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A day in a Kenyan public hospital

Even as the internet and the so called KOT (Kenyans on twitter) team tries to destroy and tarnish the name of the Kenyan doctor with bizarre campaigns as #iwafikiemadaktari, the Kenyan doctor continues to struggle in trying to make work a neglected system.

The campaign led by the consumers association of Kenya, or whatever they call themselves, paints the Kenyan doctor as greedy and out to get money and get rich at the expense of the health and well-being of their patients in the public hospitals. KOT go ahead and accuse doctors of focusing their efforts and time on private hospitals. This might all be true: but the real puzzle is not whether or not it is true, what we need to be asking each other is why this is happening.

First and foremost, it is important that we all understand the fact that Kenya is a capitalist country where everyone is out to make as much money as possible as fast as possible. We are living in a country where the cost of living rises day and night while our salaries remain exactly the same. You cannot expect doctors to remain poor depending only on government salaries in mediocre working conditions when they can work in a far more sophisticated private hospital and get paid an amount equal to the work they’ve done.

We are in a country where a receptionist, with an education level that can only be described as basic, is a millionaire flying around town in private choppers, while a professor of medicine is stuck in traffic on Ngong road on their way to KNH for a ward round, in a vehicle as old as himself. A vehicle whose maintenance is rapidly getting out of hand due to the high cost of fuel despite the country having struck oil. With a basic salary of 200,000 he is supposed to raise a family, educate his children, who looking at their father now think education is overrated, and still attend village harambees and contribute as big as his name is “daktari”.

Typical public hospital equipment in Kenya

Arriving late for work, angry patients blame him and label him lazy and claim that he was attending to patients in private hospitals. They ignore the fact that the money that is supposed to be used to transport their doctor to work in good time is being used to acquire luxury homes and choppers for cleaners at NHIF.

On a typical day a consultant gets to the ward at around 9.00AM and patients, junior doctors, students, nurses and relatives are all waiting for him, the single surgeon at the hospital, since the county “doesn’t have the money” to employ more than one. Typically, during the round, every patient is given enough time, thorough discussion around each case and every patient is given full attention one at a time- he/she is a well-trained and highly experienced doctor anyway. However other than the right diagnosis and perfect plan, do you think the 200 patients occupying 100 beds were actually treated?https://www.nation.co.ke/news/kenya-public-hospitals-horror-doctors-strike/1056-3787936-yuk53n/index.html

Mothers rest with their newborn babies at

More than half of the in patients are those that have been seen by the same doctor for weeks now. He knows them by name, he knows their diagnoses and their treatment plan right at his finger tips but he can not help them. Questions like, “Victor, have your relatives donated blood? Michael, have you bought the nail for fixing your leg? Jane did you get a CT scan? We cannot operate without it! And the answer is almost always ‘NO’ And to the nurses and junior doctors: Do we have culture results for this patient yet? Have the results for the TB test come back? And to those, our good doctor gets answers as no the lab staff are on strike, or no the lab says there are no reagents and my personal favorite the laboratory staff misplaced the results so we will repeat today.

Don’t even get me started on lack of drugs, lack of catheters lack of sample bottles and all other sorts of excuses. Bizarre statements like the BP machine was being used in the pediatric ward so we don’t have any BP readings for surgical ward today. So, at the end of the round, having attended to 200 patients only two or three get treated. The rest we wait. We wait for drugs, we wait for the CT machine to be fixed, we wait for your relatives to donate blood, or we wait for the harambee happening in your village to raise theatre fee. Meanwhile let us keep out already wasting away patient on the “very nutritious” hospital diet and IV fluids if they can afford.

For the lucky patients going to theatre tomorrow, lets cross our fingers and pray to God that there will be water in the theatre, there will be electricity, and the equipment will have been autoclaved and ready for use. Let us also pray that Nurses don’t go on strike in the overnight and nothing comes in the way of our one and only surgeon reporting to hospital tomorrow.

My point is, doctors don’t go to private hospitals just because there is better pay. Why would a doctor waste his entire day in a smelly public hospital ward waiting for the government to realize that it takes more than just a doctor for a hospital to run? Why not rather spend the day in a conducive environment in a nearby private hospital or personal clinic and ask to be called when his primary employer is in a position to be served.

Yes, doctors work both private and public hospitals and yes 10 out of 10 doctors prefer working in a modernized, well organized, smooth flowing hospital, which in our case happens to be the private sector. They are only human.

The Kenyan consumers and their government need to borrow a leaf from other countries that actually care about their citizens and improve public hospitals. But as long as leaders and the rich in society continue to take advantage by building more private hospitals and making them world-class perfect, as long as public money ends up in the pockets of greedy individuals, there will be no progress for the public health sector. Mothers will still die during birth, cancers will go undiagnosed and untreated until its too late and more Kenyans will hate the public sector.

Then to add insult, opinion shapers will be paid to make it look like it’s the doctors’ fault that the system is failing then use that as the basis for defrauding more and more of public funds in the name of Cuban doctors and other misguided priorities.

 

 

by Nyadimu Festo

Nyadimu Festo

Medical student at Maseno university, with a passion for medicine, service and leadership. founder and CEO of theDoctor.co.ke. (by a doctor for the doctors)

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