be able speak without fear of being branded just another angry black man, angry for what I don’t have that others do?

Sad as the Queen’s death is to those that survive her, honouring her service is a symbolic gesture that must be contextualized because, for many, and not just in the UK but all over the world, the English monarchy is a symbol of oppression. I recently listened to a podcast in which a Black podcaster scolded an guest who said this of the Queen: “She is the symbol of colonialism and racism for many; however much we want to romanticize the Queen of England’s long reign on the throne as a stabilizing force on earth, she has also allowed many human rights violations on her watch”. The podcaster’s response was a classic putdown, “Why do Black people have to always bring up racism? Someone’s grandmother just died!”

Racism endures because when we identify with its symbols, we will do anything and everything in our power to justify and defend them.

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Reflections

So What is an African Immigrant Today?

Anti-migration policies against Africans and a general climate of persecution against foreigners in Europe and North America are sending African migrants to new destinations such as China, Turkey, the Middle East and even South America.

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So What is an African Immigrant Today?
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I was 24 when I fled Rwanda for the UK in 2007. A successful political reporter, I had just been made head of the flagship investigative pull-out magazine The Insight, whose work was gaining the admiration of many inside Rwanda. I also ran a weekly column, The Municipal Watchdog, writing about topical social issues, and was filing for Reuters, Al Jazeera, Xhinua, as well as the Associated Press. This was my life, and I loved every bit of it.

Meanwhile, some 4,000 miles away in the UK, and in my case Glasgow, a city that had now become home, a dangerous and sustained campaign against people like myself was taking shape. Britain was in the tenth year of a Labour government, and while the party had transformed the country’s economic fortunes, a particular kind of malaise was beginning to set in. Desperate for power, opposition party politicians (mainly Conservatives and UKIP) as well as sections of the media were starting to whip up public anger over two issues: immigration and welfare. Debates around immigration were getting nastier, often with racist undertones. The BBC broadcast The Poles are Coming, a 50-minute television documentary and part of the White Season Series in which filmmaker Timothy Samuels set out to interrogate the growing narrative against immigration.

“You don’t have to go far these days to find a little slice of Poland or Eastern Europe in your town,” he says, before adding, “But for some in Peterborough it’s all too much.” The film cuts to a crowded doctor’s surgery and school before a visibly irate middle-aged British man retorts that Peterborough is “completely and utterly swamped”. Seconds later, a town councillor chips in to say that the country has had enough of immigration.

I remember watching the documentary in my one-bedroom flat in Glasgow, and feeling scared. There is a tendency to think that asylum ends the day you become resettled. While this is somewhat accurate, it is far from the truth. The loneliness, the worry about all the things left behind, family and friends, keeps one wondering. Nothing is ever certain. It also depends on one’s specific threat. I know of people, myself included, who continue to look over their shoulder years after we were granted protection – because the truth is, you can never be sure. The question that kept coming back to me was, if this is how Eastern Europeans are treated, the majority of them white with blue eyes and so able to blend in, what chance is there for us Africans?

After all, I was already living in a high-rise building, with all sorts of neighbours, some of them active drug addicts or recovering addicts. But life goes on, and indeed it did. Despite the occasional noise, I got on well with my addict neighbours and was never subjected to insults or troubled in any way for the six months I lived in the flat.

A common misconception about those of us seeking refuge is the almost universal condemnation as to why we didn’t seek protection from the first safe country we entered. “France is a perfectly peaceful country, they could have stayed there,” I have heard people say of those crossing the Channel in dinghies. There are of course a myriad reasons why people may not avail themselves for protection in certain countries despite passing through them. People want to settle in countries where they have a local connection – friends, relatives, or because they speak the language.

