At Sagam Community Hospital payment is voluntary and can also be done in kind

Dr Khama Rogo with his wife, Lucie, at the hospital. TOP, LEFT AND INSETS: Sagam Community Hospital.[PHOTOS: LUCY MARONCHA AND COURTESY/STANDARD]

LUCY MARONCHA visited Sagam Community Hospital, where payment is not only voluntary, but can be done in kind, and at the rate the patient deems comfortable. It redefines ‘for the people, by the people’.

As Felistas Akello walks along the village path, the sight of the local hospital brings a smile to her face.

Only five months ago, she was on the same path but on a stretcher. In her abdomen was a tumour that called for urgent surgery. Had it not been for Sagam Community Hospital, Felistas might not be alive today.

Today, tumour-free and after full recovery, the grateful patient is on a special mission; she is going to pay for her treatment. That explains the basket of maize on her head and the goat treading the path behind her.

You see, at this hospital, patients can not only pay for their treatment in kind, but also determine how much to offer the facility. They can bring livestock, maize, millet or cassava. Or, if they have no items to give as a token, they could request to assist with light duties in the hospital, as assigned by the medical staff.

There is no time constraint for all this, and everything is on a voluntary basis.

This is the joy of the villagers of Sagam in Siaya County: a fully equipped hospital right in their neighbourhood. The trips to Kisumu and Nairobi for scans, ultrasounds and surgery are now things of the past. Though it is in the heart of the village, Sagam Community Hospital has all the facilities a modern hospital would need.

“The only difference between Sagam Community Hospital and other big hospitals is that here, we pay in kind,” says Felistas, pointing at the goat and maize.

How this modern facility came to this far-flung area is a story only Dr Khama Rogo can tell. The obstetrician-gynaecologist graduated with a degree in Medicine from the University of Nairobi in 1978, and like many young doctors, he had great expectations for his practice. But never in the wildest thoughts did he imagine he would be a “village doctor” as he refers to himself, in jest.

“When I finally settled on the idea of using my profession to help my people, I vowed to give them a one-stop shop. I could not bear the thought of referring patients to other hospitals when I had what it takes to serve them right here,” Rogo says in an interview with Sunday Magazine.

His dream of starting a hospital was hatched many years ago, when, as a boy, he helplessly watched his grandmother kicked out of hospital on the grounds that she was wasting medicine that could otherwise be used on “more promising patients”.

Shortly thereafter, one of his neighbours was neglected in a certain hospital for several days, and when Rogo went to visit him, the frail man only requested to be taken home, where he died after two days.

“Everyone in this area knew me as a doctor, and expected me to be able to address their health issues. Every time one of the villagers was unwell, I would be informed. This day, as I carried my neighbour home, I felt very inadequate,” Rogo recalls, his eyes misting with emotion.

This feeling of helplessness prompted him to start planning how he would bring better health services nearer to the people of Sagam.

STRUCTURE

Before the neighbour died, he had sold Rogo a piece of land, which was where the hospital was built.

“When the opportunity arose and I knew I had enough savings, we teamed up with the community and cleared the bush. In three years, the hospital’s structure was ready and we had already started seeing patients,” says the doctor who stresses that his idea was not to make money, but to save lives.

But even with the health facility in place, there have been numerous challenges to tackle. For instance, Rogo admits he was shocked at the villagers’ scanty knowledge on matters such as HIV and Aids, early pregnancies and contraception.

“This led me to conclude that these people needed to be educated on how to understand their bodies,” he points out, adding that since the inception of the hospital, he has been holding free medical camps and medical outreaches after every three months throughout Siaya County.

GRATIFICATION

The father of four explains that has received a lot of support from his family, although, sometimes, he has to withdraw money from the family accounts to keep the hospital going. Though his wife and children live in the United States, they travel often to Kenya to help run the hospital.

Sagam Community Hospital has 50 workers, with four doctors and six clinical officers. There are 50 beds, and occupancy is always between 80 and 100 per cent.

“My greatest gratification is to see people going about their business in good health,” Rogo says, adding that since the hospital was built by the community, it could not have a better name ‘Sagam Community Hospital’.

And the hospital has not only brought physical health to the village, but other kinds of development as well. For instance, for the facility to function well, there was need for electricity, so the doctor incorporated stakeholders to ensure that every household got electricity and water in the village. And the for the sake of the hospital’s security, the police have also been involved, so that there is a police post in the neighbourhood.

SPECIALIST

Apart from overseeing Sagam Community Hospital’s management and proper running, Rogo is also a health-sector specialist with the World Bank, and former vice president of medical affairs for Ipas, a global non-profit organisation that works to increase women’s ability to exercise their sexual and reproductive rights, and to reduce maternal mortality. He earned a PhD in Public Health from Umea University, Sweden. He is also an authority on reproductive health issues in Africa and a lecturer in various local and international universities.

Sagam Community Hospital hosts doctors from across the world, and offers attachments to younger doctors from various hospitals. At the moment, the hospital is hosting doctors from Havard University, and Rogo hopes to collaborate with the Government of Kenya and Havard University to enhance rural medicine in Kenyan hospitals. Plans are underway for the partnership to establish a medical school in Kenya.

“This will enhance emergency and family medicine in our hospitals,” he says.

The 58-year-old man, who clearly has a soft spot for his rural area, says he likes taking long walks at sunrise and sunset and enjoys watching nature, especially from his Sagam village home. He lauds his family for their great patience and support, especially when his children visit and have to help in the hospital.

His greatest support, he says, comes from his wife, Lucie Rogo, who is “unmatched in generosity”.