By Lukoye Atwoli
Sunday Nation 09 March 2014
Kenya’s health sector is in a shambles. Hundreds of health workers
have now worked for over two months without pay because the national and
county governments cannot agree on who is responsible for them. Shortages
of medicines and important supplies are rife, even as governors try to
outdo each other in ‘flagging off’ lorryloads of medications in their
counties. As a result, ordinary Kenyans are suffering.
weeks ago, a middle-aged man from my village suddenly collapsed and had
to be rushed to hospital. The local hospital could not manage his
condition because he needed intensive care facilities that were not
available. The nearest referral facility was over a hundred kilometers
away in another county, but the family organised quickly to transport
When they got to the hospital, all the intensive care
unit (ICU) beds were occupied, and they were informed that the next
available ICU beds were at a nearby private hospital. The relatives
agreed to have him admitted at the private hospital where after more
than a week in the unit, and despite the best efforts of the team
managing him, the patient died.
This is when the problems began
for the family. Intensive care is very expensive business, and the
family was asked to raise over a million shillings to clear the hospital
bill. This poor family could only raise a fraction of the cost and had
to beg the hospital to release the body for burial. This took a
while to happen, and in the meantime the family looked around for
someone to take responsibility for their conundrum. Of course doctors
and other health workers bore the brunt of their criticism.
TURN AGAINST HEALTH WORKERS
is not a scenario unique to my village, or indeed to any one part of
our country. This is a story every ordinary family of Kenyans has had to
live through at some point. Unfortunately, when it happens, we turn
against the very same health workers who have struggled in very
difficult circumstances to save lives, and accuse them of all manner of
In my discussion with the bereaved family, it struck me that
they all could not make the important connection between their own
choices and the fate that befell them. I asked them if they had informed
any of their elected representatives about their problem. They
informed me that the politicians had done their duty before elections,
and owed the electorate nothing. Their twenty and fifty-shilling
handouts had bought these villagers’ votes, and there was no use
approaching them to solve such ‘small’ problems as the health of their
constituents, among others.
Flabbergasted, I attempted to
demonstrate that if they had voted based on policies and not because of
clan, family and handout considerations, perhaps their local hospital
would have been better equipped to save their relative’s life. Perhaps the county referral facility would have had well-equipped ICU facilities, with adequate beds to help all those in need.
they would have had functioning ambulance services that would have
arrived a few minutes after the patient collapsed, and carried out
onsite procedures that would have prevented further damage and improved
his prognosis. If they had used their vote better, perhaps their
relative would not have collapsed in the first place.
I do not know if I
managed to convince them, but I hope I did.
Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. firstname.lastname@example.org