Let’s accept Cuban doctors to resuscitate our health system

The Government has hired about 100 Cuban doctors to address the unacceptable doctor-to-patient ratio in Kenya. The target for this partnership is to hire specialists in complex areas of medicine, including ontology, nephrology, dermatology and to build expertise and capacity at grassroots hospitals. A closer reading of healthcare systems in the world justify that Cuba has one of the most advanced and sophisticated systems which other countries need to borrow. The Cuban health system is recognised worldwide for its excellence and its efficiency, particularly in preventive medicine.

Despite extremely limited resources and the dramatic impact caused by the economic sanctions imposed by the United States for more than half a century, Cuba has managed to guarantee access to care for all segments of the population and obtain results similar to those of the most developed nations. However, the decision to hire the doctors has elicited mixed reactions among Kenyans and stiff opposition from the doctor’s union who have faulted the Government’s plans to hire medical workers from Cuba, while thousands are jobless in Kenya. To me it seems the Government has got it right this time round.

In Kenya, the problem is not the thousands of unemployed doctors. The problem is about doctors’ cavalier attitude towards work in public health facilities. While the unions may argue for employment of more local doctors to receive additional union deduction they should acknowledge that their members do not have time for out-patients or in-patients in Kenya's public health facilities. It is common knowledge in Kenya, that doctors in public hospitals will do “ward rounds” in the morning and leave immediately before noon to their private health facilities. The hurry with which doctors attend to patients in public hospitals has resulted into several cases of professional negligence and medical malpractices. The unfortunate happenings at KNH show the kind of neglect poor patients undergo. Even worse is that many public hospital doctors encourage patients to seek assistance in private facilities where they conveniently charge them professional fees.

A Kenyan radiologist employed in a public health facility will examine four or five x-ray images per day and mysteriously disappear to a private facility. A doctor in one of the referral hospitals in western Kenya will stay in his private facility well past mid-night attending to long queue of out-patients, something he cannot do in the public facility where he only makes technical appearance. This means that our doctors value the private facilities more. With this kind of induced healthcare seeking behaviour, the costs of healthcare for the poor shoots up since they do not get required attention. Moreover, there are indications that most of the poor are also illiterate and are taken advantage of by the personnel in health care systems. They end up overpaying for services, taking unnecessary medical tests and because they cannot afford proper healthcare, they never get better.

Any respectable Government worth its salt cannot sit back and watch this unfortunate scenario. As a country, we need a system which can free our own doctors to work full time in their private facilities and allow poor Kenyans the opportunity to receive quality treatment in Government facilities. The attitude has created a notion which privileges private health provision which is unlike Cuba which has made public health system much superior. The rich among can pay an extra amount to have their healthcare needs met appropriately and fast while the poor have no option but to accept whatever care they receive, at whatever time it is availed. As a country, we must focus more on the healthcare demands of the majority of the population. With the kind of attitude, Kenyan health system is one of the most dangerous in the world, with the worst outcomes as measured by child mortality rates and maternal deaths.

Many Kenyan doctors argue that they practice under deplorable conditions, characterised by the failure of the county governments to invest in the public health infrastructure. Specialist doctors in rural areas make do with no equipment and, in most cases, moribund infrastructure such as operation theatres. This may be true, but it does not in any way explain the unfortunate doctor “absenteeism” in public health facilities. We need to broadly look at health related corruption in public healthcare system and how it impacts on provision on healthcare infrastructure in Kenya.