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Illustration by Ivyy Chen

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Under the mkone tree

When I returned to Kenya, where I grew up, I found biomedicine and traditional medicine in conversation about mental health

by Priya Basil + BIO

Illustration by Ivyy Chen

Which way now? We scan the verge for signs to a place that is not on any map. My smartphone purports to know where we are. Invisible signals bounce and connect to inform Location Services: the world shrunk to a set of coordinates, a dropped pin, a pulsing blue icon confirming you are here: near the town of Malindi. But what good is a position when you have no sense of direction?

The World Health Organization estimates that around 80 per cent of the world’s population relies on traditional medicine as a source of healthcare. The importance of such knowledge has long been recognised by many scholars, including Elialilia Okello and Seggane Musisi in ‘The Role of Traditional Healers in Mental Health Care in Africa’ (2015). I am trying to get closer to this reality, to understand what has endured – how, why?

If there was a tradition around medicine in my Indian family, it was sharing pills. Painkillers were offered at the first twinge-throb-strain: don’t wait! Take a para. Medicine had nicknames; we were, after all, on intimate terms, thanks to my grandparents who had a shelf full of medications in their kitchen, a veritable pharmacy stashed between shelves of spices and pulses. It held the promise of a fix for every ailment. If things got serious, leftover antibiotics – hoarded from an uncompleted course – were brought into service.

Traditional medicine, according to the World Health Organization, ‘is the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.’

Eventually, memory leads us there. We have to take that dirt road, says Mary Bitta, the researcher who’s been there before, and has arranged this visit. I put away my phone, feel foolish for thinking I could rely on it. Here, I must depend on the orientation-kindness-knowledge of others. Bitta, who started and heads Difu Simo, a mental health campaign that has been running since 2019 in Kilifi County, Kenya, seems to approach the way anew each time, even over paths long-trodden.

Biomedicine is ‘a framework, a set of philosophical commitments, a global institution woven into Western culture and its power dynamics, and more.’ In short, writes Sean Valles in his entry on ‘Philosophy of Biomedicine’ (2020) for the Stanford Encyclopedia of Philosophy, it is ‘the name for how most powerful global institutions envision the relations between biological sciences and medicine.’ Is this dominant Western reality what has most shaped me, though I grew up in Kenya?

An ancient settlement is a contemporary refugee camp is a walking library is a death sentence is memorising the future is land is territory is rupture is legend-myth-reality is repair is a crime is flesh and blood is land is forgetting is I am you and not is spirit and ancestors is connecting is youth and desperation is owning or sharing is prayer and ritual is caring is old age and alienation is forgiving-accusing-preserving is territory is community is a rescue centre is history is hurting is a chance to heal, to tell…

They come, old men, old women. They emerge from makeshift tents of white canvas stamped with the words ‘Kenya Red Cross’; they step out of solid, conical huts made from lengths of dried grass tied with string to a framework of poles and sticks. They come to receive us.

Everything is at once recognisable and unfamiliar, like hearing an echo you can’t quite make out. I strain to grasp it, not stopping to wonder: why is knowing the goal? Might not knowing also have its uses?

We gather in a lopsided circle, unevenly spaced, unequally endowed, briefly united through an incantation recited in the Kigiryama language of the Giryama people by a local spiritual leader. He calls out words and those in the round reply, their hands outstretched, palms turned towards the sky. The gestures unfurl an aura of faith that glides fleetingly into view, and slips away as I wonder if I believe in… what?

I am no longer a disciple of the dispensary. Though I’m continuously struck afresh with wonder at the restorative powers of biomedicine, over the years I’ve also been forced to learn its limits in-by-through my own body and those of others. Yet my wish for the all-curing pill has not abated; a pill that would not just restore health, but fix the past.

My grandparents were among the many Indians who migrated to East Africa from India in the early 20th century, at the height of the British Empire, to work for the colonial administration. Colonised people who came – knowingly, unknowingly? – to help their colonisers colonise others. My ancestors joined a segregated society, were shoved into the middle of a racialised ranking that set whites above everybody and forced Black people to the bottom. Oppressor and oppressed – that’s how I came to see the Indians in Kenya, including my family.

When the Giryama welcome ritual is over, the circle disbands, then immediately re-forms: plastic chairs and wooden stools are arranged under the brim of a nearby mkone tree; each person takes a seat within the disc of its shade. The elders, some of whom are traditional healers, now live together as a community in a small compound on the outskirts of Malindi.

