Devolution of health services is here to stay. That is the resounding verdict in Dr Joseph Amolo Aluoch's new book, launched this week.
He says there’s no going back for Kenya.
“Devolved system is the best across the world. Everyone from Nigeria, USA to Sweden have devolved their health services,” he told the Star early this week.
Dr Aluoch
says while devolution in Kenya is not perfect, it is improving. He accuses young doctors of failing to appreciate this fact.
Under the Kenya Medical Practitioners Pharmacists and Dentists Union, young medics are currently campaigning for a backdoor return to the centralised system through a national health service commission.
"Area health authorities (counties for Kenya) are the norm al over the world, after all," he says.
Dr Aluoch pours out his thoughts unrestrained in the book Fifty Years of Health System In Kenya (1968-2018).
It is probably the first ever compendium of Kenya’s medical history.
Dr Aluoch, the 76-year-old known as father of respiratory medicine in Kenya, is among the towering pioneers of indigenous medical practice and still practising to date.
In the 372-page book, more than 15 of his peers in different medical fields also candidly share their experiences, stretching from independence to date.
Dr Aluoch also wades through more contemporary issues like the ballooning health care costs, especially in private facilities.
He
admits private doctors are often ‘wasteful’ by carrying out more than necessary procedures on their patients, which drive the costs high.
He says the ideal situation for Kenya would be to channel more resources to public health facilities, which will reduce the demand for private facilities.
“In reality, doctors in private practice make too much use of Intensive Care Unit facilities and perform some surgeries more often than warranted by clear clinical indication,” he says.
And many times patients are helpless.
“An inescapable evil of private healthcare is that doctors fees may be too high and this require supplementation
from the patients pockets,” he says.
The book
is published in Mauritius by Lambert Academic Publishing company, and each copy goes for 93 Euros.
Dr Aluoch has written four chapters, devoting the rest to other medical pioneer in various fields to narrate the history of their practice in Kenya.
Prof Peter Odhiambo, Kenya’s first indigenous cardiologist, offers are rare glimpse of his life from Primary School to Hindu College of the University of New Delhi, where he studied Medicine.
He would later specialise as a cardiothoracic surgeon in London and Canada.
Prof Odhiambo was instrumental in establishment of the cardiac unit at the Kenyatta National Hospital.
He led the first heart surgery by an indigenous Kenyan at KNH on February 8, 1979.
The operation was conducted on a 12-year -old Huruma Primary School leaver with a hole in the heart (atrial septal defect).
“The operation was successful and she proceeded to join and complete her secondary school education,” he says.
Unfortunately, the beneficiary succumbed to complications of alcoholism 27 years later at the age of 49, but was survived by a daughter.
Prof Odhiambo is surprised that today many people know him as an anti-tobacco campaigner than Kenya’s pioneer heart surgeon.
He served as pioneer chairman of the Kenya Tobacco Control Board. But he has no regrets and says this is his contribution to preventive medicine.
“What I have and still do to eliminate tobacco is an effort not in futility, but in dealing with a major cause of many diseases in mine and other specialities. That is what I call preventive surgery,” he says.
Other medics who have penned chapters include Dr Dan Gikonyo, David Silverstein, Prof George Oyoo and first indigenous Kenyan surgeon Dr Michael Warambo.
Others include Prof Erastus Amayo,
Dr john Kariuki, Prof Ruth Nduati and Dr Max Okonji.
