I spent six hours on Wednesday night at Kenyatta National Hospital with a friend who had suffered a Transient Ischemic Attack (stroke). Fourteen exhausting hours later, she was discharged. She was lucky. Road accident victim Hannah Njoki didn’t make it. Three days after being brought in, KNH still hadn’t found an ICU bed for her.
Without the money to access private emergency health care, she died on Tuesday. We need to ask what fails Hannah and all patients denied health care and how we can fix this. Kenya has made some of the most important declarations on the right to health on paper.
Article 43 of our Constitution and the Health Policy 2014-2030 obligates national and county governments to provide the highest possible standards of health for all Kenyans. The right to health is personal for us all. At this moment, I have no less than seven members of my immediate family grappling with debilitating or life-threatening health conditions. The experience is simply frightening.
The denial of quality and affordable health care is still the number one killer and financial catastrophe risk for too many of us. This is why we must take note of the recently released Ethics and Anti-Corruption Commission (EACC) systems review into the pricing of pharmaceutical and non-pharmaceutical medicines and equipment.
Launched by the Health Cabinet Secretary on August 17, the report found several systemic weaknesses and failures in the ministry’s procurement policies and practices.
The lack of a list of accredited suppliers, periodic reviews of essential medicines, involvement of health experts in developing market prices index and general procurement guidelines are among them.
While very welcome, the review findings are not a surprise to some of us. It validates the whistle-blowing policy brief released three years earlier. The EACC acknowledge the “sealing corruption loopholes in our health procurement system” 2015 report as the primary reason for the review last year.
The issues it touches on relate to lapses in the ministry in 2014 and 2015. At least three Cabinet and Principal Secretaries have come and gone. The scandal with GAVI and other donor funds remains unaddressed. Accounting officers entrusted with public duty have neither been absolved or implicated by this or any other investigations.
There are two questions we need to ask. Does the government treat these lapses as matters of systemic failure, criminal negligence or both? What is the impact of delayed reviews and institutional reform?
In his national call against corruption in November 2015, President Uhuru Kenyatta seemed clear on the first matter. He called for major reforms at the Public Procurement Oversight Authority (PPOA) and announced that the Department of Criminal Investigation (DCI) and Assets Recovery Agency would investigate both companies and state officers who have colluded to illegally increase health care costs. Secondly, we know that the percentage of citizens using government health facilities dropped by 27 per cent last year. Nearly half of these may have moved to private or NGO facilities. These figures sound an alarm to those of us who believe in universal health care. Citizens have cited the lack of medical staff, cost, distance and quality of treatment in this order. To borrow a phrase from our indefatigable Director of Public Prosecutions, the system of chaos has to be transformed from many ends. Tighter policy oversight, swifter interruption of corruption cartels and deeper patient awareness and vigilance will fix this.
If we do this, our public clinics, dispensaries and hospitals will become equipped, empathetic and professional spaces of sanctuary and recovery. Not just for Hannah and some of us, but even for the relatives and friends of those currently sabotaging our facilities.
-The writer is Amnesty International Executive Director. He writes in his personal capacity. Twitter: @irunguhoughton.