Last blog from Kenya

01/05/09

Jomo Kenyatta

I’m typing this at the airport, having arrived at Nairobi (Jomo Kenyatta) airport a while ago from Kisumu. I still have 5 hours until my flight to Istanbul, and then 8 hours or so there before I go to Israel. So I have time to blog. Or at least to type, since I can’t connect to the internet here.
Que dire? I spent a month in Kenya, going on safari, treating HIV, seeing kids on the inpatient side with tuberculosis, malaria, cholera, typhoid, marasmus, kwashiorkor – diseases that, in my world, only exist in books. Diseases that should exist only in books. All of them, except maybe HIV, can be easily prevented. When caught in time, they also can be fairly easily treated. But so many forces here have conspired to allow these diseases to flourish.
Poverty is of course chief among them. But the poverty is complex, and I’d need to spend much more time in Kenya figuring it out. The legacy of colonialism is, to me, strongly felt. Hundreds of years of oppression, followed by rapid independence based on map lines that have, or had at the time, nothing to do with Kenyans’ (if we can call them that) lives. And then somehow we expect them to have a flourishing democracy. Just like Iraq has.
I also think centuries of white oppression has divorced people from their culture, and therefore from their land. Not only do people not have the means to feed their children, they don’t know how. I am sure, before colonialism, there was no such hunger and malnutrition. People farmed, hunted, fished to eat, and though there were general problems (wars, floods, famines, etc), there was local knowledge and wisdom about how to farm without raping the land, about what constitutes a good diet. Now all people have is Ugali, which has the texture and likely the nutritional value of wet sawdust. I don’t think I’m romanticizing here. Whatever was here before white people was better than what is here now. “Progress” has only made the majority of people poorer, unable to feed themselves and their families.
Incompetent government is easily seen in the papers here every day. I thought Stevie was something, but we’re talking orders of magnitude here. And the corruption the incompetence engenders is also palpable. Government money simply disappears. As if there was enough to begin with, the government spirits it away. Much of the population has nothing to eat but maize, and the MP’s are raking it in. Families lose half their children to malnutrition and related diseases, but the government is more interested in power-grabbing than in solving socio-economic problems. Recently the Ugandans planted a flag on a small island in Lake Victoria that is also claimed by Kenya. Luckily the Kenyan government decided not to go to war over this, but the amount of energy devoted to this in politics and on the streets is unbelievable. As if a tiny fishing island has any effect on the majority of the population.
But similarly what they do with their free time. In general, men here are obsessed with one thing, and that’s Champions League Football. In Kenya, you’re either a Man United fan or an Arsenal fan. As if some game played on another continent has any bearing on anything here. But it does, because that’s where people’s emotions are invested. Which I find difficult to swallow. I do understand the wish to escape from the daily life, but this is crazy. In Sindo, for example, which goes without power for much of the day and night, some people have their own gasoline generators. And what do they do with the gas they buy? They watch TV, of course, and mostly it’s football.
Kenya is an economic success in sub-Saharan Africa. I can’t imagine what countries like Angola look like, let alone Zimbabwe. One reason people at the clinic were sad to see me go was that they could see how a paediatrician was so important. And they don’t usually have access to one. As they said, my services are more needed here. And they’re right. There is an abundance of people to take care of the preemies at UCSF for the next month. But for the rural population of Suba, there is no paediatrician.
So I’ll be back. Maybe not exactly here, but somewhere where they need me more than at tertiary-care centres in the developed world. I’ll probably come as part of something organized rather than on my own. I’m not sure what form that will take. Maybe as part of the MCH’s cardiac team, but that’s not what I feel is really needed. What’s needed is fairly basic care. Not like kids with cardiac disease don’t deserve to live, but the resources that need to be invested in them are huge, and with that money, you could make Sindo District Hospital into a place that could actually be conducive to healing, rather than death.
OK. That’s a downer. And this is long again. Not blog-like. I’m sure I’ll soon find good things to write about. Like this mosquito I’m hunting right now…