Extracts from “On the African Bus” by Abimbola Lagunju – An Activist takes the floor on the Bus

An Activist takes the floor on the Bus

Be patient! Don’t shove, don’t shout, and don’t squirm. Be quiet! Let me say my bit. Let me tell you what I see, what I think. Everyone will have his chance to say whatever he wants.

I have the same questions: questions of identity; questions of values; questions of history and questions of deprivation.

I nurse the same pains: pains of identity crisis; pains of loss of values; pains of historical calamities; pains of misery and of apparent helplessness.

I nurse the pains of loss of courage, pains of transformation of the hunter into the hunted; of metamorphosis of an aristocrat into an unwanted classless being. I am a pained witness to the deconstruction of a creator of ideas to a crass consumer; to the change of roles of benefactors to beneficiaries. We, the drivers of history have become passengers of life, living on the fringes of our appropriated past. Disrobed, divested of our princely garments in the predatory arena of conquerors, we, the descendants of Kmt[i] say “…yes to the whip under the midday sun.”[ii] How have the mighty fallen!! And while the tired builders of ancient Egypt take their rest under the neem tree in the Sahel and on the coast, others claim their feats as theirs and then confine the exhausted warriors to books of historical failures. Like all conquerors, they rewrite history. They forget at will things that happened when they were historical infants; and frequently remember things that never happened.

Now, at the mercy of the elements, sans direction, sans plan, we dance to all winds. We are drenched when it rains. Our brain sizzles in the cooking sun. Fried. Barbecued. Roasted. Boiled. Cerveau Sauté à la carte.  And even now in our prostrate state, everyone picks the brain. Each according to his appetite. They eat as much as they want and even do take-away.  No credit to the brain restaurant. No mention of the incorrigible Good Samaritan except in bad books. He is not even mentioned as the Foolish Samaritan. Just plain bad. Useless. Bad genes.  Black sheep. God’s mistake! 

No history – we had no history until the arrival of foreigners. No culture – “their condition is incapable of any development of culture…”[iii] No past except a savage one.  No present, except aid - left, right and centre. No future.

Their Seine swallowed our Sine[iv] as recently as six hundred years ago. Dyed its mind blonde and blue. Hapless Sine digested, it gives up its calories and proteins. Now, stripped of everything except misery, disease and hunger, and mangled in assimilation, acculturation and globalization, Sine is spewed in putrid vomitus. And in big banners, Sine is declared detested, unwanted. Mission accomplished: pushed, used, dispossessed, now thrown to the bottom of the ladder.  

This Bus is a wreck. A nightmare. Ah! You! My brother over there in green rags. Look! I know it is not my business, but I can hear your joints quaking, ten points on Richter scale, chorusing quik-quak to the bus-squeak; cries of pains to pothole-inflicted torture. Bone music. Were you a drummer before you boarded the bus? A Djembé[v] drummer, perhaps? I am sorry; I do not mean to be rude; I am just curious. I wonder if one can guess someone’s vocation by observing bus-induced anatomical changes. Hear the tenor of my empty stomach, a storm without a cloud, a void. Not my fault.  I used to play saxophone in my previous life. Come to think of it, we can start a bus band. You have the bones, I have the stomach. Kak-kak-prompon-proporonpon-kak.-kak.

I am light headed. I have not had a meal or even smelt one in three days. I am observing sappath.  Do you remember the daily menu formula, made famous in the eighties by the sapostles. Yes! The same High Priests and preachers of SAP. The Structural Adjustment program that ran donm our households! You remember our daily menu? Yes, the zero-one-zero. Nothing to eat in the morning, miserable garri soaked in turbid water for lunch, nothing for dinner. I didn’t know that there could be many variations of a simple formula with only three variables. Many passengers here worked out different formulas. The common denominator was two zeros. Even small children knew the formula. Each child knew his household’s formula by heart. Remember how many children we had to stop to bury? They all died from insufficient food. Malnutrition, Dysnutrition, Denutrition, Exnutrition, Call it what you like. The bottom line is that food ran out, and has been on the run since. Even babies died because their mothers ran out of milk. The mothers dried up like the Red Sea, when the sapostles waved their wands.

