Kutembea, Looking Up

There are many things I enjoy about my daily morning walk to work. Generally I try to leave a few minutes early, in order to avoid the mass exodus of white-coated mzungus that traverse the well-known path between IU House and MTRH every morning, in order to have 15 minutes of uninterrupted time to myself, to think.

The musings on these daily strolls range from the absurd (why is that man carrying a lawnmower on the back of his bike?) to the practical (note to self: avoid the cow dung) to the introspective (what should I blog about next?) to the mundane (what do I need to get in town today?). On occasion, I will just allow myself the opportunity to spend 15 minutes thinking about absolutely nothing and simply enjoy a walk in the early morning Kenyan sunlight. On these occasions, when I take the time to not think, I find that I take the time to notice.

On my left, just outside the IU House gate, a school, busy with the hustle and bustle of a new school day starting. Uniformed children of varying sizes exiting the school bus, toting their school books, waving goodbye to their parents for another day. I notice that the sounds of children playing, talking, teasing, and laughing are the exact same in any language. If I close my eyes, the lilting, high-pitched timbre of their voices could be transplanted to any playground in America with no translation needed. I notice, every day, a little girl who lags behind the others. She is probably 9 or 10, wears braces on both of her legs, thick glasses, and hearing aids. She walks to school every morning, with her mother trailing protectively a dozen steps behind her. There is an unspoken code between them: how close the mother is allowed to come to the school gate, when the girl must turn to acknowledge that she has made it through that gate, the nod of understanding that passes between them. I notice that a child’s desire to fit in and be accepted by her peers is not a feeling constrained by country boundaries or cultural norms.

I walk on, noticing the steady stream of diesel-belching trucks, passenger-laden matatus, and bicycles carrying impossibly high and precariously balanced loads of people, wood, cloth, and everything else that can and cannot be imagined. As this eclectic assortment of traffic traverses the busy Elgon View Road, I notice how intent everyone seems on their destination, not unlike morning rush hour traffic in the US. One does not need to speak Kiswahili to recognize the unmistakable appearance of people heading to work. The most remarkable thing about me noticing them is that they hardly notice me. Granted, Eldoret has seen its share of mzungus in the past two decades, but this is still Africa, a place where the owner of a white face can attract a great deal of unwanted attention for what that skin color historically represents. However, I usually receive no more than a cursory glance or two, with a “how are you madame?” thrown in for good measure, and pass my walk to work quite undisturbed. There is no glaring conceit, no open hostility, no obvious disdain for me as an American. Despite what some would have you believe, there is no grand conspiracy. I truly believe that the vast, vast majority of people in this world are too occupied with trying to live to think about much else. I notice that here. I notice an entire city of people: not whispering, scheming, or plotting; but simply trying to…live.

Further up on Elgon View Road, just before the left hand turn onto Nairobi Road, a construction site, a high-rise building going up. Again I notice industry, progress, people working. I notice an entire line of trench diggers along Nairobi Road, rhythmically pounding their rusty pick-axes over and over into the rock-hard, red clay soil of Eldoret, making slow progress. I notice the intense physical demands of such a job; a job few Americans could or would undertake. I notice the woman selling maize at the same corner every day, effortlessly fanning the flames of the same Giku with the same palm frond every day. She always has her daughter with her, and I notice that they wear the same clothes every day. I notice that the woman sits at this same corner from dawn until dusk, probably earning the equivalent of one US dollar per day selling her maize, which is maybe all that stands between her family and starvation. I notice an intense feeling of guilt mixed with appreciation and gratitude every time I pass by her.

Most especially on my daily walk I notice how carefully I have to place each step. The roads and footpaths are riddled with a figurative minefield of rocks, potholes, trash, gravel, and animal flotsam. One misplaced footfall can easily turn an ankle or even topple to the ground all but the most wary of travellers. I notice, if I’m not careful, how easy it is to spend the entire 15 minute commute staring at my feet, never looking up at the world around me. Do I really want to have spent the majority of my time in Eldoret, in Africa even, staring at the ground? Not really.

Then the more I start to notice this, the more I start to think again. What would it be like to live every day in this way: to have to so carefully monitor each step that you never lift your eyes to see what’s ahead? Seems a perfect analogy for African life if you ask me. For Westerners, one of the most frustrating aspects of Kenyan culture is the apparent inability to look toward the future, to make a long-term plan. Kenyans, our patients especially, stereotypically think of today as the only day of concern. They may spend an entire project budget on only one line item, they have difficulty with the concept of saving, and they spend a month’s pay in town on “paycheck Friday.” On rounds, whenever I ask questions along the lines of “Well, that temporary fix will work for today, but then what do you want to do tomorrow about this exact same problem?” my Kenyan colleagues look at me as though I have a third eye. From an outside perspective, Kenyans seem frivolous, bad with money, poor planners, and completely unable to think things through beyond the problem at hand. It is an extraordinarily frustrating system for us to work in, because Americans are culturally a goal-oriented group, especially physicians.

The more I think about the physical act of walking to work though, the more I get it. The average Kenyan navigates potholes in their own lives the size of which we can scarcely fathom; women and children especially. Rural Africans are up at dawn, possibly walking miles to fetch a single day’s supply of water before beginning the routine of cooking, cleaning, childrearing, farming, and possibly even running a small business selling fruit or clothing. Days stretch late into the nights as they go about the affair of simply surviving. Throw into that mix intolerable levels of disease and death, and the whole “one day at a time” concept becomes more than just a cultural norm, it becomes a coping mechanism. Today is filled with enough travails and challenges to worry about, how can impoverished Kenyans be expected to anticipate the needs and worries of the next day, let alone months or years in the future? The thing is, the average Kenyan can’t look up from the road they’re walking to see what’s ahead. The thing is, maybe today is all they have.

The majority of Americans, even poor Americans, have never had to walk such a fine line of survival. Looking forward, planning for the future, is a luxury we have. We can afford to take our eyes off of today, because today is already taken care of. We take for granted, for the most part, that we will have water, food, warmth, shelter, and health for ourselves and our children. Our basic needs are met, so we can think about, dream about, and plan for the days ahead. How can the woman selling maize on the corner possibly be expected to do the same? Her entire day is consumed with earning the money she needs for this day. How can we expect her to also be thinking about her daughter’s secondary school or university fund? Our Western ideals of planning, saving, and looking toward the future are completely incongruous in this setting.

In Kiswahili the verb “to walk” is kutembea. Kiswahili verbs in general are tricky; however, I have a tendency to confuse kutembea with the unrelated verb kujifunza, “to learn.” Maybe it makes sense that these two words would be so related (or even interrelated) to me. I walk as I learn. I learn as I walk. Maybe the only way we can help a “one day at a time” culture start to see the big picture is by walking alongside its people, learning what it is like to live as they do. And now, again, I think I’ve arrived at a perfect example of what the AMPATH concept aims to do. Westerners partnering with Kenyans to think about, plan for, and arrive at a brighter future for their country. It is not a perfect system, nor will it ever be, as disease and poverty with always exist. What AMPATH can do, though, is relieve some of the burdens of disease (via HIV/AIDS care), poverty (via FPI and HHI), and childrearing (via OVC) associated with daily life in Kenya. Then, and only then, can Kenyans start to look up, see a future, and pursue it with the hope that today may not be all that there is.