First, Do No Harm

Brenda Wambui
28 February ,2017

Though widely thought to be taken from the Hippocratic Oath, the phrase as we know it does not appear in the historic document. The Oath instead says “I will utterly reject harm and mischief.” However, this phrase remains a key guideline for medical professionals – when faced with a problem, it is better to do nothing than to cause more harm than good. When acting, or failing to act, we must consider the possible harm of our actions or lack thereof. We must weigh the inherent costs against the benefits, of which many times we are not certain.

This principle of non-maleficence has been ringing in my head for a month now, no doubt due to the doctors’ strike that is now in its sixth week. Of course, some will feel the need to interject here to let me know that the strike is doing harm, but I would argue differently. To be complicit in the government of Kenya’s constant dehumanization of citizens by agreeing to anything less than the CBA would be to do more harm than good, especially in the long run.

We have made inquiries into the state of health in Kenya, one such taskforce was led by Mutava Musyimi, and the report they generated, like many others, collects dust in some government office somewhere. In many cases, the problems in Kenya should be able to seed their own solutions, and indeed they have, but there exists a maleficence, or incompetence, or lack of incentives to solve them. An oft repeated saying is “Never attribute to malice that which is adequately explained by stupidity.” However, stupidity has a sort of hapless quality to it – stupidity makes one cause harm to others while deriving no personal gain (sometimes, one even incurs losses). Think of the Trump voters who are now shocked that he actually wants to revoke their Medicare despite him saying so over and over on the campaign trail. That is what stupidity looks like.

Our leaders, however, are not stupid. They do derive benefit from our suffering. Nothing binds Kenyans together like our suffering. Our country suffers corruption, poverty, flooding, diseases and epidemics, fire outbreaks, senseless road accidents, terrorism, drought, famine among many others. These are mostly as a result of gross negligence on the part of our leaders, as well as lax systems that don’t work as they should, and as often as they should. As a result, the quality of life in Kenya is reduced, our infrastructure destroyed, our economy disrupted, and our resources wasted. This is how we remain underdeveloped.

We are currently in the throes of yet another drought. It may be argued that drought is a natural phenomenon, but it is not one that comes by surprise. Only 20% of our country receives high and regular rainfall. The other 80% consists arid and semi-arid areas. Because of low annual rainfall, drought regularly ravages these areas. In 1997, we had a drought that affected the lives of 2 million people. In 2000, Kenya had its worst drought in 37 years. It affected 4 million people, who all needed food aid. In 2004, the long rains (which we normally expect between March and June) failed, leaving 2.3 million people in the need of aid. In 2005, famine was declared a national catastrophe, affecting 2.5 million people in Northern Kenya. In 2010 and 2011, we had our worst drought in 60 years. Across Kenya, Ethiopia and Somalia, 13.3 million people were affected. In 2014, we had a drought that affected 1.6 million people. In 2015, approximately 1.1 million people needed food aid because of rainfall shortages. It is 2017, and we are doing it all over again – this time, 2.7 million people are affected.

Drought can be predicted – we even have a National Drought Management Agency (NDMA) and an early warning system to boot. Yet every time we have drought, famine is never far behind. While drought is a natural phenomenon in which there is an extended period of dryness, famine is entirely man made, because if it comes after drought it indicates a failure to plan and prepare. Due to this drought, we have had reduced rainfall, leading to maize yields falling by 50%, beans by 40 to 50%, and sorghum by 30% when compared to 2015. Some places have experienced as much as a 70% drop in crop yields. This is what causes famine and hunger, as maize is Kenya’s staple food.

Famine is just one of the many examples of harm that are inflicted upon us by our leadership and poor systems. Only that in this case, they are caused by inaction – the money for interventions to solve these crises is likelier to get diverted into the bank accounts of an unknown cabal before it is used to do good for Kenyans. And on days like this, I despair, because in my life I have yet to see this country in a functional state – the only baseline I have for when things used to (kind of) work are stories from my parents and their peers. And I ask myself why.

Why and how we find ourselves co-opted into the perpetuation of our own suffering, especially in this election year where the message was basically that “you may be dying because doctors are on strike, but make sure you register to vote!” Perhaps we are refusing more and more – we had a much lower registration turnout than was expected. Perhaps we are finally standing up against a system that impoverishes us and the people who perpetuate it. Moving forward, it would be beneficial to us all if we weighed every course of action in this way – does it cause more harm than good to the collective? If so, we are better off not pursuing it.

I am interested in seeing a Kenya that does what is good for its people, as opposed to what is expedient, or good for a few.

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