The body, I always thought, is messy. Not that the mind isn’t, but bodies – with their sounds-smells-secretions – intimidated me. I tried to flee these swampy, pulsing lowlands of being for what I saw as the elevated regions of the mind, as if the two could be separated, as if the mind didn’t have its own bogs and valleys. Then I began to study colonialism, racism, feminism, capitalism – and their intersections – and suddenly the body was central. Which bodies are subjected or entitled to which forms of attention-force-care? What does this mean for these bodies, these minds, inside and out?

If my family were oppressor and oppressed, what did that make me? In his book The Implicated Subject (2019), Michael Rothberg outlines ‘a figure who is neither the criminally responsible agent nor a mere innocent bystander to violence’. This captures my family’s predicament even better, but I could start to see myself as such only after reading Tessa Morris-Suzuki’s reflection in her book The Past Within Us (2005):

We live enmeshed in structures, institutions and webs of ideas which are the product of history, formed by acts of imagination, courage, generosity, greed and brutality performed by previous generations … Though we may not be responsible … in the sense of having caused them, we are ‘implicated’ in them, in the sense that they cause us.

My parents had no Black friends, and barely a handful of white friends. It was the same for me. We lived cut off from the wider Kenyan society, eyes turned to Britain as the place of aspiration. I would later go study and live there, before migrating to Germany.

The story of colonialism is always different, even when it’s the same

For the Giryama people, as for many across Africa, the mkone has long been an important tree; the wood of its trunk used to make poles for house construction or carvings to worship ancestors; its root, leaves and bark used in traditional medicine.

Joseph Karisa Mwarandu, a local lawyer, arrives late but slips into the circle with ease: ‘Just as a tree needs its roots to flourish, we believe that a people need their culture to flourish.’ Mwarandu is secretary general of the Malindi District Cultural Association, founder of the local Kiuye Uye movement to revive Giryama culture. ‘Sadly, we have reached a point where people are afraid to learn their own traditions for fear of being branded witches, and elders who maintain traditional culture risk being called “witch doctor”,’ he tells me. ‘We are working to rescue them from this fate’ – he gestures towards those seated, then adds: ‘We don’t support witchcraft, but we will protect those who are threatened because of it.’ I wonder about the threat, but find myself asking about the difference between traditional medicine and witchcraft. Mwarandu says: ‘These forms of knowledge can’t be scientifically measured or defined. The same knowledge that is called “traditional”, when used for the benefit of an individual or community, may be deemed “witchcraft” if it is used to harm.’

He explains the plight of his community by going back to colonialism. The British colonisers and their accomplices – the missionaries – deemed Indigenous practices evil, saw traditional medicine as witchcraft. He pauses as he talks, gives me time to jot notes. He spells out Kigiryama words, names of places marked by the past. Kaloleni. Kibwabwani. Mwanamwinga. He says: ‘Our culture was washed away by alien influences.’ He speaks as if I don’t know this history. Part of me thinks: I know, I’m a consequence of the British project of domination; my family was made and un-made by imperial forces. Another part of me thinks: he’s right, I don’t know. The story of colonialism is always different, even when it’s the same.

That day, I was at the beginning of a journey to explore understandings of mental health in different cultural, social, historical contexts. In the weeks to follow, I would ask dozens of people in Kenya how they understood the notion of ‘mental health’, and if they had used or ever would use a mganga, a traditional healer. Such experts specialise in treating various conditions including problems related to mapenzi (love), biashara (business), shango (uterus). Studies of traditional healers note that one reason for their enduring appeal is that they deal with issues not addressed by Western medicine, such as bad luck or matters related to (lack of) success in business, studies, love, or politics. Many I spoke to were evasive about consulting such healers: ‘I haven’t, but I know somebody who has.’ Others said: ‘I’m a Christian, I don’t believe in that.’

The responses to the term ‘mental health’ were more uniform, and reflected a view also common in London and Berlin: for most, it implies something negative, an affliction. ‘She’s got mental health’ is a mundane expression in Kenya, meaning the person has problems and is anxious or depressed. Few associated the term immediately with wellbeing. The word ‘mental’ has a fraught history, reflected Boniface Chitayi, a psychiatrist based in Nairobi. He mentioned Mathare Valley, the psychiatric hospital notorious for decades as a mental asylum. It loomed large even in my childhood: ‘Go to Mathare!’ was regularly hurled between kids as taunt or curse. ‘My life’s struggle is against this stigma,’ Chitayi said. He now uses the term afya ya akili, brain health or wellness. This aspect is what Bitta also seeks to emphasise by fostering awareness that ‘mental health is being able to cope with life’.

