There are two kinds of Kenyans. Those who can afford private health care, and those who cannot. The former include the striking doctors, many who work at private clinics even when they are on strike; the county and national government officials negotiating with them; their mediators; and the judges. They all say that their primary concern is the welfare of poorer Kenyans – they also have a bridge to sell you if you are buying.
I was at a private hospital in Nairobi last week. My cousin had a Caesarean section and my daughter was unwell. The doctor charged Sh300,000 for the Caesarean section. This figure was minus the hospital bill, which included Sh8,000 per day in nursery fees for the baby without a single complication for mother or child.
A young doctor attended to my daughter. I asked what she felt caring for my child who could pay, but not the patients who cannot dream of being treated in a private hospital. She told me she hated it. A good person by what I could see, and there are plenty. Yet, I felt disgust at the striking doctors’ pose of moral uprightness. And disgust at the perverse incentives that undermine the rights and interests of patients in public or private care. We have many dedicated doctors who work very hard to save lives. But we all know another dark reality. Holding Kenyans to ransom for almost three months as a bargaining chip is not new.
Hospitals detain patients who cannot pay their bills. Some spend months in wards. Is this even legal? Patients, who are too poor to pay for health care, are too poor to hire lawyers. The only reaction by activists, lawyers, policemen, Members of Parliament, and prosecutors is to send an M-Pesa contribution to pay the bill. Kenyans bargain in tears for the bodies of their dead relatives so they can bury them. Have you been on a harambee committee for a dead relative’s hospital bill? You send a representative to go through the bill item by item. You find, always, double billing, and extra items that were never used.
We have cried from unnecessary and dangerous surgeries, the draining of every available insurance and harambee cent. A friend’s mother passed on from renal failure that led to multiple organ failure. The doctors kept piling on new diagnoses and treatments, all for the money, as we eventually discovered.
Then there is the Intensive Care Unit. We know of terminal patients being put in the ICU by doctors to accumulate bills.
There are surgeons who will keep treating you when they should send you to a regular physician, and vice versa. Doctors work as few hours as possible in the public service because they are allowed to run private clinics. The striking doctors keep talking of their low number compared to the population. They had better include their own absenteeism. I know many good doctors who do their best in bad conditions for their patients. I hope they are not thinking that this strike is some sort of extension of their moral posture. It is a travesty; a game between alternate wings of uncaring, self-segregating elites. Nurses and clinical officers keep hospitals open. They work hard, and we thank them. But public hospitals need doctors. Please, county and national governments, pay so our people do not suffer any further. Then, Cabinet Secretary Henry Rotich, raise that amount from taxes on private clinics and hospitals.
Parliament should pass a patients’ Bill of Rights that provides transparency, recourse and stiff criminal penalties for doctor and hospital malpractice. Whoever regulates the sector should eliminate the incentives that favour private over public care, and allow doctors to hold onto patients for personal gain. Equally, senior policymakers in public health should not get private care: if you lead it, you should use it.
Education officials, too, should not tell us about curriculum changes when their children are learning under the British system.
Doctors, please spare us the moralising. Just earn your money. Even better, register your union as a political party. That is what you remind me of – preaching good while practising cruelty and lying.
Lancy Dalton Kuchilo works in security.