Sunday, May 15, 2011

Doctors too suffer from poor health services

By Lukoye Atwoli
Sunday Nation 15 May 2011

The health care delivery system in Kenya is in a mess. Almost everyone agrees on this.

Indeed, prominent Kenyans would not trust their lives with the local health facilities, and often travel abroad for treatment that even newly-qualified doctors in Kenya could deliver.

Despite this acknowledgment of the poor state of affairs in this sector, the Kenyan populace often turns against the poor health care worker whenever things go wrong, blaming them for all sorts of things including profiteering and unethical practice.

Whenever doctors appear in the streets or at press conferences complaining about the conditions under which they work (which incidentally are also public health facilities), the average citizen is wont to dismiss them as pampered overpaid brats just asking for more money.

Nothing can be further from the truth, as illustrated by the following incident. Less than two weeks ago, a young public servant working in Busia managed to get some time off to visit with his family in Kiambu.

While there, he developed malaria and decided to visit the Kiambu District Hospital for treatment.

Malaria is usually a straight-forward diagnosis, and the medications are readily available at all public hospitals, so everyone expected the young professional to be treated quickly and get back to his usual routine.

Unfortunately for some patients, malaria can complicate and cause more damage than normal. In this young man’s case, he developed kidney failure and his doctors determined that he needed dialysis to save his life. This is where the problem began.

There is no dialysis machine at the Kiambu Hospital, although there are doctors qualified to administer this life-saving treatment.

Transport arrangements were quickly made and the patient was put in an ambulance for transfer to Kenyatta National Hospital (KNH) for dialysis.

I am made to understand that the only other public facilities with dialysis machines are the Moi Teaching and Referral Hospital in Eldoret, the Coast General Hospital and the Provincial General Hospital in Nakuru.

The young civil servant did not make it to KNH. He is said to have died in the ambulance. This incident is an indictment of the health sector in this country.

While our ministers fight over turf, and struggle to introduce programmes for the treatment of cancer and other exotic illnesses, people are still dying of easily manageable problems all over our country.

While the government spends large sums of money on the ICC process and foreign trips, many are still contracting malaria and dying of its reversible complications.

The larger tragedy in this story, however, is that the young civil servant who suffered this fate was a new doctor who had just completed his internship and had a brilliant future ahead of him.

Although I never met the young civil servant, his short life and unfortunate death provides a big lesson for all of us working in health.

Evidently, even doctors cannot afford the care they give to their patients in high-cost hospitals.

A friend remarked that the doctor’s life might have been saved had he been able to visit the Karen Hospital or some other private hospital in Nairobi.

Clearly, a rational plan needs to be developed, with appropriate health priorities for our population. And don’t get me started on the ministry’s pet project — the opaque taxation system christened NSHIF!

Dr Lukoye Atwoli is a consultant psychiatrist and lecturer at Moi University’s School of Medicine

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