Saturday, 4 May 2013


When I was fresh new in the profession, I thought I would employ my go-getter, type A personality to get things going. To get things done. To prevent that mother from going home childless after nine heavy months. To save that leg from amputation. To stop cancer cells from growing. I pretty much believed, like many class 8 kids would after KCPE results, that I am the change I was looking for.

I do not know anymore.

In my first year, I was thrown into the deep end of things, without a floater and expected to be seen alive at the shore. In between my failed attempts to save lives and certify the ones I had lost, I was in utter confusion.

I could no longer tell whether the wetness down my face was sweat from my brow or tears of exasperation. I remember keenly my seniors warn me not to die with every dying patient, not to be too attached. That would affect my service-rendering. I was supposed to move on swiftly like batman from one death to another potential one. Struggling amidst limited or no resources to work. And work we did.

As an intern at the largest referral south of Kenya, I happened to rotate alone for 2 months in obstetrics and gynecology and surgery departments. It was my mandates to do all the night calls, find sleep at the25th hour of the day, and return early morning to memorize my patients’ menstrual cycles. Accurately. More like an illicit lover would need to do to prevent unwanted…well you know what. My routine life had changed without realizing it. In a quick spark, I had begun dying with every dying person, witnessing and officiating needless deaths. I would develop a deep sense of guilt.

The dewy mornings to work would more or less be like an eternal walk to a funeral. Funerals. Sending patients to buy essentials and hiding my guilt with a straight face. A face that masked the inner me, the deep personality that would ever so often, almost always be crying out for change. I would, and still do, work an an average of 10 straight hours. In risky ambiance. Expose my throat to that TB patient who had defaulted treatment and only God knows if he now has Multi drug resistant TB. Happy and eager to help him too nonetheless, after all I get paid for it; the government makes sure that I have a medical allowance of $7 in case it gets me as well. I would hug the infected air, I still do, knowing pretty well I would come back home and my loved ones would run to hug my dirty self. Isn’t that what they see the neighborhood do, why would I deny them this.

A patient would cough straight into my lungs as I struggle to fix the improvised chest tube, my motto; this man must live, the ink to certify a death is too expensive.

I would be left to explain to that woman with fibroids why she would have to do with blood on her bed sheets for a further month or two, the autoclave machine had broken down. To the child with cancer, I would pray and hope that the donors would show up again, like they did 3 months ago, if they didn’t I would sit and pray that the cancer cells would stand still like Joshua’s sun, invariably, this was a useless prayer. I often choked up tears, to maintain a strong face, as I saw them steadily walk towards death. I wondered whether they were scared to die. Were they like me?

Sometimes it got me too angry, and I would run to my room listen to gothic beats and promise myself never to go back to that place again. That place-the hospital. This would only last as long as the anger. Pent up emotions.

Some patients would shout, scream at me, I saw one slap a lady doctor colleague. They just cannot understand how you would stand and do nothing as they lose a loved one. Aren’t you a doctor? Isn’t your work to save lives? What they did not notice were the empty shelves. They also wouldn’t remember when I had to take antiretrovirals for an entire month that time I had an unimpressive contact with blood from a HIV patient. That I bore alone. Not even the people I live with knew why I would rush to the sink to vomit my intestines out  ever so often  thanks to the side effects the drugs had on me. My heroism had handed me a near death deal. Like a bolt.

Sometimes our health administrators would do their rounds, we all know who Dr.Kimani is. The man with his own ideas of how doctors’ lives should be. Some say he is a sadist. How else would you describe a man who made sure hell was always so near. Autocratic and clueless.

I became angry. Every time I would run around, get blood sample, rush up the the stairs that were built by the Chinese to the lab and back to get my seniors to teach me the art of this science, I would break down when all that was in vain. When my pen would be needed in the death certification book; this happens very many times. In just a year, I had witnessed a ‘genocide’ of sorts and  certified it. While the entire nation of Rwanda had to go through mass counseling for their genocide, I was left alone and in the dark. I had to deal with it myself and wake up the next day fit as a fiddle. I had to fit in society too.perfectly.

I was not particularly waiting or hoping to develop a thick skin. A kind of skin that makes me indifferent to deaths. I thank God I am not even close to that.

While this was happening, our country was up in political flames. When I tried to say I need someone who has gone through the experiences that I have to manage the system, I was quickly shut down. Remember how my female collegue was slapped, it felt like that. A million times. When our hopes were sky high with the new government, they cut down spending on health. That to me means, more hazardous working conditions. More empty shelves. More resignation letters from collegues who simply choose to save their own lives.

Today I was at work, even now if I am called I will be there in a split second. Tomorrow too. But I am not sure whether I will be of any help. It is not well with my soul. Maybe we need to go on strike again. It is said, that sometimes to move forward we have to take few steps back. But who will we do it for?  With Kenyans, at least the vocal ones, it is well with their souls.


  1. great piece Abi, when i read this am asking maself if am having 'thought broadcasting' cuz its like you read all our thoughts and put them in black and white

  2. Well scripted daktari. Reading throu' it feels like I should start a movement called " Kenyans 4 Kenya's Doctors"

  3. deep stuff man, that is the plight of kenyan proffesionals. being a doctor is the dream and ambition of many kenyan children. it is unfortunate that the rosy career looks flowery but it is full of thorns realistically..

  4. You have done brilliant work dactari.

  5. Thank you for your efforts daktari......

  6. On Point! And men you can write too!