Human evolution has been a journey of survival. We are the survivors –through our ancestors- of great earthquakes, countless disease epidemics, extreme weather conditions, famines, human-wildlife conflicts and some nasty wars.

Central to our survival story has been the need to adapt – shedding baggage and acquiring the wings to take flight towards the bright new horizon.

One and half a century ago, Charles Darwin developed a theory published under the title ‘origins of species by natural selection.’ Through this theory we learn that variations that occur randomly within a species can confer advantage or disadvantage thereby determining survival or the extinction of a species.

Natural instincts must have developed as part of the natural selection process. In this regard we can safely assume that all instincts initially had some positive value. The motherly instinct, procreation, fight or flight responses and territorial-ism are instincts that helped our cave-dwelling ancestors to survive the savage contingencies of their age.

The coming of civilization has rendered certain human instincts at once irrelevant and harmful. Revenge, anger, greed and tribal loyalty are incompatible with civilization hence men led by intellect have formulated laws which negatively reinforce these primitive tendencies by severe punishment culminating in suppression, disuse and programmed attrition of retrogressive behavior.

Tribal loyalty has seen better days: When communities positively responded to their instincts of fighting over resources such as water, food and grazing land. Those were the dramatic days of ‘survival for the fittest’. ‘In the incessant inter-tribal wars of those days, heroes were as thick as the flies that throve on the battlefields they created for their glory.’ (Bindeh’s gift by Sarif Easmon). 

To survive in these perilous times, political organization around a common language and common culture was of unquestionable primacy. The tribe was born. Tribal loyalty became established and has since outlived its welcome and gate crashed our golden age of cooperation, nationalism and globalization.

Tribal loyalty is at the heart of many human conflicts. It is the hidden driver of the Israel-Palestinian crisis. It was partly responsible for the 1994 Rwandan genocide. It is this same instinct that led to the Nazi policy of expanding its lebensraum (living space) partly resulting in the second global war. Many human lives have been lost over an identity that is as abstract as they come.

Will human intelligence triumph over this dark primitive instinct?

Tribal instincts like racist instincts are firmly entrenched in the human psyche. Embracing tribal instincts is as easy as gliding downstream the happy river to destruction. Defying the natural tendency demands one to run ahead in evolution. This attempt to aid evolution can itself result in violent conflict between the person and his society.

If the laws of evolution were left in place and nature allowed its course, tribal instincts would meet their extinction between 200 to 300 hundred years from today. There is no certainty that this journey will be marked by tranquility.

Education and civilization have given us the power to defy nature. Why should we wait for 200 to 300 hundred years to bury ‘the tribe’ that was proclaimed dead at the birth of civilization and independence?

Every human being has the power to destroy his own tribal instincts. On a large scale, this could form a new survival story based on artificial selection and reaffirm the place of Homo sapiens in history as a truly intelligent organism.



The health workers in Kenya have the answer to the question of public health. They have had these solutions for the past 50 years .The generations that came before us were as passionate as the current one on matters public health.

However every time we articulate these solutions, we are dismissed. We are told to go back to the wards and treat. We are told that we have no business in management. We are harshly silenced.  The result is that since 1965, virtually anybody and everybody has been at the apex of the health ministry except the health expert.

In the end the health system in Kenya has been run on trial and error for the past 50 years.

When Kenyans sit back in the evening to watch the horrors unfolding in the corridors of a national referral hospital, they are staring at the accumulation of errors of management and government neglect over the past 50 years.

I hope that after the airing of the ‘rufaa mahututi’(a critically ill referral system) on K24, no hypocrite will rush to KNH to look for scapegoats in the hapless KNH casualty workers for cheap PR reasons.The scenes aired in that feature have nothing to do with the ineptitude of the worker but everything to do with chronic miscalculations and systemic failures.

KNH is only an embodiment of a dysfunctional health system that was left behind five decades back. The hospital itself is performing the functions of 47 referral hospitals.The poor Kenyans who come to the public hospitals for treatment are what Alex La Guma in his short story, ‘out of darkness’ refers to as the ‘wreckage which mankind left behind in its onward march’. This is the guilt of the whole nation and crucifying the health worker will never wash away the sins of the health care system.

In fact, all health workers still working for government deserve the highest medal of honour in Kenya ,perhaps EBS, for their patriotic service. The most sensible of us resigned many years back and fled into exile in various countries around the globe. Others are in private practice and NGOs.

The few health workers remaining in the system are only doing so in the stretched hope that somehow things might change someday. That somebody with the goodwill and the expertise will come a long and fix the system. The longer the wait, the more health experts throw in the towel.

We the health workers have the solutions to the ailing system and have known all along how to make it work. We can in a few years fix the mess and save Kenyans from this hell-on-earth that public health has been all these years.

However our solutions like the proverbial ‘stone that builders rejected’ have been ignored in preference to the incantations of what a young kenyan doctor – Paul Bundi calls ‘charlatans’.

There can never be a better time for the whole nation to embrace a change of heart and join the health experts in their quest to reclaim the health sector. Kenyan citizens should not be quick to accept mediocrity but must challenge leadership.

Kenyans, drop that gullible demeanor and ask your leaders why they do not bring their family members to be treated in public hospitals as a sign of patriotism and faith in the public health system.

The celebrated Kenyan master playwright the late Francis Imbuga in his book ‘betrayal in the city’ once said and I quote ‘When the madness of an entire nation disturbs a solitary mind, its not enough to say the man is mad’.