‘What do you mean “not allowed”!?’ Walt yells. ‘I bloody well say what is and is not allowed around here. Now open that bloody gate at once!’
The noise is growing closer: it’s a mob of some kind, that much seems clear.
Patrick looks at me, panicked.
Walt looks at me, angry. ‘Is this your askari? Tell him to let me out at once – I want to see what the hell is going on out there.’ He’s got that look on his face. Teeth clenched. Jaw set. There’ll be no talking him out of this one.
‘It’s okay, Patrick, open the gates,’ I tell him. Fuck it. If this is what Fiona thinks we should do when Walt gets wound up, let’s do it.
Patrick unlocks the padlock, loosens the chain, pulls the gate open. Walt marches through and charges off down the road towards the noise, Chiku trotting along beside him, tail wagging.
‘See if you can get James, please, Patrick?’ I say. ‘Just tell him to follow us, in case I need his help. And leave the gates unlocked, so we can get back in easily.’
‘Yes, madam, yes, yes,’ Patrick says, running off to find James in the garden.
I follow Walt at a safe distance, several paces behind. This is much further than Fiona’s three-metre rule, but I’m making an executive decision – he doesn’t want to be shadowed right now.
The drums are rumbling, the voices undulating in some kind of call and response. The pattern puts me at ease – it sounds dramatic but not aggressive, and suggests an organised demonstration of some kind, not a riot.
Walt rounds the corner ahead of me and slows. Chiku runs a few yards ahead, barks, and circles back beside Walt, where they both just stand and watch. As I catch up, I see a mass of hundreds of people in bright orange shirts, marching down the main road. They wave banners and balloons, blow horns and whistles, sing and dance and twirl.
I stand beside Walt. He’s already calmer, but slightly baffled by the spectacle. ‘What on earth do they want?’
‘It’s an AIDS awareness march,’ I say, catching sight of a sign that reads ‘HIV – towards zero’.
‘Oh, right,’ he says. ‘Yes. The Church has a lot to answer for when it comes to all that business, what with their anti-prophylactic preaching.’
‘Jambo, mzee!’ a couple of women at the edge of the procession shout to Walt. Then a whole group of them join in. ‘Jambo, mzee! Jambo, jambo!’
A young guy comes over, shakes Walt’s hand and puts a sticker on his collar, saying something in Swahili that Walt laughs at. ‘Asante!’ he says.
After a few minutes, the tail end of the march passes us, and a long, slow snake of honking traffic drags behind it.
‘Can I interest you in a pot of tea, Walt?’ I ask, wanting to get him back home while he’s still smiling, before the frustration of delayed motorists changes his mood.
‘Oh-ho, I never say no to a pot of tea!’ he says, whistling for Chiku to follow as we make our way back to the iron gates, where Patrick, James and Ruby are all anxiously waiting.
The day Walt chases me with the nine iron feels like it should be a turning point. The moment when our physical safety is so seriously compromised that something has to be done. I tell Fiona how the morning had started smoothly enough, but took a turn when the diesel generator kicked in during a power cut. How Walt had gone through to the garage to investigate the sound of the engine, then seen the keys to the Peugeot sitting on the kitchen window ledge. How I’d snatched them up just in time, and how he’d become enraged, grabbing one of the golf clubs from the bag that had been left leaning against the deep freeze.
Marguerite is getting especially anxious about being responsible should anything happen to us. She begs Fiona to do something. Fiona refuses. She says that our poor control of his ‘triggers’ is letting us down – the car keys should never have been left on the ledge, the golf clubs should have been put away. She says that Marguerite is to blame for most of his upsets.
I can’t stand it any longer. I arrange a Skype meeting to discuss what can be done one day while Walt’s down having a nap.
‘I don’t know why you didn’t just show Dad his passport,’ Fiona says, when Marguerite tells her about the time Walt became so furious at not being able to fly out of Kenya that he refused to eat lunch.
Poor Marguerite. That woman just cannot win. She fires back: ‘You said not to let him see that sort of thing! You said it would “set him off” about having all his documents in order!’
