Friday, 28 September 2012

There is only One Justified Vacancy in the Medical Services Ministry

Josef Rudolf Mengele was a German SS officer and a physician in the Nazi concentration camp, called Auschwitz.  He was notoriously and ultimately responsible for the deaths of thousands if not hundreds of thousands of victims, and was famed for his human experiments, especially on children. Such experiments earned him the nick-name, “The Angel of Death”.
Mengele’s work, approach to anti-Semitism, and his overall role and duties at Auschwitz gave him the distinction in medical history of being known as both a monster and the father of systematic medical genocide. Indeed his very name was added to the English language to mean to maim, mutilate, and disfigure. To be mangled is a state that depicts an utter ripping apart of oneself.
Yet Mengele, was a medical officer. In his field, he distinguished himself, albeit with horrors, nevertheless, he was a qualified medical practitioner. In fact, Mengele was a decorated officer, having saved the lives of 3 German soldiers.  For all his failings, Mengele’s contribution to the medical field did bring a new perspective to scientific research. Mengele’s work with twins especially, is quite astonishing.
In this concentration camp of a medical sector in Kenya what indeed can we say our own Mangler of Medical services is worthy of noting? What indeed is Professor Peter Anyang Nyong’o worthy off, in the medical field? Let’s applaud the one person responsible for maiming and mutilating the health sector single handedly.
You see dear Kenyans, this doctors’ strike, which, surprisingly receives very little media attention, is the death knell for the health sector as we used to know it. There must come a time, when mediocrity is unacceptable in entirety. It’s no secret that public health facilities are in dire need of refurbishment, that we need even more doctors, nurses and healthcare professionals, it is no secret that we need an abundance of resources in order to meet the needs of this country and rather than address these immediate issues, our very own Mangeler of Medical services chooses instead to fire staff, correction, to fire Doctors.
In a world where the richest nations on the planet are actively recruiting and training medical staff, a third world political scientist in a third world decrepit nation where not even third world doctors can earn a decent living, chooses to fire the only qualified medical staff available in the country, and he seems to have gotten away with it.
In his mangled, nay strangled, view of medical administration, Kenyan Doctors are plenty. Never mind that the doctors themselves say they are too few.  In fact, should they not apply for these vacancies, the strangler of medical services proposes to hire foreign doctors, from countries like say, Uganda or South Africa.
In addition to this, he chooses to increase the rates of contributions to N.H.I.F despite protests from COTU and a decision by the Industrial Court to stop the increase of NHIF rates.
It is at this point that we must examine the mind of a destructive man, in the throes of his art. How can one purport to fire the only doctors this entire country has produced and retained, only to desire to hire doctors from a country that is considered less developed than Kenya? And how can one actually hire those foreign doctors when they currently earn more than their Kenyan counterparts? Doctors in Uganda recently received a 400% pay rise. I am quite sure our recently fired Kenyan doctors are headed to Uganda for work themselves, an exodus of Imhoteps!
Is medicine so simple a field of study and professionalism that any sort of bushwhacker can come along and figure out how to manage the healthcare for 40 million people, regardless of what the qualified professionals view as qualitative and quantitative palliative care?
If so, why can’t this particular government with its two esteemed principles simple find a far more intelligent gibbon to do this job? Or any monkey for that matter.
There really is only one clear and obvious vacancy in the Medical Services Ministry and it doesn’t take a genius to realize that though psychiatry is advised rather than decapitation in a human being, this situation calls for rather drastic measures. Someone fire this guy, please.

Friday, 21 September 2012

How long a strike lasts depends on what side of government you are on

You know how it feels when you want to go to the loo and there is somebody in there already, and he/she says, “Just a minute.” How long a minute lasts depends on what side of the door you are on. It’s the same scenario when government is issued strike notices and they wait till the whole country is in crisis.

Njeru Githae is one very interesting Finance Minister. Lest we all forget that not so long ago, Mr. Githae introduced a bill to parliament that sought to increase remunerations to members of parliament and the parliamentary service commission back dated to 2006. At the time, he was quite confident that he had the budget to pull off this trick. Now he is telling the whole country that government does not have the budget to meet the teachers’ demands, while at the same time completely ignoring the doctors’ case.

Now, unless my mathematics is as skewed as the Finance Minister’s, money that was available in treasury at the time that bill was drafted should still be in treasury a few months later. So no, I am not buying this tale of “budgetary constraints.” In fact, should we all pretend that 3 months after he read the national budget that he cannot meet the conditions of a deal they did years ago? 

This isn’t just about missing a few weeks off school. This is about a government that indulges in neglecting its people to the point that its own civil servants have to resort to industrial strikes so that the government can be forced to do what it’s supposed to do.  Njeru Githae and his fellows in Cabinet are not just being arrogant by suggesting the school term be extended, they overreach their own mandate. Because they have forgotten one precious thing: Government is supposed to work FOR the people and not the other way around. 

Yes that’s right, Mr. Minister. You, work for me and not the other way around.  When your own fellow civil servants have to strike so that you do what you are supposed to do, it is sheer lunacy for you to suggest that the school term be extended, because you can extend 3rd term to January 2013 and the teachers still won’t go back to work unless you meet their demands. So it is your fault that our children are not learning at the moment, and you should be ashamed.

It’s the teachers and doctors constitutional right to strike, it is their right to express themselves and it is their right to seek better pay and working conditions. It is my child’s constitutional right to an education. The longer the teachers strike, the more likely my child’s constitutional rights will be contravened even as those rights are already being infringed upon. The waiting game only suits government; it certainly does not suit the patients who are not accessing health care. In fact when it comes to healthcare, waiting is not an option.  

