side of the tracks.
Resigned now to the inevitable request for money, I asked Isaiah how it was possible to send money to his family if he had no job. Unfazed, Michael rose to the occasion, while Isaiah sat silently, anticipating rejection.
“Isaiah lost his job from Asian boss in Biashara. He closed his shop and refused to pay last week’s wages. Now my brother can’t pay his rent. It’s a very bad situation, you understand, Scott.” Michael’s persistence was relentless.
“How much is rent?” I said, incredulous that rent could be collected for such a place. That was it; the trap was sprung.
Triumphant, Michael announced, “Rent is 1,800 Kenyan shillings a month. Isaiah must pay his share, 300 Kenyan shillings, by this evening. Only 300 Kenyan shillings, Scott. Can you help him?”
I pulled out my wallet and passed the money to Isaiah who appeared stunned at this miraculous event. He accepted the money without saying a word. Michael quickly added, “God bless you and your family, Scott.” Turning to his brother, he added something in Kikuyu that sounded like a rebuke. Isaiah remained silent. The business over, it was time to go. Isaiah’s roommates had gathered round the doorway, anxious to return to their sleeping quarters. We made our way out into the press of people, towards the eastern end of the slum, where Michael had left his car.
There was something impressive about Kibera. In spite of the dirt, poverty, and unsanitary conditions, there was a social order that I found extraordinary. The intensity and vibrancy of close quarters, shared hardships, and the mix of generations gave Kibera a sense of community. This enormous congregation of people, mired in pollution, without police or government, had a commonality of purpose which focused on day-to-day survival. It was unlike anything else I witnessed in Nairobi during my two-year stay there.
Sometime later, I learned from friends in Westlands, a well-to-do suburb, that their African staff, living in separate quarters palatial by comparison to Kibera, became lonely, missing the life in Kibera, depressed by the material comforts of Westlands but devoid of human contact. Similarly, aid agencies such as the Flying Doctors Service spoke of refugees who were loath to abandon the intense social life of the massive refugee camps, no matter how bad the conditions, for the less human prospects of resettlement.
Michael and I made our way along the railway tracks that bordered the slum. Mounds of rotting garbage piled several stories high redefined the landscape. I could see first one, then two, and soon over half a dozen children, picking and sorting their way through the slime, in search of anything of value they might possibly turn to a shilling. Their eyes darting, alert to danger and opportunity, the scavengers were totally unaware of our presence.
Monday morning, November 18, 1996, I walked up the laterite path that led in from the main road to Wilson Airport, to an area where a collection of attractive bungalow-style buildings butted up against a nondescript office block. A large nandi flame tree had dropped its gold-laced, reddish flowers on the dark earth. There, under the leafy shade of a parking lot, dappled in sunlight, I found the main reception of the African Medical and Research Foundation (AMREF) headquarters. I was pleasantly surprised. Inside, the atmosphere was professional and efficient. The corridors buzzed with activity; doctors, nurses, secretaries, and messengers were striding purposefully from office to office, sheaves of paper in hand, intent on AMREF business. A small group of Africans waited patiently for news about a sick relative or a job application. The phones never stopped ringing. On closer examination, the buildings required minor repairs and a lick of new paint but, for an NGO (non-governmental organization), dependent on private funding, headquartered in Africa, the place scored high on first impression.
The African Medical and Research Foundation was the brainchild of plastic surgeon Sir Michael Wood, who was knighted for his work in Africa. He was born in 1919, educated at Winchester, and interned at the Middlesex Hospital in England. He and his wife, Susan, immigrated to East Africa after the Second World War. Two other plastic surgeons, Sir Archibald McIndoe, a New Zealander, and Dr. Thomas Rees, an American, arrived in Nairobi in 1957. All three met and together founded AMREF; however, it was Sir Michael Wood as director general who continued to be the driving force of AMREF until his premature death in 1987.
Sir Michael Wood, a man of charismatic charm and imagination, was also a pilot and larger than life. He realized that in Africa it was impossible for the sick to reach the large hospitals in major centres such as Nairobi and that medical help should be delivered to the outlying areas where people lived—a concept later endorsed by the Declaration of Alma Ata at a World Health Conference in Kazakhstan in 1977. He initially organized AMREF with trucks equipped with an operating theatre, dispensary, and radios, but he quickly discovered that these vehicles were cumbersome and impractical given the impassable roads in Africa, particularly during the rainy season.
Small planes were the answer: planes equipped with HF radios that could fly in and out of dirt strips. And so, the Flying Doctors Service was formed as a division of AMREF. Michael Wood’s personal plane, a Cherokee 180, and a twin-engine Piper Aztec donated by Arthur Godfrey (the 1950s host of The Arthur Godfrey Show on ABC television) formed the Flying Doctors Service’s first fleet of airplanes.
Years of hard, selfless work followed, building countless dirt airstrips, installing an expansive HF long-distance radio network, constructing outreach clinics, and raising donations from Europe and North America. Forty years later, the Flying Doctors Service had become a critical part of Kenya’s medical infrastructure.
I knocked on Dr. Michael Gerber’s door. His second-floor office was a large room, nicely appointed with black-and-white photos of doctors and nurses dispensing aid to black women and their children—typical NGO advertising, designed to tug at the donor’s purse strings. I found Michael Gerber at his desk, hunched over a computer from which he directed a seven-hundred-employee organization, responsible for training and operating clinical outreach programs for the whole of Kenya and much of East Africa as well as the Flying Doctors, who provided medical evacuation services.
Right from the start, Gerber made me his confidant, unloading his private thoughts and frustrations without seeming to worry about the political consequences of such indiscretion. Over the next two years, our regular weekly meetings would cover subjects that went far beyond my assignment to reorganize the Flying Doctors Service. Gerber’s concerns included the composition of the AMREF board, governance, and personnel issues—all political minefields that were driving him to distraction.
That first day, though, we spoke only of my assignment. He launched into it almost before I had a chance to sit down.
“Scott, I’ve got a hell of a problem with the Flying Doctors Service. It’s badly run, losing money, and draining resources from the organization. My board members are upset. They insist I do something about it.”
Gerber had inherited an awkward corporate structure that complicated the reorganization of the Flying Doctors Service, which was legally owned and operated by AMREF. The Flying Doctors Service’s revenue came from funds raised by the Flying Doctors Society, referred to as the “Society,” a separate legal organization whose sole purpose was to raise money for the Flying Doctors Service.
The Society was made up of volunteer ladies, most of whom were well meaning but completely out of touch with the operating requirements of the Flying Doctors. The Society’s constitutional mandate was to raise money for the Flying Doctors Service by selling annual memberships to the Society for KS 30,500 or $65 per member. Membership entitled a member to a free emergency medical evacuation from any swamp, mountain, or desert in East Africa, by the Flying Doctors Service. It was an excellent fundraising idea, popular with travel agents and tourists visiting the game parks. The only problem was that the Society jealously