The sapostles came among us, waved Canaan of structural adjustment and development programs in our faces, and we packed our bags out of Egypt. Out of Kemet. Yes, they promised us snow and we believed that snow was good for us. They said the Red Sea was nothing but a dying stream. That our pyramids were nothing but chunks of stones; that we needed to forget our past in order to be free. Forget the past to be free was what they told us. The past is a chain, it is bondage. Leave it. Let it die a quick death. One of their wise men called it “Aid-Induced Accelerated Collective Amnesia” in a conference.

They said the road out of Egypt was not difficult. They claimed it was laid with cheese, burgers, salad, caviar, foie gras, French fries, curry and every other thing alien to our palate. And our mouths watered!  We believed that alien foods were good for us. We did not think about indigestion, diarrhea, flatulence and indeed cancers. We left everything behind, sold every possession, and moved out into the wilderness, straight for the Red Sea. How on earth could we have believed that the sea was not wider than a stream? Did they hypnotise us? Or are we just plain naïve?

And at the banks of the sea, when we began to understand their intentions, they did not give us any chance to go back or to escape. They blinded us with SAP flipcharts and beamer lights, conferences, workshops and seminars. Some of us even got some perdiem and some, time at the podium. Tons of industrial words, phrases, plans, objectives and indicators. And we forgot everything. Yes we forgot everything as soon as each meeting was over. But that was a major mistake. They thought we were ignorant, that we couldn’t hold anything except combs in the tiny curls and they organised more meetings and workshops. And we chose to forget again.

We told them what we wanted, what we needed. We needed glucose, not grammar. We needed proteins, not programs. We needed vegetables, not variables; we demanded our stolen dignity, not pity. We demanded respect, not project. They wouldn’t listen. They said donors would not want to hear us. We were beneficiaries, and donors were donors. Beneficiaries do not know what is good for their benefit. Donors know better what the beneficiaries need. Beneficiary compliance is very important or the donor could go into fatigue mode.

We began to complain. And when the sapostles heard rumbles of rebellion, they threatened us with selective and collective sanctions, visa restrictions, aid withdrawal, credit denial. We acquiesced, then they herded us into the sea. They pushed our bus in. Some of us broke their legs and others, their heads in the fall. Many pensioners lost their lives. The hardy ones lost all their teeth.  Our bus lost all its shock-absorbers. The silencer broke. The radiator sucked in mud. Even, Jonscariot silently complained.

And now, look at the sapostles in their tight jeans at the banks of the sea, guzzling beer, eating prawns, munching lobsters, watching sunset on our beaches, laughing at us, making studies and writing endless reports. They now call themselves the local Universal Community.

The sapostles took the man and left the hood. They restructured the man. Changed his genes, adjusted and reprogrammed him. They restructured his DNA. Unzipped it. Broke off some proteins, and then zipped it back. They DNA-yed him.  Now, everyone complains about the hood. He is toxic, some say; he is a nuclear waste, claim others; and yet, others say he is a biological pollutant, undesirable in sterile atmospheres. See what I mean? Just look at the way they treat our people like the plague at those embassies. And see the way they handle those piroguistes like deadly microbes in a surgical theatre when they manage to land on distant shores. They use two layers of latex gloves, multiple layers of facial masks to offload them. We have become human microbes. Yes! Human viruses.

Personally, I am in a very perilous situation. I have sold everything to survive this journey. The only thing I have left is this tattered recycled shirt, these silly trousers that have long forgotten their cotton origin. And hope. Yes! Hope. I have been holding dearly on to it. It is the only valuable thing in my possession now. I have no job, no rich relative, and our local representative on the bus parliament simply ignores me. I put my shirt up for sale last year, no one would buy it. They have no money. No dollars! No local currency. I read that a wise man said that we live on less than a dollar a day. A very wise man. He got an award for the discovery.

I am thinking of selling my hope. It is the only thing of value that I have in my possession. I heard that the man over there, No! Not the man with the skull grin, the one with the bamboo neck, is a business man. Yes, that’s him. Don’t point fingers. He buys hopes. Anybody’s hope. Children’s, adults’, it does not matter. Says we don’t need them any longer. He says we’ve crossed all the borders where hope is of any use. Now, it is a useless asset. No market value.  He pays peanuts for hopes and sells them to Jonscariot, our driver. Jonscariot sells them to strangers at each bus stop, and keeps the money in their charge, in their pockets, in their banks. He does not want to keep the money in the bus. Says we are thieves. Someone told him that we are thieves.

