CORONAVIRUS; A CRY FROM OUR PUBLIC HOSPITALS

Sometimes we all are but little children. Sitting on the floor gazing at the backside of a canvas being painted. It looks ugly. Senseless and downright boring. We can’t wait to go to the other side and see the whole picture. At the core of it is a special thread that holds the entire canvas in place. Without it, the painting crumbles. It becomes a mishmash of wet and thick liquids.

That is the situation Covid-19 has presented to the Kenyan masses. For the longest time, healthcare workers have gone on strike to decry, in part, deplorable working conditions. I remember my colleagues at Kerugoya Referral hospital refusing to work because of horrible conditions. They were sacked. Some even contracted Hepatitis B.

Not here to lament though , believe me I would like to. However I’d hate for pain and grief to be my most prized possession. Today, Kenyans are listening thanks to the Covid-19 pandemic. I love good opportunities. Actually, I take advantage of opportunities; their nature notwithstanding.

I will hope to God that you do get the courage to take a leap with me into the murky waters that are our current public healthcare system in Kenya. Hold my hand.

Underfunding

Working in the Renal unit at one public hospital in Kenya last year was a blessing to me. I had an opportunity to learn the challenges we face as nurses and the entire renal team. On this particular Thursday, we had no food to serve our patients on dialysis. Many may identify with this situation. Hemodialysis is one of the most energy intensive procedures a patient will ever have to undergo.

Going without a meal was beyond me. I remember having a chat with the powers that be (many know me as a salient activist especially where injustice prevails). I posed questions whose answers came in choked bits and pieces.

The Hospital, a level V one, had not received funding for about six months and it was in enormous debts to her suppliers. All suppliers had stopped supplying us with food items and now it was all man for themselves.

It pained me when my colleagues and I had to tell patients to bring food items in advance from home. This situation was replicated in the general wards. For patients whose relatives didn’t visit often, they were left at the mercy of other patients if not nurses. I lost count of the many times some of my fellow nurses brought packed food if not went to the shops to buy food for patients.

When one is quarantined at Mbagathi, the most unselfish thing for her or his folks to do is to NOT visit them. What was kind to do yesterday is unfortunately very irresponsible to do today. Covid-19 pandemic has turned our values inside out. Our socialization challenged.

Patients are expected to have relatively comfortable lives for the period of the isolation. These are the same wards that should provide enough food, toiletries, hygiene products and beddings to name but a few of the required consumables.

Fellow Kenyans, when you strangle funds to reach public hospitals, the result is a malnourished public healthcare system. You must contend with limited supply of services at the same Hospital you despise.

Understandably, everyone loves quality healthcare. That has informed the upsurge of medical insurance targeting private hospitals. Private hospitals are never lacking in commodities. They are always offering decent meals and nurses and doctors wear ever present smiles for your pain. Friends, a pandemic is not insurable.

You might have to find yourself in that public facility that you have treated like dog poop for all this while. You will have to be served by the same healthcare workers who you have time and again labelled selfish when they strike to seek better terms and conditions of work.

If the government and you the entire citizenry actually cared, public hospitals would never lack funds to run her operations . Suppliers would be timely paid. Machines would be promptly repaired. Casual workers and cleaners would never go a month without their wages. We would be proud of our public hospitals.

Covid-19 is exposing our underbelly as a nation and unless we have an honest conversation geared towards efficiency and effectiveness in the public healthcare system, then this exposure will be for nothing.

There is nothing as bland as passing through pain and not learning a thing from it. Time and again Afya House has been embroiled in scandals. Scandals which have been sanitized if not swept under red carpets. We lose funds in the most ingenious ways.

Funds meant for the sick and lonely. Funds meant to finance public Hospital operations. We stopped caring as a leadership in Kenya because we can afford the notable private Hospital charges. If that fails, we can grab the next flight to London or India and get our broken bodies fixed. Unfortunately our spirits are left in irreparable shreds. Covid-19 however has allowed nobody to travel to seek treatment. We perish or stand together.

I am a firm believer of our public healthcare. If you invested in us in the public healthcare sector, perhaps you would not have to feel so edgy at the prospect of being quarantined in an emaciated ward, would you?

Dishonesty

I thrive in veracity. No matter how hurtful it is, I desire the truth. I love more when I am confronted with hard truths than when I am cushioned with soothing lies.

We have used public healthcare as a campaign tool for eons. That is decrepit by now. Kenyans need to ditch the mediocrity bubble they have been accustomed to. We need to be awake to the fact that proper healthcare is not a favor but a RIGHT enshrined in our constitution.

We must be honest when we demand better services. On one hand, we treat nurses and doctors and other healthcare professionals as the enemy while the actual enemy is your political leader who expects these professionals to work around the clock with little if any, resources.

