According to William Ruddick, the wide field usually referred to as “medical ethics” comprises a range of disciplines, including medical ethics (primarily, medical doctor-centred), and healthcare ethics (including nurses and other healthcare providers), clinical ethics (focused on hospital case decisions with the aid of diverse committees and consultants), and bioethics (including general issues of reproduction, fair distribution of organs and other scarce life-saving resources, and protection of the biosphere). All discussions of medical ethics proceed from the assumption that all things being equal, all patients have moral status. As Matjaž Zwitter observes in a chapter on “Moral Status”, “There should be no doubt that all of us with a capability of deciding about ourselves have moral status.” Zwitter further points out that only beings with moral status can be meaningfully said to have rights.

However, in our time, the misconception is widespread that science, of which medicine is a part, is all about “objective” observation of facts without any consideration of values (standards by which we judge some things to be good or bad, right or wrong, beautiful or ugly, and so on). Nevertheless, we human beings cannot live without values, because it is they that make life truly human by enabling us to choose our goals and the appropriate means of attaining them. Thus, in the introduction to his Medical Ethics: A Very Short Introduction, psychiatrist Tony Hope writes, “As my clinical experience grew so I became increasingly aware that ethical values lie at the heart of medicine. Much emphasis during my training was put on the importance of using scientific evidence in clinical decision-making. Little thought was given to justifying, or even noticing, the ethical assumptions that lay behind the decisions. So I moved increasingly towards medical ethics, wanting medical practice, and patients, to benefit from ethical reasoning.” In what follows, I examine the viability of the doctor-patient relationship, undergirded by medical ethics, in the era of COVID-19.

Principles of medical ethics in the era of COVID-19

One of the best-known texts associated with medical ethics is the Hippocratic Oath authored in ancient Greece about 2400 years ago. It required a person being admitted to the position of a medical doctor to swear by a number of healing gods to uphold certain ethical standards. The oath established several principles of medical ethics that are still considered crucial to the conduct of a medical doctor today. At the heart of medical ethics are questions regarding what is morally acceptable or morally unacceptable for a doctor to do in the course of caring for the sick. Three of the key issues in medical ethics are commitment on the part of the doctor to do only good to the patient, to respect the patient’s right to accept or decline a medical procedure, and to conduct medical research in line with sound ethical principles.

Doing only good to the patient

According to William Ruddick, the Hippocratic injunction “Strive to help, but above all, do no harm” is the ruling moral maxim in the doctor-patient relationship. In current discussion, this maxim has been codified in oft-cited principles of beneficence (action to promote the good/welfare) and non-maleficence (refraining from doing evil). For the doctor to achieve these noble goals, he or she must utilize their medical knowledge in a free atmosphere in which their only concern is their patient’s well-being, without having to worry about demands from an elaborate medical care bureaucracy. Yet in the era of COVID-19, the doctor has been turned into a functionary of just such a bureaucracy, receiving instructions from local and global health authorities, and being stopped from using certain medications, even if he/she and his/her patient would have liked to use them.

Respecting informed consent

The principle of informed consent stipulates that the patient has a right to accept or decline a medical procedure after being duly furnished with information about what it entails and the possible positive and negative impacts arising from it. As I indicated in COVID-19 Vaccine Mandates in the Light of Public Health Ethics, the medical ethical principle of informed consent is based on the conviction that each and every human being is endowed with intrinsic infinite worth (dignity) and human agency (the capacity of the person to act out of his/her own uniquely human viewpoint). Underlying the two considerations is the assumption that the human person is a ‘know-er’, since it is impossible to adequately enjoy human dignity and human agency without knowledge. All this implies the idea of human rights—certain entitlements due to every person by virtue of his/her humanity.

Human dignity, human agency and human rights presume the autonomy of the individual. In his On Liberty, John Stuart Mill asserted the autonomy of the individual as follows:

“The only part of the conduct of any one, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.”

In a chapter on “Autonomy and Its Limitations”, Matjaž Zwitter highlights at least five characteristics of individual autonomy. Understood as the right to self-determination, autonomy includes the right to information and protection of privacy. In an ideal situation, a patient with full autonomy participates in all essential medical decisions, and consents to every invasive procedure. Nevertheless, even patients with full capacity have the right to transfer their autonomy to others such as family members, friends, or to their physicians. In cases where patients are unable to decide for themselves and therefore with limited autonomy, surrogate decision-making is justified. Nevertheless, a doctor is not morally obliged to respect a directive by a surrogate decision-maker if this directive is clearly against the patient’s interests. Some persons make advance directives, to be followed in case of their future incapacity to participate in decisions regarding their treatment. While such written or oral directives are helpful, their validity may be re-considered in situations that the person could not have foreseen at the time of making the advance directive.

In the era of COVID-19, the doctor has been turned into a functionary of just such a bureaucracy, receiving instructions from local and global health authorities.

