Due to an emergency or unavoidable circumstances, some of us might find ourselves hospitalized in a public facility. We also know that most of the health services offered there are creaking! Yet hospitals should be the place where people go to get better. We have heard and read stories of patients who have been admitted with one ailment or infection and have come out worse or even dead from procedures that were done wrongly or never needed to be done in the first place. One of the most important needs for human beings is not just healthcare but also a good health service system in order to prevent loss of life and decrease in human capital.
What are some of the health gaps ailing Kenya?
Corruption and Misuse of Resources
The disease of corruption has infiltrated the health sector from grand corruption in the higher levels of government where much needed resources are diverted from delivery of healthcare which in turn reduces access to services. Petty corruption effects might not be as small as the name sounds. This is where some doctors either sell drugs that are supposed to be free or divert them leading to insufficient supply in most healthcare centers in the country. Some doctors spend more time in private practice when they are supposed to be working in public hospitals thus creating congestion and overcrowding of the sick there. Counterfeit drugs are everywhere and it is hard to differentiate between genuine drugs from counterfeits due to the rise in technology. Unscrupulous dealers contribute towards this rise by using bribery to by pass quality inspection.
Lack of Adequate Medical Personnel
Human Resource is in short supply with the doctor to patient ratio in Kenya currently standing at 1:16,000 according to the world health organization against the preferred 1:1000. There’s a continuous loss of qualified doctors and nurses to foreign countries which offer better remuneration. The few available medical personnel left are overburdened with excessive work, culminating to fatigue, inefficiency and professional negligence.
A doctor who prefers to stay anonymous had this to say about the sector, ” Doctors are responsible for so many lives in the country! I have helplessly watched people die, yet I have the knowledge and competency but no resources to save lives. The government has a duty to furnish doctors in every capacity possible including making sure we are well rested for us to fulfill our oath. You will only realize your life’s worth the day you walk into a public hospital which has no resources to treat you whether you are broke or not. Worse still the doctor serving you is probably too demoralized to try their best.”
Lack of adequate supplies
Most of the important preventive drugs are not available in most healthcare centers, especially in the levels of dispensaries and government clinics. People are forced to travel to different clinics to find a doctor with the right medicine, a situation that causes overcrowding in hospitals. Dire consequences such as deaths occur as a result of medicines shortage.
Lack of vital and modern diagnostic equipment such as x-ray machines, ultrasounds, monitors or chemistry analyzers due to lack of prioritization of health issues has hampered the healthcare delivery process. If available, equipment are mostly found in the bigger hospitals which compromises the health of patients especially in the smaller hospitals. Sometimes wrong diagnosis have been done because of lacking proper equipment or due to the faulty nature of existing ones.
Referral only hospitals and healthcare centers are accommodating a high number of patients most of who are not supposed to be there, thus denying the referred their rightful place in these hospitals. This is because there are no healthcare centers to deal with smaller and sensitive issues like maternity leading to poor service delivery. Lack of electricity in some hospitals or perennial blackouts sometimes forces doctors to improvise; use their cell phone lights during surgeries, thus compromising the operation. Fewer hospitals mean that people from rural areas have to travel far to seek medical help which leads to the overpopulation of the few available facilities as well as overworked doctors and nurses.
Lack of proper health policies
The government shouldn’t let the health budget compete with the warfare budget. This is because health is vital. It should increase funding for this sector and enact effective policies to counter drug shortage and enhancement of hospitals with modern technology. Focus should not only be on Malaria and HIV but also on noncommunicable diseases often brought about by lifestyle which are also leading causes of death. Policies to address healthcare cost and insurance in order to enable patients afford medical care, and hence reduce the longstanding prevalence of high mortality rate should be formulated.
Policies should be created around the purchase, installation and maintenance of medical equipment. They should also define when replacement of the obsolete machines should take place. There are around 1700 qualified doctors in Kenya without employment yet the government is planning to hire 100 Cuban doctors. Our doctors are as well trained as any others, but they need proper tools and a conducive environment to do their job.
Majority of the top government officials don’t patronize the country’s hospitals yet they are the very same ones at the helm of affairs in this sector and are a stumbling block to having the final stages of the CBA signed and implemented. A policy should be put in place to forbid them from traveling abroad to seek treatment inorder for the services here to improve. Approximately 10,000 Kenyans travel abroad yearly seeking medical treatment which is a hit to the Kenyan economy. This would change if we improved our health sector and instead there would be influx of patients from other countries to Kenya.
This may sound like an over-flogged issue but it has to be addressed because it’s a countrywide concern. All the above gaps are some of the sad reality of our public health facilities. Yet these problems are not new and were factored in the 2013 Collective Bargaining Agreement (CBA) signed by the Government and KMPDU at that time which wanted to see a 300% pay rise for all medical practitioners. In the agreement, there would be a review of job groups, promotions, and deployment. There would also be an annual recruitment of 1,200 doctors, with those working in public hospitals being compensated for extra work outside the stipulated 40 hours per week.
Although many do not like to acknowledge this, a lot of doctors are miraculously working in very poor conditions to treat millions everyday without basic equipment. There’s rarely time off in a doctors diary as is with most other professions. The work is intense, mentally tiring and often emotionally draining. There’s no guarantee in conducting a 100% successful operation under such circumstances.
The government, doctors and health stakeholders should not wait for people’s lives to be at stake in order to have a pro active engagement. The conversations should continue ASAP because this time they will be devoid of last years political temperatures. Has the CBA been fully implemented? Not yet. Why is it taking so long? The government should honor its end of the bargain and engage with stakeholders to iron out infrastructure, human resource and policy issues according to the CBA. At least the treasury cabinet secretary Henry Rotich has confirmed that the government is not broke so we all know it’s not because of lack of funds that the CBA has not been implemented.
The government should be prepared to go as far as tampering with the powers of some people if it means that the health system will be improved. Most of the money needed for health infrastructure should not be diverted to corruption. Let the people in charge of health in our country use this time to build firmer foundations and systems and to ensure that these systems are so robust that they withstand any change in leadership. When all this is done, then we can hold the doctors to account if they go against their oath.