Over 1,000 women treated in Kenyan hospitals have come forward to tell of botched operations, high-handed dismissal of complaints and long-lasting trauma in the care of gynaecologists and obstetricians.
These patients are proof of an increase in complaints against obstetrics and gynaecology departments, as compared with other medical professionals.
The latest analysis of complaints received by the Kenya Medical Practitioners and Dentists Council showed that the percentage of cases filed against the practitioners, compared with other departments, is increasing.
The data showed that 26 per cent of all cases reported were made against the practitioners who the highest in number in the country. Kenya is already suffering a specialist deficit with only 2,560 specialists. Obstetric and gynaecologist department has the most specialists in the country at 430.
Mr Michael Onyango, a legal officer at the council, who was speaking last week during the Nairobi Hospital moral injury symposium said of the 1,124 complaints lodged, 291 were made against gynaecologists. “The question we need to ask ourselves is are cases increasing or are people more aware of their rights. The blame cannot be solely put on this group of specialists because there are micro and macro issues in the health sector that result in that," he said.
From the analysis, there are 168 internal medicine related complaints and a further 157 on surgery. Plastic surgeons and haematologists have the least complaints lodged at five and one respectively. Mr Onyango said patients reported cases of malpractice and sued the healthcare practitioners for various reasons.
“They want to ensure other people do not get injured the same way. Patients did not get an adequate explanation of what happened. Others want compensation while some desire accountability and someone to take responsibility for what happened,” he said.
Mr Onyango said most healthcare practitioners denied so-called "errors" took place by pointing out that doctors were not perfect, and the medical field had a lot of "grey areas”. “Other doctors repress the errors, admitting they have probably made mistakes in the past, but claim to be unable to recall any specific situation. Some say, ‘I have never killed anyone in the past which is a tactic’,” he said.
He added that physicians also discounted errors, placing the blame on someone or something else such as bureaucracy at the hospital, the incompetent subordinates, the superiors, or even the patient.
Mr Onyango said as healthcare continued to be commercialised, the doctor-patient relationship continuously became less connected and distant and due to this, patients were more likely to sue the facility than the actual doctors. "There is a global shift from the deny position to a more disclosure oriented approach to medical errors and mistakes. This is something that needs to be tackled," he said.
He added those dissatisfied with any professional service offered, or alleged a breach of standards by a registered or licensed person, may lodge a complaint to the council. “The council, or through a committee appointed for that purpose, may inquire into any complaint of professional misconduct, malpractice or any breach of standards.
"Upon an inquiry held by the council to determine the complaint made under subsection two, the person whose conduct is being inquired into shall be afforded an opportunity of being heard, either in person or through a representative,” said Mr Onyango.
Depending on the severity of the medical errors, the council may issue a caution or reprimand in writing, direct a medical practitioner to undergo remedial training for a period not exceeding 12 months.
They may also direct the medical practitioner to be placed on probation for a period not exceeding six months or suspend, withdraw or cancel the practising licence for a period not exceeding 12 months.
The council could also suspend, withdraw or cancel the licence of a health institution or a section of the health institution for not more than a year. It can also permanently remove the name of a medical practitioner from the registers or impose a fine which the council deems appropriate in the circumstances.
The World Health Organisation states that there are a number of different approaches to classifying medication errors. One approach is to base the classification on the stage such as prescribing, transcribing, dispensing, administration or monitoring.
Another approach is to consider the types of errors occurring, such as wrong medication, dose, frequency, administration route or patient.