Thus, in “COVID-19 Vaccine Mandates in the Light of Public Health Ethics”, I pointed out that in the light of the notions of human dignity, human agency and human rights manifesting in medical care as informed consent, any measures imposed on the patient in the name of containing COVID-19 is paternalism, that is, the treating of adults as though they were children. This is equally true in medical care where the doctor-patient relationship is in operation, as in public health policy where health authorities institute measures for the welfare of populations.

Research ethics in medicine

Progress in the medical field rides on research, but therein also lies the danger of the violation of the moral principles that ought to govern the doctor-patient relationship. Consequently, as Adebayo A. Ogungbure notes, the aim of medical research ethics is to ensure that research projects involving human subjects are carried out without causing harm to the subjects involved.

One of the most outrageous violations of medical research ethics was the “Tuskegee Study of Untreated Syphilis in the Negro Male”  of which Ogungbure writes:

“The Tuskegee Study of Untreated Syphilis in the African American Male was the longest experiment on human beings in the history of medicine and public health. Conducted under the auspices of the US Public Health Service (USPHS), the study was originally projected to last six months but ended up spanning forty years, from 1932 to 1972. The men used as subjects in the study were never told that they had the sexually transmitted disease. The term “bad blood” was coined to falsely depict their medical condition. The men were told that they were ill and promised free care. Offered therapy “on a golden platter”, they became willing subjects. The USPHS did not tell the men that they were participants in an experiment; . . .

Though the study was organised and managed from Washington, the participants dealt with a black nurse named Eunice Rivers, who helped with transportation to the clinic, free meals, even burials. The project did not stop until Peter Buxtun, a former PHS venereal disease investigator, shared the truth about the study’s unethical methods with an Associated Press reporter.”

As Ogungbure further explains, the health authorities went to great lengths to ensure that the men in the “Tuskegee Study” were denied treatment, even after penicillin had become the standard cure for syphilis in the mid-1940s. He points out that the ignominious study only came to an end when the Associated Press published a well-researched article about it by whistle-blowing reporter Jean Heller. As a result, writes Ogungbure, congressional hearings about the Study took place in 1973, and the following year the United States Congress passed legislation creating the National Commission for the Protection of Human Subjects of Biomedical and Behavioural Research. Apologising for the Tuskegee Syphilis Study on 16 May 1997, President Bill Clinton described it as “deeply, profoundly, and morally wrong”.

Yet in the early years during which African Americans in Alabama were being ravaged by the Tuskegee Syphilis Study, Adolf Hitler’s regime in Germany was busy conducting grossly unethical research on segments of the population that he considered to be inferior to his mythical Aryan race in the name of eugenics (a set of beliefs and practices that aim to improve the genetic quality of a human population by excluding people and groups judged to be inferior or promoting those judged to be superior). Ogunbure explains that one of the consequences of the atrocities committed by Nazi Germany was the drafting of the Nuremberg Code by an international panel of experts on medical research, human rights and ethics, which served as the initial model for those few public and private research and professional organisations that voluntarily chose to adopt guidelines or rules for research involving human subjects.

Progress in the medical field rides on research, but therein also lies the danger of the violation of the moral principles that ought to govern the doctor-patient relationship.

The following are the ten basic principles of the Nuremberg Code: Seek the voluntary consent of the human subject; conduct only an experiment that is necessary, and whose results will promote the good of society; an experiment on humans ought to only follow experiments on animals; an experiment ought to avoid all unnecessary physical and mental suffering and injury; no experiments likely to cause death or disabling injury should be undertaken; the humanitarian importance of the problem to be solved by the experiment ought to exceed the degree of risk involved; the experimental subject should be protected against even remote possibilities of injury, disability or death; an experiment ought to be conducted only by scientifically qualified persons; the human subjects should be at liberty to opt out of an experiment at any stage; the scientist in charge must be prepared to terminate an experiment at any stage if he/she has any reason to believe that its continuation is likely to result in injury, disability or death.

Several other documents on medical research ethics have been issued since the Nuremberg Code, including the World Medical Association’s Declaration of Helsinki of 1964 which has been revised several times since, and Canada’s Belmont Report of 1979.

Centralisation killing the doctor-patient relationship 

One of the dominant trends in our day is the centralisation of services. Those of us who are older recall a time when the branch bank manager had considerable freedom to make decisions. Then, due to digitisation, came the motto “Every Branch is Your Branch”, because every branch was now directly link to the head office. What we were not told was that the branch manager would henceforth be a mere functionary who had to wait for decisions on every minor detail from the head office. We have witnessed similar developments in the university system, with the Commission for University Education (CUE) now having massive control over the operations of universities in Kenya, so that although there are over forty public universities in the country, CUE requires all of them to operate along the same lines, leaving very little room for lecturers to exercise the time-honoured academic freedom.

