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Nothing that has value, real value, has no cost. Not freedom, not food, not shelter, not healthcare.
~ Dean Kamen
After all the grandstanding, and the threats, and the dithering, predictably, the chickens are coming home to roost… Doctors will not back down, and this fight has finally come to a head.
Initially a lot of Kenyans on social media were talking about the doctors’ strike like something that’s way out there, that’s not really touching their lives directly, after all it was just another protest like many others. In fact I even saw some argue that doctors could be proving they are not indispensable because the country had gone 70 days already without doctors and they were still breathing. I just shook my head.
The update-posting, selfie-taking, pizza-eating, mall-cruising, tweeting middle-class did not particularly feel the pinch, not until today. You see many of us have medical covers and are not planning on going to that Vihiga District Hospital where patients relieve themselves in buckets on the ward floor; few of us have ever set foot in Kenyatta Hospital where you can watch a tractor drive out the back every morning with a pile of bodies from the wards headed to a mortuary piled to the ceiling with corpses in various states of decay; many have never been to those level 4 hospitals where you can watch patients die in waiting lines; they couldn’t understand how a quack doctor has been performing caesarian operations in a county for years without detection.
People felt cushioned from the ongoings, aloof to the struggle of the public hospital doctors; after all Aga Khan, Mater, Nairobi, Getrudes, etc, were all still operating at full speed, and with personal doctors sat dutifully at their work stations and doctors’ plazas. That’s until yesterday when things changed. That’s when panic set in, that is when matters were thrown into perspective, that is when shit got real.
I have got news for you: it’s always been real, it hit the fan a long time ago, and for us all. If you ram your jalopy into a truck carrying broilers pumped with steroids at Ngoliba you will not be taken to Karen Hospital, you will be dumped at the nearest public hospital which is manned by those same doctors we watched march on our wall mounted curved screen TVs as we discussed ‘their greed for money’ in our posh accents; your relatives in the sticks don’t have those medical cards to swipe at 5 star hospitals, they depend on those district hospitals where doctors don’t even have gloves or clean syringes, they sorely need those public hospital doctors; mothers giving birth in the boondocks, they don’t have the options of epidurals at fancy hospitals with Cayenne driving doctors; little babies in the ‘reserves’, those don’t have several branches of Getrudes at the corner of every estate. These calibre of patient all need better public hospitals with working facilities and well motivated doctors. In fact we all need the same things they need whether we know it or not.
As a matter of fact, it has been pointed out several times that what we call a middle class in Kenya is just but a working class, basically that means a class that is just one missed salary away from desperation and destitution; lose your job today and of course that medical cover will disappear faster than money is siphoned out of Afya House.
Let me give you a personal story: In December 2005 my late father was preparing to retire for the night at the Nairobi Club when he felt a sharp pain in his upper chest and neck, he called his doctor at Aga Khan, Kisumu, who on hearing the symptoms advised that he take a taxi immediately to Nairobi Hospital because it sounded like the onset of a heart attack. The old man did as he had been told and called a taxi which took him directly to the hospital, in fact he walked by himself from the car to the hospital main door as the taxi guy then left; which is the exact reason he was all by himself when he collapsed right there in the reception. Now the hospital could not book him in unless someone signed a guarantee. By the time they found my mum’s number in his diary and called her and she called me to rush over to the hospital, it was too late. You can’t sit around with a heart attack waiting for a cash guarantee (I hear it is now 600K). In fact in 1996 my dad had fallen gravely ill and been rushed to MP Shah, he was lucky that at that time he was with my mum and they had a Diners’ Club credit card, or they would not have been booked in without a 150,000 shilling cash deposit.
So what’s the point of my story you might be wondering, and just what is its relevance to the current doctors’ strike? Well look at it this way: doctors are fighting to have public hospitals equipped better, working and living conditions improved, and facilities for patients upgraded (it is all there in the dishonoured CBA, but the government would rather you only pay attention to salary demands). If this fight had been won all those years ago and public hospitals were better equipped and manned with motivated staff then it would have made better sense for the taxi driver to take my dad to Kenyatta Hospital instead (where they don’t ask for a Diners’ Club card or a deposit of half a million shillings to admit a dying person), maybe if Kenyatta Hospital or Mbagathi hospital had been a viable option I wouldn’t be writing this today and I would instead be telling you about the pressure from my dad to settle down… These second chances at life, these options for patients everywhere, that is what the doctors are fighting for.
