Mum, Wife, Anesthetist, Entrepreneur, Addicted to Challenge

At approximately 4:30 pm of Friday the 27th of January 2017, my wife, my best friend, the love of my life, Dr Eunice Songa-Saraceno, died like a hero. Aged 34, she died young and beautiful, like the heroes of the ancient myths; willing to change her Country she died fighting inequality and injustice, like only true heroes do.

This is what I will tell to our beautiful daughter about her mum, when she will be old enough to understand what a true hero is. At her early age of one year and ten months, she can now only ask every day ask where mummy is and hug me back when I hold her tight, trying to hide my tears.

Eunice loved Kenya, and made me quickly love it; with its inner and outer beauty: the beauty of its landscape and the kindness and hospitality of its people. As a foreigner I immediately felt welcomed and loved in Kenya, being always loved by Eunice, by her family, by her friends and very often by many of her fellow Kenyans, who welcomed me like a brother. We lived a good life, every day we reminded ourselves we were lucky and happy; she considered herself privileged for what she had, she considered herself privileged for being happy to live here and live now.

Eunice was certainly among the few lucky Kenyans, those who can be defined as middle-upper class, but she also knew also very well what is happening on the other side of the well-manicured fences of Loresho or Lavington or the fancy apartments of Kilimani or Westlands. She knew that existed an ugly side of Kenya and an ugly side of Kenyans. She knew it and she decided, humbly and nimbly to fight, step by step, the injustices, the wrong and the ugly that afflicts Kenya, for the sake of her beautiful Country.

She knew and understood the challenges of her Country and fought for Kenya when, with a BSc in Psychology and Physiology at the University of Western Ontario, Canada and a Doctor in Medicine Degree Magna cum Laude at the University of Santo Domingo, Dominican Republic, she decided to come back to Kenya, to work in a Country where there is a patient / doctor ratio of 0.2 doctors for 1,000 people, that means one doctor every 5,000 people (any doctor, not a specialist!). In the US the ratio is 2.5, 12.5 times more, in the UK is 2.8, 14 times more. With her degrees she could have chosen to go anywhere, to take an easier path: instead she came back to Kenya, to join an overworked, battered and neglected workforce, hoping she could contribute to change things in better.

She knew, understood and fought the absurdity of the tribalism and nepotism that still so often drive the power dynamics of her Country when she spent time away from me, her friends and her family and for over three months, as part of the program Uongozi Kenya, demonstrated with her exceptional leadership skills what a good leader should do, which should be his/ her quality, how these should not be measured on the basis of his/ her surname or place of birth.

She knew and fought the injustices and the wrong that exists in the Kenyan healthcare system when she enrolled in the Masters in Anesthesia at the University of Nairobi and started working at the Kenyatta National Hospital. Working is actually an inaccurate word: she started committing her time, strength, sleep, her sharp mind and her big heart for the sake of her patients, fully for free. Yes, she was not paid, and she accepted that she would not have been paid at all for the four years of her residency in Anesthesia, in order to join the ranks of one of the smallest groups of Doctors in this Country daily dealing with the neglected field of critical care.

She spent so many nights and weekends in ICU or surgical theater away from me and our daughter; coming back always tired, but excited for the lives she had saved, many times defeated for the ones she could not. We promised each other back all that precious time, which now will be no more. She would never give up: the little cheerful baby patient who for years has been obliged to live in ICU attached to a respirator, she could not believe that for her that life could be present and future; she started reading and studying her file, trying to figure out what was causing that condition, contacted specialists abroad, she could not accept a constant purgatory as a baby life. I remember the day she came back home exhausted after she pumped oxygen into the small chests of children whose lungs got burnt by the flames of exploded paraffin lamps, the only source of lights in the many areas of Nairobi where electricity is a luxury; she spent sleepless nights trying to bring back to life mothers, sisters, daughters; with the strengths of her arms, the acumen of her mind and the size her heart.