Similarly, as hospitals have grown in physical size as well as in the number of personnel, so have their centralizing bureaucratic procedures (“red tape”). Doctors have to comply with elaborate protocols put in place by hospital management to avoid or reduce the number of court cases filed against the hospitals. Similarly, the elaborate chains of command pile pressure on doctors to comply with the policies of the hospitals even when those policies are contrary to patients’ interests. For example, one leading hospital chain in Kenya requires doctors to “request” three different tests on every patient suspected of having malaria, significantly raising the patients’ bills. If the results show that patients do have malaria, doctors in the hospital chain are again duty-bound to administer only a specific set of drugs. In short, doctors have very little say in that whole process.

Furthermore, hospitals have now become centres for gathering detailed information about patients for purposes other than the patients’ welfare. Many of my Kenyan readers have probably noticed that they can only purchase drugs or have tests done in private hospitals after giving their phone numbers to the personnel at the front desk. This enables the hospitals to access a patient’s personal records for the purpose of building a detailed history of all the drugs and tests that he/she has procured from that hospital over the years. This is precisely the kind of information which large pharmaceutical companies are eager to buy from the hospitals for a handsome price. In the era of the Fourth Industrial Revolution, the pharmaceuticals use artificial intelligence to analyse the massive information (“big data”) to get a  very clear picture of trends in the health of individuals and populations, thereby enabling them to design business plans that bring them massive profits.

As hospitals have grown in physical size as well as in the number of personnel, so have their centralizing bureaucratic procedures.

The death of the doctor-patient relationship on the back of intense centralisation has already taken a huge toll on the quality of health in hospitals in Kenya. According to the “Kenya Patient Safety Survey” conducted by the Ministry of Health in 2013, a patient’s safety could not be guaranteed in a majority of medical facilities in the country: only 13 hospitals out of 493 public and private health facilities in 29 counties surveyed achieved a score greater than one on an ascending scale of 0-3. The report stated, “Overall safety compliance was relatively poor, with less than one per cent of public facilities and only about two per cent of private facilities achieving a score greater than one in all five areas of risks assessed.” For instance, less than 10 per cent achieved a score greater than one in providing safe clinical care to patients. Of the 13 that scored more than one, 11 were private facilities, while only two were public. Furthermore, less than six per cent of public hospitals achieved a score greater than one in having a competent workforce. According to the report, this state of affairs had in some instances resulted in death.

Besides, in mid-2015, twenty-eight children in Busia County became partially paralysed due to medical malpractice. According to The Standard, the children had partial paralysis arising from injections given in the six months between December 2014 and June 2015, although those with severe paralysis reported initial complaints after treatment in 2013. The Standard quoted then Cabinet Secretary James Macharia as stating, “Our initial investigations point towards medical malpractice from inappropriate injection techniques as the primary cause of partial paralysis in all the 28 children.”

This is precisely the kind of inforamation which large pharmaceutical companies are eager to buy from the hospitals for a handsome price.

Yet in the era of COVID-19, the heavy centralisation of hospital operations that is stifling the traditional doctor-patient relationship has moved to an unprecedented high level. COVID-19 testing and treatment are heavily centralised and meticulously directed from the highest health authorities in each country. In many countries, doctors are strictly forbidden to use COVID-19 vaccines and therapies that have not yet been approved by the World Health Organisation (WHO) and adopted by their own top health authorities. Besides, countries are required to share their data on COVID-19 infections, hospitalisations, vaccinations and deaths with the WHO. Many health authorities at country level run online COVID-19 databases through which citizens can request for vaccination, download their vaccination certificates, and show proof of vaccination. Various governments also have arrangements among themselves to verify the authenticity of international travellers’ vaccination certificates/passports.

Furthermore, David Ngira and John Harrington inform us that generally, WHO recommendations are used as a form of quality control by domestic regulators who view them as a guarantee of safety and effectiveness. Ngira and Harrington also point out that many African states have relied wholly on the WHO Global Advisory Committee on Vaccine Safety given their weak national drug regulators and the limited capacity of the Africa Centre for Disease Control (CDC). The Africa CDC itself deems vaccines safe for use by member states on the basis of WHO recommendations. This means that the doctor no longer has the latitude to give his/her patient guidance strictly on the basis of his/her medical training and experience, but rather on the basis of protocols formulated by local and global health authorities.

Thus in the face of intense centralisation of medical care in the era of COVID-19, time-honoured principles of medical ethics such as the single-minded promotion of the good of the patient, confidentiality, respect for the patient’s right to informed consent, and the imperative for moral integrity in medical research, all of which held the doctor personally responsible for what he/she did in the course of his/her work, are inconceivable in a situation in which a doctor only acts on “orders from above”. The loser in this undesirable paradigm shift is the patient, and the winner the wealthy who have turned medical care into a business. I recently heard a senior Israeli medical professor state that when politics is mixed with science, all that remains is politics. To which I add that when medical care is mixed with business, all that remains is business.

