The hue and cry about the alleged rapist ‘doctor’ hitherto operating from Zimmerman and Githurai is a manifestation of our decayed health sector – one that has been on its knees for decades.
Since the days of the World Bank-induced cost-sharing policy during the Moi era, proper healthcare has been beyond the reach of many poor Kenyans who have instead been forced to seek services from dubious medical facilities and herbal clinics. These have sprung up in the various cities and towns, residential estates and villages and come in all forms and shapes.
Most of these medical ‘shops’ are dingy one-room affairs manned by equally dirty and uncouth personnel. Mostly the staff in these clinics are made up of one indifferent ‘doctor’ (who in real life may be the village chicken thief) and a sulky assistant that nobody can employ as a house help. Dusty medical instruments are thrown in one corner in an untidy mess and the few medicines on the shelf are in discoloured packets and appear as ancient as to be donations from the British colonial government of the 1950s.
But with the nearest public medical facilities being miles away, congested and lacking medicines, Kenyans are forced to go for these sickening alternatives and hope to God that the man playing doctor has ‘Googled’ enough to know at least how to administer an injection.
When the media, as they often do, raise the issue about quacks and unlicensed and unfit units, the concerned medical boards rise to the occasion and carry out ‘surprise’ inspections and in the glare of television cameras, arrest the culprits and issue ‘stern’ warnings to like-minded ‘practitioners’. Facilities are closed down but no sooner than the media turns the other way, these facilities are back in operation. And Kenyans, forced to hopelessness by lack of alternatives, throng back to the ‘sick’ service providers.
The alleged ‘rapist’ doctor and his dispensaries are therefore just the tip of the iceberg in a sea of illegally dangerous medical facilities and unqualified or downright untrained personnel. It is also obvious that the inspection units lacking an enforcement arm are challenged in terms of manpower and are not able to inspect all the facilities on a continuous basis. In fact, in a recent live television interview, one of the officials of the medical board admitted that routine inspections are carried out about six months apart. So before the board comes back, the quacks would have made their money and even if arrested, have enough to bribe their way out of police stations to continue with their malpractices.
The medical boards go round inspecting the facilities, closing the unsuitable ones, and then leaving the county governments with the responsibility of ensuring enforcement. Unfortunately, these are the same governments seeking to raise revenue by any means.
So revenue-oriented are these county governments that when this newspaper raised the issue of some herbal ‘diagnosis’ centre in a 10-by-10 sacks’ tent in Kikuyu town and which the public health officers disowned, it was ‘pulled down' only to reappear in less than a week.
Question is: who regulates the herbal medicine sector and how can the greed of the county governments in collecting levies from them be tamed? Again, how do Kenyans, most of them unexposed, find out what facility is licensed and who is qualified enough to treat them?
As the poor Kenyans seek care from the unqualified clinicians and outright fraudsters, Kenyans of means and those covered under the various medical schemes and insurances, go to expensive private hospitals and individual practitioners who charge an arm and a leg to treat the tiniest complaint.
At the reception of these establishments, the first question patients are asked is whether they are paying by cash or through insurance cards. The facilities are slightly lenient to those paying in cash, but at the point of examination, at times one can sense that the doctor is also assessing your worth and would recommend the tests you should have or the medicine you should buy depending on how he values you.
Kenyans are apt to make a killing, no matter what is at stake, and so there is urgent need for expanded medical inspection units and the scaling down of the greed to collect more and more revenue by the county governments and damn the consequences. The national and county governments must take seriously the health of their people by ensuring illegal facilities stay closed and medical miscreants stay in jail.
Njonjo Kihuria is a freelance journalist. [email protected]