Our dysfunctional health sector is in dire need of immediate attention

Our dysfunctional health sector is in dire need of immediate attention.
An otherwise hyperactive and jovial kid, Jarvis became uncharacteristically quiet at around 1500hrs last Sunday. Even by the feel of hand, a touch on the forehead confirmed his body temperature was way above normal.

A dose of paracetamol syrup lowered the temperature and four hours later, he tried to sleep, but could not. In that state of drowsiness, his eyes suddenly flew wide open as if he was responding to an alarm, but they were blank. Almost immediately, he curled into a ball and the body stiffened, followed by spasms. Worse, he was struggling to breathe, and that is when panic set in.

The urgency was in taking him to hospital. At that hour, however, public dispensaries had closed and the referral hospital was too far. On arrival at the nearest private hospital, approved by the National Hospital Insurance Fund (NHIF), a malaria test was done but showed negative.

The hospital staff recommended another private hospital, but not before charging Sh500 for the test. Half an hour later at the second hospital, a malaria test turned positive, added to which the doctor declared there was an ‘infection’.

To cut a long story short, the simple malaria test, an injection and attention that did not last half an hour attracted a charge of Sh5,200. Cumulatively, the family spent Sh6,500 in both hospitals and on taxis within a couple of hours. How many Kenyan households can afford such money at the drop of a hat when millions of them live below the poverty line?

Wrong diagnoses

Worse, In 2015, accident victim Alex Madaga was rejected by hospitals around Nairobi because Sh200,000 needed upfront was unavailable. In 2018, Matilda Anyango died at a city hospital a few hours after being stabbed, yet her family was charged Sh850,000.

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Who foresees such situations to walk around with ready cash? Preposterous, but then, that encapsulates the state of medical care in Kenya; it is designed for the super rich. The poor can only pray and hope affordable Universal Health Care becomes a reality. 

Public hospitals in Kenya are run down. So much that even the indigent regard them as a waste of time; they would rather sacrifice whatever little they have to get medical attention in private hospitals. Yet despite this seal of approval from the public, private medical practice in Kenya is a money minting venture. Their charges defy logic in every conceivable way. Families have been driven deeper into penury footing humongous medical bills. Many others have lost family members to treatable diseases because of the cost factor.

The dysfunctionality in public hospitals, characterised by endless medical staff strikes, lack of medical stores, wrong diagnoses, negligence, poor management and inadequate staffing has contributed to the exponential growth in private hospitals which, incidentally, are owned by doctors and clinical officers in government employ.

Medical stores stolen from public hospitals end up in these private clinics. Some of the clinics are not even registered, and are run by quack doctors. It is scandalous that a county hospital like Kerugoya can be closed for being dirty. Of course, this is not news, but it bothers that there is so much corruption-induced lethargy in government yet nobody gives a hoot.

Health insurer

NHIF, as I have pointed out numerous times before, is a fraud. It is a conduit for syphoning workers’ contributions to health insurance. Billions of shillings have been lost through collusion between hospitals (some of them fake) and top NHIF officials. Neither party can carry out a heist without the other. Indeed, at a breakfast meeting with NHIF, a manager admitted after prompting that some hospitals approved by NHIF borrow beds and equipment for inspection purposes and return them after the exercise.

A hospital management as dishonest as that cannot be expected to be diligent in caring for patients. And knowing this happens, why hasn’t the health insurer been tough on such malpractices?

Thus, to expect that the Universal Health Care goals can be realised within the set time frame and this, through NHIF without reconfiguring it, is expecting too much. The pilot project on UHC in four counties hasn't shown promise. In Kisumu, for instance, patients have complained that despite the hype, they were yet to see any positive results.

I have no doubt President Uhuru Kenyatta is determined to leave an enduring legacy, particularly with his flagship Big Four Agenda, but the axis of evil that coalesces around the presidency won’t give him peace. With its endless politicking, loose talk, vindictiveness and braggadocio, the axis is primed to sabotage Kenyatta every inch of the way. The intellectual hollowness that defines these belligerent individuals is manifest in their fetish for ad hominem.

The medical sector calls for serious attention if only because a healthy nation is a working nation. A working nation is a prosperous nation, hence higher levels of contentment. To doctors; Primum non nocere.

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Health sectorDoctorsImmediate attention