I have asked myself several times if we do really need hope? What are we going to do with hope? Mine grew, then shrank, and continues to shrink. I should sell it before it disappears.  We have been feeding hope for the last one thousand years. And what has hope given us in return? Tell me, what hope has given us in return? It fed fat on our misery, married and gave birth to many other hopes. The children of hope also delivered their own babies. Multiple pregnancies. Not in vitro fertilization, my friends. Natural process. Four babies at a time, ten babies sometime. And they are all feeding fat on us. I starved my hope, and that is why it is malnourished now, ready for sale. And see where hope and its descendants have brought us. Right into the middle of this very Dead Sea.

Our people are dying of terror. Terror of everything. Terror of water; of the present; of the future; of the sapostles and their aid godfathers. Terror of their evil epistles. And there is no one to turn to. No honest person around. Just muggers, buggers and rustlers. Vultures. Just vultures crying, “Vultures of all cultures, Unite!”

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[i] Kemet – Ancient Egypt

[ii] David Diop – Africa. A Poem

[iii] Georg Wilhelm Friedrich Hegel - Philosophy of History

[iv] A river in Senegal.

[v] A kind of drum popular in Senegal.

Extracts from “On the Africa Bus” by Abimbola Lagunju – The Drivers of the African Bus

The Drivers of the African Bus

The First Driver

Do you remember the first driver of the bus? The one that drove us out of our shrines, right into the desert sun, away from any shade. Yes, the one from Ah-Rabe-yah! He damaged our sight beyond repairs, burned out our retina…….

 

The driver hacked off some stubborn heads

And did we learn anything from this experience? No! We thanked him for his service, and gave him a parting gift, an eternal gift in a little bottle. A piece of our mind to play with when he is bored or feels threatened by draughts of westerly winds. Touched by our largesse, he gave us orders at the pain of death to adopt his creed, his sun, his language as ours, to keep the names he gave us, to keep our own gods under lock and key, imprison ourselves in dome - tories, think in his letters and mumble broken syllables.

He moved into shadows of the sun when the second driver arrived from the snow. He could not melt the snowman.

The Second Driver

And the second driver! The slave driver! The senior gardener of Eden. The man of God who knew by sight, by phenotype, and later by genotype, the legitimate sons and daughters of Adam. And he knew his bastards too. Made when his God was looking away. Ham came from nowhere, and entered the loins of Adam through Noah! An abomination! Ham the harm. Error of creation; the worm and his descendants, deserved nothing but enslavement for contaminating history, for darkening the blond sun.

Holy Driver

  

He taught us many things! He taught us to call him master! He forced us to call him massa. We cowered, that was the first C ! He taught us cowardice and fear; then mounted on our backs. And while we cowered and wondered, his “….civilization kicked us in the face,…and his holy water slapped our cringing brows[i]” He fragmented our shrines with the “… monotonous rhythm of paternoster…,”[ii] undid our minds, and then he taught and taught! He taught the natives! He lifted the dark curtain from the eyes of the savages!

Four hundred years later the second driver got tired of us. God and conveyor belt overtook his mind, and he gave the keys to the third driver.

The Third Driver

The third driver!

He cockroached himself into our midst. He colonized us body and soul.

The third driver and his thieves

 We fought him with our loud silence. We fought with our submission. We gave him everything we had but our hope.  Fed up with us, he fled the bus. He handed the keys of the Bus to Jonscariot, our own man at “independence” and jumped out or so we thought. Before he jumped, he unleashed the market forces in our midst to decimate us.

 

Market Forces

  

The Fourth Driver

AN Jonscariot, our fourth driver is one of us. In his previous life, A.N. Jonscariot was a cart driver. A village cart driver. He then had another name, a name with a meaning: “the son of thunder who brings good tidings.” A good man he was. He loved his family and his neighbors. He took good care of his horse. He was normal, our “normal” until he changed his name and jumped into this contraption.

Now, we don’t know him anymore. Sometimes he drives the contrivance, our bus like a cart. Sometimes he apes the driver from Arabia, other times, the European drivers and many times, he is a combination of the four. A hybrid, neither here nor there. Neither carrot nor cucumber.