If you are walking by yourself on the street and suddenly fall down in a heap, there’s a very good chance that you’ll find yourself at Mbagathi Hospital or Kenyatta Hospital, than that you’ll end up at Karen Hospital or Aga Khan. And even if you were taken to one of those premier private hospitals, woe be unto thee if you are not walking around with a travellers’ cheque for a million shillings in your pocket, for otherwise you might still find yourself at Mbagathi, if you make it there alive at all. That is when you will understand what the doctors’ strike is about, at that shattering moment when your relatives find you lying alone in a dark corridor because there was no space in the wards, and worse no one knows what’s wrong with you because there’s no functioning X-Ray machine, there’s no basic equipment, no anaesthesia, and in any case the doctors themselves are languishing at King’ong’o, Kamiti, and Kodiaga like common criminals for shining a light on our dark despicable healtchare conditions.
This fight is not just about better salaries for doctors, this fight is not just for the poor that go to public hospitals. This fight is about improving all public health facilities, it is about improving working conditions for medics and ultimately for patients, it is about equipping healthcare facilities with at least the basics. It is a fight that you are invested in whether you realize it or not.
Don’t wait until that day you wake up on the cold cracked floor of a public hospital with nothing but painkillers in your hand and not even a cup of clean water to wash them down with to come to the startling realization that this was your fight.
Don’t wait until that day you will be writing a story about losing a parent(s) at the reception of a private hospital that needed a million shilling deposit to book them in; and worse, they only went there because there was no public hospital in the vicinity that could have saved them.
We’re now being told the Standard Gauge Railway is a “feature” through the Nairobi National Park… WTF!
“This park isn’t attracting proper income, but this feature (#SGR), will change the narrative”
~ Atanas Maina, Kenya Railways MD
The uncertainty of the danger belongs to the essence of terrorism.
~ Jurgen Habermas
As I write this, I am shaken, confused, scared, angry… today morning I nearly lost sensation in my legs, I stood trembling in a dark corridor for an hour and fifteen minutes hearing the macabre symphony of grenades for snares and the terrifying staccato of 39mm AK-47 rounds ricocheting on walls and floors, and whizzing through the air, and ripping through human beings whose only mistake was to be non-locals and followers of a different faith that had chosen to try their luck in Mandera. This all took place a mere fifty metres from where I was trying to catch forty winks before being awoken by the loud bang of an Improvised Explosive Device whose purpose was to blow open the gate to a compound that held over thirty souls whose lives were about to be put on a knife’s edge by extremists who have no respect for the sanctity of life. At the end of the carnage, six were dead, scores were injured, and the police and other armed forces then kept the town on edge for hours as they shot continuously into the air targeting remorseless phantoms that had already disappeared into the night with innocent blood on their hands.
Those 75 minutes were excruciatingly long and hard, they brought me face to face with myself. I contemplated the worst. I was numb. But in all this, I remembered something I had read in a book recently: confronting the reality of our own mortality is important because it obliterates all the crappy, fragile, superficial values in life. While most people whittle their days chasing another buck, or a little bit more fame and attention, or a little bit more assurance that they’re right or loved, death confronts all of us with a far more painful and important question: What is your legacy?
Allow me to share a story from this book with you.
“Ernest Becker was an academic outcast. In 1960, he got his Ph.D. in anthropology; his doctoral research compared the unlikely and unconventional practices of Zen Buddhism and psychoanalysis. At the time, Zen was seen as something for hippies and drug addicts, and Freudian psychoanalysis was considered a quack form of psychology left over from the Stone Age.
In his first job as an assistant professor, Becker quickly fell into a crowd that denounced the practice of psychiatry as a form of fascism. They saw the practice as an unscientific form of oppression against the weak and helpless.
The problem was that Becker’s boss was a psychiatrist. So it was kind of like walking into your first job and proudly comparing your boss to Hitler.
As you can imagine, he was fired.
So Becker took his radical ideas somewhere that they might be accepted: Berkeley, California. But this, too, didn’t last long.
Because it wasn’t just his anti-establishment tendencies that got Becker into trouble; it was his odd teaching methods as well. He would use Shakespeare to teach psychology, psychology textbooks to teach anthropology, and anthropological data to teach sociology. He’d dress up as King Lear and do mock sword fights in class and go on long political rants that had little to do with the lesson plan. His students adored him. The other faculty loathed him. Less than a year later, he was fired again.
Becker then landed at San Francisco State University, where he actually kept his job for more than a year. But when student protests erupted over the Vietnam War, the university called in the National Guard and things got violent. When Becker sided with the students and publicly condemned the actions of the dean (again, his boss being Hitleresque and everything), he was, once again, promptly fired.
Becker changed jobs four times in six years. And before he could get fired from the fifth, he got colon cancer. The prognosis was grim. He spent the next few years bedridden and had little hope of surviving. So Becker decided to write a book. This book would be about death.