She fought day and night for her fellow Kenyans, for the wananchi (the general public) who did not have the chance, the money, the luck to go to a major private hospital, or to fly to India or the UK. There, in the poor, under resourced conditions of Kenyatta National Hospital - the biggest referral Hospital in East Africa, in the heart of Nairobi – she had to run across hospital wards looking for spares to try to find a solution to the injustice of patients who could not receive treatments because machines were unavailable, or broken; she fought for the basic right of patients to receive care as soon as possible and not days and weeks after their admission when their conditions would have deteriorated; she despaired for the unforgiving absence of basic citywide and nationwide ambulance services: in the few cases in which vehicles were available they had no fuel, material, trained paramedics and this meant that regularly patients arrived to her in the backseat or boots of cars, when it was simply too late to do anything to save them.

And she was talking to me every evening, looking at me with her beautiful shiny dark eyes, telling me about all these things, telling me - who regularly traveled to work in some of the worst places and ugliest conflicts: Somalia, Yemen, South Sudan, Central Africa, Niger to deliver and strengthen basic healthcare services for desperate communities - that the ugly and horrible was actually in front of us in plain sight, not far away from our home, our garden, our daughter.

She eventually realized that there is a common denominator that allow the ugly and wrong to thrive and grow in Kenya. That there is one main reason why the “system” remains broken, why services remain absent, why young mothers keep dying in public hospitals way more than in private hospitals, why so many young children continue to miss basic opportunities, even why roads have always and constantly potholes.

She realized that that there is a reason why things are not changing, why systems are not improving, despite people getting richer all across the country, despite the economy thriving, despite the tourists coming back en masse. And she realized that the reason is the apathy of the Kenyan middle-upper class when put in front of the funds mismanagement, corruption, misappropriation of resources that should finance public services, the guilty apathy of the Kenyan middle-upper class to hold Government Officials, Institutions, Authorities (regardless of tribe and politics) accountable.

Unfortunately, I do not have the writing verve of Eunice, or her exceptional dialectic skills, so I will not paraphrase what she wrote; I will however copy two paragraphs, which I believe summarize very well how strongly she believed and she hoped that this Country could eventually change, if only those who have the power to make it change will demand for it.

“I want to inspire and motivate those who are cozily wrapped in the blanket of comfort of “it’s not my fight” of “what can I do?” and tell them to get up! You have a post-secondary education, you have a job and you have internet access…start there! If you want to know why condoms are free in public institutions but disadvantaged girls in your constituency or anywhere in Kenya for that matter don’t go to school because they have no sanitary pads, then put your Women’s Rep to task via social media and ask why how her and her 46 elected counterparts in almost five years were not able to offer a program of free sanitary pads or the equivalent for girls and women in their counties.

[...]

This is important because we who can, we who have a lot, can help those who have nothing. We can no longer blame the ones who are broken and down trodden. We can no longer blame the ones who live each day as it comes. We must use our hard earned privilege to fight for them and fight for us. If we had a government that put its people first, there wouldn’t be a need for “their Mbagathi” and “my Nairobi Hospital” or “their matatu” and “my Uber”.”

I invite everybody to read her entire article here, https://thenewmaumaurevolution.wordpress.com/2017/01/24/a-call-to-action-wake-up-middle-and-upper-class-kenyans/. it is definitely worth the ten minutes it will take to read and hopefully the time you will take to digest and reason around what she wrote. The words of that article, which she titled “the new Mau Mau Revolution” and she posted on all social media, sending it also to politicians and newspapers, eventually posting it even on the Facebook page of the President of the Republic of Kenya, were Eunice’s latest public thoughts.

Only three days after she published what is now a public Manifesto, Eunice - Dr Eunice, the love of my life, died. Pulmonary Thromboembolism was the cause: a condition occurring in about 1 out of a 1000 individuals and often fatal, causing when acute a rapid death and without evident warning signs, but that with appropriate and prompt care can, in some cases, be reversed saving the patient’s life. She collapsed in front of her car, while she was just about to enter in it, during a sunny afternoon, in a busy road in the heart of Westlands, Nairobi. A place full of banks, shops, people. Full of everything, but without even a single ambulance, not one in standby in the area, not one that could be called by the public that started surrounding her.