Constitutionally, Ethiopia is a democratic federal state organized along ethnolinguistic lines. However, the de facto centralization of power, political repression and politicization of ethnicity continue to be the dominant features of the state.

The Oromo national movement began to develop in the 1960s by challenging the policies and practices of the Ethiopian colonial state. Even though the Oromo people are the largest national group in Ethiopia—estimated at 50 million—they were treated as a political minority both by Haile Selassie and by the Derg regime that overthrew him.

From the beginning of Haile Selassie’s autocratic rule in 1941, the Oromo language was banned from use in the education curriculum, in schools, and in the administration. The Abyssinian bourgeoisie viewed Oromo identity and language as a hindrance to the expansion of Amhara identity. Amharic, which is the language of the Amhara, the politically dominant ethnic group, and the mother tongue of less than 20 per cent of Ethiopia’s population, was imposed on the other ethnic groups without considering their sentiments and opinions. The Oromo language ban would remain in place until 1991, resulting in ethnonational domination, political disenfranchisement and exclusion, cultural destruction, and sparking outrage that would lead to radical Oromo nationalism.

Moreover, in spite of their diversity, their numbers and their occupation of large urban and pastoral zones, the Oromo people of Ethiopia have experienced a long history of marginalization, forced assimilation and the loss of their fertile lands, which were annexed and ceded to other ethnic minorities by the ruling Amhara hegemony. This ostracism has resulted in the decline of the pastoralist lifestyle among the Oromo.

The creation of the Oromo Liberation Front (OLF) and the 1974 Ethiopian revolution awakened Oromo aspirations to regain their political rights, human dignity and equality. The revolution not only aroused Oromo pride in their national identity, language and culture, but also raised their hopes of regaining their lands; after the 1974 revolution, land reform of some kind was a foregone conclusion.

Post-Derg 

Two major geopolitical tragedies caused by former Somalia strongman Siad Barre—the 1977-1978 Ethio-Ogaden war and the civil war in 1991 that led to the collapse of Barre’s military regime—produced a massive wave of return of Ethiopian refugees and an influx of newly created Somali refugees.

In 1977, with Ethiopia in turmoil, and the balance of power decisively in Somalia’s favour, Barre had launched a ground invasion of Ethiopia to wrestle the Ogaden—or Western Somalia as Somalis referred to it—from Ethiopian control. This triggered the movement of refugees fleeing the Ogaden war and the drought-stricken regions of the Horn.

The situation was further exacerbated by the massive displacement of Somali refugees fleeing the civil war that had begun in Mogadishu, the capital city of Somalia. As the civil war in Mogadishu deepened, other parts of the country fell into the hands of clan-based warlords. Somali refugee arrivals in Ethiopia increased significantly due to the combined effects of drought, famine and political instability in Somalia.

The Somali returnees were assisted by the UNHCR and by several NGOs. In some districts and Kebele (the smallest administrative unit similar to a ward), the returnees overwhelmed the local populations by up to nearly 300 per cent, a figure indicating that the returnees were mixed up with new refugees from Somalia and immigrants from Kenya; by registering as returnees, families could access support from the UNHCR.

The situation was further exacerbated by the massive displacement of Somali refugees fleeing the civil war that had begun in Mogadishu.

Getachew Kassa writes that the Garre (a major Somali clan inhabiting southern Somalia, Ethiopia and northern Kenya) were identified as Qohati (returnee). During their stay in Somalia, and in the course of their repatriation, the “returnees” had developed a higher opportunistic capacity to act in modern politics and to successfully interrelate with international refugee policies and UN organizations. Upon their return, they linked up with the local pastoralists of their own clan, but retained a rather separate identity and lifestyle compared to the pastoralists.

While the Arsi and Guji ex-members of the Somali Abbo Liberation Front redefined their agenda and identity in the terms agreed with the local Oromo and left the organization, the Garre, the Gabra and the Mareexaan returnees changed the name of the organization to Oromo Abbo Liberation Front (OALF).

Claiming an Oromo identity was a way of legitimising their demands to be resettled in an Oromo-speaking region. In both Liiban and Dirree, conflict first broke out in November 1991 between the Gabra Miigoo and the Borana, following an attempt by the former to open an OALF office in Yaaballoo.

The Degodia, one of the major Somali clans, had supported the Borana in checking the movements of the heavily armed and motorized ex-soldiers of Siad Barre that had been supporting both the Mareexaan and the Garre/Gabra Miigoo against the Borana. The Degodia did not side with the Somali owing to their clan affiliation in opposition to the Said Barre-led Mareexaan in Somali politics. The Tigray Peoples Liberation Front (TPLF) tried to arbitrate between the conflicting parties, while simultaneously re-organizing the administrative set-up and building its local network of alliances.