Becker died in 1974. His book The Denial of Death, would win the Pulitzer Prize and become one of the most influential intellectual works of the twentieth century, shaking up the fields of psychology and anthropology, while making profound philosophical claims that are still influential today.
The Denial of Death essentially makes two points:
1. Humans are unique in that we’re the only animals that can conceptualize and think about ourselves abstractly. Dogs don’t sit around and worry about their career. Cats don’t think about their past mistakes or wonder what would have happened if they’d done something differently. Monkeys don’t argue over future possibilities, just as fish don’t sit around wondering if other fish would like them more if they had longer fins.
As humans, we’re blessed with the ability to imagine ourselves in hypothetical situations, to contemplate both the past and the future, to imagine other realities or situations where things might be different. And it’s because of this unique mental ability, Becker says, that we all, at some point, become aware of the inevitability of our own death. Because we’re able to conceptualize alternate versions of reality, we are also the only animal capable of imagining a reality without ourselves in it.
This realization causes what Becker calls “death terror,” a deep existential anxiety that underlies everything we think or do.
2. Becker’s second point starts with the premise that we essentially have two “selves.” The first self is the physical self—the one that eats, sleeps, snores, and poops. The second self is our conceptual self—our identity, or how we see ourselves.
Becker’s argument is this: We are all aware on some level that our physical self will eventually die, that this death is inevitable, and that its inevitability—on some unconscious level—scares the shit out of us. Therefore, in order to compensate for our fear of the inevitable loss of our physical self, we try to construct a conceptual self that will live forever. This is why people try so hard to put their names on buildings, on statues, on spines of books. It’s why we feel compelled to spend so much time giving ourselves to others, especially to children, in the hopes that our influence—our conceptual self—will last way beyond our physical self. That we will be remembered and revered and idolized long after our physical self ceases to exist.
Becker called such efforts our “immortality projects,” projects that allow our conceptual self to live on way past the point of our physical death. All of human civilization, he says, is basically a result of immortality projects: the cities and governments and structures and authorities in place today were all immortality projects of men and women who came before us. They are the remnants of conceptual selves that ceased to die. Names like Jesus, Muhammad, Napoleon, and Shakespeare are just as powerful today as when those men lived, if not more so. And that’s the whole point. Whether it be through mastering an art form, conquering a new land, gaining great riches, or simply having a large and loving family that will live on for generations, all the meaning in our life is shaped by this innate desire to never truly die.
Religion, politics, sports, art, and technological innovation are the result of people’s immortality projects. Becker argues that wars and revolutions and mass murder occur when one group of people’s immortality projects rub up against another group’s. Centuries of oppression and the bloodshed of millions have been justified as the defense of one group’s immortality project against another’s.
But, when our immortality projects fail, when the meaning is lost, when the prospect of our conceptual self outliving our physical self no longer seems possible or likely, death terror—that horrible, depressing anxiety—creeps back into our mind. Trauma can cause this, as can shame and social ridicule. As can, as Becker points out, mental illness.
Becker later came to a startling realization on his deathbed: that people’s immortality projects were actually the problem, not the solution; that rather than attempting to implement, often through lethal force, their conceptual self across the world, people should question their conceptual self and become more comfortable with the reality of their own death. Becker called this “the bitter antidote,” and struggled with reconciling it himself as he stared down his own demise. While death is bad, it is inevitable. Therefore, we should not avoid this realization, but rather come to terms with it as best we can. Because once we become comfortable with the fact of our own death—the root terror, the underlying anxiety motivating all of life’s frivolous ambitions—we can then choose our values more freely, unrestrained by the illogical quest for immortality, and freed from dangerous dogmatic views.”
Equal treatment for children in unequal situations is not justice.
– Jerry Brown
Growing up in a small village in the western part of Kenya, I thought I knew struggle. The first school I attended in the late 80s was very rudimentary in terms of infrastructure, and the colonies of jiggers flourishing in the earth floors in the classrooms didn’t lack for food, this is because most pupils went barefoot as cheap plastic Sandak shoes were out of reach for all but a few. To keep the gnats at bay required applying cowdung on floors by hand every Friday (a disgusting task that was not optional), even worse if your family had no cows, or they didn’t do the needful, then you’d have to go to a neighbour’s compound, container in hand, and request a serving of animal waste. Fumigation or other means of pest control was unheard of and most likely unaffordable anyway.
I cannot really say I knew hunger, three meals a day were a given. In deed my biggest worry in those days was getting a shilling to go with to school every day (wrapped in a handkerchief pinned to my chest). Back then a single bob could buy ten vitumbwas or sugarcane almost a metre long come break time, plus there was the free nyayo milk that assuaged the pain of having to cram the dictatorial propaganda that was Nyayo Philosophy.
