Small planes were the answer: planes equipped with HF radios that could fly in and out of dirt strips. And so, the Flying Doctors Service was formed as a division of AMREF. Michael Wood’s personal plane, a Cherokee 180, and a twin-engine Piper Aztec donated by Arthur Godfrey (the 1950s host of The Arthur Godfrey Show on ABC television) formed the Flying Doctors Service’s first fleet of airplanes.
Years of hard, selfless work followed, building countless dirt airstrips, installing an expansive HF long-distance radio network, constructing outreach clinics, and raising donations from Europe and North America. Forty years later, the Flying Doctors Service had become a critical part of Kenya’s medical infrastructure.
I knocked on Dr. Michael Gerber’s door. His second-floor office was a large room, nicely appointed with black-and-white photos of doctors and nurses dispensing aid to black women and their children—typical NGO advertising, designed to tug at the donor’s purse strings. I found Michael Gerber at his desk, hunched over a computer from which he directed a seven-hundred-employee organization, responsible for training and operating clinical outreach programs for the whole of Kenya and much of East Africa as well as the Flying Doctors, who provided medical evacuation services.
Right from the start, Gerber made me his confidant, unloading his private thoughts and frustrations without seeming to worry about the political consequences of such indiscretion. Over the next two years, our regular weekly meetings would cover subjects that went far beyond my assignment to reorganize the Flying Doctors Service. Gerber’s concerns included the composition of the AMREF board, governance, and personnel issues—all political minefields that were driving him to distraction.
That first day, though, we spoke only of my assignment. He launched into it almost before I had a chance to sit down.
“Scott, I’ve got a hell of a problem with the Flying Doctors Service. It’s badly run, losing money, and draining resources from the organization. My board members are upset. They insist I do something about it.”
Gerber had inherited an awkward corporate structure that complicated the reorganization of the Flying Doctors Service, which was legally owned and operated by AMREF. The Flying Doctors Service’s revenue came from funds raised by the Flying Doctors Society, referred to as the “Society,” a separate legal organization whose sole purpose was to raise money for the Flying Doctors Service.
The Society was made up of volunteer ladies, most of whom were well meaning but completely out of touch with the operating requirements of the Flying Doctors. The Society’s constitutional mandate was to raise money for the Flying Doctors Service by selling annual memberships to the Society for KS 30,500 or $65 per member. Membership entitled a member to a free emergency medical evacuation from any swamp, mountain, or desert in East Africa, by the Flying Doctors Service. It was an excellent fundraising idea, popular with travel agents and tourists visiting the game parks. The only problem was that the Society jealously guarded the funds it raised and had no legal obligation to hand the money over immediately to the Flying Doctors Service. The Society’s board believed their first obligation was to Society members to ensure that monies raised were properly spent.
The Society had lost confidence in Mike Gerber, and because they felt that the Flying Doctors Service was poorly run, the Society’s board felt justified in withholding funds. While there was some justification for their complaints, no one on the board had a clue about the operations of an emergency medical flight evacuation unit, and this led to ferocious arguments and much bitterness.
Since the Society had few expenses and no obligations, it had accumulated substantial amounts of cash. Its board met infrequently to review its bank account and members debated whether or not to make a “donation” to the Flying Doctors Service, usually amounts that were pitifully small and bore no relationship to the actual costs of operation. To make matters worse, the Society did a lamentable job selling memberships; they had little incentive with so much cash in their bank account. Meanwhile, the Flying Doctors Service, carrying all the expenses of running the medical-evacuation service, was cash-starved and hounded by outraged creditors who threatened to close them down.
Gerber’s frustration over this impossible situation and his uneasy relationship with his own board had him pacing the room. Part of his problem lay in the fact that AMREF was still living under the shadow of his predecessors, Sir Michael Wood, whose reputation had taken on mythical proportions, and his younger brother, Christopher Wood. Sir Michael’s charismatic personality had been universally attractive to all those connected with AMREF, making him a tough act for Mike to follow.
Mike Gerber was an American who had grown up in New York City, received his doctorate in Asian studies from New York University, and then became a professional aid worker. He had spent a number of years in the Philippines and India before joining AMREF’S national US office in New York. Tall, warm, and gregarious, he seemed nevertheless out of place at AMREF. It was generally agreed that he was the complete opposite of the legendary Sir Michael Wood.
Over the years the Flying Doctors Service focused on emergency medical evacuations, employing professional pilots and nurses, sometimes accompanied by doctors. Seriously ill patients were flown from outlying areas to Nairobi to be treated by doctors at one of the major hospitals. Since most emergency evacuations involved Africans who had no money, the Flying Doctors Service division, without access to the Society’s cash, eventually became a financial drain on its parent, AMREF—a drain that AMREF could ill afford. My assignment was to free Gerber to concentrate on AMREF and to reorganize the Flying Doctors Service, making it more efficient, providing it with a renewed sense of purpose, and, more important, reversing its financial losses.
Mike Gerber and I quickly agreed that I should spend a few weeks at the Flying Doctors Service hangar to assess the operation, produce an initial set of recommendations, discuss and agree on a business plan, and then submit it to the board for approval.
“Well, that’s fine, Scott,” he said. “It’s wonderful to have you with us. I really need your help and I look forward to your recommendations.”
Suddenly, he seemed to realize that he hadn’t made the proper polite inquiries about how and when I had arrived in Nairobi and whether I had a suitable place to stay. We took another few minutes on the subject, following which he insisted that I join him and his wife for dinner. By the end of the evening, I realized that I could be of real help to Mike. His daily routine had become a struggle, made difficult by a political board and a recalcitrant Society. I sensed he was looking forward to early retirement.
The next day, I bought a second-hand Nissan sedan, and soon discovered that driving in Nairobi is a blood sport. It is not so much that drivers drive too fast, which they do, but that virtually all cars on the road are unsafe, wrecks held together by a grotesque patchwork of metal and body filler. No matter how old or damaged cars appear, however, they remain a potential target for thieves. The manufacture of security devices ranges from enormous links of chain to bars inserted through the steering wheel and red-blinking lights that warn of electronic sirens—mostly non-operational. The sale of security systems was and still is a thriving industry in Nairobi. Popular bumper stickers read “This car is protected by the blood of Jesus.” Expensive Land Cruisers and Mercedes-Benzes usually carry the added protection of a chauffeur armed with a billy club or a pistol, the use of which is never really in question.
The roads in and around Nairobi when I was there were a disaster. Potholes were so numerous they served as speed bumps or what some called “sleeping policemen.” On occasion, I would bring my Nissan to an abrupt stop as the frame rested on the edge of a hole, leaving a front wheel hanging suspended in mid-air. Extrication