These political dynamics can only be analysed in the light of the OLF factor where the Boranas were alleged to be OLF sympathizers. At that crucial early stage, the Borana came to be identified as strong OLF supporters, although the organisation was only active in the Borana zones of Dirre, Liiban, Yaaballo and Moyyalle during the short period of campaigning from 1991 to 1992 when it was part of the Transitional Government of Ethiopia.

This impression was later exacerbated by the position of the Borana along the border with Kenya, an area where one of the OLF military branches became active after 1992; several Borana elders were quite critical of the OLF’s decision to withdraw from the 1992 elections, a decision that exposed youths, supporters and sympathizers to harsh state repression.

The Ethiopian constitution grants the Oromia region “special interest” status because the city of Addis Ababa is an enclave in Oromia. However, a law that stipulates how this “special interest” region is to be governed has yet to be promulgated.

Researcher Sara Lister suggests that even in those districts that had remained under Oromia administration (Region 4) after 1994, into which the Borana had been squeezed, the Gabra Miigoo have generally been well-treated by the Ethiopian People’s Revolutionary Democratic Front (EPRDF) in order to create a counterforce to the Borana, and have benefited from increased numbers of political positions.

The 1995 and 2000 regional and federal elections, and the 2001 Woreda (district) and Kebele (ward) elections were held without any opposition figures running, with the result that all political representatives and administrators were simply “appointed” by the Oromo People’s Democratic Organization (OPDO) through an internal party process. A few Borana with a low level of education who were affiliated with OPDO managed to get some political positions, mainly at the lower district level (Woreda).

The Ethiopian constitution grants the Oromia region “special interest” status because the city of Addis Ababa is an enclave in Oromia.

By 1995, the Maareexan seemed to have fallen out of sympathy with the EPRDF. In 1998, the pastoral component of the Maareexan gave up Somali territorial claims in the Liiban District of Region 4 and recognized the Borana traditional system of resource management. They slowly re-established themselves in pastoral life.

The Gabra Miigoo retained their Oromo identity and aligned with the OPDO, the Oromo branch of the EPRDF. As mentioned, the Gabra pastoralists slowly re-built their relations with the Borana pastoralists by revitalizing their customary leadership and Yaa’a.

Tigray uprising

In the spring of 1991, the EPRDF, a Tigrayan-led coalition of rebel organizations under the leadership of Meles Zenawi, began to achieve real successes and defeated the Ethiopian army, forcing military dictator Mengistu Haile Mariam, who had ruled the country since 1994, to flee the country. In the midst of cease-fire talks, EPRDF tanks entered Addis Ababa virtually unchallenged and a transition government was formed soon after, with Meles Zenawi as its president. In July, a new democratic constitution was drafted, and Eritrean independence was acknowledged without incident.

Formed in 1974, the Oromo Liberation Front (OLF) was the first major Oromo political party. However, it was overshadowed by the ruling EPRDF coalition member, the Oromo People’s Democratic Organization (OPDO) created by Meles Zenawi. Seeking self-determination for the Oromo people, the OLF pulled out of the interim government with the EPRDF in 1992.

Reality dawned on the Oromia nation as soon as the TPLF leader, Meles Zenawi, ascended to power. The Federal Democratic Republic of Ethiopia was proclaimed, the EPRDF was swept to power in poorly contested, sham elections in August 1995, and Zenawi became Ethiopia’s first prime minister. The TPLF dominated the EPRDF ruling alliance. The Tigrayan minority dominated the senior ranks of government and the TPLF promulgated a series of laws crippling the opposition, ethnic-cleansing the Oromos and Amharas, muzzling the media and shackling civil society.

The reality is that the TPLF faced the united opposition of almost all Ethiopian nationalities. This is because, in the nearly three decades that it was in power (1991-2018), the organization had a dismal record of governance and gross violations of human rights

The political emancipation of the Oromo and the ignominious defeat of Tigray/TPLF and their apologists in Ethiopia is a culmination of many years of struggle and sacrifice. Tens of thousands paid the ultimate prize while many others were arrested, liquidated, maimed, or displaced throughout Oromia.

The Oromia region has 21 districts, also called Aanaale or Woreda. The district is the third level of the administrative units of Ethiopia after the zones and the regional states. All the clusters of Oromo groups, which are a combination of the two confederacies, Borana Oromo and Barentu Oromo, contributed to the triumph over Tigrayan oppressors. In particular, the Borana who occupy the Borena zone of southern Ethiopia and northern Kenya that stretches to the Tana Delta off the coast, contributed significantly to this struggle.

The reality is that the TPLF faced the united opposition of almost all Ethiopian nationalities.

