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Virus outbreak opportunity to get serious on essential social services

Monday March 23 2020

Medics test protective gear at Mbagathi

Medics test protective gear at Mbagathi Hospital during the launch of an isolation and treatment centre for the new coronavirus disease -2019, dubbed Covid-19, in Nairobi on March 6. PHOTO | FILE | NATION MEDIA GROUP 

KALTUM GUYO
By KALTUM GUYO
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One thing I have taken out of the Covid-19 outbreak is that life in Kenya is all about perception. When we are told to wash our hands with soap and water again and again, I am left scratching my head and asking where the water will come from for most citizens.

The contradiction between such government advice and daily long queues of plastic jerrycans in front of unreliable water taps left me confused.

Water supply has never been consistent in the villages, let alone urban areas. I hope those giving such advice felt a little squeamish knowing poor Kenyans do not live in villas with spare taps for fountains in their gardens as they do.

WEAKNESSES

Coronavirus has clearly exposed our weaknesses on service delivery and the impact corruption has had on essential services such as water and healthcare. We are turning to water and healthcare now for help with the pandemic, knowing very well we have put little effort in improving both on the ground.

However, this is not the time for head bashing. For once, we need to ask how we can ensure key services and items will be provided without ‘ifs’ and ‘buts’. If ever there was a time to ensure dams and other water reservoirs are built and maintained without money being siphoned off, it is now. Hand sanitisers have proved too costly to most Kenyans.

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The call on water and electricity utilities not to disconnect supplies if people are struggling to pay their bills is commendable. Given the importance of water to public health, it should never have to be disconnected even in normal times. Disconnection should be the last resort, only after all other legal measures have been exhausted.

Customers who struggle to pay bills should be allowed to pay in instalments and those who cannot supported to keep the taps running in homes and industries. The government has a legal duty to ensure the country is water-secure but most citizens are forced to fund their own water supply in desperation, ending up playing into the hands of cartels.

UNIVERSAL HEALTH COVERAGE

With the Covid-19 pandemic our health system, like many others in the world, will be challenged like never before. We are nowhere close to achieving universal health coverage (UHC). Part of the problem has, again, been the runaway corruption that has plagued the sector for eons. Pandemics such as this one expose the myriad challenges in our health sector that we have neglected to deal with or adopted a laissez-faire attitude about — such as medical research, adequate funding and capacity building.

UHC was launched with pomp and fanfare and forms part of the ‘Big Four Agenda’. NHIF was meant to be the main link between the Big Four ideals and hospitals. But it has been plagued with one problem after another.

The policies within it appear not to be cogent or thought through. They keep being chopped and changed, which, in turn, leaves patients even more vulnerable.

Health policies perhaps need to be reviewed and new ones interrogated before they are implemented.

There have been many contradictions, too, since UHC was launched. One is about medical personnel, who are key in driving the healthcare agenda. Ironically, we see counties sacking doctors and nurses when we should even be employing more to meet demand. Nurses seem to be constantly fighting for their salaries, leading to unnecessary strikes.

Patients end up bearing the brunt of the medics’ frustration. Governors and their executives have hardly gone without pay themselves while they fail to ensure key workers crucial to UHC are well remunerated.

CHALLENGES

The challenges in provision of water and better healthcare are not the only ones that threaten our public health. Lack of proper sewerage is another. Better housing for all is also a pressing need. We await to see whether Big Four will become the springboard for better housing policy. Slums, which have expanded, will always pose a big challenge to public health.

The self-isolation, social distancing and handwashing being preached in these coronavirus times will not be easy. That makes Covid-19 an inspiration for the government to put its money where its mouth is. Lip service needs to be replaced by effective policies that get implemented for the benefit of every citizen.

* * *

The proactive response to the coronavirus outbreak by the government is commendable. I hope the transparency shown around the pandemic will be the norm in all areas of governance.

The government has always failed on communicating effectively with the public but it is reassuring to see this change. Ministries may need to consider introducing desks that respond directly to concerns of the public. That is the true meaning of open governance.

With that, I am still waiting for an acknowledgment of, and action to, my email to the DCI and EACC.

Ms Guyo is a legal researcher. [email protected] @kdiguyo

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