Heroes and Villains..

You wake up very early one day.
You go through your usual morning motions and in no time are good to go. There is nothing special about the feel of this particular morning but you somehow know it will be a good day.
Just like most of Nairobi roads are in the morning, you have the very hectic Outering Road and Juja Road traffic jams to beat. In between these there is Kariobangi Roundabout; a deviously brisk place. You have nothing but hard memories for this place...in the morning it's bad, in the evening it's hellish and that's just being very civil. But you conquer jam one, confusion two, jam three and just barely beat the clock.
It is Wednesday, one of the most delicate days of the week; And today it's the monthly pediatric psycho-social support group. Today you are running it.
You check in and engage in a little chit-chat with your colleagues; the usual adult jokes that are the staple of a far-from homogeneous setting. You jest and ridicule and laugh and jest some more. Your sport betting inclined friends' fortunes have taken a nose dive and you take the opportunity to rub it in! This is perhaps the only time you will have today for such vain engagements. For in a short while it shall be raining work-
One by one everybody settles down.

There is a very erroneous notion which I hear pretty often; that HIV infected people should not have children let alone enjoy coitus. This must have had its roots in the 90s and early 2000s when efforts to combat HIV were rather clumsy and knowledge about the same rather shaky. It must rank as the golden era of stigmatization. Health care providers must have gone about it with a certain sense of detachment and incidentally perpetuated the ostracization. It is why anyone infected and happening to fall pregnant was frowned upon. Whether this was done subtly or covertly the message was clear.
We have come a long way from those early days. Childbirth and intimacy are universal human rights. Advancements in HIV care have also seen to the possibility of eliminating vertical transmissions. But we still see infections and this is saddening. And so it happens that the infected children and their parents or guardians need an attention that though not strictly special is still special all the same. There are a lot of sensitive issues that have to be scouted when dealing with this group. On this particular Wednesday you are working with the social worker and the other team members to run these activities.

Mathare Valley.

What is an informal settlement? For these people it is very formal. The entire bulk of the city's low wage earners make this and other similar settlements their home. It is all they can afford. It is also very true that the material net worth in some of the shanties will put many a decently employed fellow to shame. It is however an undeniable fact that these people have got so much to contend with. You only need to take a guided (yes guided) walk here to appreciate the dire conditions that nobody is willing or unable to do anything about. This in itself is a catalyst for so many of the social problems observed here. Crime and a complete breakdown of law and order, violence, an open and thriving illicit drug and alcohol market. It is a world unto itself these parts. I am no sociologist nor moralist and so won't wade into this territory.
What is however clear to me is these backyards are deep and with many layers. The physical conditions and low economic status of the majority of the people here make this a truly deserving segment of the urban population. This is where you come in not just augmenting the government efforts but playing a very big role in bringing these social services close to where they are really needed.
It is Wednesday. The preceding Sunday as you go to a medical camp you have organized in one of the locations of the vast settlement you are waylaid by a gang of ruffians and mugged at knife point. It is ten in the morning. You are lucky to come out unscathed with only blows to the head and face. This has come to be accepted as the norm here. Mathare Valley.
Back to this particular Wednesday. The group session goes on well. Then you settle down to the individual consultations and it goes without saying that by lunch time you have had a great deal to handle. If it is not relatives who have no idea what the medicines the young ones under their care are taking then it is parents who have traveled to the rural home and overstayed by a month; effectively missing medicines for the same duration or this sensitive teenager who is shown open dislike and neglect by his current guardians.
It is thus way past the conventional lunch time when you get to sneak out for a quick one.


The after lunch.
You start off right where you left off because nothing has moved. Then your attention is drawn to a disturbance outside. It is just too much to be ignored and so you step outside and up the first floor to investigate. You walk right into cameras and a mass of confusion. A group of street urchins are here with some shocking accusations. That one of them we did a circumcision on died from an unspecified complication, another developed a severe infection and yet another had his glans cut off. Of course all these come as a shocker but what is more shocking is the deep involvement of the media and the police. However an argument that lasts close to two hours ensues. Your day is about to take a dip for the worst.
Do we have an active street children program? No. Do we go out there on the streets rounding up the street children for forced treatments let alone procedures? No. But do we offer services to this same group? Yes. Is this a crime? For they come to us willingly without any coercion or incentive. By this time you are simply stupefied by these ridiculous claims. This cannot possibly be happening. In no time you are being labelled a criminal, a villain. What is your crime? "Let us go to the police station you record a statement". All this time the media guys are bursting at the seams with glee, "Story imeiva, Story Imeiva". You are unceremoniously hounded out of your workplace, your protestations nearly landing you in handcuffs. You are roughed up and led to the media house van. Then to the police station.
When you get here more shock and anguish awaits you. You are held at the holding area or something of the sort, all the while the police officers here making their rude rough jokes about you. They actually think this is a joke.
You are getting agitated by the minute...