The Fourth Driver - Our own A.N. Jonscariot

Is ANJ really one of us? ANJ has always been a good apprentice, a good student of his previous masters. He diligently learnt from the previous drivers, his masters. He learnt everything by heart. If ANJ is really one of ours, it is by color only. ANJ has bleached his genes, his DNA and his mind. ANJ likes to ape his masters. He loves their way of life. He lives by their standards. He now wears blue contact lenses.

ANJ is real bad news! Bad News our ANJ is. Just like his masters. Since ANJ took over the bus from his masters at independence, he has diligently continued his inherited tradition of wreckage. See how bald the tires are! And he says he just bought them only last week ….brand new. Lately he has been saying democracy will repair the bus! Democracy! He just painted the word on our bus. In red and blue. He even calls himself Democracy sometimes. And sometimes he says he is the father of democracy of our bus.

Democracy!  From where did he get the name? He likes big colonial words, our ANJ does!  He borrows words from everywhere, and from his colonial master in particular. Important words and phrases. Toxic words. Industrial phrases. Terrorist sentences. Letters of mass murder.

 

Toxic Words

ANJ is adept at borrowing. He borrows words for himself, in his name. He then maims us with the words, and while we hold our heads in confused agony, he speeds off to borrow money and other valuable things in our name for himself.

Jonscariot is toxic. A virus. More dangerous that the former three drivers combined. No mind. No head. No plans. We are in historical trouble!

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[i] David Diop – The Vultures. A poem.

[ii] David Diop – The Vultures. A poem.

Extracts from “On the African Bus” by Abimbola Lagunju

The State of the African Bus

The bus is in an appalling state, inside and outside. The outer paint has peeled off in many places, and attempts to retouch the painting give it a leprous appearance. Water-emulsion paints have been used to “gloss” over the different patches where the original painting has failed. The headlights have broken and the cable from the guts of the right one is hanging out with its dislodged bulb. The front bumper is twisted; the chrome has peeled off, exposing the rust going on beneath. The side mirrors have fallen off, the front screen has cracked in many places. It is a wonder how the driver manages to see the road. The roof of the bus is dented, and a green pool with some floating garbage has formed in the depression. The water stinks, and hordes of flies and mosquitoes hover around the pool, from where they make their way in and out of the bus. But for one stubborn one, all the side glass windows of the bus are all broken. Here and there, the passengers nearest to the windows have contrived plastic sheets of different colours and painted cardboards to cover the windows. The cardboards all bear inscriptions more or less reflecting the state of mind of their inventors. There is one with “The Lord is my shepherd: I no dey fear” the other says “Time and Tide no get time; dem no dey wait,” another reads reads “Consultance de l’Oracle Adjonifere gratuite. Devinez votre destine! ” and yet another says “Deus è grande!” And there is another that says “Immediate answers to your prayers. No questions asked. Hebrew, Arabic and Latin services available.” Some inscriptions call people to worship, some confess the faiths of their inventors and others are just commercial adverts. It is dark inside the bus, because of the different window covers. The air is heavy and still. There is a garbage heap in the middle of the bus. The bus is overcrowded.

The left side of the bus is dented and there are what appear to be bullet holes in the body of the vehicle. Smoke from the exhaust pipe is leaking out of these sides holes. The vehicle appears to have many exhaust exits.

The rear end of the bus is in the same state. The rear lights are broken and the reverse lights are permanently on irrespective of the direction of the motion of the bus. The number plate is faded, but one can still see traces of half letters of Africa. The rear baggage compartment is half-open, held together by a blue rope; the belongings of the passengers in different plastic bags are bulging from all sides, and threatening to fall off.

The noise of the engine of the bus is deafening. Added to this is the clanking noise of the broken front wheel of the vehicle. The Bus grinds its way slowly round and round in the same place. Jonscariot has been told that under no circumstances must the Bus remain stationary. The broken wheel makes its impossible for the Bus to move forward. It can only turn around like the hands of a clock in the same place. It can also move backwards to some extent. Jonscariot alternates between moving the Bus backwards and turning it round in the same place in order to keep the Bus in motion. 