To be blunt, government is making us wait to get what we already deserve and need. We deserve better resources for schools, we deserve more teachers, more doctors, more hospitals more equipment. We deserve a healthy nation that is well educated. We are tired and fed up of mismanagement, we are tired and fed up of being put last when it comes to social amenities when the very reason government exists is to provide those amenities in the first place.

The idea that civil servants have to strike so that babies can get intensive care units in hospitals is just bizarre.  3 babies die each day at Pumwani Maternity Hospital because there is no Neonatal Intensive Care Unit there, they just have incubators. The fact that doctors have to strike so that government is forced to just think about providing such resources is not only a sign of how repugnant these ministers are, it’s a clear indication that they have out lasted their own use.

If government won’t work for the people, refuses to do so, then these ministers should be fired immediately. When cabinet refuses to do what it’s designed to do, then it ceases to have meaning or value altogether. So instead of threatening to fire and firing teachers and doctors, these ministers need to be fired themselves for sheer incompetency and creating national crisis that is leading to deaths. Its criminal negligence to create a stalemate that has lasted this long when lives are at stake, and it’s about time someone was arrested for it.

It’s unthinkable that the Finance Minister can even state that he doesn’t have the budget to meet demands when it’s his job to budget for these sectors, clearly he stinks at budgeting. So let him be fired and we get someone who knows what a budget is for so that Pumwani and other hospitals can have Intensive Care Units that are fully kitted. Let’s just remove the real problem in government, the Ministers.

Friday, 14 September 2012

Doctors don’t owe government anything!

Let’s talk about cancer.  Let’s talk about how the only place in Kenya where you can find radiation treatment in a public hospital is at Kenyatta National Hospital. Let’s talk about the fact that should you be diagnosed with cancer, you’d have to wait 6 to 9 months before you can receive your first session of radiation treatment and also before you can receive surgery.  Let’s talk about the fact that there are no easily available or affordable drugs for cancer treatment. Let’s talk about how the combination of those factors plus your own poverty as an average citizen makes it most likely that you will die should you get cancer in Kenya and cannot attend private hospital.

There are only about 2500 doctors serving public facilities in Kenya, and the Medical Services Minister recently fired about 320 of them because they went on strike. In fact, the general tactics this ministry is using to deal with the doctors is to threaten, coerce and intimidate them. The idea, that a ministry that has such a massive shortfall of doctors can in turn threaten and fire them when these doctors demand better pay, better working conditions and more doctors to be hired just boggles the mind. How can you fire doctors when you don’t have enough doctors in the first place?

It’s a sad day in Kenya, when you can walk into a pub at 2pm on a weekday and find it filled with civil servants who are on strike. The doctor is on strike, and his heart and mind is still with his patients such that he is making calls to the hospital periodically. The teacher is on strike, and at the same time wondering how his students are doing with their revision work. The striking civil servants can’t even enjoy their drinks; they are just frustrated, oppressed, and frankly, depressed.

This government and its Ministry officials need to understand some very basic facts about Kenya. Firstly, it’s a sweet dream to have Vision 2030, but it’s utterly ludicrous to have such a vision when in 2012, you only have 16 doctors per every 100,000 patients.  In fact it’s an insult to one’s intellect that someone can even harp on and on about how they are reformers when they cannot even understand simply mathematics when it comes to the number of doctors and teachers needed in Kenya.

You know when a patient has prostate cancer; one of the first measures taken by the doctor in order to treat the disease is to excise the testes.  I think the Medical Services Ministry is suffering from cancer and its time its testes were excised. This is one ministry where mismanagement has led to such a massive brain drain that roughly about two thirds of Kenya’s medical practitioners are actually living and working either in private sector or abroad. There is this ridiculous illusion created by the media that doctors are rich people who run private clinics during the hours at which they are meant to be working in the public hospitals. The media forgets that those same doctors they caricature are struggling to provide medical care in a facility that has no gloves, no medical instruments, no resources, and insufficient or inadequate medicine, or in fact do not have the drugs needed in stock anyway.

Here we are, bartering the very health and lives of our people away over allowances, yet the demands made by KMPDU were extensive enough to at least improve health care across the board.  You know the doctors are simply repeating the very same guidelines that the World Health Organization stipulates are necessary for a developing nation’s health sector.  This country is supposed to allocate about 16% of its budget to healthcare in order to adequately meet the country’s needs, and instead of increasing budgetary allocations, this year’s budget actually decreased its allocation to healthcare. 

When a ministry deliberately creates crisis, the onus is not upon the doctors to deal with the crisis, and yet they are forced to do so on a daily basis.  It is at that moment that statements like, “Government does not owe doctors anything” are not only insulting they speak volumes of the irrational mindset that is caused by excised testes.

The teacher in the pub sits next to the doctor.  The conversation they are having rotates around the teacher being responsible for inspiring his students to become doctors, only for the doctor to become just as frustrated and overworked as the teachers.  For one brief, scary moment, I think that both are strongly considering becoming hawkers.

Doctors don’t owe government anything. They don’t owe government their peace of mind, they don’t owe government their education and they don’t owe government their financial freedom. Government owes doctors everything, because without these selfless and dedicated individuals, the Ministry of Medical Services would have completely and absolutely shut down. Its time these government officials grew a pair and faced the facts of their abysmal incompetence.