‘Yes, but if he asks for something and you can’t distract him from it, then you should give it to him,’ Fiona says. ‘In fact, you girls should mock up an e-ticket for a flight to England and keep it with his passport at all times. You’ll have to print out a new one every few days, updated so the dates line up.’
‘This is getting impossibly tricky to keep up with,’ Marguerite says. ‘And it’s getting very unsafe around here, for me and the girls and the staff. You know, I’m legally responsible for everyone here – what if something happens, if somebody gets hurt?’
‘Dad won’t hurt anyone,’ Fiona says.
Ruby, Jade and I all look at each other. We know otherwise.
‘He might, Fiona!’ says Marguerite. ‘Dr Andrews says there’s a drug called Risperidone we can try.’
‘Marguerite, you know you are not to change his medication without consulting me and the Trust!’
‘I understand that, but you simply cannot leave us in this situation. Something must be done.’ She storms out of the room.
I really don’t want to get involved in this debate, but I want even less to be attacked by Walt wielding a blunt object. I’ve done a bit of research, and it is true that people with Lewy body dementia in particular are sensitive to antipsychotic drugs, and that they can come with undesirable side effects. Even so, we’re at the point where I think it’s worth at least a trial of the drug, to see if it helps. So, I enter the fray. ‘Listen, Fiona, I really do think we have to try something. He’s getting out of control. First we had the garden hoe incident. Then the golf club. He’s getting worse.’
‘You should have just given him the keys.’
‘I did in the end! He nearly drove through the back fence! You can’t seriously suggest letting him behind the wheel is safe. There are other people here too, you know.’
The bed alarm goes off. Ruby and Jade go to check on Walt.
With just me on the line, Fiona relents. ‘Listen, I’ve got an old friend who’s just moved back to Nairobi. Suzanne. She’s a psychiatric nurse, running some sort of mental health clinic there. Marguerite should remember her from when we were at school together. I’ll ask her to go around and assess the situation, see how Dad’s going. It would be good to get an independent opinion anyway. I’m not sure I trust Dr Andrews when he’s only got Marguerite in his ear.’
‘That sounds great,’ I say. ‘Tell her to come as soon as she can.’
As I hang up, I see Walt through the window, marching back and forth between the three locked cars in the driveway, Ruby by his side as she desperately tries to convince him to come inside.
Fiona’s friend Suzanne comes around to assess Walt, and he thinks Marguerite is his mother.
We’re sitting out on the patio when he beckons us into the living room with a finger held to his lips, while Marguerite is sorting through files at her desk in the study. ‘My poor old mother through there,’ he whispers. ‘She’s gone completely barmy – thinks I’m her husband!’
‘Oh dear,’ I reply, ‘she must be getting a bit confused in her old age.’
‘I’ve tried to set her straight but every time I tell her I’m her son, she insists her name is “Marguerite” and says we’re married!’ He holds out a Post-it note that has been stuck to her desk since her last visit to Dr Andrews. It reads ‘ADD LIFE TO YEARS – NOT YEARS TO LIFE’.
‘Jolly good advice, I’d say!’ Walt says, not realising it’s for him, not her.
‘I suppose there’s no harm in letting her think you’re her husband, don’t you?’ Suza
nne says, immediately seeing the need to play along.
‘Yes, I think you’re probably right,’ he agrees. ‘I don’t want to fuss the poor dear anymore.’
Marguerite calls out from the study – some tennis is on TV. ‘Are you coming to watch the tennis, darling? One of those big black American girls is playing. I never know which one it is. Mars or Venus? Or is it Saturn? My word she can give that ball a thwack! Ooof!’
Suzanne raises her eyebrows at me. I get the sense she’s come across people like Marguerite before – that it’s a British thing. A Prince Philip kind of thing.
‘Coming, dear!’ Walt calls back. Then to Suzanne and me, with a conspiratorial wink, ‘I think this is going to be a very, very tricky day.’
Suzanne sees right away that Walt’s dementia is much more severe than Fiona will admit. She sits with him for an hour, running through some basic cognitive screening tests to come up with an overall assessment. ‘I’d place him somewhere between moderate and advanced phase dementia,’ she says to me. ‘Closer to advanced, really. He’s mixing up family members, experiencing hallucinations, becoming aggressive when he gets frustrated – this is certainly the point in time at which many people would start to consider psychiatric medication.’
