For the past one hundred and twenty four days, public hospitals have been non-operational owing to the nurses’ strike. For one hundred and twenty four days, Kenyans have had to seek for alternative ways of keeping their sick alive as they wait for the government, ‘their government’, to do something.
The national government has been quoted on several occasions saying healthcare is a devolved function, in other words, the nurses’ strike is the headache of county governments. Meanwhile, the very national government that has exonerated itself from matters nurses’ strike is hopping from one county to another bragging about ninety four referral hospitals it has ‘opened’, MRI machines it has bought and installed across counties, numberless C-ARMS, dialysis machines bought and installed and blah blah blah. That the deputy president had the audacity of standing before the people and God in Vihiga County and mention machines and referral hospitals on the 4th/10/2017 in the midst of the longest nurses’ strike is plain sad. That two or three people clapped for him says a thing or two about us.
For a hospital to run, doctors, nurses, cleaners, lab technologists, porters, security personnel, sonographers, clinical officers, et cetera are needed. If hospital cleaners went on strike for an hour, hospital operations will grind to a halt. Same applies to cooks, lab techs, doctors and nurses. Nurses are a vital part of the healthcare system. This part has been missing for the past four months.
In the four months that nurses’ have been out of hospital, too much damage has happened. Too much that can not be undone. There are women who have died while giving birth; there are those who have lost their un-born children. HIV positive mothers have remained uncared for through-out pregnancy, some have had to give birth at home hence exposing their babies to HIV. Children born months before and those born during this strike are missing their immunizations and this will haunt us in the future.
Patients who were waiting in line to have operations are dying without ever stepping in theatre and this is after selling plots for theatre fees. Patients needing dialysis have had to do without dialysis for as long as their bodies can, they have changed their dialysis needs from twice a week to intermittently because that is what they can afford with the rates charged in the private hospitals. Cancers are progressing, cancer patients are making do without their morphine because palliation centers have been closed. The old men have had to live with infected urinary catheters. Hypertensive patients have had to post-pone their check-ups. Diabetics have resorted to alternative medicine and prayers and hope. Meanwhile, their kidneys are getting damaged; blinding cataracts are slowly but surely growing in their eyes. Killer clots are developing in their arteries.
Too much damage is happening. But sadly, life is going on even as our children die of simple diarrhea and vomiting, pneumonia and malaria. We have been so busy politicking that we have forgotten we have no place to take our sick, our injured. The media has been so busy with one political headline after another; it has no time for stale news about the health of the bottom class.
The opposition is so keen on getting into power it won’t talk on behalf of their poor supporters! We are busy feeling sorry for Uganda we have forgotten that we have no healthcare in our own country! Meanwhile, we are busy ‘advising’ women and girls to go for breast cancer screening because that is what the whole world is doing. We seem to be forgetting that we practicallyhave no hospitals at the moment!
If the government is going to be silent about the rampant industrial actions in our public hospitals, then it is pointless to talk about free maternity. It is not fair to mislead masses about free services which are not always available or guaranteed. Free maternity should cease being a campaign point because as we speak, most maternity wards are under lock and key, the few that are open are without midwives. We all know that a maternity ward is only operational if we have the labor and majority of these labor comes from nurses who will admit patients, examine them , alert doctors about high risk patients and those that might need caesarean sections, monitor labor and assist in delivering mothers, and newborn resuscitation. While nurses are out on the road, the government has remained mum about all issues concerning the strike by nurses; our people are dying and rotting away at home, some have remained in nearly non-operational public hospitals, receiving just food, no meds, no one to dress their wounds or even change their beddings. The worst hit are our pregnant mothers, sisters , daughters. While people can postpone seeking help for their infirmities, labor cannot be postponed. These are people who got pregnant in the first time knowing that all these things would be catered for by the government. Shock on them now when they walk to maternity wards only to encounter large padlocks on the doors of the very places they knew they would get help. Families are now being faced with the tough decision between soliciting for the help of traditional birth attendants and selling whatever they own so as to cater for maternity services in the costly private hospitals. Some high risk patients, patients previously admitted for close monitoring have opted to risk their lives by walking back home and waiting on fate or for whatever is their lot. They know they would bleed to death at home, or get eclamptic fits and lose their lives and those of their unborn children at home. But what choices do they have? Some women are well aware of the risk of getting still birth ‘babies’ after nine months of nausea and vomiting, nine freaking months of waiting for a child who will come out dead and macerated. But again they have not many choices. It is now upon the government to decide if the strike ends so they can get reprieve. Otherwise, most will go on with life and wait for a miracle. A miracle which may happen or not. Surely expectant mothers should save up for emergencies, any logical person would say. But the realities of life are sometimes harsh. Way harsh than logic. Take for example a nineteen year old casual laborer who makes one hundred shillings in a day, with pregnancy comes fatigue and general laziness and as a result, can only work three times a week. She manages to raise three hundred shillings. She needs to eat, clothe, and pay rent. The farthest thing in her mind when she eventually gets a hold of that money is saving or emergencies. They will spend their earnings on their most pressing needs and will never think about a future which might as well take care of itself.
