Dr. Alfred Saigero, MMK Kenyan Daktari
UPDATE: Congratulations to Dr Alfred who is now a father to a son with his Samburu girlfriend Agnes, the girlfriend his parents did not want. He delivered his own son since...well, he is the only doctor in Kimanjo. Agnes is a law student in University of Nairobi. And yes, I am thinking of Dr Martha Ingles who predicted that the next time we go to Kenya we will find Alfred with a family.
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Dr. Alfred Saigero is our long serving MMK lead doctor in Kenya and I feel absolutely privileged to share his amazing and incredible story. He has served with MMK since 2011 and continues to coordinate MMK logistics in Kenya. His story is nothing short of amazing. Alfred is a doctor today through Dr Alfred Saigero is our long serving MMK lead doctor in Kenya and I feel absolutely privileged to share his amazing and incredible story. He has served with MMK since 2011 and continues to coordinate MMK logistics in Kenya. His story is nothing short of amazing. Alfred is a doctor today through sheer and fierce determination for a local Maasai boy who dared to dream big and desire a life outside a village. The Masaai are a Nilotic ethnic group of semi-nomadic people inhabiting Northern and southern Kenya. Their lives revolve around tending to their animals (sheep, goats and cattle), as their main investment.sheer and fierce determination for a local Maasai boy who dared to dream big and desire a life outside a village. The Masaai are a Nilotic ethnic group of semi-nomadic people inhabiting Northern and southern Kenya. Their lives revolve around tending to their animals (sheep, goats and cattle), as their main investment.
In 1985, in a little village of Kimanjo located in Laikipia district, after laboring silently for hours on end, a mother delivered a set of twins, a boy and a girl, at a time of great tumult and severe drought. There was no food or water but the mother nursed her twin babies with dedication, walking for long distances in search of milk and water. This is a community where because infant mortality is so high, infants are not named until they are 3 months old (3 moons), so the three month old boy was named Alfred. He was the 7th in his mother’s 9 children. His father had four wives and a total of 26 children plus. Okay, I know you didn’t get that but just read along…
Alfred was 4 ½ years old when he started tending the sheep and calves around his village. And at 5, Alfred started herding the animals alongside his older brothers. The majority of kids in his community do not attend any formal schooling but they are taught early how to take care of the family’s livestock. Herding animals is tough and often dangerous work. The boys leave before sunrise and are gone for long hours without any food or water in dangerous fields infested with poisonous snakes and deadly animals. Their sole purpose is to find water and grass, a scarce commodity that takes them to hundreds of miles away from their homes. They also have to protect their livestocks from predator animals on their search for greener pastures with their own homemade weaponry that includes spears, clubs (rungu), sharp knives, shields, bows and arrows. Their shields are made from cow-hide and their rungus are short throwing sticks of wood so dense they can easily crack a skull.The worst crime a herdsboy can do is to loose an animal. The consequences were clear and well known. Alfred says if you lost a goat, you might as well disappear from the face of the earth. The beatings are salvage and merciless, first from your siblings and then from your parents. This is followed by even more brutal beatings from the morans who will have to go out into the night looking for the missing goat in the forests, or evidence that the goat was killed by predators.
The worst crime a herdsboy can do is to loose an animal. The consequences were clear and well known. Alfred says if you lost a goat, you might as well disappear from the face of the earth. The beatings are salvage and merciless, first from your siblings and then from your parents. This is followed by even more brutal beatings from the morans who will have to go out into the night looking for the missing goat in the forests, or evidence that the goat was killed by predators.
It was hard for the young Alfred and the other boys. They were subjected to ritual beatings to test courage and endurance; beaten mercilessly by the Morans who crossed their path while they were herding. The morans would beat the boys for absolutely no reason at all. Alfred never forgot one time he was almost beaten to death by a moran who found him taking a bath in a spot that the Morans had supposedly decided it was “exclusively” a moran spot”. How was he supposed to know that the particular spot in the winding river was out of boundaries for everyone else? Sometimes while they were herding, the moran would beat the boys because they are too far away from the goats. They had to be within an arm’s reach but when you have 500 goats, that is virtually impossible but the morans didn’t care. The boys would be beaten up anyway.
Alfred was a natural in herding and he quickly became his father’s favorite, the responsible son. He was perfect, knew all the animals by the color and size and had the ability to identify a missing animal by a flash of sight. He never used to wander away with other boys, he was very keen on tending the animals and immediately developed a deep attachment with them. He learnt his surroundings and did not get lost in the forests and always found his way home even after travelling for days in long distant lands.
