Living with uncertainty

So we're back in Nairobi after 5 weeks away, more relaxed than pre-departure and more competent than this time last year. And with the greater detachment after absence I'm aware what I'm grappling with is the lesson of living in shades of grey, living in the moment, less worrying about the morrow, being in the here and now, seeking not to focus on the worries at the corner of my eye, but to act justly in the moment.

The month before we left was overshadowed by worrying about illnesses of our house staff. Waking up at 3am worrying. We'd decided when we employed people that we would aim to be good employers subsidising their health and their children's education. After checking with friends here long term we agreed to take on responsibility for paying 80% of their medical costs and to pay it from our pockets rather than paying for individual private medical insurance at £270/per person pa. And over much of the year it was clear that the staff really welcomed this degree of security, and the only health costs had been a gift of £30 when the 3 year old son of the handyman was knocked unconscious and needed rushing to a clinic, a scan and a doctor's consultation. Though school fees for five children and part fees for another two is another matter again.

But then one night I realised that E, the night guard who covers at weekends, had lost alot of weight. About a stone and a half. And he said he'd been diagnosed with diabetes. You buy insulin privately here if you can afford it. $80 a daily dose. But his monthly wage, as sole wage earner in his family, is about $100/month. And though we are the people he has regular contact with, he is employed by a major global firm - which doesn't offer health cover - and contracted by D's employer not by us. On the one hand it is clear he needs access to insulin and would get this, were he in UK. On the other, amidst the many responsibilities we have to others we are employing, the cost, and not creating something which can't be sustainable in the medium term at latest once we've left Kenya, beyond a supply for emergencies this is something we are choosing not to take on. With heavy hearts. And as you dig beneath the surface it becomes clear how pressing an issue this is for many in our lives. L, our homehelp, has adopted her dead sister's two children, alongside her own. But as I discussed E's diagnosis with her, she noted that the sister who died had died from a diabetic coma. And another adult sister who lives intermittently with her is diabetic, attempting to manage the situation by diet.

And so to R, our handyman cum gardener, who always wears a hat, no matter what the weather. I had just assumed he was a fanatical Arsenal fan, never to be seen without his supporter's woolly hat even when unblocking the sewage pipe in full midday sun. But 2 days after the E incident he was looking tired on a Monday morning. What's up? Heavy weekend?

He hadn't been sleeping for the last month. Bad headaches. Whipped off his hat to show a growth the size of a pancake on the side of his face and neck.
'How long have you had that for?'
8 years... but I've only had the headaches for the last month. When I went to the doctor 3 years ago he told me it would cost £60 to operate.
Brain tumour.' I was thinking. 'Thousand dollar bills.' 'And this one IS up to us.'

A friend whose daughter fell this year paid $1000 deposit before seeing a neurosurgeon and a further $1400 for a scan and consult. How much would potential brain surgery cost? But R is in his thirties, and is employed by us, again sole wage earner and has 4 young children. Though we pay generously there is no way he could begin to meet the costs of potential neurosurgery.

So I gave him £60 to go and see a doctor at the local clinic, and he queued for two days to get to the head of the queue. And off we flew on our much needed but by no means cheap holiday, while I checked my phone for a text on the debts we might have run up in our absence.

But praise be, on our return, there is R, weeding in full health, without hat for the first time, with a neat little scar on the side of his head. Its a bit hard to determine what was up from the scrappy note in internationally illegible GP handwriting and our language difficulties and lack of diagnostic skills. But not a brain tumour, only a further £60 owed, and if I understand correctly, possibly a fatty deposit caused by too much heading of the football in his youth. Headaches gone. Beauty restored. And a sound night's sleep for all concerned.

And what am I learning? That there aren't solutions to everything. That what matters more - or maybe not more, but as much - is concern and involvement. That E wasn't expecting or asking for us to pay for insulin for him, - though this IS what we expect from our solutions-focussed perspective. That what matters now to him is that we are willing to enquire, do what we can, and to sit with him in the messiness and anxiety of a life without safety nets and solutions. That he feels he can ask us in an emergency. That in our limited way, with our self imposed restrictions, we don't just walk by on the other side of the road.