I passed through Uganda, Kenya, and Holland before landing at Heathrow. In my asylum interview, I was asked why I did not seek protection in Uganda or Kenya. My answer was always the same: Rwanda continues to have very good relations with its neighbours, and in the case of Uganda, they share a border. The possibility of being harmed is increased the closer you are to the country you fled, and the better its relationship with one’s host country. Besides, there is no legal obligation for refugees to claim asylum in the safe countries they pass through. Declining to do so does not disqualify them from refugee status.

People want to settle in countries where they have a local connection – friends, relatives, or because they speak the language.

Most of these conjectures are built around a lack of understanding of the diversity of African migration. Anyone following debates on migration from Africa to the Global North might think that the burden is too much. But as studies have shown, this is not true. As The Elephant has previously reported, most African migration remains on the continent. Around 21 million documented Africans live in another African country, with countries such as Nigeria, South Africa and Egypt being some of the main destinations. Targeted anti-migration policies against Africans, implemented in part through stringent visa policies, and a general climate of persecution against foreigners in Europe and North America, have seen would-be African migrants head to new and more receptive destinations such as China, Turkey, the Middle East and, in some cases, South America.

From my own experience as a former asylum seeker, I know that migrants are not necessarily fleeing war or poverty. Those who saw me land at Heathrow on the morning of 22 July 2007 might have thought I was another African immigrant, escaping poverty and disease. But the truth is that, like the majority of the people who make it out of Africa into Europe and the Americas, I wasn’t. If anything, I was part of the African elite that is able to cut through the stringent visa requirements, can afford the pocket-busting airfares, and is able to take risks to come to countries where, whether they are seeking asylum or not, they are not exactly sure of the final outcome of their case. To the suffering Africans, this is often too much of an outlay, especially so when the country next door or the country a few countries north or south can welcome you and provide sanctuary for less than the cost of a UK visa. When it comes to migration into the Global North, Africans will only migrate if they have the ambitions and resources to make this happen.

Around 21 million documented Africans live in another African country, with countries such as Nigeria, South Africa and Egypt being some of the main destinations.

In the lead-up to the Brexit vote – which was heavily influenced by what those campaigning to leave the EU kept referring to as uncontrolled immigration – there were more Eastern Europeans in the UK than migrants from Africa or Asia combined. Yet the entire campaign was dominated by discussions about illegal immigration – deliberately painting the picture that the country was being swamped by foreigners, many of whom were already subjected to some of the most stringent visa requirements. Even Nigel Farage’s infamous Breaking Point poster, which was correctly reported to the police as inciting racial hatred, was deliberately punctuated with brown faces as if to emphasize the point that white migration is OK, non-white not as good.

I was having a discussion with one of my neighbours a few weeks ago – a son of Irish folk who migrated to Birmingham, England, in the 1950s. He has only been to Ireland twice in his life and while he considers himself Irish, he doesn’t think he is regarded as Irish. He speaks with a Birmingham accent and has lived in the South East of England for over 30 years now. I do not believe him to be racist but some of his views could be very easily construed as racist towards “these foreigners that can’t stop complaining”.

“Why is it only young men that are crossing the Channel?” he asked. “If the situation in their countries is so dire that they have to flee, why are they leaving behind their family? Would you leave your wife and children to be killed or even raped? I wouldn’t.” When I asked him what he would do if the only money he had left after selling most of his possessions was enough to transport one person out of a family of four, he replied: “I don’t know but I would have to think of something”. And when I pestered him to tell me what that something was, he responded: “I don’t know.”

And herein lies the folly of the dangerous migration rhetoric that has been carefully promoted by right-wing politicians with the help of an increasingly agenda-driven media. A son of an Irish couple, who left Ireland for a better life in Birmingham, and were most likely subjected to discrimination as IRA sympathisers during the Troubles, has grown up to Other those doing exactly what his parents did all those years ago. “We can’t let in everyone,” he says. Except we are not.

This article is part of a series on migration and displacement in and from Africa, co-produced by the Elephant and the Heinrich Boll Foundation’s African Migration Hub, which is housed at its new Horn of Africa Office in Nairobi.

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