What’s coping? I wonder. ‘Staying calm while trying to find a solution,’ she says. Her work at Difu Simo is dedicated to understanding and supporting the conditions that enable this.

Mwarandu repeats that the elders had to be rescued because their lives were threatened and, he adds, because they are repositories of knowledge that is vanishing: ‘Each one of the elders is a living library.’ If a library is a time capsule, then a living library is a clock – the hour hand always hovering near midnight, the second hand boldly ticking, ticking, ticking. Temporary loans seem like a luxury. To reach for a story-remedy-memory here is to accept responsibility to preserve it. I sense the weight of this, thick as the heat upon my skin. What will it mean to get closer to knowledge systems that have been disdained and marginalised by the West, that I have been conditioned to regard with scepticism? What will I be able to do with what I learn, and what will it do with me?

The mkone drinks up the sunlight, spills shade down our faces and backs. Under the thick, green canopy it’s hard to tell the hour. Mwarandu keeps speaking. I feel like interrupting, but hold back because no one else interjects. He says the British forced locals to learn English, to abandon their own customs and follow European ways – punishing all who resisted. Emanuel Chengo Munyaya, a Mijikenda rights activist and one of the pillars of the Rescue Centre, is also quiet. Only when I talk to him the next day do I understand that it wasn’t reserve behind his silence, but deference. The circle seems to embrace everyone, but there are forms-codes-hierarchies that affect all interactions in its area. Eventually, Mwarandu is gently re-directed by Bitta: ‘Perhaps you can say a bit about how we started working together.’ And so, only now, in this moment, do I grasp the purpose of this constellation of people under this tree: collaborating to find a balance between biomedicine, traditional medicine and culture, in the service of mental health.

For a while, Emanuel was stranded, neither part of the old world nor the new

‘The colonisers told people: you can’t have both cultures, you have to choose one. Traditional or Christian.’ As a young boy, Emanuel suffered from a condition that made his heartbeat irregular. His father, a traditional healer, gave him a charm to wear under his clothes, near his heart, and told him: ‘If you remove this before I tell you to, you’ll die.’

At school, during sports class, the missionary teacher took him aside: ‘When you come tomorrow, I don’t want to see that.’

‘But my dad said if I take it off, I’ll die.’

‘If you wear it, you can’t come here,’ the teacher said.

Emanuel didn’t return to school for a year. The break meant that, later, he didn’t go into further education. Nor did he seek the traditional knowledge of his father, who died without passing any of it on to him. For a while, Emanuel was stranded, neither part of the old world nor the new. One day, a healer, who used to be his father’s assistant, told him: ‘You young people will always suffer because you deny what is yours and follow what is not yours.’

The story is familiar in its arc, if distinct in its details. Colonialism works by denigrating-assaulting-destroying even as it copies-steals-profits from peoples-places-cultures. I was taught by, lived among, people who believed there was little of cultural value here, in Kenya: art, ideas, science, progress, history, possibility – everything worthwhile – was over there: in the West, in Europe. I was never made to feel any of it was mine, but I was groomed to aspire to that world, to covet it and conform in ways that would enable me to be part of it. I strove to belong there. Some might even say I got good at it. So much so that it took a long time before I began to question what I was denying and following, what was mine or not, why any of this mattered.

Kiuyeuye refers to the first aid, a kind of resuscitation, administered at birth in Kilifi County to help a baby take its first breaths. The suggestive name began to seem too gentle for the situation. At one point, Mwarandu himself remarked: ‘If our culture were in hospital, it would be in the ICU.’

In her forthcoming essay ‘On Greatness’, the Cameroonian author Léonora Miano writes:

Intellectual and cultural domination encourages the oppressed to embrace many aspects of the oppressive system, thereby complicating their opposition to it, shifting the conflict to the interior of their psyche, and diminishing the possibility for them to liberate themselves from it. For this reason colonial systems do not rely on physical violence alone.

I asked Bitta what she thought about someone like me coming from Europe and seeking to understand traditional knowledge systems. Did it feel like a form of extraction? She said: ‘I do not think that if you take something away, we will be left with less.’ But Esther Kamba, a Kenyan artist, whom I told about my research into mental health across cultures, said: ‘You took our land, our resources, our ancestors – and now you want our spirituality.’ I knew that ‘you’ was not personal, but once again I felt implicated.

