There was a time about 15 years ago, in the period before the new constitution was promulgated in 2010, when each time Kenya had a new Minister of Health, you could be sure of two pronouncements the minister would make in due course.
First was that only about 30 per cent of all Kenyans had access to modern medical services; and that 70 per cent of our population relied on either traditional healers; or else on self-diagnosis ('I feel feverish. I must have malaria') followed by purchase of over-the-counter medicines, which were plentiful in even the smallest duka in the remotest villages.
Second was that sooner or later, the new Minister of Health, while addressing Parliament, would plead with the MPs to please stop building 'clinics' all over the country. Which might seem a strange thing for the minister to say, only there was a sound reason for this plea.
What used to happen is that – prior to the 2010 Constitution, which made health services a devolved function – all nurses, clinical officers and doctors were first employed by the central government, and only then deployed to the various parts of the country.
And although there was already, even back then, a huge surplus of nurses and clinical officers (if not necessarily of doctors) the Ministry of Health could only employ such numbers of them as its annual budget allowed.
However, by that time, Kenya had already established the Constituency Development Fund – the highly popular CDF – which allowed ordinary citizens at the village level to dictate to their MPs what their development priorities were.
And very many such ordinary citizens demanded a 'clinic', which the MP was willing and able to build, only it then remained an empty shell, awaiting such time as the Ministry of Health would provide it with staff, equipment and medicines.
Predictably, the rate at which such 'clinics' were built greatly outpaced the ability of the central government to provide personnel, equipment and drugs. At one point, famously, there were about 1,000 such 'CDF clinics' around the country, which were essentially small, empty buildings with none of the things that would make it possible to provide medical services of any kind on that location.
I review all this history to illustrate the point that the creation of a viable – and sustainable – health services infrastructure is no easy matter. It requires intricate coordination of all kinds of factors.
As a government, whether regional or national, you can build a road or a bridge, and walk away upon completion of the construction, knowing that you have delivered on your promise. But with medical services, when you finish with the construction phase, you have barely just begun.
This awareness of how difficult it is to create the infrastructure that supports health services should serve to restrain those who have recently taken to proclaiming that vaccine apartheid is the reason why Kenya has not moved further down the road to having the bulk of our population vaccinated against Covid-19.
Now it is true enough that when first there was a breakthrough in the search for a vaccine against the raging Covid-19 pandemic, there was a shameless rush to corner as much vaccine as possible, by countries who could afford to buy as much as they needed of the new vaccines.
This was only to be expected. It is easy enough to criticise rich nations for their unseemly haste to corner the vaccine supplies; but if Kenya had in any way been able to do the same, I don’t think we would have accepted anything less from our leaders.
But we have since seen even countries not famously rich (eg, Slovenia) making donations to Kenya of their surplus vaccine supplies, and also African nations who lacked the capacity to utilise all the vaccines they had received, also kindly handing them over to us.
This has been possible because – even with all our failings – we do have some rudimentary public health infrastructure that can ensure the proper utilisation of these vaccines.
To claim therefore that there is something fundamentally racist about the manner in which the life-saving vaccines are being distributed merely reveals the old Kenyan psychology of victimhood, which is so often a substitute for effective policy.