Strikes by healthcare workers may look like a small matter, but it is no small matter. Not to the mother who lost her twins at the eleventh hour because her cord had prolapsed and the theatre in a public hospital was closed. It is not small to that young man who, lacking money sat his wife on a small stool the whole night, urging her to push, not knowing that the process of being in labor is a long one, and the reaction to every pain is not push. Certainly not to that clueless neonate who lost her teenage mother to post partum hemorrhage because she couldn’t afford a safe delivery. When the government sits wherever it sits and pretends that these strikes are about healthcare workers being heartless, greedy, selfish and whatever nouns they use to describe them, nothing gets solved. It is the responsibility of the government to provide healthcare to its citizens. These wars between counties, national government, nurses, doctors, clinical officers and morticians do not make sense to a mother who, after laboring at home for nineteen hours is finally pushed to a theatre only to be told that her uterus is badly ruptured, her baby didn’t make it and that she cannot carry another pregnancy in the near future. It doesn’t make sense to that woman with stage four cervical cancer, whose voice has become hoarse , who no longer screams of pain but is instead curled up in bed as if making herself smaller would reduce the pain. There is no amount of development that can make a life lost come back. Build thirteen standard gauge rail way lines, talk about it to everyone, advertise it all over, but do not forget that there are deaths that happen when healthcare workers go on strike. There are children who are left with no parents, mothers with no children, men with no wives, wives with no husbands, and that loss, can never be compensated by a better economy!
The damage that has happened in these fifty three days has been immense; unfortunately, it is a damage that cannot be undone. In fifty three days, women have died while bringing life to the world; children have died too young, patients in stage one of cancer have progressed to stage two. Diabetic and hypertensive patients have missed their follow-up clinics; they have probably missed their drugs too. Patients who were to undergo elective surgeries in the past two months have had to live with their fibroids, large prostates and other ailments for two more months. Because doctors have been out of hospitals, many women have had to deliver at home for fear of the high cost of service in private hospitals. In fifty two days, we have succeeded in increasing the number of orphans in Kenya and enriching private hospitals. We have increased the number of brain-damaged children, and increased the number of widows and widowers.
Sadly, the world has not come to a standstill. The sun continues to rise and set each day. The wind continues to carry the dust with it as it blows. Everyone is going on with their lives, each thinking of their own trouble. Not many have paused to think about the doctors’ strike, except the doctors and the sick, their relatives too. They are the ones who have had to spend all their savings, sell the maize they were saving for the drought, and borrow, to pay for hospital bills. Cancer patients have had to waste away at home, feeling their pain to the bone, dying slowly, and surely.
Unfortunately, the government has done nothing much to end the suffering of Kenyans. (Okay it has been paying thirty six bloggers to create twitter hashtags and demean doctors). Our political leaders are oblivious of the situation in public hospitals. They have no idea how a ward in a public hospital looks or smells like. That is why they can’t see issues from a doctor’s or a patient’s view point. Our leaders are confident that they will never set foot in public hospitals; not in life, and never in death. They have looted enough money to enable them fly South, each time they have common cold, an abrasion on the nose, teeth that need cleaning and twisted balls (I hear there is a member of parliament who suffered torsion courtesy of another honorable member). They have enough to have their bodies flown back to Kenya when they die, enough to buy space in one of the fridges at the Lee Funeral Home. This way, they will never find themselves side to side with us in the led, not even in death. The government is terming doctors’ demands unreasonable, unachievable citing lack of money and yet the cabinet secretary of finance stated the real reason why they don’t want to honor what they said in paper in national television, “if you pay public doctors that amount, there will be influx of doctors from private hospitals and that will be the death of private hospitals”. – ROTICH CS FINANCE. These politicians have stolen for their children, grand-children and great grand-children up to the tenth generation while poor Kenyans continue to languish in want. Apparently, they are not satisfied-yet; they have businesses that must make profits hence the unfortunate remark by the cabinet secretary, so dis- honorable!