Honesty comes in the form of candid discussion where I get to tell you the challenges I face. That the radiographer machine is not working since three months ago and no, the clinic you will go to is not run by myself. That we do not have gloves and masks and therefore I want you to come with some at your expected date of delivery. That I have no linen in store and so I will humbly ask your relatives to bring some blankets for you to shield you from the cold.

When mothers are forced to share beds after delivery, caesarean or normal, I ask you to please make room for the next patient. That should make you very pissed. Not at me, because Jesus help me, I have no bed I can add to that ward, but at the right people.

That should infuriate you. That should incense you. Light up a fire that you direct to your governor or national government. It should make you dial the HOTLINE numbers that you otherwise dial when you suspect negligence at service delivery.

It should spring you into action by calling media houses. The same way you call them to say nurses have ‘allowed a mom to deliver on the floor.’

See, you are a dishonest populace that expect us to run on bare minimums and still deliver excellent care standards. My worry is, we hardly survive on a normal day, how will we survive with this pandemic?

However this is a conversation we do not want to touch as a people. We want to continue swallowing campaign promises year in year out. Therefore, for the deplorable conditions that our isolation wards will soon enter into, we have nobody but ourselves to blame. I do not expect you to change because I can count on you as long as I can count on a politician’s promise in an election year.

Tattered ethoes

By either default or design, healthcare workers got sucked up into an unforgiving system and they became better students than the master. Most of the healthcare workers have perfected the art of survival by rendering what I call shitty services in public hospitals while offering the same services; only this time ‘above excellent’ is the term I will use– in private hospitals.

This is how it works. Some doctors and independent practitioners hold two jobs if not three. This makes sure that they attend rounds at a public hospital for say an hour then ask the entire lot of waiting patients to return in a week’s time so that they can spend the rest of the afternoon minting tax free money at private Hospitals.

Nurses have more than once been at loggerheads with this clout of doctors. Our ethics as professional healthcare workers have been sacrificed at the altar of greed and we are damned. A radiographer will take his sweet time to come to a public hospital where he is employed and on the government’s payroll because he is hidden in another radiography unit in a private facility making quick bucks. Our moral fabric silently tears apart.

The oaths we took at graduation are no longer binding. They are just empty chants with no hold on our conscience.

It almost looks like a favor we are rendering patients when we treat them or serve them well in public hospitals. As if they must beg us to do what we are employed to do.

Granted, we have excellent doctors, nurses and other healthcare professionals in public hospitals. However, the few ( debatable I know) rotten eggs make the whole crate smell like Satan’s broth.

Indeed the infrastructure is there. Many times the system fail us but I will be lying if I say that we are not sometimes part and parcel of the failure.

This is a call for us to understand that Covid-19 is and will affect us as healthcare workers. It will be very dramatic to see yourself being treated as a child of a lesser god just because you seek services at a public Hospital.

This is one time that we must blot out those stubborn stains within our personalities. We need to treat our jobs as a gift; whether we come out successful will be dependent on our interpretation of this pandemic.

Political Goodwill

It is no longer enough to say you dislike politics. Good politics translate into a good life while bad politics brew the opposite. Policies and regulations made at different levels of the government need the willingness of the political class to enact. Our political elite must face the truth that indeed it is no longer enough to just write down policies. They must be translated into small actionable deeds. These directly affect the consumer who is people like you and I. People that rely solely on public healthcare to survive.

Covid-19 is a pandemic that does not respect social strata or kickbacks from private health facilities. It is a time of reckoning I daresay.

You have become the proverbial ogre. Passing laws that seemingly protect universal healthcare but also passing others that prioritise private health facilities.

It is sad the limited number of Intensive Care Units (ICU) beds we have in public hospitals half a century later after independence. Covid-19, if you did not know, at its severest is causing acute severe pneumonia which necessitates an ICU.

My question is, how many patients do you think we can accommodate in our ICUs across the country? Let me save you the trouble, we have less than 500 ICU beds in public hospitals in the entire country. To get one in a private facility, you will have to pay a deposit of roughly Kshs.100,000.

We have complained of this little fact for the longest time but as usual, our voices were lost in the din of better problems.

I dread the day that we will need to make a decision on who to save and who not to. It is happening in Italy, a country that has fairly stable public healthcare facilities. I hate to think what would happen in Kenya. I hate to even imagine it. But here we are, playing Candy Crush and eating Mukombero because well, that is not our problem, is it? Until it is…

Going back to that canvas which we were painting, perhaps if it was turned and the painter chose to move his paintbrush delicately as we watched, maybe we would appreciate the entire meaning of what he has been trying to day all along.

Covid-19 is that hidden canvas. We are only seeing the back of this tapestry and it initially isn’t making sense. Soon it will and we may not like what we see.

Mine is a voice calling out in the desert of the skeleton of public healthcare, is anybody listening?

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