‘So do you know much about Risperidone?’ I ask. ‘That’s what the doctor has suggested – but Fiona’s dead against it.’
‘Look, it’s very commonly prescribed and quite effective. I can’t see any reason not to try it out. You should just start at a low dose and see how he responds. It’s for his sake as much as yours – he’s experiencing quite bad anxiety, and being wound up like that so much of the time isn’t good for anyone. It’s no wonder he’s starting to lash out.’
‘Yeah, we’ve been trying to explain that to Fiona, but she doesn’t get it. She’s not around enough to see how bad it gets.’
‘I’ll talk to her about it,’ Suzanne says. ‘She trusts me. I don’t know what’s going on between her and Marguerite, but I don’t want to get involved.’
‘Trust me,’ I say, ‘don’t.’
‘Honestly, Walt could not possibly be any better looked after. The way he’s being cared for here is beyond gold standard. To be in his own home, with this many people around to monitor him – really, there is nothing more anyone can do.’
Suzanne, as it turns out, knows better than anyone just how lucky Walt is. She’s recently set up an NGO to provide affordable mental health services in a country where, understandably, the whole concept of ‘mental health’ is poorly understood and takes a back seat to the more tangible concerns of physical diseases and hardships. The clinic runs from a tiny shack on the north-western edge of the city and is open to the public twice a week. Word of the clinic has spread, and hundreds of people now travel hours – some on foot – to be treated for afflictions ranging from depression and anxiety through to schizophrenia, Alzheimer’s and epilepsy. Until it opened, Nairobi only had one dedicated mental health facility: the notorious Mathari Hospital, a concrete asylum where chronic under-resourcing and overcrowding meant patients were routinely neglected, exposed to abuse and deprivation, and very rarely – if ever – received the care they needed.
One report, by the Kenya National Commission on Human Rights, estimated there were 8.5 million Kenyans with untreated mental health issues. Suzanne wants to change that. In addition to providing diagnosis, treatment and support to patients and their families, she’s working to increase awareness of mental health issues more generally. Each year, she offers nursing scholarships to train counsellors who can then take their skills back to their communities and establish outreach clinics of their own. Her passion is palpable – this isn’t some half-hearted, do-gooder effort, the sort of ‘dig-a-well-and-go-home’ charity that gives so many foreign aid projects a bad name. Suzanne sees the organisation as the beginning of something much bigger and longer term: the foundation for a better mental healthcare system throughout the country.
‘You should come along and see what it’s all about some time,’ she says.
I will, I say, I will.
I’m on back-up duty one morning, sitting in the computer room at the Club. Ruby is having morning tea with Walt in the garden room, while Marguerite has a round of golf on the course next door. I get a Skype message from Fiona:
Hiya, urgent. Can u talk?
It’s always urgent with her. I take my laptop into the booth and dial in.
‘Okay, so,’ she says, ‘I’ve had a good chat with Suzanne. And she’s convinced me it’s worth trialling the Risperidone with Dad. But he will need to be very closely monitored – and only on the smallest dose, 0.25 milligrams. For no more than two weeks to begin with.’
‘Okay,’ I say, relieved she’s at least come around to trying something. ‘But is two weeks going to be enough to know whether it helps? I thought it took several weeks for that sort of thing to kick in.’
‘Look, it’s a serious psychiatric drug, and Dad is very sensitive to any kind of drug, as you know. And it increases the likelihood of stroke. So we need to be sure it’s well worth the risk if we’re going to use it.’
‘Okay.’
‘Dr Andrews has written a prescription. Marguerite isn’t to know about it.’
‘Well, I won’t be lying to her if she asks about it,’ I say. Fiona clearly needs some reminding that I’m not getting dragged into that shit again.
‘Just please be very careful with him once you start with it,’ she says.
‘Yes, of course we will,’ I promise. I understand her reluctance – I wouldn’t want my dad put onto unnecessary drugs either, I don’t think anyone should be. But I really do believe we need to at least try this.
