Counties blamed as doctors snub cancer training

Medical experts have raises concerns over the few number of Kenyan doctors applying for specialist cancer training.

Currently enrolling the second lot, the fully-paid for two-year course was launched in 2016 as a first step to address the shortage of cancer specialists in Africa.

However, Programme Director Nicholas Abinya of the University of Nairobi (UoN) says uptake has so far been disappointing.

Prof Abinya says while the programme has the capacity to take up to 22 trainees for the two-year period, only five were enrolled for the pioneering group, which graduates next month. The next batch is supposed to be applying.

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“But too few, especially from Kenya and East Africa, are applying for the course,” said Prof Abinya.

He said the programme is open to doctorswith post-graduate degree in internal medicine from all over Africa. These are basically practising doctors at the moment.

However, the number of applicants from Kenya and East Africa generally has been disappointing. For example, in the outgoing group, more than 100 applications had been received from Nigeria alone but only about 10 from Kenya.

“We finally picked on five, with only two from Kenya,” said Prof Abinya who in 2015 surprised Kenyans in a study which showed wearing of a bra could lead to breast cancer.

“This is the best time for doctors in the region to take up specialisation in cancercare,” said Dr Nazik Kamad of Queens University, Canada, and one of the external lecturers to the programme. Others are from South Africa, Egypt and Europe.

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Scarce personnel

One of the reasons for the slow pick up among Kenyans, Prof Abinya says, is reluctance by county governments to release their medical personnel for training.

While in training, it is a requirement that doctors, who are employees of the countygovernments, continue receiving their salaries and other benefits.

The trainees should also be assured of re-absorption into the system once they are through with the training, with guarantees of all earned promotions.

However, counties have been reluctant to release doctors for the training, especially because of already existing shortages.

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“Also because most counties lack specialist cancer facilities they may not see the training as a priority,” said Dr Kamad in an interview at Kenyatta National Hospital.

There have also been proposals for all medical specialists to be put in a national pool from where the expertise would be sourced as required.

In such an eventuality, the countygovernments argue then it would be the responsibility of the national government to pick the full training bill, including payment of salaries.

Kenya Medical Practitioners and Dentists Union Secretary General Ouma Oluga says in some instances, county governments refuse to pay salaries for doctors who go for specialist training or give them release letters.

“When you want to go for further studies, you are required to get a release letter from your employer and salary while on study. This has not been happening. They either refuse to give you the release letter or stop paying your salary,” says Dr Oluga.

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The other problem comes from the national government, which also runs a competing specialist training scholarship programme that prefers to train abroad.

Prof Abinya says many potential trainees may prefer training abroad due to the prestige involved.

The training based at the University of Nairobi is conducted at KNH, Nairobi Hospital, Plaza Imaging and Lancet Kenya Laboratories through a public-private partinership.

While KNH gives the trainees access to a wide range of cancer patients, Prof Abinya says the other institutions have top quality equipment and technologies.

“We have some of the best cancerdiagnostic and pathology equipment found anywhere in the world,” says Dr Ahmed Kalebi of Lancet Laboratories Nairobi, an affiliate of the South African Lancet Group of Laboratories.

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cancerMedical expertsKenyan doctors