Healthcare: Patients pay the price as counties and doctors play blame game

On the morning of August 14 this year Evans Ayodo rushed his cousin, Bernard Odhiambo, to a local hospital in Nairobi.

The clinical officer on duty gave them a cursory glance and continued to type away at her mobile phone. Her colleagues also offered no help claiming, that the hospital did not admit patients during weekends.

Ayodo pleaded with the officer who was seated at the reception to attend to the ‘emergency case’ but she was indifferent and “about 53 minutes later”, Odhiambo died in the cold hospital waiting bay.

Other patients and their relatives at the waiting bay had seen the events unfold and were now baying for the medical officer’s blood.

Sensing that things would get out of hand she made a call to the medical superintendent and a security officer was directed to confiscate the mobile phone that Ayodo had been using to take photos.

But Ayodo had already uploaded some images of the medical officer on an online vault, which he later posted on social media, alongside an extended narration of the incident.

Readers condemned the treatment from officers whose professional code of ethics requires them to do all within their ability to preserve human life.

As depressing as the above incident is, even more saddening is the fact that people like Odhiambo succumb to their illnesses or injuries countrywide in front of medics who appear to lack even a bit of humanity.

Kenyans have been decrying the conduct. But the Kenya Medical Practitioners and Dentists Board (KMPDB), the medics personnel regulator whose mission it proclaims is to “ensure the provision of quality and ethical healthcare”, has on several occasions been on the spot for not being strict on the enforcement of work ethics despite the numerous complaints launched by patients.

To date, only one doctor has had his licence revoked by the KMPDB since it was formed in 1997.

Dr William Omondi Oduor’s permit was revoked after he operated on a pregnant woman in Mwingi, Makueni County while drunk, resulting in the death of both mother and child.

Critcs have argued that the KMPDB laxity, has emboldened health workers to throw ethics outside the window and treat destitute patients as they will.

A fortnight ago State House hosted a Health Summit to discuss the achievements and challenges in the sector. The meeting brought together health practitioners, policy makers and other stakeholders under one roof.

When the issue of bad attitude and lack of adherence to basic ethical code was brought up, there was blame game to go around.

Health practitioners pointed the accusing finger towards the national and county government.

Dr Ouma Oluga, Kenya Medical Practitioners, Pharmacists and Dentists Union secretary-general said the biggest problem is the management of human resource.

“When doctors are feeling harassed and under-paid how do you expect them to give the public their best?” He posed.

“Doctors are moving from the public health sector to private practice or going to work in other countries because the system has made the sector inhabitable,” he said.

Seth Panyako, secretary-general for Kenya Nurses Union said: “Staff welfare cannot be taken lightly. There are many factors that must be approached and resolved at good manner.

For instance, Nandi, Nairobi and Kakamega are the most inhabitable counties for health officers, they are always on strike or threatening to down their tools. Why don’t these counties move in to address the issues on ground once and for all?”

READ: Devolved healthcare turns sour as doctors quit service

He added that the national and county governments, being aware of the disparity in salaries between county health workers and those employed by other organs of government need to harmonise worker’s pays to ensure that the sector is run uninterrupted.

“As much as we are talking about how health officials are neglecting their duties let us also move in to solve health workers issues,” he said.

However, these explanations by the medics regulator and the nurses’ union are not new and when they have been given before, critics have argued that it does not cost a penny to treat a fellow human being, much less one who is suffering, with dignity.

In this debacle the national government has come out as being aloof. During the summit Health Ministry Cabinet Secretary Cleopa Mailu announced that the government had invested Sh98.3 billion in specialised equipment in hospitals and free healthcare services, including free maternity services, in health centres and dispensaries.

Delegates however said that it would be a complete waste to spend billions of shillings to purchase equipment if doctors, nurses and other health workers were not willing to attend to patients.

Kisumu Governor and County chair of Health Committee, Jack Ranguma, denied allegations that the devolved units were mismanaging the health dockets saying the staff challenges were only ‘teething problems’.

Amid the never-ending health workers strikes in the counties, there has been a clarion call for the return of county healthcare management to the central government. County chiefs have resisted such move.

“ We are still in early period of devolution and there is disconnect between the governors and health workers but this should be addressed,” Ranguma said.

But as counties try to overcome their ‘teething problems’, the central government takes an ‘onlooker’ position and practitioners blame everyone else, but themselves for their ethics shortcomings, a recent report by Twaweza, a citizen-c entered initiative, shows that three out of four Kenyans rely on public health centres, meaning most people do not have alternatives.

The report showed that 92 per cent of Kenyans visit the centres knowing well that they will get sub-standard treatment.

“Nearly half of Kenyans forthrightly stating that the country’s healthcare system has major problems, coupled with the fact that insurance cover remains elusive to 70 per cent of citizens,” said the report.

Further, it added that both the national and county governments are now under immense pressure to address the underlying issues of service provision in the crucial sector to overcome this negative reality.

Three years into devolved governance, the outcomes have been mixed: more points of access for health services have been opened up, and county health referral facilities have been refurbished.

On the other hand, we continue to observe tension and dissatisfaction among both healthcare service providers and consumers, the report said.

However in this lose-lose situation consumers are the greatest losers, sometimes paying the price with their lives, like the case of Odhiambo.