In the autumn of 1992, reflecting on a string of unpleasant happenings involving her kingdom ranging from royal family scandals to a lost overseas colony, Queen Elizabeth II of UK paraphrased her secretary’s terms to declare the year annus horribilis (Latin for horrible year).
Viewed through health binoculars, we might want to say the same about 2017 in Kenya.
The 100 days doctors’ strike
We ushered in the year with our doctors having been on the street for nearly a month. As days passed by, the situation worsened with the union leaders being imprisoned in a move that did not help matters, further deepening the labour crises and roping in the private sector. It’s a labour dispute that exposed the soft underbelly of Kenyan healthcare- lack of political good will and commitment.
Regime friendly bloggers maliciously painted doctors in pathetic light on social media and senior politicians fell short of openly declaring that they don’t care about public hospitals as long as the private ones worked. Insincerity from Afya House towards doctors, and between ministry top officials came to the fore during media interviews or parliamentary hearings. By the time the strike was called off, significant mistrust may have been sown and watered between the body of doctors and various healthcare administrators in the national and county governments.
This was a nasty time we all would hope to quickly forget.
‘A government that signs a collective bargaining agreement with its workers must be ready to implement it’, the doctors argued.
‘Never again should Kenyans be held hostage by a clique of elites’, Peter Munya, then council of governors chair, implored in his comments during the signing of the return to work formula.
Whichever side of the divide you subscribe to, no one wants to witness another 100 minutes of doctors’ strike in this country.
But it was the ordinary Kenyan who suffered the most. Him/her that didn’t have health insurance and could not turn up to a public hospital whose wards had been turned into breeding grounds for village hens. He/she that was not on social media and could not start a hashtag appealing for financial support.
To crown it all, the governor of Nyeri county passed on while undergoing treatment in a European public hospital. Back home the public ones still grounded. I just could not absorb that last bit.
No sooner had the medics strike ended than other cadres staged theirs. Notable was the nurses strike outliving the medics’. And in the euphoria of general elections, we activated our insensible selves and dived headlong into the campaigns. Again, health issues became mere sound bites under the political campaign banners and punchlines on our national platform.
Data are stubborn. Outbreaks of cholera and other hygiene related communicable diseases signify a public health system on its knees. It’s the crudest of health indicators.
Cholera outbreaks sprang into the limelight, from high end state, commercial and residential establishments to informal estates, from Nairobi to coast among other scattered scares. Like I have observed previously, four decades after the Alma Ata declaration, we as a country seemed to take a reverse top gear into precomputer health standards.
Later on in the year when we thought we were making headway, Baringo happened; numerous children died from malaria in the central rift county. Here again was a section of the country suffering the wrath of nature in a way reminiscent of the civilizations that predated the discovery of penicillin. Being unable to handle repercussions of a good rainfall. For this section of Kenyans, it may have felt like you either die from the ravages of drought or those of ample rainfall (we are not even talking about floods here).
‘Prof Hassan is Dead!’
‘Today the angels welcome a renowned anatomist, surgeon, trauma scholar and a mentor to many. Death is cruel. RIP Prof Hassan. #Devastated.’
This was my tweet on that afternoon of 29th August, 2017 after receiving the shocking news. I didn’t know what else to say at the moment. The surgical fraternity had lost a ‘giant’, in the words of my undergraduate classmate. The professor of human anatomy and head of University of Nairobi’s Chiromo campus was the definition of humility and mentorship. He mentored so many peers and juniors alike. I was honoured to be assigned him as my mentor during the last two years of my surgical residency at Aga Khan University. And the impact he had on people was reflected during his funeral in Kibera. Attended by who is who in surgery and academia in Kenya. Eulogised by many locally and across the Atlantic and voted posthumously as the ‘surgeon of the year’ during the inaugural Surgical Society of Kenya’s president’s dinner.
‘I mean all that surgical skill, all that knowledge. How does it just go like that?’ My friend Dr Kobe reflected as we walked away from the Muslim cemetery towards the parking.
Two months after prof Hassan’s death, my friend Dr Allan Makokha passed on. It was too hard for me to take. I had met him in 2005 when I joined medical school. I basically took after him, deputising and later succeeding him as the Catholic Students’ Association Choir boss. And a few years later succeeding him in the students committee in charge of grand rounds. Allan served Kenyans in the coast since 2010. He was also a firebrand unionist. I elect not to write more as it will turn emotionally personal. As Dr Bosire wrote, Allan’s death reeked of someone failed by a broken system he had worked so hard to fix. And such is the fragility of life.
This year alone the medical fraternity has lost so many other colleagues from disease, accidents and all. This column is not enough to list them.
The tarmacking doctors
Just recently the secretary general of the doctors’ union told us that there are around 1000 doctors that roam across our country jobless. Without automatic absorption by county or national governments, that number is likely to increase as the current lot of interns finish their terms.
Kenyans are soon coming to terms with the reality that doctors, like most other university graduates, will have to fight out for the few available job opportunities. It is called tarmacking. It is not a sound modus operandi given the horrible doctor to population ratio in our country. But hey, this is the reality on the ground.
Against this back drop, 2017 should end already. One only hopes that 2018 will be better. That we all in our different capacities can learn from the happenings of 2017 and be/do better. Every cloud has a silver lining. Happy new year!