Sitting under the mkone tree, I was eager to ask how the healers understood mental health, how they treated it. But I veered away from the chance without even realising. Reaching across worlds can be transformative, but also tricky, treacherous: you, inevitably, miss-avoid-misunderstand things. Later, I had to resort to other sources; I found orientation in the work of the researchers Okello and Musisi who say that, in traditional African medicine, mental ill health is defined as a situation in which the victim tends to interpret reality in unusual ways. It seems to me that this capacious definition invites an engagement with the sufferer’s world view and circumstances. And I wonder if this approach might, at root, be informed by another philosophical understanding of self – one derived from the African concept of ubuntu, which, at its simplest, means, ‘I am because we are.’ In this sense, any remedy, however specifically it may be targeted, often involves looking beyond the individual to the collective.

Emanuel Chengo Munyaya had felt lost, like others around him, especially boys and men, who’d dropped out of school or couldn’t afford to keep studying. In 2020, the median age in Kenya was 20.1, and 38.7 per cent of the population was under 15 years old. This should be a source of tremendous potential and cause for optimism, but poverty – exacerbated by rampant corruption, poor governance and lack of social support or educational training programmes – means many young people have few prospects. Some turn to drugs, others to crime. A few wonder why they have to struggle when their family or community owns land; if they could only sell part of that, surely they could start a business, have a better future?

Land for the Giryama, as in many Indigenous cultures, has traditionally been held in common with a commitment to preserving it for future generations. Tsi Kaiguzwa – the land must not be sold – is one of the central tenets of Mijikenda law, underpinned by one insight: you did not make the land, so who are you to put a value on it, or sell it? ‘The land cannot be sold,’ Munyaya said. ‘But anyone in the community has the right to live on and work the land. Unfortunately, most of our youth today don’t feel any connection to the land, they don’t want a life [of] farming or conservation. State education gears us towards white-collar jobs. The system is misleading; it doesn’t give people the right life skills, it leaves them lost and depressed. The most many young men here aspire to is buying a boda boda and making a living as a motorbike taxi driver. That’s their big hope, and some try anything to achieve it.’

The project aims to bring the world of biomedicine and traditional healing and culture into dialogue

In Malindi and Kilifi towns, you can’t go more than a few hundred metres without spotting a makeshift sign hanging off a baobab tree or an electricity pylon, nailed to a fence or the side of a shop, advertising a mganga. Besides the healer’s phone number, areas of expertise are listed. The sheer volume of offers suggests high demand, and I wonder what sorts of remedies people get. Bitta describes a range of possibilities: you may receive herbs to steam and inhale medicinally, or to burn as a cathartic act to banish bad spirits. A charm or amulet could be given to attract or retain good luck, or ward off evil. Tattoos or cuts with specific meanings could be prescribed, or certain chants recommended to be recited at specific intervals in particular ways, related to the condition. Sometimes, the mganga performs a ritual, and the client goes away without anything tangible, only their belief in the procedure.

Bitta observes that faith plays a vital role in traditional medicine; those who accept such treatment speak of belief in its efficacy; those who reject it speak of superstition. Difu simo means ‘breaking free’ in Kigiryama. The project aims to help people break free from the stigma around mental health by bringing the world of biomedicine and traditional healing and culture into dialogue, exploring how such a combined, uncompetitive approach may help more people access, accept and respond to treatment for mental illness. ‘The first step is raising awareness of what mental illness is: anxiety and depression are not recognised as something for which you get help,’ Bitta said. ‘In Kirgiryama, such conditions might be covered with the word shulamoyo, a heavy heart. This requires care and attention, we tell people, don’t ignore it. We try to open different channels through which they can get help. Some will reach the psychiatric clinic to receive drugs only after being referred there by a traditional healer.’

The slogan Difu Simo also signals a chance to break free, if only temporarily, from the prejudices against what constitutes ‘true’-‘reliable’-‘scientific’ knowledge and method. ‘I don’t think biomedicine has all the answers,’ Bitta says. ‘And I want to search for other answers here, in my African culture.’