At the far right end of the bus is a group of wild-eyed worshippers in billowing white gowns, singing and praying for rapture. Right opposite them on the left is another group arguing about the direction of the east in order to take up their prayer positions. They finally agree that the east is in the opposite direction of the movement of the bus. The bus hits a huge pothole as they take up their prayer position and they fall on their backs. They decide to face the direction of the movement of the bus to say their prayers. One of them holds up a piece of tattered green cloth to screen off the white-robe worshippers on the other side of the bus. Their prayers must not clash.

The passengers shout to communicate with each other. Words lost in the enveloping noise make sentences either meaningless or offensive. There are pockets of quarrels and fights from misunderstood sentences. One man punches his neighbour for proffering what he considers insulting words to his tribe. The man had said, “The Thakas are great smiths, they can forge any implement; and are as hard working as the industrious Tivs.” The noise swallowed some words and contorted the sentence. The other man, apparently from the Thaka ethnic group heard, “Thakas can forge any document...and are hard thieves.” The attacked man falls on his back in the garbage heap in the middle of the bus, his nose and mouth bleeding. Other Thakas in the bus begin to attack members of the felled man’s tribe. Missiles fly about in one section of the bus. A missile hits the last glass window of the bus and shatters it. The splinters cut the face of a baby on his mother’s laps. The baby yells, the mother screams, and pandemonium engulfs another part of the bus.

The driver’s cabin is completely sealed off from the interior of the bus. There is no communicating door or window with the rear part of the bus where the passengers are seated. The partitioning is made of very thick (bulletproof) opaque glass. The passengers cannot see the driver; neither can the driver see them. The direction and the route of the bus are entirely at the discretion of the driver; the passengers have no say. Once every four years, the driver comes down through the front side door, climbs into the section with passengers, talks with them, gives them some gifts and then returns to the driver’s compartment. Sometime the driver does not come down for as long as fifteen years. He just drives.

But for the strange items in the cabin, the driver’s compartment is sparkling clean, air-conditioned, and very modern. The seat and the armrests are of pure leather. The floor of the cabin is covered with a beautiful and expensive Persian rug. The dashboard of the vehicle is however in a bad state. The dashboard has cracked in many places and here and there, the crevices disgorge long and short lines of mites carrying white bits and pieces of the gut of the dashboard. The speedometer is broken, the fuel gauge is non-functional, and the engine temperature gauge is hanging limply down. It is rusty. The only functioning instrument on the dashboard is a bright new radio with a disc player. The driver has turned it up loud. Its stereo effect has shut out the noise of the engine of the bus. On the passenger seat beside the driver is a small refrigerator with all kinds of drinks. The driver drinks deeply from a chilled can of beer and belches loudly.  The driver hardly looks at the road; he is either counting the money in his pocket and in the little safe in the seat-side glove compartment, or he is eating and drinking, or he is changing discs in his bus hi-fi. Occasionally, from under his seat, he takes out a big book with a brand new cover, but with yellow-from-age pages and consults it. He seems to be looking for direction for the bus in the book. After rummaging through the book without much concentration, he returns the book to its storage, and then turns his attention to his radio or to the refrigerator.

The driver hums to the music of the hi-fi continuously. He does not stop even when he is eating or drinking. Occasionally, he takes out one piece of paper or the other from any of the different crevices under his seat. He looks briefly at whatever is written on the paper and memorizes them loudly. Now he is memorizing “EPA; Economic Partnership Agreement.  PPP is a win-win strategy. Public Private Partnership is a win-win strategy.” He repeats this over and over again. Occasionally, he confuses the order of words; he pauses for a minute, takes out the paper again and refreshes his memory.

Unlike all the passengers in the bus, the driver is very smartly dressed. Very neatly cut business suit, silk tie, silk socks and leather shoes. He sports a silk handkerchief in the breast pocket of his suit. But for the ludicrous cap on his head, he would have easily passed for a successful businessman anywhere. The cap is a strange combination of a bowler hat, a turban from Arabia and traditional African cap. It has patches of dried blood all over.

In the right corner of the dashboard, between the dashboard and the windscreen of the bus is a Bible, opened at the psalms pages; in the left corner is the Koran. Different charms are hanging in all the nooks and corners of the cabin. On the floor, in front of the passenger seat is a clay bowl with a slaughtered bird, some sand, a red candle, and salt. A burning incense stick with pungent odor, hung on the ceiling of the cabin makes the air quite difficult to breathe. However, this does not appear to bother Jonscariot.