When I head through to the garden room to give Ruby the update, Magda has joined her and Walt. ‘Kirsten! Hello! I was just telling Ruby – did you see on the noticeboard? There is a fun run in the Karura Forest in a few weeks. A corporate thing. You girls should go! It is lovely through there! Yes, because you know there are the walking paths, but it is a bit too dangerous to go on your own even during the day because of the bandits, as it were, but with all the people and a big event like this it will be very good. Don’t you agree, Walt?’
‘Oh yes, very good,’ he says, spooning more jam onto his scone before Ruby can stop him. I don’t think he’s followed anything since ‘noticeboard’.
‘I will put your names down on the list, yes?’ Magda asks. ‘It is just one-thousand shillings to enter.’
‘Jeez, Magda, are you getting commissions on the people you sign up or something?’ I tease.
‘No.’ She frowns, confused. ‘A commission? But why would that be?’
‘Never mind, it was a joke,’ I say.
‘Sure, sign us up,’ Ruby says. ‘I’m sure Jade won’t mind covering for us that morning.’
‘Okay, well, I’m just off to pick up some things from the pharmacy for the mzee,’ I say. ‘I’ll see you back at home.’
But I see something curious when I go down to the shops after picking up Walt’s new prescription.
It’s Marguerite. Sitting at a café. With an African woman. Wasn’t she meant to be playing golf?
‘Kirsten! Yoohooo! Over here!’ she waves me over. ‘This is my friend Deborah.’ Ahhhhh, so this is the famous Deborah.
‘Hi, how are you?’ Deborah smiles, shakes my hand. She has a slight British accent, short cropped hair, and is stylish as heck in a bold print dress and matching headband.
‘Hi! Good thanks, nice to meet you,’ I say. She looks about forty-something. Why is she friends with Marguerite? Why is Marguerite friends with her? Maybe I’m the one being ignorant, or unfair to both women. It’s perfectly feasible that they could enjoy one another’s company.
‘We thought we’d have some cake, given how well I went at golf today,’ Marguerite says, pointing to the remaining crumbs on the plate in front of her. ‘Only nine holes, but I was very quick.’ I look at her shoes. They’re not wet with dew. She doesn’t look pink
in the face. I don’t think she’s been playing golf this morning at all.
‘Marguerite loves telling me how well she goes at golf,’ Deborah teases.
‘Now, what are you doing here anyway? Shouldn’t you be at the Club with Walt?’ Marguerite suddenly becomes terse.
‘Oh, I’m … ah …’ I hesitate, unsure whether to tell her here and now about the Risperidone. I decide it’s best not to. ‘I’ve come to pick up some more of Walt’s pills.’
‘Well, run along then. You ought to get back to the other girl. In case she needs help.’
Marguerite’s not normally this bossy. I can’t tell whether she’s showing off in front of her friend, or trying to get rid of me.
I open the newspapers the next morning to find I won’t be going to Dadaab any time soon.
Two Spanish aid workers, with Médicins Sans Frontières, have been kidnapped – grabbed as they left a health centre set up to treat the thousand Somalis who stream across the border each day, fleeing famine and the Al-Shabaab militants who won’t let Western aid groups into its territory to feed them. The women’s Kenyan driver was shot and wounded in the attack, the first one to have occurred inside the confines of the camp.
NGOs are pulling out all over the shop; even the UNHCR is considering recalling staff. Everyone is rattled. Alex emails me to say the FilmAid project is on hold indefinitely.
The whole north-east part of the country is facing a security crisis now – only a few weeks ago, a quadriplegic Frenchwoman was kidnapped from her holiday home at Lamu. Somali gunmen pulled up out the front of her house in a speedboat, then carried her off without her wheelchair or cancer medication. She died in captivity a few weeks later. A month before that, a British man was shot dead and his wife taken from a resort on Kiwayu Island, further north. Aside from the obvious human cost, the economic hit to the region will be devastating. The Lamu archipelago, an ancient Swahili settlement with a number of significant historical and archaeological sites, is one of Kenya’s most popular tourist attractions – now it’s a tropical gauntlet.
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