Alfred has horror stories from his herding days. A young Alfred witnessed a moran being mauledto death by a lion he was chasing away from their goats. He also witnessed two morans who confronted a cheetah that had been stealing their goats being mauled. Although the two morans survived, a 3rd moran who came to assist the two morans died right during the attack. It was dangerous work, almost like going to Afghanistan.
In 1992, there was another severe drought in Laikipia district. In a group of six, the then 7 y/o Alfred, his older brothers and a few morans had to wake up very early in the morning and move their family’s 300 cows and 500 goats away (migration). They will not be back in months or even years. They slept in the forest taking turns to watch the predators. Alfred little bare feet were swollen from being stuck by thorny bushes and for walking for such longs distances. They walked and walked, with no food or water, for 3 days from Kimanjo to Rumuruti town, some 130 kilometers away (80 miles). They found some good pastures for their animals there. Alfred lived with the other herdsmen for one year, moving from one place to another.
It was a difficult year, the cows didn’t have enough food, and were slowly becoming thin and weak. The Rinderpest epidemic struck with a vicious blow. The herders watched in horror as each day they lost an animal due to the disease. Alfred’s family lost 180 cows, and almost all the sheep. Every time a sheep died Alfred was devastated. He would hide and cry every night. As a maasai boy, crying is considered a sign of weakness in a society where strength is worshipped.
After a year and with almost all the animals dead, Alfred and his group headed back home to break the news to his parents.
Back at Kimanjo, things were getting desperate for his family. The animals were gone, there was barely anything to eat and they survived by drinking the blood of the surviving herds and their milk. His father would beat Alfred’s mother and his other wives almost everyday because of lack of food. And the boys were idling around all day, with nothing to do. Twenty six children living in the same compound and no animals to take out became a little too much for the family. When they started fighting each other, Alfred’s mother decided it was better for the kids to go to school, just to find something to do. At least at the school, the missionaries will feed the boys lunch. And it was this fate that took Alfred and his brothers to the nearest school at Lewasho village some 20 miles away from where they lived. He was nine years old and walked to school everyday.
Alfred quickly learned English and Swahili, and excelled in all the tests which the teacher noticed. But on the weekends and on holidays, as the rainfall started and there was food for the animals, Alfred was out herding with the other herders. It was one of these trips that a 10 year old Alfred witnessed a huge lion snap their biggest goat right under their noses and dragged the goat under a nearby tree for a feast. The moran who had accompanied Alfred started screaming war cries at the top of his voice surrounding the tree, jumping up and down and making threatening gestures until the lion became too perturbed by the threats and run away without eating the goat. But the goat was already dead. Alfred and the moran carried the carcass home for the family to eat.
Losing a goat to an animal predator is an unspeakable crime and his father was livid. He criticized Alfred and the moran mercilessly and did not want Alfred in his sight for two weeks. But his father also knew that Alfred was a good herdsboy who was the only one who could count the animals. So when school opened again, his father wanted Alfred to keep taking care of the animals. But when the teacher noticed that Alfred was not attending school anymore, he immediately contacted his father who quickly dismissed him. He then pleaded with Alfred’s mother telling him that he believes Alfred is a very smart kid and is better off at school than in the fields herding the animals.
In this community, a boy’s highest achievement is to become a moran (a warrior). Education is not regarded as important and is actually scorned of. Alfred was torn. Although he enjoyed going to school and learning all these new stuff, he loved the animals and wanted to be like the other boys. But when the mother pleaded with his father to allow him to go to school, Alfred and his older brother went back to school on one condition. They will still be required to tend the animals during migrations and the animals will take priority over school. He stayed with a widowed woman who was a family friend at Lewasho. She was poor and only provided the boys a place to sleep in her manyatta but barely had any food for them or herself. Since lunch was provided at the school by the missionary, the boys got used to only eating one meal a day at the school and went to bed with empty stomachs.
He had prolonged absences, sometimes he couldn’t go to school because he had to travel with the herders for the migration of the animals in search of green pastures. There were other obstacles too; like elephants blocking the pathway to school. Despite all these challenges and prolonged absences, when he did attend school, he was always # 1. He knew he wanted to become a doctor before he graduated from elementary school and said as much when he was interviewed for his scholarship application. When he was asked why he wanted to be a doctor, Alfred did not hesitate saying he wanted to come back and run a hospital in a community that had no doctors or any formal health care system.