A pregnant woman falls into labour in one section of the bus. Some old women hover around her. A woman carrying a sickly looking baby with yellow hair on her back explains the situation to another woman. She says, “Poor woman! That is her ninth child. I hope this baby survives. All the other eight died. The last child had a bout of fever, vomiting and diarrhea, and despite all the sacrifices to appease the gods, the child died the next day. Some people suspect that the old woman mumbling to herself over there, the one in the brown boubou[i] is responsible for the deaths. They say she is a witch. See! I always tie a little stone in my children’s clothes to ward off her evil looks.”

The woman in labour groans. The old women shout, “Push! Push! Push!”

“I am tired,” the woman says.

“But you have to do it. You must have courage. Now, take this drink. Take it! It will give you strength.” One of the old women puts a dirty cup with a brown concoction to her lips. The pregnant woman sips some of the drink. The woman groans again.

“Push! Push! Push!” the old women chorus again.

A distraught barefooted man in green shorts and a dirty white T-shirt, apparently the husband of the woman in labor, asks one of the old women, “Mother, can I go and get the doctor? This is taking too long. She has been in labor since yesterday morning. The herbs seem not to be

working.”

“Okay! Go quickly. Get the praying group too. They are at the back of the bus.” The husband runs down the aisle of the bus.

The man returns to the scene a few moments later with a group of six women. The leader of the group sports a dirty white cap with “Prayer Warrior” written in blue in front of it. The women have red sashes tied around their waists in a true warrior-like fashion. One of them is carrying a crooked staff; the other has a club with the inscription “With this, we overcome the devil.” The prayer warriors squeeze themselves among the group surrounding the woman and begin to pray in loud voices. The leader of the group produces a little jar from among the folds of her clothes. She sprinkles some of the contents on the face of the woman in labor, and then asks her to drink the rest.

The pregnant woman groans again.

“Push! Push! Push!” the old women chorus.

“Push! Push! Push!” the prayer warriors echo.

“Where is the doctor or the nurse?” the mother of the husband asks her son.

“The doctor says he is busy. He is playing cards with his friends. The nurse says I must give her some money before she comes. What I shall I do mother?”

“Let us leave things in the hands of the gods and God! Do not worry my son.”

“Push! Push! Push!” the old women chorus again.

“Push! Push! Push!” the prayer warriors echo.

The woman gives it one last effort; and suddenly, the cry of a baby boy rises from among the group. The old women hug each other; the prayer warriors throw their arms up in the air and begin to sing. In their joy, they do not see the mother of the baby quietly give up the ghost.

Meanwhile, in the midsection of the bus, near the garbage heap a man wearing a dirty yellow armband with “Black African Activist” written in red on it is on his feet, talking or rather shouting to a group of passengers. He gesticulates in all directions. He appears angry. A member of the audience, a barefooted white African with a red T-shirt with the inscription “Son of the Soil” raises his hand either to speak or to ask a question. The Activist ignores him. The white African shrugs  and waits for the Activist to rest his case.

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[i] A large flowing robe.

The Bamako Initiative - Wrong Medicine for Wrong Ailment By Abimbola Lagunju

Sometime in 1987, at a gathering in Bamako, Mali under the auspices of Unicef and the World Health Organization, African Ministers of Health, browbeaten by IMF and other lending institutions into cutting government expenditure on social services, agreed to reduce the budgetary “burden” costs of provision of healthcare for their population by introducing user-fee payment for healthcare at all levels of service delivery. Known as the Bamako Initiative, the scheme was structured to make money for the government to finance health budgets through profits made from sale of healthcare services and drugs to the population. The intention of the promoters was not stated this way; it came in the guise of decentralization, community empowerment, health worker motivation and a host of other breezy phrases, but with a single goal of making people pay for services.

There were two major things wrong with this Initiative right from onset. Firstly, the scheme assumed that the modern healthcare system had the complete trust of the population and thus, the population would conform themselves to the new change whatever the costs. Everyone involved in this initiative either forgot or was oblivious of the fact that many of the signatory-countries to this initiative were either passing through or had just passed through socio-political upheavals including wars, coups and general instability which had left many infrastructures and services either destroyed or ineffective. In other words, the health system had never been at its best and had never really had the time to build a relationship of trust with the people.

