Coronavirus Edition — Mildred Smith Mission Health Center

May 25, 2020

This Memorial Day finds me back in the United States, by an amazing set of circumstances. I have been in Kenya since March 3, before the Covid-19 thing became a thing, and with the airport closed and Nairobi in quarantine, I was not sure when I might have been able to travel again! My purpose in Kenya was two-fold: to get my work permit and to get the clinic building in order to open the clinic. The good news is that the second goal has been realized, but we will get to that in a minute.

The first goal has been a little more elusive. In my last blog, I wrote about my hopes to have the work permit by the time we left in December. Optimism has always been my strong suit, but it is getting tested! In February I finally got word that my work permit would be granted, as soon as I presented my Kenyan medical license to the Immigration Office. I was returning in March, so I sent all of my credentialing in to the board and also sent the hard copies by First Class Mail to Eric Odidia, the local representative to be taken in to the Medical Board. They actually arrived about 4 weeks after I did, so the hard copies were not helpful. As it turned out, it was all for naught anyway, as they required the license for the institution I would be working at in order to license me. This is because they do not license me to practice medicine in Kenya, they license me to practice medicine at a specific facility in Kenya. We had been holding off on committing to purchasing land or a building until I had a work permit, but it was now obvious that I would need to have that in place before I could get my license, which of course was necessary for my work permit!

So it was back to square one to get a physical clinic. I had two friends working with me as we looked again for a good location at a reasonable price. It seemed as though we were just destined to be blocked in our endeavors, however. We would find plots in good locations, only to find that the price had tripled or quadrupled when it came time to sign a contract. This was usually when I arrived on the scene to close the deal, or when I went to actually look at the land or buildings we were considering purchasing. Several times, we found that the plot sizes on the supposed land titles did not actually the match the size of the plot we were being offered, which did not seem to be an issue with some people, as they claimed they had purchased it that way without issue. When we insisted the plot size match the title, we were told it would be a lot of trouble with neighbors, or the Title Office, so that was enough of a red flag to wave us off. Other times, it would turn out that the person selling the land did not have the right to sell it, as there were several other family members who also had claim to the same land. One time, we found out that it was a wealthy Aunt in Nairobi who was selling the land, but it was the only land the family had, and if it was sold they would be thrown out in the street! Apparently, the Aunt had been given control of the family land, and was taking all of the proceeds for herself, and leaving the family destitute!

As the weeks went by, and we dealt with Realtor after Realtor, there began to be bad feelings against the two gentlemen who were helping me with evaluating and procuring the land. The Agents started sending them threatening texts saying that they were “going behind their backs” because land that we rejected would be sold to someone else, and they suspected that we had obtained it through a back door somehow. One of the local guys even was beginning to be threatened because people were saying they were preventing me from buying the lands at inflated prices, and so were betraying their community!

In order to protect everyone and just get a land deal done, I eventually turned to one of the church men who owned some property in Riat, a suburb up the hill from Kisumu. It was not necessarily in the greatest location, but I figured we at least would be able to know we had a clear title and that we could pay an honest price for the land. He was very helpful, and we got surveyors from the land office to come and demarcate the plot exactly...except they couldn’t do it. The surveyor was very apologetic, but took us aside to say that there apparently had been some shenanigans going on in the land office, because there were addendums to the original title, which essentially left no land for the owner! The owner said to me,”Doug, I live in a very funny country, where you can have a piece of paper that’s says you own land there, but there is no land to be found!” As that case was obviously going off to a long, hard fought court battle, we opted out of that also.

After going back online, we found some compounds for rent in the area we were looking for, so we went to LakeEstate Realty, to enquire. There we met Nishma Karia, and were directed to a compound in Milimani which was renting for a tolerable sum, and consisted of two buildings and an outbuilding, a bougainvillea wall around it, located on a good road and one block from Nyalenda, one of the larger slum areas in Kisumu. Milimani is considered to be one of the safest areas in Kisumu. The owner was in the process of renovating, and was very open to our needs to convert the place into the clinic. So two days later, on May 7, 2020 we signed the contract to rent the compound!

This is going to be the clinic facility proper, and the second building, which consists of two rooms, will be a place where patients can be treated who need a bed. We will have two female and two male beds, but we needed a toilet facility. The owner said he wanted to put in a toilet anyway, so he is building the toilets and tying them into the sewer system for us, free of charge!

Finding our location was a blessing in many ways. Two days before we signed the contract, the US Embassy contacted me to let me know that there was going to be a flight out of Nairobi on May 14. The airport had been closed since the end of March, so I had thought my planned return to the US on May 12 would be impossible. My wife Judi had also planned to come over to assist in the clinic set-up, but her April flights had all been cancelled, and she was unable to come. With the Covid scare now coming full force, I had gone to the local hospital to offer my services if they were needed, but there actually have been very few cases outside the Nairobi and Mombasa, so they did not need help at the time. The rest of the licensing had to be done online anyway, with the Government offices being shut down, so it seemed like a good time to return, work in the US to refill our personal coffers, and await the lifting of restrictions. Now with the clinic location determined, and licensing just depending on finishing the renovations, everything seemed to be finally coming together.

Then we went to the bank, and found another problem when we tried to take out money to pay for the rent and security deposit. When we registered the company, we had made Eric Odida the Local Representative, so that he could sign checks and do the banking until I got my work permit and would be able to use bank funds. However, the Kenyan government changed the rules on us, and said that only a Local Director could do banking transactions! This was because there had been so much trouble with local representatives conning companies and stealing money from foreign companies! While I appreciated the sentiment, it would have been good if someone had told us us this earlier, because now we could not access the funds in the bank until Eric was made a local director or I got my work permit! Fortunately, we also had an account for the company in the US to handle dollar transactions, so we were able to close the deal for the rental of the clinic compound, but we are going to have to be working on getting Eric’s status changed to Local Director remotely as soon as possible. And hopefully and prayerfully, we will find the funds to complete the renovations we need to do so the clinic can be licensed, so I can be licensed to work there, so I can get my work permit and start the work we have been pursuing for so long.

And so despite the Covid-19 virus, the difficulties in doing simple things like purchasing land or using a bank account in an underdeveloped country, and the challenges of getting back into the country, we continue to trust that God will do this in His time...we just hope and pray His time is soon!