Universal healthcare must be the primary social objective of any society

Last month in Nakuru and Baringo counties, a disease struck and killed more than 30 people.

This unusually high mortality rate was chalked down to a medical misdiagnosis by the medical staff involved.

Doctor’s jobs is to save lives. Such a costly failure that accelerated, rather than ameliorated suffering cannot be taken lightly.

Lax professional standards are tolerable in other spheres, but in medicine, mistakes are lethal. Correct diagnosis and administration of the right drugs often is the difference between life and an early death.

In any other country, doctors’ misdiagnosis that killed more than 30 children would have the public baying for blood, commissions of inquiry set up, and at the very least, a resignation by the minister in charge.

I find it hard to condemn officials for this latest debacle though. It isn’t the doctors who failed, it is society that failed our doctors. In Kenya, our health service is flat lining. Newspaper headlines constantly scream of woe in the sector.

Patients die in ambulances waiting to be checked into hospital. Children are stolen in maternity wards and replaced with dead ones. We have annual strikes by medical staff that endanger life and lead to cancelling of operations and plunge our country into suffering. Cancer machines break down. Some of the doctors employed by our public hospitals are truants, preferring to tend to their own clinics. They also do not want to be transferred to small towns as it reduces their opportunities to coin it in their clinics.

Now medical staff incompetence at diagnosis kills 39.

We have a country where the government spends more on the NYS than curative and preventative health service. We are increasing the bed capacity of the National Youth Service to a ludicrous number while neglecting the bed capacity of our maternity wards.

DONOR FUNDING

The government, while increasing funding to the healthcare sector, does not take into account inflation or population growth.

It seems infallible like papal doctrine that the needs of the military, the intelligence service and most troublingly, the NYS should come before that of the health service. This policy on spending more on security than healthcare is madness. All of us will need a doctor when we get sick, not a soldier, so soldiers shouldn’t come first.

Our funding to health is a fifth of what is recommended by the Abuja Declaration, which we are signatories to. This year, healthcare received the lowest funding in five years. Obviously, the share of the pie going to health is shrinking.

I should mention that the number of people living below the breadline has gone up since 2003, the number of children facing malnutrition is up and we face the real possibility of a stunted generation.

We aren’t doing enough. We are putting too little money into the healthcare system and the government has left too large a chunk of the disease tab to be picked up by our Scandinavian benefactors.

Our healthcare strategy shouldn’t depend on the kindness of the Bill and Melinda Gates foundation.

We are proud that the Kenya Revenue Authority has reduced our need for donors, but why is it that in public health we still need Dollars, Pounds and Euros rather than the Kenyan Shilling?

Meanwhile the sheer scale of waste by the National Hospital Insurance Fund beggars belief. Forty per cent of the National Health Insurance Fund contribution is wasted shuffling paper, rather than providing health services. What national insurance provider can get away with spending two fifths of contributions on administration and then in the same breath claim that it is running out of money?

The pharmaceutical procurement system in the Ministry of health makes the security service supply department look competent and scrupulous. The robbery is both pervasive and brazen. Drugs imported through the Kilindini harbour cost three times more in Mombasa than they do in Kisumu, a thousand kilometres away.

Medicine seems like one problem we still can throw money at to help alleviate the burden. I read recently in Tim Jackson’s Prosperity without Growth that an organised health care system can be achieved at relative low cost. Cuba, with a tenth of the income per person of the United States, managed to have better health outcomes for its citizens than her northern neighbour.

Closer home, we have a country to benchmark against to see if our health service is the best we can receive for the amount we spend.

Rwanda manages to spend less per head on health yet they end up better off.

According to the Population Reference Bureau, Rwanda has higher life expectancy compared to Kenya, their children are more likely to make it to the age of five, and their women are less likely to die in the maternity ward.

EXTRAVAGANT INDUSTRY

All the while, the WHO says that Rwanda has a bigger alcohol problem than we do. The average Rwandan drinks twice as much alcohol as the average Kenyan, and a larger percentage of their population drinks compared to our country. So they drink us under the table and yet live longer while spending less on healthcare. Why do they get more value for their money?

Our maternal mortality has not improved in a quarter century, according to the latest Demographic and Health Survey. A 2012 report found that more than a million Kenyans are pushed below the poverty line by medical expenses.

The healthcare service is regressive, and the poor bear the burden of disease most acutely.

To beat the queues in government clinics, you must pay out of your pocket. Privately sourced medicine meanwhile is too expensive. The cost of one day’s occupancy of an ICU bed is two years median salary at one private hospital. At those rates, even the few with healthcare insurance and terminal illness will be driven to penury.

Healthcare remains an extravagant industry because it is built on fears around our mortality, and a government that is inherently wasteful. Our mishmash system dependent on donors and out of pocket payments will always deliver terrible results.

Through this waste and incompetence in the system, we could, if we get our act together, healthcare coverage to all Kenyans.

Universal healthcare must be the primary social objective of any society. It makes economic sense. Is there any better way to raise labour productivity than ensuring people live longer?

You may think that Kenya does not have enough money to provide us all with the best healthcare possible. We should make money first then give everyone free healthcare. Well, Rwanda has Universal Health Cover and it is a poorer country than ours. Rather than borrowing their idea for laptops for schools, let us borrow their ideas concerning tablets. Medicinal tablets.

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BAD ADDICTION

Sport betting isn’t as bad as the lotto

A lot of the condemnation of sports gambling is misplaced. The gambling platforms that deserve your anger and opprobrium are the ones without a clear criteria of picking a winner.

The pay-outs from sports betting are more frequent and straightforward. If your team wins, you get paid. The expectation of a payout is a lot greater. In an SMS-based lottery, who knows what algorithms they use to pick winners?

If you must bet, and really you mustn’t, betting on a sport with known possible outcomes is a lot better. Gambling on the lotto is madness. Who knows which numbers will pop out?

All betting is bad, however, some are worse than others. Sports betting is less bad than these SMS-based campaigns.

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AQUATIC ANIMALS

Hasn’t the human race always lived next to rivers?

On Social media, much was made of a supermarket that had flooded - the fact that it had been built next to a river was used to convict the owners of engaging in poor building practices and encroachment.

Hasn’t the human race always lived next to rivers? Doesn’t the story of civilisation begin at Uruk on the banks of the River Euphrates? Didn’t we follow rivers and settle next to them? Didn’t we worship them for their life-giving qualities? The Indus valley, the Nile River valley and the Danube River are where our number thrived. The annual floods from the Himalayas support more than a third of humanity.

 We had a few floods every so often to deal with, but the benefits outweighed getting water up to your knees.

Also, isn’t Nairobi mainly swampland that we settled on? Isn’t a third of the Netherlands reclaimed from the sea? Don’t they constantly have to pump water out to keep things dry? If the flood gates fail and it floods, should the Dutch give up and move to higher ground?

Doesn’t China divert whole lakes and rivers to water their parched North? Doesn’t the South-North Water diversion in China rank as an architectural marvel? The need to support such a large population compels us to disregard geography and rebuild the natural world as it would suit us.

We are forced to be stewards of Mother Nature. If we made way for flood waters when they rose, we wouldn’t succeed as a species. We sometimes need to dam rivers, and we still need to build alongside them. Our goal should be to see how our aspirations can exist alongside nature, not become Earth worshippers the moment your slipper gets wet.

It is okay to build next to rivers. Just get an Environmental Impact Assessment clearing to do so.