Secondly, the scheme assumed that people had money and would pay if the services were good. And this was during a period when the Structural Adjustment Program of the IMF had not only decimated the middle class, but had also impoverished the poor rural population beyond the limits of any memorable time in history. It caught the people by surprise and alienated them from the public health service. Thus, the introduction of user-fee payment for health services wedged a barrier between the health system and the population it was meant to serve. It divided the population into dependables, i.e. those who could pay for services and the expendables, i.e. those who paid with their lives.

The impoverishment of the middle class through the devaluation of national currencies directly affected the health service providers as well. Their salaries could not meet their needs. The health professionals left the shores of Africa in droves to sell their skills in Europe, America and the Middle East. As a young doctor in a public hospital, one of the authors of this article saw many of the senior doctors leave for what later came to be known as “green pastures” in an exodus later dubbed “brain drain”. This meant that clients could not get services during an episode of illness or an emergency even if they managed to scrape some money together.

Consequently, as would be expected of any other population under such circumstances, the African people, particularly the expendables, fancifully called the “poorest quintiles” found alternatives which included the reinforcement of their beliefs in time-tested traditional medicine, self medication and in some cases, recourse to divine intervention during an episode of illness.

The consequences came in high disease burden, high infant and under-five mortalities as well as pregnancy related deaths. In other words, infanthood and young childhood became a very dangerous road for African newborns to navigate and pregnancy transformed into the dangerous Russian roulette for women. The statistics that rolled out of Africa became very alarming. It was evident that something had to be done.

The responses, when they came addressed other things but not the main problems. Firstly, big investments were made in building health facilities – health posts, health centers and hospitals in supposedly underserved communities. In some instances, these facilities were not equipped, and in many other instances where they were fully equipped, there were no staff to work in them. As health consultants, we saw many equipped health facilities in a state of abandon scattered across West Africa.

Secondly, the blame was shifted to the population. They did not know enough to protect themselves and their children and were ignorant of life threatening complications of diseases and pregnancies. Another round of big investments was made in informing and educating African people on individual self-care and protection of their children.

Thirdly, it was assumed that the lackluster performance of the largely demotivated available workforce was linked to lack of skills and knowledge. Large amounts of money were again spent on skill-upgrading trainings for health personnel. Considered a fashionable project output, many agencies fell over one another to train these personnel. It is not uncommon to see a nurse or a doctor who has been trained for five or more times on the same subject by different agencies using the same curriculum. The additional income from daily allowances (perdiems) paid by these agencies for the health staff made these unending trainings attractive.

If these strategies worked at all, the statistics did not show it. The achievement of any of the maternal and child health related targets of the Millennium Development Goals looked farther as 2015 approached.

It took the courage of an international agency sometime in 2005 to denounce the payment of user-fees as a major obstacle to any meaningful change in the preventable deaths of children and pregnant women. Many agencies have since conducted different studies on the impact of user-fees on health service uptake and have come to the same conclusion. It took close to twenty years to understand that many children and pregnant women from poor households were dying simply because the families could not afford to pay for health services.

The exemption of pregnant women and under-fives from payment of user fees soon became an important subject of advocacy and government lobby for different international agencies working in Africa. The “race” to meet the MDG maternal and child health targets at least halfway for most African countries has increased the tempo of pressure on African governments.

The response of African governments to this pressure has been dual. Firstly, it is a studied silence – a quiet wish that something else would soon catch the fancy of the agencies. African governments have come to learn that international agencies have a short attention span on any issue and will quickly shift their focus to wherever there are funds. And secondly, some, just because this new cliché won’t go away as soon as wished, have turned this into a political advantage. They simply declare free medical treatment for all children aged less than five years and payment-free consultation and delivery for all pregnant women. They want peace, so they jump the fence to placate and quieten overzealous lobbyists as well as score a political point at the home front. The financial and operational implications of their declaration elude these politicians.

Now that user-fee payment has been proved to be a public health hazard for children and pregnant women, and those that saw it as a “necessary evil” have been largely silenced, the challenge does not lie any longer in overbeating the drums of the benefits of the removal of user-fee payment but in proposing sustainable ways of its implementation in order to convince African governments that are sitting on the fence now and those who are intent on only making a political profit out of the issue that it is not only possible but also achievable.