What Would Socrates Do?

Perhaps I should come here more often now that it is all sewn up..

Sometimes (most of the time) Fridays are usually very hectic days where I grind the hours at. Then sometimes it loosens up and then a man has to keep himself pretty engaged; maybe reading up a little medicine or his favorite subject; this and that.
Thus was it this particular Friday. The serenity was however shattered when the early afternoon registered an inexplicable bustle of activity. Man, it was like Monday morning all over again. But a man's got to put in hours.
You will meet some of the most strikingly smart people in the most unexpected of places. This is not news; what is news is that in the morning they will be wasting away their immense brain power drinking bitter liquors brewed along open sewer lines. In the afternoon they will sit by the shacks, silently watching the unending wheel of life going on by them. They register all this and mutter some pointed observations about what they see. In the late afternoon they will drink some more and by evening they are laid a complete waste; splattered all over the dirty pavements, unceremoniously locked away by the potent brews of the alleys. Thus ended is one day. Tomorrow is day one all over again. Vicious cycle.
The particular bustling Friday shoves one such fellow my way. Poor fellow is however a new admission to the community of the downtrodden.
He smells like a tramp and he talks animatedly like he is possessed. His one stand out appeal even before I get down to his actual problem is "daktari kindly help me, daktari kindly help me". Of course I am so used to this sort of thing but still alarmed by his stance and insistence noting that he is not drunk then. Sometimes when I meet fellows of his ilk I just let them vent and ventilate out as they give you some very startling perspectives on issues. But you have seemingly intelligent men wasting away their lives in the dungeons of dark and sad alleys overwhelmed by squalor and misery to change a thing about their existence. That is the great tragedy. The ghetto is the social black-hole; once you willingly slide down it's bowels you hardly make it back out whole or alive for that matter.
So I ask him what help he wants. He launches into a tale. His wife of twenty years kicked him out of his home. "But where do I come in?" I curiously ask him after he is done. You can talk to her so that she lets me back in, I am leading a very despicable life now. I have neither bathed nor changed my clothing for five days, I owe my stranger hosts some money, all I do now is survive on drink, left-overs and crumbs and as you might guess they are in very short supply there. It is only the drink that flows freely.
Though you hear gripping tall tales like these with a surprising frequency, this one was somehow believable. His lips are dry and cracked, his eyes sunken and cheek bones beginning to show prominence. I give him a small amount of money and he breaks into innumerable thank yous. He steps out after we are done with the consultation which happened to be rather long. He has a spring in his step and a glow on his face.
Sometimes a total stranger will astonish you with their faith in your ability to solve a pressing problem they have. This must be the special relativity of humanity; problems gravitating towards solutions! And so he comes back after his meal; more convinced that I am the man to crack his complicated domestic situation-
That one man can descend from home owner status to a homeless vagrant beggar is not strange. It happens pretty often. If the man is going to willingly lose the sight of his life mission's compass then something like this might be the outcome. But the reasons are many.
Man had severe bronco-pneumonia; so severe that I was initially convinced it was open tuberculosis. Subsequent tests however ruled out TB and this perhaps saved him from his predicament (his wife had insisted to be told whether it was TB because then there was no way she was taking him back in) So we had given him proper treatment and given him temporary admission. Later a little drama would ensue involving his wife, his mother, his uncle, his aunt and a family pastor friend all who had to be called to arbitrate. Turns out our man was even lucky to be freely roaming the streets. He had caused a grievous injury to his wife after a domestic misunderstanding, then he had bolted.