Fast forward to 2016, thirty years later, and passing through Mandera I behold scenes of kids eager to learn having to make do with: tattered clothing, lessons in swirling dust under thorn trees, a semi-illiterate teacher, no furniture whatsoever, scorching heat. And all these when their diet consists of a cup of black sugar-free tea in the morning that will keep them running till they’ll have some porridge for dinner, plain drinking water is in fact a luxury. I now realize I had it really good growing up actually, my childhood was a walk in the park in comparison. The discomfort of a bloodsucking jigger is tame compared to an empty rumbling belly in dusty forty degree heat; blistering sandak shoes are far more comfortable compared to tiny bare feet on blazing sand in landscapes teeming with scorpions, snakes, and thorns as tough as nails.
These kids don’t need laptops, they need a roof over their makeshift class. They don’t need roadshows, they need school feeding programs, they don’t need non-existent stadia, or fables about sovereign bonds, or yarns about togetherness and unity. It’s water they lack, clothes they don’t have, food they could do with, some shelter that would do them good. These kids just want a qualified teacher. The basics of starting out in education and life.
We need our leaders, if we can call them that, to understand this: we can’t keep our children in such conditions and then boast of percentages in growth while nibbling on croissants and sipping iced tea in air conditioned hotels in cities.
It is the children forgotten in such conditions, without hope and without a future, that we will tomorrow claim to not understand their choice (or lack of choice) in embracing radical strains of politics, extreme religious ideologies, and conversion to mercenaries for hire with little respect for the sanctity of life and human dignity, a dignity they’re denied now.
Wake up. The children are the future. Take care of them today and invest in future stability.
Assassination is the extreme form of censorship.
– George Bernard Shaw
Who murdered Jacob Juma? The answer is I don’t know, and in all likelihood neither does anyone reading this.
What I do know is that this was a man who lived hard and fast, and he had, as a consequence, made many powerful enemies both in the government of the day, in political circles, and even in former business associates. Any of them could have taken his life, safe in the knowledge that the entity (and those who run it) with the monopoly on violence would be first to be fingered.
The same persons controlling this entity could have actually assassinated him, knowing they have the power to scapegoat one of his numerous enemies, such as the already arrested Yongo.
Either way he made it clear he wasn’t afraid to go, this conviction and strength of character gave him the courage and/or foolhardiness to say things and act in ways few of us dare to.
He soared with the eagles and now sleeps with the fishes. But in between he lived on his own terms.
“The diesel engine can be fed with vegetable oils and would help considerably in the development of agriculture of the countries which use it” and that “The use of vegetable oils for engine fuels may seem insignificant today. But such oils may become in course of time as important as petroleum and the coaltar products of the present time.”
– Rudolph Diesel, 1912
Volkswagen is in crisis, they’ve deliberately set out to make millions of diesel powered cars pass for cleaner than they are by programming some 500,000 vehicles to emit lower levels of harmful emissions in official tests than on the roads using clever computer algorithms.
The fact that a major company would go this extent to pull such skulduggery should be a pointer to the fact finding a balance between level of emissions and efficiency/performance is proving tough for cars running on diesel. Maybe this is because the inventor of the diesel engine intended it to run on vegetable oils but died mysteriously shortly after affirming this position in 1912.
But what is of more concern to me is that often on Kenyan roads you see lorries, buses, matatus, pickups, and other diesel powered cars belching so much smoke and soot you’d think someone had lit a coal fire to beelzebub’s backside. Worse this is not an unusual sight by any means, which is why it should worry us all.
What the Dieselgate scandal by VW has alerted me to is the dark side of diesel that I have not been paying attention to: diesel engines release 15% more CO2 per volume of fuel than petrol engines as well as 20 times as much mono-nitrous oxides (NOx) — a chemical that damages respiratory systems.
My worry then is just how badly exposed we are to this dangerous diesel emmissions seeing as it is acceptable locally to drive behind a lorry that is farting so much smoke into the air that you can barely see the road ahead nor breathe without choking. Maybe we need to ask ourselves why nowadays we have so many cases of asthma, pneumonia, and other respiratory and chest problems as compared to the old days when we had fewer cars.
Are checks for levels of emmissions included in the inspection that is carried out annualy on public service vehicles and commercial vehicles? Are our diesel vehicles fitted with Selective Catalytic Reduction systems that are actually working? Is the use of diesel powered vehicles in this country subject to any specific regulations? Do we care about this things?
Let it not be forgotten that Rudolph Diesel was dead long before they named a by-product of petroleum as diesel fuel. This had nothing to do with him or the engine he invented.
In the words of Dary Hannah “Most people are really stunned to find out that the technology has been around for more than 100 years, and that the diesel engine was in fact invented to run on vegetable oil.”