A ward in a public hospital is basically a little hell; those who have been unfortunate enough to be admitted in public hospitals can bear me witness. Wards are not partitioned, not even by see through curtains! A patient on one end of a ward can see without straining the goings on in the other end of the ward. Mycobacterium tuberculosis gladly moves from patient to patient. Patients have to share beds, sleeping two mostly and sometimes three in not so large beds, while their care-takers spend nights on floors. Sometimes, patients have to sleep on cardboard boxes with nothing to cover them, not even tattered bed-sheets. When one patient dies, all patients in a ward are forced to watch as mortuary attendants load them into a carrier and wheel them away into the cold room. Patients have had to sleep with bleeding patients. They have had to endure the smell of rotten or rotting flesh, urine and poop. You walk into a public hospital knowing you will share a bed with a stranger, you will strip in front of many eyes and there is nothing you can do about it.
Heavens know that doctors have tried their level best to work with what is available; given their all to do this, worked for forty eight hours straight, with no sleep because public hospitals are grossly understaffed. Doctors have tried all manner of improvisation, using feeding tubes as catheter sand gloves as urine bags, giving pain meds to patients who need antibiotics but can’t afford. Doctors have had to watch patients die slowly and painfully knowing they could help, but can’t. Our government has failed the doctors, it has failed ninety nine percent of the Kenyans who can’t afford “the billing machines” that are the private hospitals. The government is playing politics with healthcare and that is gross. Instead of increasing the bed capacity of our hospitals, employing more doctors, more specialists, instead of ensuring that hospitals have basic drugs, they are busy channeling money into useless projects, talk of misplaced priorities!
Medicine is a passion, and it is this passion that has kept doctors in Kenya, it is passion that keeps them on their feet for eighteen hours. It is passion that makes a doctor risk their life at three in the morning to go help a dying drunkard. It is passion that keeps a doctor working even after pricking themselves, taking ARVs for a month and suffering headache, diarrhea, jaundice, pruritus. Passion keeps a doctor in their feet for three hours, bagging a half a kilogram neonate, because they too matter. Sadly, passion is not edible, it cannot pay fees, and it cannot be traded for food. It doesn’t buy coffins for their dead. Doctors too have bills to pay, relatives to support, bodies to clothe, tummies to feed.
Maybe we should all try their shoes for a mile. Then we will be shocked to learn that medicine is not a white collar job, there are lots of blood involved, amnion, bone chips, urine and so much more. They spent their youth hopping from class, to the wards then to the hostel, every day for six years so they could become doctors. Doctors recognize depression in their patients but fail to recognize it within themselves, they have become insomniacs, because duty has always demanded, have seen too many deaths, much more than they can effectively handle and remain sane, are unable to take their own advice, but drown their sorrows in alcohol. Doctors render services they cannot afford (strange right?). They die poor; of friends and money, miss the mile stones of their children, and their homes are cold in the verge of breaking. Sadly, doctors are strangers to their own children, their relatives, to themselves too (yes I know, I am also shaking my head). It is no wonder doctors are not entitled to entertainment allowance but our politicians are! They have been undeservedly blamed for deaths, termed weak when they show emotion, heartless when they don’t. Doctors have been doing their best.
The government should wake up and work. It should employ more doctors hence reduce the waiting hours for patients, train specialists and ensure complicated cases are dealt with ASAP. The government should pay doctors well hence ensuring they remain in Kenya! It is the work of the government to buy drugs for hospitals, enough gloves, catheters, feeding tubes. Surely doctors are not magicians?
If we can manage position 145 internationally as far as corruption is concerned then surely we as a country shouldn’t have a problem implementing the 2013 CBA as it is. Doctors shouldn’t be blamed for a patient who died of anemia because there were no reagents to screen donated blood (happens more often than you can imagine), they shouldn’t be held responsible for that brain damaged child they couldn’t help because there was no oxygen in a referral hospital! They shouldn’t be blamed for that child who contracted HIV after rape because there was no PEP in the hospital. It is exhausting knowing you will be blamed for using too many gloves, honestly they are not edible. Those looks patients give doctors when they miss theatre six times in a row are not sad, they are worse than sad, and it is really unhealthy( suicidal even) running around in a full bladder, missing meals, barely sleeping because the government can’t employ enough doctors.