By EMMANUEL WERE
KENYA: One of the biggest causes of medical negligence, according to the medical authorities, is poor communication between doctors and patients, resulting in wrong prescriptions or procedures that lead to disability and sometimes death.
But those looking in on the sector also point to poor or absent medical equipment and training.
According to Daniel Yumbya, CEO of the Medical Practitioners and Dentist Board, the oversight body in Kenya, patients need to shoulder blame in miscommunication with the doctors.
“Patients might withhold some important information. A doctor might not know how to break some difficult news to the patient or break down the medical jargon into layman terms,” he said.
But doctors may also overestimate their skills. “The doctor wants to make a decision and he is not sure, and many fail to say ‘let me confirm if it was this or this’ with another doctor. Sometimes, ego kicks in,” said Yumbya.
The result is that doctors end up performing or recommending procedures, which endanger a patient’s life rather than curing them.
Patients may also be told little about what lies ahead. “The lack of communication in explaining the after effects of a surgery is one of the causes of conflicts,” said Samir Inamdar, a lawyer who acts on behalf of doctors.
But there are also endemic management failures. “If the laboratories are poorly managed, what are the chances that the doctors will make the correct diagnosis,” said Dr Moses Njue, a pathologist.
One doctor, who sought anonymity, recalled a case when the only microscope at the district hospital broke down, so the lab technician split the blood samples for malaria into two and labeled half positive and half negative without carrying out any tests.
“I was mad. Imagine the number of people who we treated for malaria and they did not have, and the people who we did not treat for malaria and yet they had it,” she said.
Other causes of medical negligence are poorly trained medical personnel, from laboratory technicians to nurses and doctors.
On average, doctors spend about six years in medical school and two years on internship before they practice.
“If you look at the reduced number of facilities and the reduced number of lecturers, the quality of training is actually coming down,” said Dr Nyaim Opot, chairman of the Kenya Medical Association.
It costs about Sh7 million to train a well-qualified doctor.
For the doctors to specialise in their field through a Masters it costs a further Sh5 million.
Previously, the government used to fully sponsor most of the doctors who worked in public hospitals for their Master’s degree, while also paying their salary. Now, doctors who work for public hospitals are only entitled to study leave and must find the fees.