On my bookshelf in Berlin is a collection of mostly green slips of paper. Every single one lists my name, address and date of birth. Every single one details medication and dose, it shows the date on which the treatment was proposed, plus the stamp of the medical practice and the signature of the doctor. The dates go back almost 14 years. The prescriptions are a record of visits to my GP, a wonderful woman whom I trust yet whose prescriptions I rarely follow. She often suggests a natural remedy, exercises, a change in diet or routine alongside a medicinal intervention. Sometimes I decide I’ll try the other options before taking the medicine, sometimes I don’t do anything she recommends; it’s as if the consultation alone is enough and I begin to feel better. Might it simply be the reassurance that nothing sinister is afoot? Or could there be some kind of sorcery at work? The unique alchemy of sympathetic human contact? A shared conviction that things can get better? ‘Biomedical practices,’ observes Megan Vaughan in her book Curing Their Ills: Colonial Power and African Illness (1991), ‘can be as ritualised and “exotic” as any other healing practices.’

Patients can pay with a chicken, or a quantity of potatoes

Within some circles in Kenya, Munyaya has gained a reputation as an expert in Giryama culture; professors quote him in their papers, invite him to contribute to their seminars. I ask if they pay for this, and he is startled by the question. Munyaya has never requested or received payment, but he has sought recognition: ‘I asked, is my knowledge important for your work? They said it’s very important. Then I asked, can you give me a letter or certificate, something that confirms my knowledge? They say that’s not possible. You have to go through the system to get such confirmation.’ His story makes me think of an insight from the feminist scholar Donna Haraway in her paper ‘Situated Knowledges’ (1998):

Science has been about a search for translation, convertibility, mobility of meanings, and universality – which I call reductionism only when one language (guess whose) must be enforced as the standard for all the translations and conversions.

A 2011 study by the World Bank in Kenya estimated that there’s one healer per 950 people, compared with one doctor per 33,000. In the UK in 2019, there were close to six doctors per 1,000 people. Sheer accessibility makes traditional healers a more viable option. Moreover, traditional healers accept payment in unconventional forms, and are happy to receive it in instalments: patients can pay with a chicken, or a quantity of potatoes. People generally get more time with traditional healers than with doctors. If the treatment doesn’t work, there’s no obligation to pay up in full. Plus, according to Bitta, with traditional healers, people feel they can negotiate the diagnosis. People meet traditional healers on a more equal footing, she suggests, because both are embedded in one community, are already known to each other, share culture and history, experiences and beliefs. You are emboldened to offer elements of your life story or situation that seem pertinent to your suffering, to explore the links between loss or fear and pain. In traditional medicine, are more people spared what Arthur W Frank in The Wounded Storyteller (2013) callsnarrative surrender’, that ‘central moment in modernist illness experience’, almost ‘an obligation of seeking medical care’?

One medication that my grandmother, Mumji, takes daily changed. The brand, the ingredients, the place of manufacture – everything was the same, only the packaging design was different. ‘The tablets are not as good,’ she complained after a few days. ‘I don’t feel well. I’m not going to take them any more.’ Her doctor assured her the product was identical, and advised her to keep using it or she’d soon feel worse. Unconvinced, she complained to the pharmacist, her long-time home-deliverer of pills and potions. He came over with both versions of the medicine, pointed out every aspect in which they were the same and told her packaging re-design was a sign of success. Then he revealed the price she’d be paying per tablet if it weren’t for Britain’s National Health System. It’s a very expensive, popular medication, the pharmacist said, but if she wasn’t happy, he could of course look for an alternative. No need, Mumji said, she would continue with the medicine. ‘I’ve never felt better,’ she reported a few weeks later.

Few people I spoke to in Kenya admitted they use traditional healers, though many said they would if need be. Kamba, whose artistic work connects with Indigenous health practices, told me she had come across people, including priests, who went to church during the day and visited a traditional healer at night. ‘Colonialism distorted loyalties,’ she said. ‘It’s left many of us conflicted and dishonest, even about what we do to our own bodies.’ Was there not also a certain skill in negotiating the supposedly oppositional?

Witchcraft is used as justification for the violence, but the true motivation is land

Although the majority of Africans used traditional medicine, it is still illegal in many African nations. In 2012, Kenya amended the colonial-era Witchcraft Act, which had outlawed the practice since 1925; the law now penalises only those who practise witchcraft ‘with the intent to injure’; the punishment can be up to five years in prison. An additional clause makes it an offence to accuse someone of being a witch or practising witchcraft. These changes were enacted in response to reports of elders being attacked or murdered by their adult children. This was the threat Mwarandu had referred to; the picture slowly filled out as I talked to Bitta and Munyaya, then read and researched further.