Long after my colleagues had gone home I was still stuck in a delicate mediation process which mostly involved rebuking our man for he owned up to turning into an moron after he lost his job which was in itself caused by his drink. His uncle had secured him another position but what does he do! He gets into a vicious confrontation with his new supervisor and is cut loose almost immediately. When our man had gone back to his uncle's house for just the chance of a meal he had been sent scampering to safety by his machete wielding uncle. He could not take any more of his grown nephew's bullshit!
Now here we were trying to reconcile the parties each with a bagful of grievances.
Two things had prompted me to meddle in this matter; the condition of his chest and his expressed intention to board on the hospital coaches which he deemed a great deal better than his current lodgings. He had even broached the subject of me taking him in. And I have seen so many cases of hospital abandonment to treat these threats lightly. Privately he had told me that he had seriously contemplated jumping just to end it all. With the little cash I gave him he had debated with himself whether to buy a cyanide laced poison. The only thing that held him back was that his wife was listening to me. However this had not been an easy task. She had been greatly embittered by his guts to even think about calling her. What she had told me was that she would even be very happy to hear a car had fatally knocked him down. He had relatives and they should assist him. My pitch had been plain; he remained her husband and whatever differences they had were best addressed conclusively. But that now he needed help and we had gone over our limit in aiding him.
When uncle had been informed he had said nothing. It was thus a surprise when he showed up and and in tow his wife, a family pastor friend, our man's mother and two other acquaintances. Uncle had to be restrained from delivering a thorough thrashing to our poor fellow. Then wife had also come and I had wondered whether I had thought this through well. I had however given them conference space and they had a bitter family exchange with some very private details that will remain private. My moderation pitch was however singular; they were the people to provide a solution to all this drama. Family was family and I was even out of my mandate to intervene in a matter of this sort.
But after all the tugging and high emotional points it had ended well. Reconciliation had been achieved and the man had been pardoned first by his wife and then by his uncle. Peace had triumphed. "I will not drink again, I will hustle harder, I will stop wasting money and time on trivia", a man will say things like this in a situation like this. His wife had gone with him to his 'benefactors' to settle accounts. What had initially been four hundred was hastily doubled after all the hidden costs like 'loss of business' were laid bare. Lucky happy chap now had one last request for me; he badly needed a job!
Saved from the jaws of pneumonia and the savagery of the harsh cold streets it was kind of hilarious to see him offering to carry his wife's handbag; the complete gentleman! He could not believe this turn of events.

Happy ending hopefully-

A man who is on his death bed already has enough going for him as it were. A soul in peril. The state of his public and private affairs. His private scruples to deal with. It thus would be in the natural order of things to have his burden made light by all those close to him; family and stranger, friend and foe alike.
This man had terminal cancer of the liver. "The man you see lying there was a man indeed", these had been his sisters words to me. We had sat at the nursing station discussing his condition, then the issue of his first wife had come up. The only time she had been to the hospital was when she had first brought him for admission. Then she had disappeared.from the picture.
So this had been partly the subject of our small talk with his sister. What was to be done about it? The confidence that we sometimes get is surprising.

"So it came about that Napoleon frequently would steal out by a little side door at night, with a soft hat pulled over his eyes, and, accompanied by one of his intimates, really betake himself to some fair lady who was expecting him, or else stroll about the great city as of old, passing through streets of the kind which an Emperor hardly sees outside a fairy tale, and breathing the atmosphere of might-have-beens."

How had matters come to this point with our couple here. When the holy flame of marital bliss flickers, cools down and eventually dies out then all that had been is quickly forgotten and what was once the warmest of a felicity turns into the coldest resentment and even hatred. He had been a man of means. Then what had befallen Bonaparte III had come home to him. A complex set of situations had led to him eventually marrying a second wife. Many situations might trigger this tumultuous cascade. His first wife had colluded with her brother (whom he had entrusted with the running of one of his enterprises) to divert a size-able chunk of funds from the same to their own private uses and thus badly compromising the financial position of the business. How do you go on about a situation of this nature? But he had talked fondly of her saying that it was all nothing.
The wife had eventually come after some days and as luck would have it we bumped into each other. I asked to see her briefly. She grudgingly consented and we stepped into an office. "But where have you been ever since that day that your husband was admitted?", "Is that all you want to know?" She had roughly retorted.
"But it's important because in his condition the presence of family counts for much".
"What you are doing is meddling and I strongly warn you to stop it henceforth, I am not in the moods to discuss such a matter with anyone. Do you have any idea what I have been through? Keep to your treatment of him and please excuse me". She had walked out and gone off. I had remained there temporarily rooted to the spot, feeling completely the idiot. But she was right; what business of mine was it? What right had I?

Some months later I happened to meet the sister of the late man and out of interest asked him how it had ended up between the estranged couple. "Badly with a lot of embarrassing drama but we are all trying to forgive and let go".

I believe I have a stronger motivation to keep to my lane. As it is the demands of this job are already too weighty for a soul!  Men and women will always love each other and with the same vigor torment and scorch each other, that is the nature of our existence...but I wonder what Socrates would do..