Anything, but two hours a day is on lowest side Mr President

The Nation health writer Verah Okeyo fact-checks President Uhuru Kenyatta’s statement at the governors’ conference in Naivasha that doctors in public hospitals only work for two hours a day. 

President Kenyatta: "They work for two hours in government hospitals…some of these doctors are still practicing in their private clinics, there is no fairness in that".

There is a gaping chasm between how public hospitals operate and how the governors and the president talk about them.

On February 2, 2017, at the height of the doctors’ strike, Council of Governors Chairman Peter Munya said: “Since devolution started, we have increased supervision and so the doctors do not have time to run their private clinics but we do want them to be remunerated fairly.”

At this very presser, Kisumu Governor Jack Ranguma said that devolution has “changed healthcare tremendously”.

2 HOURS

To the question of what informed his statement, Mr Ranguma blurted “statistics, the numbers do not lie”.

Which ones, he said, the demographic survey, a document whose data was collected before health was devolved.

Be that as it may, county governments may have stemmed the elitist attitude of medics in county facilities.

As to whether doctors work for two hours, the answer lies in the life of Senior Surgeon Elly Nyaim-Opot at KNH, master’s students under his supervision, otherwise called registrars or residents, and interns.

3 GROUPS

These three groups of health workers just make one portion of the ecosystems—like procurement of drugs, the management of the casualty area, delivery and many more—in any hospital, be it public or private.

Dr Nyaim, a lecturer at University of Nairobi’s medical school, is in charge of medical training curriculum at the Kenya Medical Practitioners and Dentists Board (KMPBD) and a former chair of the Kenya Medical Association.

He has attained a level in his career where he has the luxury of reporting to KNH for just specific days and for a number of hours; when he has surgeries, he can stay in the hospital from morning to around 6pm.

The master’s students and interns under his care cannot do the same.

The registrars, he says, do 90 per cent of the surgical and emergency work in the hospital.

EMERGENCIES

Registrars can be recalled at night for emergencies.

They are also medically trained to handle virtually most cases, and when stuck, they call Dr Nyaim.

Under the registrars are medical officers— just recently finished their internship— whose work cannot be less than 12 hours a day or more depending on which department they are attached to.

“The paediatric and maternity wing need constant supervision for 24 hours,” Dr Nyaim said.

Under the medical officers are interns, the first line soldiers and the ‘donkeys’ of public hospitals.

13 HOURS

“A normal intern works for at least 13 hours a day because they receive patients, stabilise them in readiness for the intervention of the medical officers above them”

They could get to run their own clinics except doctors cannot just set up their clinics.

Before Dr Nyaim attained his licence to run his clinic, and other administrative duties, there was a criterion.

The Nation obtained documents from the board on getting licence for a part-time clinic.

AFTER HOURS

Ladnan Hospital’s Dr Abdi Mohammed, for instance, had to surmount the challenge of capital before he was granted the licence to run a full-time general practice hospital.

Additionally, he had to have practised for a year.

Were it a part-time facility, he would have been required to get a letter of approval from his employer and statement of time schedule binding him to operate the hospital only after work hours.

Dr Nyaim, now an official at the board, says defying these work hours could lead to disciplinary action by the board.

VERDICT

Dr John Ong’ech, who runs a gynaecology specialist hospital, needed all of the above as well as a specialist recognition from the board.

He was also required to have practised for at least two years.

So, are doctors really working for two hours a day in public hospitals as Mr Kenyatta and governors claim?

If I may borrow Mr Ranguma's words, numbers don't lie.

Even if you factored in the extreme cases of medics who do not complete their shifts, two hours on average on the lowest side.