When he graduated from standard eight (elementary), he was not only the top of his class but he was the top in the whole Laikipia district and naturally won a scholarship to attend Nakuru high school, located some 130 miles away. None of his family members had ever heard of the city or been in any city. They only travel through myriads of forests for pastures. Alfred had to find his way to Nakuru by asking for directions along the way. It was a boarding school, where he attended school for three months and then went home for 3 weeks. None of his family members ever visited him and during visiting days, when other students were brought food by their loved ones, Alfred buried his face on the books and read to keep his mind away from the fresh smell of food from the other students.
Traveling to and from school was super difficult. He had no money for public transport and walked most of the journey. When he got tired, he would linger around speed bumps where he knew the big lorries open at the back would slow down and he would jump inside and hide. During school holidays, Alfred would travel home only to find his whole family had migrated away and he had no clue where they were or how to find them. He would stay with neighbors until it was time to go back to school. After four years in the school, he graduated from high school in 2005 with flying colors. But for Alfred, this was now his chance to catch up with the animals. He had developed a deep attachment. Matter of fact, when he went home after being away from school, his first question was, “how are the animals”?
With high school completed, Alfred is again herding the animals full time. 2006 was another drought year, and this time, his family migrated to mount Kenya. He was there for six months spending his days in the forests and had no contact with anyone outside his immediate family. Unknown to him, his school friends were looking for him because he was the top of his class, again. When he finally got the news, he travelled all the way to Nairobi university to beat the medical school application deadline of May 1st. He had no change of clothes and didn’t even have the required application fees of kshs 3000 ($35) three days before the deadline. But he got lucky, his cousin who lived in Nairobi loaned him the money.
Although he obtained scholarships that saw him through medical school, Alfred struggled to survive and meet his basic needs of food and transport. His father who felt that time spent away from the animals was just a waste of time was resistant to sell his cows to meet his financial needs. In desperation, Alfred approached a white family who lived in Laikipia doing conservancy work. They agreed to pay his maintenance expenses and bills not covered by scholarships while asking for nothing in return. Alfred still kept his obligation as a good son and took care of the animals when he was away from the university. Then in November 2009, another drought struck. His family lost 300 animals while he was at the university. This time, there were only 8 cows remaining and a few goats. A lot of Maasai men committed suicide due to the loss of the animals by drinking tick poison. Alfred’s father soon became depressed and started drinking alcohol.
Back in campus, Alfred was happy to meet two other Maasai medical students. During the clinical rotation Alfred noticed local Maasais who had walked all the way to Nairobi to Kenyatta hospital for treatment but couldn’t speak any English or Swahili and would stand at casualty for days waiting for an interpreter. Alfred seized the opportunity to help his communities and would volunteer to be an interpreter even during his weekend off. But he was quite disturbed by the disparity and wanted to do more. As time went by, on his 3rd year, he started educating his fellow Maasai people on preventative medicine and immunizations.
There is a big gap, a glaring disparity between health services and the marginalization of the Maasai people. Most of them travelled all the way to Kenyatta hospital but didn’t know how to access services or where they could get a certain test done. Alfred and the two Maasai students got together and decided to start medical camps to help their communities. They rallied around some professional Maasais looking for funds to buy medications. Their first camp was in Laikipia in 2010. The community provided the group with food and accommodation. The trio encouraged other medical students from other tribes to join them. Their medical missions have taken them extensively all over Kenya to Baringo, Kajiado, Narok, Isiolo, Laikipia and Samburu. MMK first met Alfred in 2011 as a result of his volunteer work where we volunteered together in Muranga and Samburu districts.
After he successfully graduated from medical school, Alfred did his internship in Embu hospital where he performed over a hundred C-section assisted by only one nurse, and delivered hundreds of babies. Like any new doctor, Alfred was shuffled back and forth through the districts. Within a year, he had worked in three different hospitals, first in Embu, and then Meru and then Nyambene district hospital. At Nyambene, Alfred was one of the only two doctors and was expected to work 24/7, with no time off. He relentlessly delivered top notch care to his patients without ever complaining in a place where previous doctors posted to the hospital would resign because of burnout. It was in Nyambene that members of his Maasai community first approached him and asked him to move back to his home town of Kimanjo and oversee the local hospital because they could not find anyone willing to work in the area. The Santuary of Ol Lentille, a nearby resort owned by foreigners had lobbied the government to build a hospital in Kimanjo which was completed in 2013. But they could not find a doctor to run the hospital. Alfred was ecstatic. Finally he will be able to deliver health care services to his own community, just as he has always wanted. And he will be home again which meant he can now supervise their family’s animals that he loved so dearly.
