While attending the World Water Forum in Dakar this last week, a few of us were invited by a senior Senegalese government official for an evening chat by the fireside.
We had earlier expressed our admiration and appreciation of the tremendous improvement of infrastructure in the country since the presidency of Abdoulaye Wade, and the continuation of the same by the current President Macky Sall.
Senegal boasts of many firsts in terms of infrastructure in Sub-Saharan Africa. A brand new airport, built 60km away from the city of Dakar, but joined to the city by double carriage superhighways, has opened up a new zone for industrial and commercial investments. Not to mention stadia, convention centres and sprawling high-rise buildings for both offices and residential use.
An electric train, as sleek and smooth as the metros in Paris or Washington, DC, leaves downtown Dakar to take passengers to the convention centre 40km away with stops at no less than a dozen stations for passengers boarding and getting off.
The metro is affordable to most ordinary folks and acts as a rapid transit to the new and growing industrial area where new jobs are available.
To put some icing on the cake, the government is also putting in place a bus rapid transit system as a more orderly manner of mass transport in this highly populated city.
But while we were having our fireside chat, it occurred to one of us to shower the current president with praises for having continued so effectively with the uncompleted infrastructure projects left by his predecessor.
Elsewhere in Africa the current president would have been inclined to start his own projects to endear himself to the people in good time for the next election. Macky Sall, however, is made of tougher political mettle.
Our friend went further to observe that the ruling party is aware that in Senegal, infrastructure does not really win the votes of the popular masses. The people say that “on ne mange pas goudron.” In other words, people don’t eat the tar on the roads!
Over the last couple of months, I have travelled quite extensively in the Mt Kenya region. I have been impressed by the fact that very soon I will be able to drive from Nairobi all the way to Nyeri on what is, for all intents and purposes, a double carriageway.
The Mau Mau roads, meandering through almost every marketplace in this region, are a wonder to behold. The roads should open up these markets to more trade and commerce, not just within the region but to other areas as well. Surely on doit manger goudron (one should literally be able to eat tar) on these Mau Mau roads.
But seeing the impact handouts has had on the mentality of the masses of this region, a government should build infrastructure while feeding the tummy as well.
It, therefore, makes a lot of sense when Raila Odinga says he will champion infrastructural development in Kenya while also giving a monthly subsidy of Sh6,000 to the poor.
This is an essential element of social protection that goes in tandem with uninhibited access to life’s basic needs that every Kenyan is entitled to under Article 43 of Kenya’s 2010 Constitution. To recap, these are access to adequate and nutritious food, health, education and security.
On October 17, 2000, while making a contribution in the National Assembly on the subject of access to health by ordinary Kenyans, I strongly opposed the cost-sharing policy of the then Kanu government in matters of health.
A taxpayer, I said, cannot pay tax to the government to run the healthcare system and then, when he goes to the hospital, he is told to pay yet another cost that should have been subsumed by his tax. He or she cannot share the cost with himself or herself!...The beauty of every civilised government is to pay for the social welfare of the people.
In that regard, I would, in the same spirit expressed more than a decade ago, like to call upon the government to look very carefully at the tyranny of financial capital in the health system today. We cannot have a health system that can easily be captured by some private health institutions (heavily capitalised) whose main interest is to trade with ill health as a people’s misfortune.
On the contrary, we should invest in properly managed social protection institutions, such as NHIF and NSSF, to promote the basic needs of our citizens and not to simply deal with the consequences of inadequate access to basic needs that finally manifest themselves in ill-health among the popular masses.
When persons in retirement eat well because they are cushioned from poverty by a well run National Social Security Fund, they are likely to keep healthy and avoid unnecessary hospitalisation.
When people in the rural areas and poor neighbourhoods in towns and cities live in clean environments and have, as well as shelter, access to drinkable water, can exercise regularly and have their health status checked periodically to catch any disease early, they are less likely to incur high medical costs for treating avoidable illnesses.
A Universal Social Health Insurance public policy embraces individual, family and community well being, which is the province of politics and public investments in social well-being.
NHIF and NSSF are two major public reservoirs of billions of shillings in our country that have both suffered the misfortune of bureaucratic mismanagement and corruption.
As Azimio focuses on implementing universal health care and social protection for the less fortunate, our focus should be on reforming these two institutions and ridding them of mismanagement and corruption.
There is no reason, for example, why NHIF should be overly centralised to the extent that it loses both knowledge of and touch with those it serves.
Likewise, NSSF hardly knows the population that it provides with social security. In a devolved system of government, it is ironic that while health delivery is devolved, health insurance is so highly centralised that NHIF finds it almost impossible to help nurture county-based insurance schemes such as Marwa in Kisumu.
Yet the future of our nation’s social and economic development lies in the success of devolved government and meeting the basic needs of the people it seeks to nurture, serve and preserve.
This, indeed, is where the rubber meets the road. And we in Azimio believe that this success can be achieved in our lifetime as we undertake the socioeconomic liberation of our nation.
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