The Tigray regime’s sunset days were characterized by politically instigated ethnic clashes and the massacre of Oromos in Nagelle, Udat, Borbor, Moyale, Bale and Hararge. Consequently, over one million Oromos, among them thousands of Boranas, were displaced. Losses from similar sporadic ethnic clashes, where the Tigray government openly sided with opponents, cannot be quantified.

The initial shock came with the cold-blooded murder of the legendary former governor of the Borana region in Ethiopia, Jatani Ali Tandhu, by TPLF operatives in a Nairobi Hotel on 2 July 1992. Former Saku Member of Parliament Jillo Falana reported that two assassins were holed up in the Ethiopian Embassy in Nairobi. The two men accused of killing Jatani were arrested, tried in the Kenyan courts and released under unclear circumstances. On 3 April 1996, Hussein Sora, the lawyer handling the Jattani case at the time, was also murdered. In April 1994, the Supreme Leader of the Borana, Boruu Guyyoo Boruu, was assassinated shortly after attending a peace meeting arbitrated by the TPLF. The assassination created differences and distance between the Borana customary leadership and the EPRDF officials.

By 1995, the Borana had been excluded from institutional politics and had lost important seasonal rangelands in Liiban and crucial water and pasture resources in Dirree.

Killings of Oromos were reported in the 1996 Kenya Human Rights Commission Report and in Oromo Commentary (1997). Other lists of the Oromo who were either killed or disappeared under the brutal TPLF regime appeared in Madda Walaabuu Press on 5 June 2018. Several Oromo refugees who sought asylum in Kenya under UNHCR protection were arbitrarily arrested and deported to Ethiopia on suspicion of being members of the OLF. “These recurring incidents have convinced many Boran leaders in Kenya that the Ethiopian agents are after the elimination of Borans both in Kenya and Ethiopia,” stated Oromia online.

There is no question that all the nations, nationalities and peoples of Ethiopia suffered under the TPLF dictatorship. However, the intensity of oppression experienced by the Oromia nation was exceptional in that the regime was bent on neutralizing Oromia’s vast human and natural resources and its centrally located landmass that shares boundaries with almost all the nations and nationalities of Ethiopia. This exceptional subjugation of the Oromo demands an exceptional solution if it is to end.

Relentless Devotion

Oromos who fled repression internationalised the Oromo struggle through massive demonstrations in various countries. In particular, the Oromo Olympian, Fayissa Lelissa became an international icon of the Oromo liberation movement, catapulting the Oromo struggle to the global arena with a simple symbolic sign of Oromo resistance as he approached the finishing line.

Oromo musicians have kept the fire burning during the high and low moments of the struggle. Oromo professionals have changed the toxic TPLF narrative and provided guidance. Oromo religious leaders have been steadfast in their prayers. This recognition of the impact of the Oromo diaspora would be incomplete without the mention of Jawar Mohamed and the Oromia Media Network, and Hamza Borana and Radio Daandii Haqaa (RDH) both of which have provided visibility and galvanised the struggle through sustained strategic communication. Sadly, both Jawar and Hamza Borana are now behind bars in Addis Ababa.

The Boranas rejected TPLF adventurism in favour of the Oromo Liberation Front. Consequently, for 27 years, the Borana endured state-sponsored terrorism (admitted by Prime Minister Abiy Ahmed in the Ethiopian Parliament in 2018). Their oppression left a scar on all Borana leaders, individuals, and institutions. Everyone suffered, especially those kin at the frontline in Ethiopia and in Moyale, Sololo, Marsabit and Isiolo in Kenya, and in the entire Waso belt, Sololo, Moyale, Saku, Waso, southern Ethiopia and in the diaspora.

There is no question that all the nations, nationalities and peoples of Ethiopia suffered under the TPLF dictatorship.

The TPLF regime and their surrogates sought to disempower the Borana in all their dimensions including in politics, the economy, culture and security, and punished them by annexing their land, in particular the Wayama belt, which was grafted onto Region 5 of Somalia, a tactic to create a protracted and perpetual war in southern Ethiopia. The losses cannot be quantified.

The Borana made this great sacrifice out of their fervent desire to uphold and protect the overarching interests and heritage of the Oromo people. Borana leaders, elders and individuals of goodwill provided open and public diplomacy for the Oromo national liberation struggle. One example is the meeting between Gen. Hussein Mohamed Farah Aideed and the Borana leadership organized by the late Hussein Sora and Waso leaders from Isiolo. General Aideed, who was on an official visit, met elders from Moyale, Sololo, Marsabit, and Isiolo. It was a cordial meeting during which the Borana elders requested Gen Aideed to support the OLF. Gen Aideed, and later his son Hussein Aideed, established rear bases for the OLF in central and lower Shabelle in Somalia near the Indian Ocean port of Merca. These bases were the target of the Ethiopian invasion of Somalia in December 2006.

