Health & Fitness

The ills of lax public health standards enforcement

A nurse attends to a patient at Marti
A nurse attends to a patient at Marti dispensary in Samburu County. PHOTO | ANGELA OKETCH 

The recently launched task force deliberating on Kenya’s universal health care (UHC) way forward has its work cut out. Top of their agenda is sourcing funds for this ambitious project. But after getting the money the problems start.

For one, even the wealthiest nations in the world have not figured out how to balance spiralling medical needs of a longer living population against resources allocated. This amidst our own ballooning lifestyle and non-communicable illnesses.

In their deliberations, the good old adage, “Prevention is better than cure!” must feature. Placing emphasis on a strong public health system as a corner stone is vital for our success. While conventional medicine has undergone evolution from its primitive days of blood-letting amputations and mythical science, it has also come with a troubling rise in healthcare costs. This despite technological advances that should help lower them.

Over time as science and better understanding on disease causation improved, more preventative approaches took place, eclipsed curative ones and gave rise to public health’s golden era. Basics like hand washing, water sanitation hygiene promotion, vaccinations, food handler’s premises inspection just to mention but a few were given prominence. And they worked!

As a gross spending on health services, preventative approaches help the system save what would otherwise be spent on treatment. Public health officers delivered commendable success against some of the most worrisome illnesses and at lesser overall cost.

In the course of time however, we have gradually forgotten the department’s importance. In a recent discussion with a retired public health officer, he shed some light into this situation.

Locally in the 70s and 80s, the public health officer was a figure of authority, held in awe and feared only second to the local chief. His very sight was met with trepidation and entry into one’s premise usually meant trouble for the owners or occupants. The same still applies in developed nations.

Gradually as the number of medics increased, our curative arm gained prominence over the public health arm and less and less weight was placed on their roles. Slowly these officers have been pushed into the periphery of the health providers’ ecosystem, relegated to fringe observers.

This decline was instigated by political interest in appointing people who could play ball in bending public health rules for commercial gain. No longer could such officers’ voices be heard on poor housing, unsafe water and sewerage, dangerous public transport systems, psychologically detrimental entertainment, infectious food catering and poisonous agrochemicals in farm produce.

Rigid public health rules were slowly bent, lost malleability and completely broke down.

Hopefully the Association of Public Health Officers of Kenya, APHOK with support can help public health officers regain lost claws in enforcement of regulations where public health interest is at risk.