Witchcraft is used as justification for the violence, but the true motivation is land; the youth, who no longer share their elders’ conviction in preserving land for future, collective use, know that if the parents are gone they will inherit the land rights – and the possibility to sell. And so, some plot to kill their parents. The coast area has had an especially high incidence of such attacks; recent counts estimated around 400 annually. The Rescue Centre in Malindi was set up to help Giriama elders who were threatened or attacked by their children. Munyaya got involved because, he thought: ‘We will all get old, and if this attitude continues we will all be killed.’

I couldn’t help but think of Mumji, in her mid-90s, living alone in a two-storey, three-bedroom house. My grandfather had left his half of the house to his children when he died a decade ago. There had been a moment when I wished Mumji – a moment when I thought how different my mother’s life might be if – thoughts banished the moment they occurred – that nevertheless recurred – buried – that would never – never – if this fount of love, of ache – no moment, ever…

What desperation – no chance nothing no way – wacha – stuck – charcoal sky – moments accumulating without adding up – flames without fuel – what tips thought into action – hazy days – time without the weight of promise – no and no and no and need – what justification – HELL IS – OTHER PEOPLE – a moment to end all moments – to start to finish – hours thick as smoke – no no more – what match lights hope and burns the future, forever.

What if we were to speak of ‘fundamental health’ – recognising the embedded nature of the self?

Msongo wa mawazo, ‘racing thoughts’, is a term for depression in Tanzanian Kiswahili that Bitta has adopted into her work. Part of mental health work is finding the language that will touch people, catch their experience, make them responsive to treatment. Yet, Bitta observes, sometimes, words are useless – as when people say: ‘There is no depression, we are just broke.’ Is it possible to separate causes, effects and consequences? One shortcoming of the Western biomedical concept of ‘mental health’ has been its tendency to zoom in on the individual, on biochemistry. Traditional medicine seems to take a wider view from which much could be learned.

What if we were to speak of ‘elemental health’ – taking into consideration, alongside the information typically sought for a patient’s ‘history’, various other elements – economic, environmental, racial, sexual – that affect mind and body? What if we were to speak of ‘fundamental health’ – recognising the embedded nature of the self, the role of relationships and community as foundational to individual wellbeing? Might such terms begin expanding the biomedical imagination, shift the framework on what makes for the most effective medicine?

‘Selling the land doesn’t solve anything,’ Munyaya reflected. ‘Guys blow it on a motorbike and a few months of living it up. Then they’re left with no money, no land and no parents. No wonder there’s so much depression and suicide.’

Munyaya has received death threats because of his work at the centre. ‘People are desperate. Some will do anything for a bit of money. A person can die for only 2,000 shillings.’ His own mental health has suffered, but he has found his medicine: ‘I sit with the elders, I listen to them, I learn, and I tell myself what you feel is small compared with what others are feeling and enduring. This helps me cope.’ He tries to be at the centre every day; when he can’t afford the fare for transport, he walks two hours to get there. His dedication brought to my mind the testimony of Peter who, through Difu Simo, accessed biomedical drugs that finally enabled him to manage his schizophrenia. Peter understood mental health as being sawa, which literally means ‘fine’, but for him also means ‘being able to help others’.

The elders sit as if time is on their side. The strips of raffia palm they weave into baskets defy the minutes, rustle a tale of countless hands that have done exactly this for centuries: moving in accord, plaiting nature into forms that will hold the basics, the essentials and, perhaps, the inessential. The elders speak little English, yet generously lend us their company. They exude what feels like infinite patience. Staying calm while trying to find a solution. I sense how much I’ve been in a rush to ‘get to the point’, whatever that may be; some deep insight, a life-altering remedy, a mind-changing fact. Where might that lie? Somewhere beyond colonialism? I ask as if there were such a place. As if I could reach it. As if I could drop a pin in the vast terrains of knowledge and thus orient myself or others. As if wanting some treasure as trophy were not the most colonial of all impulses.

Only now, months after the journey, do I have a response to Kamba’s remark. I could not ‘take’ the spirituality, even if I tried. How much of medicine is location-tradition-relations? How much of healing is faith in a given system? How much of belief is living history? What cannot be measured, cannot be taken. And still, in each encounter, each question, there is something precious. What I take is time to better understand the experiences in Kenya; I continue the journey. I may remain implicated, yet I can still participate-communicate-reciprocate. Meanwhile, I will make do with my own totems, my green slips printed with the names of pills I did not swallow.

The mkone produces branches from the base of the main trunk: instead of one tree rising out of the ground, it looks like many trees clustered together, growing in unison.