Boranas have therefore been at the forefront of the Oromo national liberation struggle. The next step is to now join their compatriots in consolidating the struggle by seeking comprehensive redress for the historical injustices manufactured by the TPLF, especially the territorial disputes concerning the Wayama belt that was annexed by the TPLF regime. This will put an end to the perennial conflict in that zone and sustain peacebuilding between Oromia and Region 5. The resolution of Borana grievances should be led and owned by a committee of Ethiopian Boranas with the tacit support of Kenyan Boranas.

For many refugees from Somalia, Ethiopia, and Eritrea, the question “Wapi kipande?” is synonymous with torture. It is a question that has been used by the Kenya Police to extort money from refugees and those from northern Kenya for many decades now. Wapi kipande? simply means, “Where is your ID?”  A question deliberately asked to a group of people whom the police are aware lack the mandatory Kenyan ID cards because of their status as refugees.

Many refugees from the Horn of Africa who have settled in Europe, North America, and the Middle East left Kenya with the horrors of wapi kipande. I have met some and they tell me that the first thing they remember about Kenya is wapi kipande and the abuse they suffered at the hands of the police. I was not spared this abuse. I have spent time in a dingy police cell despite holding a genuine Kenyan ID, having been born and brought up in the country. If you are from northern Kenya, or Somali or Ethiopian or Eritrean, lacking the ubiquitous one hundred shilling bribe can cost you your freedom.

I am from the north and, like refugees from the Horn of Africa, of Afro-Asiatic heritage, distinct from the majority of Kenyans who are from either Bantu or Nilotic communities. Their physical features make these refugees stand out, easy targets for harassment. In a report published in 2013, Human Rights Watch claimed that Kenya Police “raped, tortured, and arbitrarily detained over 1,000 refugees” with little to no action taken by Kenyan authorities to investigate and put a stop to the abuse. To date, nothing has changed.

Refugees

The harassment of refugees from the Horn of Africa is part of a pattern of discrimination against the people of northern Kenya who live along the border with Somalia and Ethiopia and who are themselves often accused of being “aliens”. Communities living on the border between Kenya and Ethiopia did not end up there by accident. They share cultural traits with communities living in their ancestral homes inside Somalia and Ethiopia. Like the Maasai and Kuria along the Kenya-Tanzania border, and the Luhyas along the Kenya-Uganda border, the northerners found themselves on either side of the border after the partitioning of Africa at the Berlin conference of 1884/5 that established most of the African borders as we know them today.

The Maasai, Kuria, and Luhya communities residing on the Kenyan side have been easily accepted and are treated much more favourably than northerners are. Discrimination against those from the north appears to be inspired by a racist agenda that has affected generations of their kin. For many decades now, there has been a policy of vetting the youth from this region before they are issued with Kenyan ID cards. Apart from those of Arab heritage, youth from other parts of Kenya do not undergo this vetting.

The ID

For the youth, and the people of northern Kenyan in general, the vetting process for the issuance of an ID card or a passport is long, arduous, and intrusive. And it can take years. Delays in the process have been known to impact college starting dates for the youth, who as a result are locked out of employment and are unable to open bank accounts or even own a mobile phone.

The discrimination of people from northern Kenya has now extended to their being termed terrorists by security forces.  Several Somalis and others perceived to be Somali or of Horn of Africa descent have allegedly been kidnapped and disappeared by the police. The blanket terming of northerners as terrorists now also informs Kenya’s policy on asylum and refugees.

In mid-2021, the Kenyan government ordered the closure of Dadaab and Kakuma refugee camps in the north of the country for “harbouring” and “breeding” terrorists without providing evidence to back its claims.  In a move that was bound to breach international law, the government ordered the forced repatriation of Somali refugees back to their country of origin despite the continued instability and insecurity in Somalia, which made it unsafe for them to return.

For the youth, and the people of northern Kenyan in general, the vetting process for the issuance of an ID card or a passport is long, arduous, and intrusive.

Kenya is a signatory to the Refugee Convention of 1951 and the 1967 Protocol. The terms of the Convention are legally binding and a breach of any of its norms is a breach of international law on the protection of refugees and asylum seekers. The forceful repatriation of refugees in the Dadaab and Kakuma camps, had it gone ahead, would have fallen foul of the “non-refoulement” rule, a core principle of the Refugee Convention that stipulates that refugees cannot be returned to a country where they would face persecution based on “race, religion, nationality, membership of a particular social group or political opinion”.

In the last few years, Kenya has demonstrated its policy of discrimination against refugees and asylum seekers from the Horn of Africa in the way it handles Ethiopian nationals; they are described as aliens and treated like criminals. The humanitarian crisis created by the war in Ethiopia has forced many Ethiopians to flee to safer countries such as Kenya and Sudan. But many of those who have fled to Kenyan have not been processed in accordance with the Refugee Convention but have instead been jailed and fined before being forcefully returned to Ethiopia despite the ongoing war and the political instability.

