Doctors can only watch as hapless patients die

What you need to know:

  • Citizens do not know what is good healthcare; death is treated as amri ya Mungu (an order by God).

  • The middle class is too comfortable with company-provided medical insurance to know the truth.
  • God forbid, if you get an accident as you drive home one day and your unconscious body is dropped off in the next district hospital by well-wishers.

  • God forbid if you ever need three minutes of specialised care to save your children from being orphans.

  • Your card will not help you.

I am a doctor working in Tana River. There are 12 of us three pharmacists, eight medical officers and one dentist to serve a whole county with 57 health facilities, including two 24-hour Level 4 hospitals.

I am among the oldest, 29 years. Very few doctors are willing to work here due to the disadvantage of low development and general harsh conditions. The few who are here are restless. It will not be long before they find better options. There has never been a surgeon, paediatrician, gynaecologist, clinical pharmacist or any form of specialised doctor in Tana River. Never. There is no hope for any. Those released from the county for specialisation choose to pay off the bonding months so that they practice in Nairobi or abroad.

The county can not handle any type of surgery other than simple tissue and straightforward caesarean sections. Any other complication requiring any sort of specialised care is swiftly referred to Malindi, Kilifi or the Coast General hospitals, which are three, five and eight hours away respectively. Even here, there is hardly any specialist. Patients are referred as a show of concern, but deep inside, doctors know that almost nothing will be done, even after the gruesome trip in the poorly ventilated pick-ups turned into ambulances.

NOT ABLE

For the five years I have worked here, I have "superintended" more deaths than those that have happened during the strike. Whether on duty or not, doctors are not able to save lives as they should.

A few days ago, I again "superintended" an 11-year-old girl panting her way to death. She lay face up, dry mouth open, chest moving strenuously. Her mother, sitting on her bedside, was softly crying, holding her daughter’s hand from 7am to 1pm. This child needed renal dialysis among other services. She had lost kidney function due to volume depletion caused by massive diarrhoea. She arrived at our health facility on a boda-boda, too late and too dehydrated, her home being five hours away from a doctor. Not even extensive dehydration could save her. Her father, in a white Kanzu, was by his daughter’s deathbed, fumbling with prayer beads, his eyes full of terror. He comforted his wife, saying that ‘ni amri ya Mungu’ (it is God’s will). The girl’s teenage brother was outside the ward, crying, making frantic calls to people who seemed as helpless.

GENERAL SURGEONS

There are no more than two general surgeons serving Tana River, Kilifi, Lamu, Mombasa, Kwale and Taveta counties. This means that citizens living in these counties are killed by simple boda-boda head injuries and normal physiological processes like pregnancy.

Death is painful to anyone, even the poor. It is worse when you know that as a country, we can afford to prevent these deaths. It is heart-wrenching when it happens under your watch, daily, for years on. Doctors can not take this anymore.

To make sure that life is protected, every county – however underdeveloped – needs doctors. A country deep into wastage can afford to attract and retain all specialties for every county. We can train the specialists we need. A country that can afford to make an impromptu, non-budgeted for Sh1 billion bail-out for miraa (khat) farmers can afford to make healthcare accessible to every citizen.

The government says that there are 97 referral hospitals in Kenya, with two in Tana River. As the young girl passed on recently, the dialysis machines that the President commissioned in the Hola Referral Hospital were still intact in their boxes. The rooms never been opened since the President left because there are no specialists to run the machines. The buildings meant to house the machines in the second referral hospital in Garsen are yet to be roofed.

FOREIGN COUNTRIES

As citizens die on a daily basis, government officials get treated in foreign countries. Why don’t we train, equip, employ and retain our own doctors? Why don’t we improve the healthcare of our country when we can afford to?

Our leaders go abroad for treatment, so whether local hospitals serve as deathbeds or not does not bother many of them. If doctors went to strike two hours a day as suggested by one opinion piece, Jesus would come before our leaders even notice.

Citizens do not know what is good healthcare; death is treated as amri ya Mungu (God's command). The middle class is too comfortable with company-provided medical insurance to know the truth.

God forbid, if you get an accident as you drive home one day and your unconscious body is dropped off in the next district hospital by well-wishers. God forbid if you ever need three minutes of specialised care to save your children from being orphans. Your card will not help you. This is what happens to Kenyans daily.

The doctors have managed to make the government sign a commitment to improved healthcare. This document is the collective bargaining agreement.

Mwende Nicholas is a doctor in Tana River.