My hope for 2019 is that State will listen to health professionals

Doctors demonstrating outside Milimani Law Courts in Nairobi on January 26, 2017. PHOTO | EVANS HABIL | NATION MEDIA GROUP

What you need to know:

  • Let our socio-economic status not be the deciding factor on whether we live or die when we get sick.

  • I hope that the people of Kenya will rediscover the value of the Kenyan doctor, and make proper use of this scarce resource in order to improve our health status and raise our national wealth.

This year the President launched a pilot scheme for Universal Health Coverage (UHC) as Kenya’s contribution to the global push to make high quality health availability to the vast majority of the people and at costs that will not drive them into poverty. The idea is to try out the scheme in four counties and then roll it out to the rest of the country after applying the lessons learnt. The medical community in this country has over the past decade been pushing for Universal Health Coverage, and we were justifiably excited when the government made health one of the pillars of its agenda for the next five years.

TASK-SHIFTING

Unfortunately we are operating in an environment in which the relationship between the government and Kenyan doctors is poisoned and unhealthy, and it would seem that certain policy makers in government have scores to settle with Kenyan doctors and health workers. A perception has been pushed over the past one year that Kenyan doctors are unqualified and inferior to those trained elsewhere, and this was solidified by the importation of doctors from Cuba. These “doctors”, whose qualifications remain shrouded in mystery, have been presented as specialists and posted to public hospitals around the country.

Other decisions that are either in the pipeline or have already been made include the replacement of medical experts with paraprofessionals who are being allocated tasks that have traditionally been considered to be beyond their job description or competence in a phenomenon known as ‘task-shifting’. This involves having highly trained health personnel expose paraprofessionals and other health workers with different job descriptions to short trainings after which the job is shifted to those other cadres.

SCARCE RESOURCE

While it is impossible to objectively investigate the efficacy of such a decision, “experts” have been rolled out to claim that this shifting of jobs works and might even have better outcomes than using the actual professionals for the job! All this is being done in the background of recent research that has shown that in the era of UHC many more people are dying from poor quality treatment than from lack of access to care.

One day the story of the kinds of risks Kenyans have been exposed to by these government decisions will be told. When this happens, let history record that the Kenyan medical fraternity rejected that notion that poor people should receive poor quality healthcare while their wealthier fellow citizens benefit from cutting-edge evidence-based medicine. The same doctors being dismissed as incompetent and unethical are highly sought after by the rich, and in fact there are moves to try and control private practitioner fees in order to make private health facilities even more attractive to the wealthy than public facilities!

My hope for 2019 is that the government, all arms of it, will begin to listen to the professionals and only make decisions that are in the best interests of the people of this great republic. Let our socio-economic status not be the deciding factor on whether we live or die when we get sick. I hope that the people of Kenya will rediscover the value of the Kenyan doctor, and make proper use of this scarce resource in order to improve our health status and raise our national wealth.

Atwoli is Associate Professor of Psychiatry and Dean, Moi University School of Medicine; [email protected]