Our health system is hurtling towards an iceberg

Kenyatta National Hospital in Nairobi. Several patients have complained about the incompetence of health workers at the hospital. PHOTO | FILE | NATION MEDIA GROUP

What you need to know:

  • I see a workforce 90 per cent of which is completely burnt out, according to a report by a team of mental health workers in Nairobi.
  • At the bottom of the iceberg, the largest, heaviest segment of this floating chunk of ice, is a totally broken down national health system.

At 11.40pm on April 14, 1912, a lookout on a luxury liner on its maiden voyage from Southampton to New York spotted an iceberg right ahead of the ship and alerted the bridge.

Despite the First Officer’s best efforts to steer the vessel around the iceberg, it was too late, and the RMS Titanic struck the iceberg and rapidly took on water, sinking completely within two hours and 40 minutes.

The Titanic had been built to be the largest, most comfortable, most luxurious passenger ship ever, and the state of technology at the time was such that ships of that size were considered unsinkable even if they hit icebergs.

In fact, many ships had had close encounters with icebergs and managed to continue with their voyages onto their destinations.

Despite all these assurances, and due to a confluence of numerous unfortunate factors, the Titanic sank with the loss of thousands of lives.

ECONOMY
Today, Kenya is cruising in the global economic environment, and growth data continues to remain on the positive side, much better than comparable economies.

Despite concerns about rising national debt, the national government continues to reassure the public that the economy is stable and the massive infrastructure projects will inject much-needed income into the national purse.

Like the architects of the Titanic, government mandarins assure us that the Kenyan economy is unsinkable.

Similarly, like Frederick Fleet perched atop the Titanic’s lookout post, I would like to alert the crew of our Titanic of an impending collision with a massive iceberg.

Let me paint you, dear passenger in our Titanic, a picture of the iceberg we are facing.

KNH
At its tip, I see patient mismanagement at the Kenyatta National Hospital (KNH).

I see patients being switched and one having a hole drilled in his skull to evacuate a non-existent blood clot while the one needing the service suffers in the ward.

I see a patient complaining that a surgeon who opened her abdomen to retrieve her distressed baby also nicked a section of her gut, resulting in complications.

I see social media reports that nursing mothers are being sexually molested in the corridors of our first national teaching and referral hospital.

I see reports of long waiting times for care to be provided, and a lot of dissatisfaction with services at the hospital.

HEALTH WORKERS
Going lower, just below the tip of the iceberg, I see a bigger segment made up of a Kenyan population increasingly hostile to health workers due to widespread dissatisfaction with the quality of service delivery, and numerous reports of unfavourable outcomes of health worker-client interactions across the country.

I see lots of avoidable deaths and suffering among Kenyans, justifying both their sense of hopelessness, and their hostility towards health workers.

The problem is thus bigger than the goings-on at KNH.

Further down towards the larger bottom segment of the iceberg, I see a completely demoralised and disgruntled health workforce.

OVERWHELMED

I see a small health workforce that is poorly distributed, and therefore mostly overworked and underappreciated, continuously expected to produce more with less.

I see health workers struggling to meet the cost of living, even as they juggle their busy work life and demanding family commitments.

I see a workforce 90 per cent of which is completely burnt out, according to a report by a team of mental health workers in Nairobi.

At the bottom of the iceberg, the largest, heaviest segment of this floating chunk of ice, is a totally broken down national health system.

At this level I see people with the same ailment getting wildly varying outcomes, including death or survival, based on their location and socio-economic status.

UNIVERSAL HEALTH COVERAGE

I see inadequate financing for health at all levels, inadequate supply of essential medicines, inadequate use of evidence in policy-making, an inadequate and inequitably distributed health workforce, all these occasioned by poor governance and resulting in poor service delivery.

Fellow travellers, I see this frightening iceberg right in front of our unsinkable Titanic.

Is it too late to navigate around it and complete our journey towards Universal Health Coverage? Only time, and the skill of the Captain, will tell.