At first glance the Sigalagala – Butere road in Kakamega County, western Kenya looks like just another busy rural African road. With markets every couple of kilometres, several schools and colleges, many more churches, and numerous villages the 30 kilometre road is a hive of activity. A dusty hive of activity as the surface of the road is not tarmac but murram. A dusty and, at night, dark hive of activity as very low electricity penetration in western Kenya means the road has no lighting.
However, first glances can be deceiving. The Sigalagala – Butere road is made of gold. Literally. The road runs through the heart of Ikolomani Constituency. Ikolomani is a corruption of the English word “gold mine”. Between 1935 and 1952 a British company, Rosterman Gold Mines, had milled about 655,000 tones of ore and produced over 259,000 ounces of gold, with a market value estimated to be about KES 4 billion (USD 43 million).
The gold ore deposits were no longer commercially viable, despite the best efforts of locals, but they have been replaced by another source of gold, sugarcane. Butere is at the heart of Kenya’s sugarcane country with thousands of small-scale farmers farming the crop. Harvest season in February is a busy but blessed time for these farmers as their hard work pays off.
Last Sunday, one of these farmers was walking contently back home from a busy day supervising the harvesting of his sugarcane. In his 70s and in good health (as farming keeps one relatively active) he was pleased with the day’s progress. Our farmer began to cross from one side of the Sigalagala – Butere road to the other like he does several times each week.
Then he was hit. By a boda boda motorcycle taxi. A few second later he was hit again. By another boda boda motorcycle taxi.
Our farmer, legs broken, bruising and bleeding from the head was rushed to the town of Mumias, which has the nearest hospital. His broken legs and bruised head were tended to promptly. The medical personnel noticed swelling around his abdomen and suspected heavy internal bleeding, they would need to take our farmer to theatre and operate to stop the bleeding and attend to any internal damage. But there was a problem, the hospital did not have any blood in the blood bank and this was required for the procedure. An urgent appeal was made to hospitals in Kakamega, 36 kilometres away, but blood banks there were empty too. Calls were made to Eldoret, 125 kilometres away, where there was blood supply but how would it get to Mumias?
As all this was going on our farmer died.
Back on the road the boda boda motorcycle riders who hit our farmer had been apprehended by bystanders and handed over to the local government officials. The riders did not have valid driving licenses. The Sigalagala – Butere road with its real and green gold is rich pickings for boda boda motorcycle taxis. For KES 300 per day you can hire a motorbike and make KES 3,000 per day. No asks for licenses. The vast majority do not have licenses. Low numbers of law enforcement officers (who are responsible for enforcing traffic rules as well as conducting driving tests) leads to anarchy. Our licensing system failed.
The motorbikes the unlicensed riders were on have no ownership documents and are not insured. You can impound the motorbikes but cannot establish through documentation whom was responsible for purchasing insurance for those motorbikes. A lack of enforcement of insurance regulations leads to anarchy. Our insurance system failed.
At our hospital blood banks are empty. No one remembers the last time there was a coordinated blood donation drive in the area. Several theories circulate on why this is the case. One claims the people of Western Kenya do not trust medical facilities to secure their blood and are afraid their blood will fall into the hands of witchdoctors. An alternative, much more scary, theory states that the last time a blood drive was conducted (which targeted schools) doctors were shocked at how many samples returned positive results for HIV, especially amongst primary school children. This fear of finding out your HIV status (all donated blood is tested for HIV and other conditions) keeps people away from blood drives as stigmatisation of people living with HIV in our communities is an enormous problem. A less dramatic explanation is the hospitals do not have the right facilities to test and store the blood. This third explanation could explain why although the farmer arrived at hospital in the company of three men who were all willing to donate blood the hospital was unable to take and process their blood. Our blood donation system failed.
Our golden road, a busy, significant, 30 kilometres artery is in a region heaving with voters. 3 Presidents, 1 Prime Minister have all passed through promising to upgrade the road from murrum to tarmac and demarcate pedestrian crossings and erect road bumps to regulate speed. Numerous promises, machinery on site, but no upgrades. Our infrastructure system failed.
Since our farmer died we’ve seen systems work very efficiently. Death certificates issued promptly, burial permits easily obtained, fundraisers for funerals happen almost automatically, insurance payments on life insurance policies processed on notification. After all as people say vandu vakhutsa vutswa people will always die. This can no longer be our mind set.
Our systems work well when we are dead, we need to work together to get our systems working to keep us alive.