She fainted and laid there, on the ground, for over one hour and the half, surrounded by tens of people, and there she died, alone, without the decency of having an ambulance running to her, without the decency of having a system that dispatch to her a paramedic, even a volunteer, someone trying to do something else rather than staring. Eventually someone, as it is the tragic normality in Kenya, put her in the backseat of a car and dropped her lifeless body onto a hospital bed, the hospital bed where my nightmare started.

And this is the ugly and wrong I kept referring to, the same one she fought against, the same I am pointing the finger against. All that tragedy I described above happened on a road seven minutes from a major hospital, in Nairobi, one of the most developed Cities in Africa; in a Country with a thriving economy, where 1.1 Trillion have been raised in taxes, but where its citizens when they collapse are left dying alone, without the minimum emergency medical support. In Kenya its citizens, all its citizens, from the poorest slum dweller to the middle-upper class members to which Eunice belonged to (perhaps with only the exception of those who she defined “upper-upper class”, accompanied by drivers and bodyguards) if they collapse in a public place will have no chance of being rescued by the public service they trust and pay; their fate will depend solely by how soon a good Samaritan with a free car backseat will appear.

Eunice, you saw with such clarity the reality of what is happening to your Country, a place that myself and our daughter despite everything that happened we keep calling home. And your tragic death only confirms the importance of what you said: “Stand up and be counted in a new revolution. A new Mau Mau movement, not to fight a foreign master who enslaved us, but to fight the inequality, the injustice and oppression that a few Kenyans enforce on us in the name of totalitarian leadership.”

So here there is a young and brilliant doctor who died and perhaps could have been saved, but that the lack of basic public ambulance services condemned to not having even an attempt of resuscitation; there is a young baby girl crying for her mum; there is a young desperate widower husband, a public health specialist who faced wars, famines and dangers to strengthen health systems abroad and eventually got stung by the poor health system at home.

It is difficult to think that anything good may come from such a tragedy, but the worst possible outcome would be that the death of Eunice would just be a statistic, one of those that would simply highlight the fragility of the Kenyan Health system.

Eunice, instead, was never a statistic: she was exceptional in life and even on her last day on Earth, she died like a hero. With her public Manifesto, and her tragic death, which confirmed in the most brutal way the truth of her words, she has awoken consciences and stimulated minds.

The entire Kenya Medical Practitioners Dentist and Pharmacists Union (KMPDU) was present at her funeral in Nairobi and burial in Kitale, the entire department of Anesthesia of the University of Nairobi, tens of doctors; condolences arrived from political figures, from the Governor of Nairobi, from Ministers. But condolences and promises of initiatives from Institutions, KMPDU and others are vane words if they are not translated into actions. Only the political leaders and the all different authorities of this Country have the power to make this happen. As Eunice said with some of her last words “We want leaders who put our interests and well-being first and their pockets second. We want leaders who take pride in their positions and use their power to inspire and create rather than trample on and destroy.”

But most importantly are the consciences and minds of all us that should be shaken. Those are the ones that need to be awoken and stimulated by Eunice’s examples in life and her tragic deaths. The consciences and minds of Doctors and Public Health Officers, even myself, who have the duty and obligation to fight for a better healthcare system for Kenya’s children, the consciences and minds of Kenya’s middle-upper class citizens, who owe to shout as Eunice said: “No more!” and truly start holding Kenya’s political Leaders, Authorities, Public Servants, accountable for their actions and inaction.

I wish that one day I may see many public ambulances running through the streets of Nairobi rescuing its citizens in need of urgent care, I wish I may be finally sure that quality basic and referral health services are provided to all citizens, regardless of their census and status and in a way that truly prevents death and suffering. On that day, hopefully not too far, I will hold my daughter’s hand and I will tell her: “Believe me, my daughter, your mum died like a hero. You need to know that your mum wished all of this, and you need to trust me when I say that she contributed as much as she could for this to happen, not only during in life, but also through her death”.

May you rest in peace and soar with the Angels my love, I know you are watching over us.

Thank you for reading, thank you for sharing.

Dr. Luca Saraceno, MSc, PhD





The new Mau Mau Revolution - by Dr Eunice Songa-Saraceno







