The walls were speaking to each other. One said, “Abandon hope!” The sign said, “Karibu! Get well soon!” There were wails and screams, and there were people who seemed like they had given up but didn’t want to seem like they had, so they all wore the expression of defiance.
We had been here for the last three hours, and you could sweat out half your body weight waiting to be served. Sitting catercorner, at the reception of Kenyatta National Hospital, where we were, someone was drinking water so passionately, it made me thirsty. Perhaps when your days are numbered, your senses heighten, and you begin to experience everything with newfound intensity.
There were people with all manner of deformities at the A&E section: distorted limbs, knotted fingers, one with skin rashes that looked highly infectious, others were lying supine, as if daring God to take them. People just like us, but unluckier. There is nothing like the sight of an amputated spirit. There is no prosthetic for that.
As background noise, we could hear the ICU machines count off numbers, providing a poignant soundtrack to the chatter of patients and clients.
When we got in, there was one breathing through a pipe, her chest heaving, up down, up down, valiantly holding on to whatever life she had left. You could see she was trying hard, and my God, did she try. She would die later in the hour.
A tired-looking doctor passed us, with the scars of turmoil he’d witnessed over the years gouged into the flesh under his eyes. To be attended to, he said, you had to get your patient, dead or alive, preferably alive, to the registration desk. To do this, you had to get a stretcher. At Kenyatta, stretchers are raw currency. It’s the difference between an extra glass of water or your last.
Inside, N— was fighting for one (a stretcher, not a glass of water). Either you believe in the good of man or you don’t. There is something in the nature of man that behooves him to protect their self-interest, despite the consequences. There is also something in the laws of man that fights for the common good. The nature of man always trumps the laws of man. And so it was.
There is a certain allure in achieving something so many people want. We were like hungry vultures circling, waiting for the moment someone drops so we can drop on their stretcher. This is how you survive, or at least don't die. If you can walk, well, it seems your condition is not dire. So, stretcher it is. We haggle, we fight, we bribe. This is how you win, by refusing to lose. The universe doesn’t quit on the ones who won’t quit.
No matter how big you are, some situations will humble you with their madness. By not playing the game does not mean the game will not occur. It just means you are too ‘nice’ and ‘decent’, and where has that ever gotten anyone? Nice guys pay more.
I thought about how these were the kinds of detail that would have eluded a person who had merely driven through Hospital Road without bothering to stop, like a foreign correspondent or a National Geographic tourist or western media commentator who thinks they know the country from the airport. These are key terms when talking about hospitals in Kenya. Make sure there is ‘collapsing healthcare’ and poor sanitary conditions, and a health workforce on strike (and they are usually always on strike). But healthcare works in Kenya, right? If it didn’t, we’d have read it on AMREF or AMNESTY or WHO magazines or better yet, the government would have told us or the CS would have tweeted about it. Right? They haven’t. So it does.
I thought too about the construction workers, putting up new wards or hostels or something like that across the road. With each concrete mix, a decision had to be made: should we add more or let it rest? It is the same with us, I suppose, when we treat a dying patient. Do you tighten the frame, or do you let it dissolve? Sometimes the decision is taken from you, like when you have a deal-making kleptocratic government that treats healthcare as a game of chance, plucking SHA petals off a national flower: she will live, she will live not, she will live, she will live not…
The foreign correspondent who glides from the JKIA airport to big hotels, with a pre-approved government guide and receiving a curated version of Nairobi, would never have known this subtle but essential detail. Just as he would never have known that to get admission, we called everyone we knew. Everyone we knew called everyone they knew. And so on and so forth. We got a breakthrough, a doctor to come see us. P—, seeing the irony in all this—that we had finally got a stretcher and yet we didn’t even need it—said, If God is for us, who can be against us? It was a good question with no answer. It is the ‘if’ I was concerned about and its implied conditions. The ‘if’ was the problem. God could go either way. Yet P— speaks with so much conviction and conviviality that he is bordering on the evangelical. He may make a believer of me again, which isn’t hard, since deep down we all want to be believers.
“It’s not looking good, son,” the doctor says.
What you really need to be doing is 'coming to terms,' and you need to be doing it now. I was impressed by the dispassionate demeanour of the doctor. Like she was a newscaster announcing that the minister for health, who allegedly has been buying apartment blocks all over town, had slashed the allocation for hospitals due to ‘unforeseen circumstances.’ But I have never been concerned with governments, one way or another, because one way or another, they have never been much concerned with me.
I found my mind returning to the woman with the breathing tube, to the pipes and the abandoned stretcher. Small objects though they be, they seemed final punctuation marks of a jumbled sentence. And I thought, not for the first time, that hospitals are only partly places of healing. Mostly, they are waystations—thresholds where we decide whether to tighten or to let go, whether to build or to dismantle, whether to continue pouring concrete into the frame or finally set down the trowel.
