There are two kinds of Kenyans. Those who can afford private care and those who cannot.
The former include striking doctors, the county and national government officials negotiating with them, their mediators, and judges.
They say their primary concern is the welfare of poor Kenyans – they also have a bridge to sell you if you are buying.
I was at Aga Khan Hospital in Nairobi last week. My cousin was having a Caesarean section delivery and my daughter was unwell.
The doctor charged Sh300,000 for the Caesarean section. This figure excluded the rest of the hospital bill, which included Sh8,000 per day in nursery fees for the baby.
A young doctor attended to my daughter. I asked what she felt caring for my kid who could pay, but not the patients who cannot dream of being treated at Aga Khan.
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She told me she hated it. A good person by what I could see, and there are plenty of those among the strikers.
Yet, I felt disgust, which I was careful not to show. Disgust at the striking doctors’ posturing of moral uprightness. And disgust at the perverse incentives that undermine, in every single way, the rights and interests of the patient, whether in public or private care.
Holding Kenyans to ransom for almost three months as a bargaining chip is not new to us. Hospitals kidnap patients who cannot pay their bills. Some spend months trapped in wards. Is this even legal?
We will never know because if they are too poor to pay for healthcare, they are too poor to pay for lawyers.
The only reaction by the activists, lawyers, policemen, parliamentarians, and prosecutors who can stop such kidnapping is to send M-Pesa contributions to pay the bills. Money is cheap in Kenya; it is principle that the successful will not spend.
Kenyans bargain in tears for the bodies of their dead relatives so they can bury them. Have you ever served on a harambee committee for a dead relative’s hospital bill? You send a representative to go through the bill item by item. You find, always, double billing, and extra items that were never used.
We have cried from unnecessary and dangerous surgeries, the draining of every available insurance and harambee cent in our moment of greatest vulnerability. A friend’s mother passed away from renal failure that led to multiple organ failure.
The doctors kept piling on new diagnoses and treatments: all for the money. Then there is the Intensive Care Unit. Meant for resuscitating patients, for those with a chance of survival. Not for those who are terminal.
Yet we know of terminal patients being put in ICU by doctors to accumulate bills.
There are surgeons who will keep treating you when they should assign you to a regular physician and vice versa. All for the billing.
Doctors work as few hours as possible in the public service because they are allowed to maintain private clinics. Many do the bare minimum of ward rounds before they leave to earn more money elsewhere.
The striking doctors keep talking of the low number of doctors in the country compared to the population. They had better include their own absenteeism.
I know many good doctors who do their best in bad conditions for their patients. I hope they do not think this strike is some sort of extension of their moral posturing.
It is a travesty; a game between alternate wings of this country’s uncaring, self-segregating elites.
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Nurses and clinical officers keep hospitals open. They work hard, and we thank them. But public hospitals need doctors. Please, county and national governments, pay the ransom so our people do not suffer any further. Pay them anything they demand; anything. Then, Bwana Henry Rotich, raise that precise amount from taxes on private clinics and hospitals.
When this drama is over, let us agree on a few action points. Parliament should pass a Patients Bill of Rights that provides transparency, recourse and stiff criminal penalties for doctor and hospital malpractice.
Whoever regulates the sector should eliminate the perverse incentives that favour private over public care, and the even more perverse incentives for doctors to hold on to patients for personal gain.
In addition, senior policymakers in public health should not get private healthcare: if you lead it, you should use it.
Doctors, please spare us the moralising. Just earn your money on our dying, suffering bodies. We are used to it.
Even better, go ahead and register your union as a political party. That’s what you remind me of: preaching the good while practising cruelty and lies.