In 2012 my mom was sick and so we made an appointment with a Gastroenterologist for an appointment. We made time for the 4 O’clock appointment and even got there earlier about 3:45 p.m. Only to discover there were about 6 or 7 other patients who also had a 4 O’clock appointment and since they got there before we did…they had the opportunity to see the doctor before us. The evening had just begun. At about 7:30 p.m. the doctor walked in and with a nonchalant manner proceeded to lock himself in his office while eating dinner. It was not until 9:30 p.m. that we saw the doctor and I was by then tired, disgusted and angry. The doctor seemed confused and consulted his book much too often for my taste. I wondered whether he knew anything about the prescription that he handed my mother. This was in Nairobi at the reputable Moody Awori Doctor’s Plaza near Nairobi Hospital.
I take you back to this story because this past weekend my mom fell sick again- a different issue. She woke up feeling weak and with joint aches. Being in a malaria-prone area she suspected Malaria and decided to go for a test. The local hospital said that she tested negative for Malaria and gave her painkillers and general antibiotics of low strength, they did not bother to run other tests. The same evening my mother called me and described her condition. I immediately knew that she had a bacterial blood infection because I had the same incident last year. Knowing that the infection can turn fatal I asked her to visit a health center in Kisumu – an hour and a half’s journey by road from her house. During the night I prayed that she would survive- there was little to do as I lived so far away from her. The next morning, after the long journey to the hospital in Kisumu, blood tests showed that she had an 82% bacterial blood infection, amoeba infection, high blood pressure (185/108) and other minor bacterial infections. I was shocked by the diagnosis but then it jolted me to the type of healthcare available to Kenyans, especially in the rural area and also based on a person’s economic status.
My mom is a retired teacher, she has an government NHIF (National Hospital Insurance Fund) card which gives her discounted healthcare (limited) and aside from that she pays for her healthcare out of pocket. She is lucky to have my siblings and me as a source of financial assistance in health issues. This weekend we spent the equivalent of USD 150 to ensure she gets the healthcare she needs to survive her infections. Not many ordinary Kenyans would afford that. The previously mentioned Gastroenterologist cost at least $400 and in the end his diagnosis was incorrect. This is just a sample of the type of healthcare that is available in Kenya.
The medical experts in Kenya are few and they Lord over their patients. I have heard many people mention that doctor so-and-so is the best Gynecologist however you will need to wait for him/her for hours. The same is said for various doctors who specialize with certain medical issues. Unfortunately these doctors are stretched thin. I am told that most Doctors in Kenya are the main doctors in various public health centers which push then to work more than 18 hours a day. At the same time the same doctors run private clinics on the side maybe because of greed or maybe because their other jobs underpay them but the result is clear…very few of their patients get undivided attention. This means that even though a patient has chosen the most renowned doctor in a certain field they are not necessarily getting the best healthcare. When my mother visited the gastroenterologist, he was visibly tired. He had difficulty forming complete sentences and also had to refer to several books to be able to figure out the prescription to write for my mother. However, this is just one aspect of the situation.
The other aspect of the poor healthcare in Kenya is the scarcity of experts in the rural areas. My mother lives 5 km from a County Healthcare center, which serves a major part of the county population. The center is unreliable in terms of offering treatment to patients and many people on go there when they are desperate. Granted the center is government run and therefore is affordable for most people however, the doctors tend to focus on relieving symptoms rather than treating the underlying ailment. The doctors who are present are also wary of referring patients when they cannot tell what is wrong with them leading to misdiagnosis and eventually deaths. One of my friends who is a government doctor admitted to me that even though he is posted to a rural area in Kenya, he spends most of his week in Nairobi running his own private practice.
The high cost of healthcare in Kenya also drives people to think of the hospital as a last resort rather than a first resort. People who feel feverish turn to herbs, or even over the counter medicine rather than seek medical healthcare. In the rural areas, people even turn to witchcraft. I have an uncle who for years visited a witchdoctor who insisted that he was being killed by his own family members. Towards the end of last year as he was wasting away and in bad shape he finally acquiesced and we took his to hospital. He was diagnosed with gastric cancer….he is still alive after and operation. However he is lucky that we were able to get his proper healthcare in the nick of time.
There is a major lack of regulation in regards to over the counter drugs in Kenya. As such people tend to treat themselves rather than seek the expert advice of a doctor. It is also cheaper, when a person suspects to have malaria, for example, to get the malaria tablets and take them rather than go to a hospital pay consultation fees, lab fees for tests and finally buy the same medicine. While this choice makes economic sense it can have very dangerous repercussions to the patient. Taking over the counter medicine can mask the results of blood tests which means that if you misdiagnosed yourself then you decrease chances of later finding out the cause of your ailment. Taking antibiotics in wrong doses for example decreases the ability of your body to respond to antibiotics in future. In addition, pharmacists, neighbors, friends, shopkeepers are not qualified to give prescriptions. Therefore their opinions though well-meaning can and have caused death in the past. If everyone keeps this in mind they may survive. However, economic ability still trumps many people’s decisions when it comes to healthcare issues.
I could go on and on about the anomalies that exist in the Kenyan healthcare system however like I have mentioned in this article I believe a few steps can be taken to resolve the issue. Each hospital should have well qualified staff and equipment. There is no sense in having a nearby hospital when all they can dispense is painkillers and antacids. Free healthcare or near free healthcare does not help the majority of the population when it is sub-standard. If the government is willing to subsidize healthcare then they should also make it better than basic healthcare. The government should have better regulation on what type of drugs can be dispensed over the counter or better still link all pharmacies to qualified doctors who can actually make a diagnosis and write a prescription. This will reduce the number of people taking unnecessary over-the-counter medication that can lead to fatalities. Lastly, increasing the economic ability of a person changes their access to healthcare. So the strive to give economic empowerment to women, men and children in Kenya should continue relentlessly. The result will definitely impact access and provision of better healthcare in Kenya.