But he had a good reputation in Nyambene and the hospital did not want to let him go denying his transfer request. Alfred went high up in administration to the director of health services in the ministry of health, Mr Francis Kimani, who finally approved the transfer. After two months of wrangling, Alfred was finally back home in Kimanjo where he belonged helping his own people and close to his animals. But he quickly became frustrated by lack of supplies at the hospital, there was no drugs, no resources, workers weren’t getting paid. He started making the trips to Nanyuki, the nearest “real” hospital to beg for medical supplies and medications. The lack of medications supplies is extremely hard to deal with. Alfred says he prescribes Ibuprofen to the most severe cases of 10/10 pain. Last year, MMK volunteers donated money to send Alfred a supply of medications and medical supplies when he reached out to Agnes Tan.
Alfred loves his community and makes a lot of sacrifices for his people. He want them to improve their lifestyles and have access to health services. He was thrilled when MMK brought along solar lights for the community. He is happy to tend as a doctor. Sometimes the community prefers a traditional doctor than him and only when they health becomes dire do they then look for Alfred. Alfred actually called a meeting, “baraza”, and donated his own goat for the occasion to persuade the communities to come to the hospital for their health needs. There are other challenges. He has no personal protective equipment to use when handling his tuberculosis infected patients or other contagious diseases. Forget about N95 masks, there are no masks at all and he knows he has been exposed a thousand times when his patients would cough or sneeze on his face. He tells me “I got to a point where I know I have TB dormant in my system”. Getting through to the Morans is another issue. On several occasions, he has had to go to the forests after the morans who run deep inside the forest after diagnosis to deliver TB medications, when they will no longer come to the hospital.
There is a big stigma surrounding a Moran coming to the hospital as it is considered a sign of weakness. The morans only come when they are really sick, like with sexually transmitted diseases or HIV. Alfred takes that opportunity to teach health promotion and medication adherence. Again, as the only doctor serving Kimanjo and adjacent communities, he is on call 24/7 and even travels to deliver babies during those “home deliveries gone bad”. With no equipment, not even an X-ray machine, he has developed superb assessment skills in the absence of technology. He can accurately predict the gestational age of an infant just by palpation and can determine a patient’s hemoglobin by just looking at the eyelids
He also managed to buy a small car and could now drive back and forth, an achievement even his own father could not ignore. As the only educated and successful person among his siblings, Alfred also supports his extended family members and even paid dowry (five cows), for his older brother to get married. When I first met Alfred in 2011, he was shy, almost introvert and just shrugged off any personal questions with a smile without really providing an answer. He was shocked at how openly Americans shared all details of their lives and felt awkward around the volunteers. But slowly and gradually, he began opening up and sharing with the volunteers. Dr Martha Ingles and Lexy Davidge, who have worked alongside Alfred for two consecutive years also noticed the change. Alfred even felt comfortable enough to let the volunteers teach him how to swim.
Despite his success, Alfred was still regarded as a disgrace by his father and some family members because he really never became a moran. His parents only appreciated him being a doctor after their neighbors started telling him how well his treatment regimens had cured them of their ailments. His father still does not comprehend what a doctor is and will occasionally pass through the hospital drunk and shout “What do you think you are doing? You are acting like you are a doctor? We survived with drinking herbs for ages. You are the one bringing the diseases. Who do you think you are?"
On the contrary, Alfred’s mother is very supportive and proud of his son. Her only conflict with Alfred is Alfred’s resistance to agree to an arranged marriage or settle down with a Maasai girl. She keeps hinting and pushing Alfred to certain suitable Maasai girls and does not want Alfred to marry a Samburu girl or a girl from any other tribe. But Alfred knows that if he marries a Maasai woman, she will be subjected to the Maasai cultural practices of wife swapping among age sets. So in order to avoid this wife sharing, Alfred knows he has to marry outside his community.
But for now, Alfred wants to go back to school for post graduate studies in internal medicine or Obgyn. But he needs money to pay for school for there are no post graduate scholarships available to him and the fees are way high that he is unable to afford. He is truly a man of honor. He could easily have worked anywhere else and could be earning more money. As it is, his former classmates are making twice what Alfred earns in the private hospitals. But for Alfred, it’s not about the money, it’s about saving lives, saving his community.