A lack of asylum processing centres on the Kenya-Ethiopia border and the non-recognition of Ethiopian refugees has forced them to turn to people smugglers. The result is a spike in human trafficking activities along Kenya’s northern border.

When war broke out in Ethiopia, Kenya did not prepare for the influx of refugees and asylum seekers that would cross its borders from Ethiopia and also from Somalia and Sudan.  Instead, it left the door open for people smugglers who have been operating with impunity as they easily smuggle people into Kenya despite the many police checks between the border towns and the capital. Corrupt immigration officers and police are paid to turn a blind eye to the people smugglers. When they are arrested, individuals who, in the legal sense, should be free and registered either as refugees or as asylum seekers and offered protection under international law instead end up in prison. Jailing and fining innocent refugees only ends up putting more pressure on Kenya’s criminal justice system.

Terrorism is also used as an excuse to return “Ethiopian aliens” found in the country. Only recently, local media reported that residents of Kenol, near Thika town, turned on Ethiopian nationals who had just survived a road accident, suspecting them to be terrorists. In the Kenol incident, initial reports suggested that an official of the Kenya Defence Forces was behind the wheel accompanied by another armed soldier who fled the scene after the accident. The picture now emerging is that the smuggling of people into Kenya is the work of government officials working in cahoots with organized criminals. The absence of refugee reception and processing centres at border towns and Kenya’s disregard for the Refugee Convention have created a thriving people-smuggling business between the Horn of Africa and Kenya.

Designated terrorists

The blanket terming of Kenyan northerners and people from the Horn of Africa as terrorists seems to be an extension of the discriminatory policies towards people from the north or those with origins in the north. This discrimination plays into the hands of terrorists who capitalize on the lack of proper procedures and policies for processing those fleeing conflict in the Horn of Africa.  It also plays into the hands of corrupt government officials who extort and harass northerners and refugees for money, or sell ID cards and passports to would-be terrorists for monetary gain.

In the last few years, Kenya has fast-tracked citizenship for the Makonde and Shona communities of Kenya, originally from Tanzania/Mozambique and Zimbabwe, respectively. They arrived in Kenya later than the communities in northern Kenya who are still waiting to be accepted as Kenyan citizens. Children born in Kenya of Somali and Ethiopian refugees who are now in their 30s qualify for Kenyan citizenship under international law, but they have yet to be regularized yet a new policy offers fast-tracked citizenship to investors to spur Kenya’s economy. It is unclear whether the many Somalis and Ethiopians who have heavily invested in Kenya will find it easier to obtain Kenyan citizenship or whether they will still face prejudice and discrimination. Refugees in Kenya, particularly those from Somalia and Ethiopia, have contributed immensely to the country’s economy.  The failure to regularize their status affects not just the refugees’ socio-economic progress but that of Kenya as well because of lack of a proper and effective asylum and migration policy.

The labelling of northerners as terrorists has also led to human rights abuses, with residents facing arbitrary detention or kidnapping by “security forces”, never to be seen again. It is also a label that has alienated northerners, who are treated with suspicion by non-northerners and non-Muslim communities.

Forcing refugees underground is potentially opening the country to transnational crime with illegal arms, drugs, and other contraband goods filtering into the country. However, corruption is also a contributing factor to transnational crime as government officials are known to accept bribes to turn a blind eye to people smugglers and organized criminals. Blaming northerners and refugees from the Horn of Africa for insecurity and illegal trade is convenient when the actual root of the problem is to be found in Kenya’s systemic failures.

It is unclear whether the many Somalis and Ethiopians who have heavily invested in Kenya will find it easier to obtain Kenyan citizenship.

An effective and fair asylum and migration policy would separate the wheat from the chaff so to speak, and help the country to create a database of bona fide refugees. Granting citizenship to long-term refugees from the Horn of Africa is a sure way of integrating them into Kenyan society and a means of protection from harassment by the police and other corrupt government agencies.

The country also needs to speed up the registration of births in the north to capture and maintain data for Kenyan citizens born in the country. This is one scheme that would save time and resources, both and for applicants of ID cards and passports from the north and for the government. Undocumented youth is a demographic that is unable to contribute to the economy or even participate in civic duties such as the upcoming general elections.

A socio-economic malaise born of discriminatory racist prejudice should have been a thing of the past by now. The diversity of tribes in Kenya is not static and is bound to expand as the country progresses. The recent inclusion of the Makonde and the Shona is proof that the ethnography of the country is open-ended. This must now also include refugees from Somalia, Eritrea, and Ethiopia who have made Kenya their home for many years and continue to contribute economically. That acceptance may just help in bringing peace to the north and putting an end to the discrimination and human rights abuses suffered by northerners. The move would also shore up Kenya’s standing on the international stage as a tolerant country and one that respects its international obligations regarding citizens of other countries.