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Health workers missed the train at the station

By D Mokua | December 22nd 2013

Dismas Mokua

[email protected]

The behaviour of the healthcare workers has got nothing to do with the Hippocratic Oath but everything to do with an incompetent leadership of a trade union.

It is the case that whenever Parliament sits to pass any legislation, only a section of the ruling class, a few interested business people, some engaged corporate leaders and – surprisingly – hordes of low-income persons pay attention to the process and content.

The motivation for the various segments of society is varied: the political class as well as the business community understand the implications of legislation on governance while low income persons follow the proceedings probably for entertainment value. When the Constitution was being crafted, Kenya National Union of Teachers, paid attention to the proceedings. That is how they rejected the idea of devolving education and in fact pushed for the Teachers Service Commission to be a constitutional body. Clearly, the union representing medics was not very keen to socialise themselves with the constitutional proposals.

And this is not unusual in Kenya, a country whose middle class is largely aloof on national issues and prefer engagement through the social media as they enjoy the benefits of pay international TV. The arguments being put forward by the doctors on the need to create a National Healthcare Commission fall on the face of logic. That healthcare is a devolved function is cast in iron. Probability of this being reversed even if we were to go to a referendum is zero. The horse has bolted.

And statistics make it compelling. Kenya has 6,500 trained doctors but only 4,000 are active. Those in government service are a paltry 3,100 and of these, 2,000 work in or around Nairobi. The doctor-patient ratio is one doctor to 17,000 patients, a far cry from the WHO recommended rate of one doctor to 600 patients.

Doctors must now embrace reason if only to respect the Hippocratic Oath in which they vow to “keep their patients free from harm and injustice”.

However, the doctor’s strike offers ingenious governors the opportunity to explore alternatives of eliminating strike threat by medics. Governors who are able to successfully resolve the doctors strike or work around it will have an added feather on their cap. However governors must avoid the temptation to inject tribalism and nepotism in devolved healthcare. Thus this strike offers governors the opportunity to strike long term deals with countries rich in healthcare facilities so that counties are immune from healthcare strikes.

Governors have a reason to visit Cuba to embrace best practices. In Cuba, the government has assumed fiscal and administrative responsibility for the healthcare of citizens. There are no private hospitals or clinics as all health services are government-run. Cuba’s ratio is one doctor for every 170 patients, second to Italy.

The writer is a communications counsel who analyses business and politics

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