Sunday, March 13, 2011

An open letter to Medical Services minister

Sunday Nation 13 March 2011

Dear Sir,

Welcome back to Kenya and to the ministry after a long sojourn abroad.

We are glad you got the treatment for prostate cancer and are back home safely, with the declaration that the cancer that threatened to interfere with your very active schedule has been defeated.

Above all, we are excited at your belated discovery while you were away in the United States of America that cancer is curable.

Hundreds of thousands of Kenyans suffering from this nasty condition will be happy to know this, and that the ministry will soon make arrangements to ensure that these treatments are available locally.

While you were away, several things happened that need your urgent attention if you are to prevent a melt-down in health service in our country.

I will point out only two of those, confident that the mandarins at Afya House will already have briefed you about the rest.

First, for the first time in a long time in this country, newly-graduated junior doctors have not been posted to their stations over four months since they passed their final exams in medical school.

Medical officers who completed internship several weeks back are also waiting to be posted to health facilities all over the country to offer much-needed services to our population.

Indeed, just the other day these young doctors demonstrated in the streets of Nairobi, asking your bureaucrats to post them so that they can start work immediately.

Unfortunately, senior ministry officials decided to come up with a draconian, contradictory contract for the interns.

The contract contains clauses such as one bonding doctors to work for the government for at least three years after internship, and another indicating that post-internship employment would not be guaranteed.

As a result of this, a doctors’ union has now been formed, and I have no doubt that you will be hearing from them in due course.

The second thing that happened just before you came back was the screening of a CNN documentary on the state of mental health services in Kenya.

Titled “Locked up and Forgotten”, it painted a very gloomy picture of mental health attitudes and services in our country.

It depicted ordinary Kenyans and health institutions apparently mistreating mentally ill and mentally disabled citizens and denying them even the most basic of human rights guaranteed in our Constitution.

Before we rush to conclusions, let us all reflect on the sort of investment we have made in mental health care delivery and research.

According to available statistics, the ministries of Health dedicate only a minuscule fraction of their budget to mental health, most of it going to pay salaries at Afya House.

Most of the expenditure on mental health services is incurred out of pocket by the already impoverished patients and it is, therefore, no surprise that even patients with easily managed conditions end up being “locked up and forgotten”.

Mr Minister, as you settle back into your comfortable office at Afya House and begin plans to roll out nationwide cancer services and comprehensive health insurance, please give some thought to improving mental health services in this country.

Please remember these two things, Mr Minister: Take care of your health workers. And, there is no health without mental health.


Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s school of medicine

1 comment:

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