Friday, February 10, 2017

For Honour and Service We Need to Pay #LipaKamaTender



Nobility of practice of medicine
Since the beginning of time no profession has inspired humanity and enjoined the saving of life like the practice of medicine. The very first oath that doctors take involves a commitment to do no harm and to save life. In all civilizations, present and ancient, doctors hold a high status (In Gikuyu tradition, the “Mundu Mugo” was the traditional healer who had a high office) not because of their personal charm, wits and ability to hypnotize but because of the importance of the calling they accepted .No other profession involves having to put personal feelings aside and attend to a dying, terminally ill patient while looking for solutions on how to prolong life through better care or to watch a road accident survivor unable to be saved because there is no theater available to handle the case.


Ciaigana ni Ciaigana


In the 60+ days of the strike, doctors have shared their horror stories and #MyBadDoctorexperience highlighted the horror stories doctors go through in Kenyan public hospitals in their quest to save lives but I guess “Ciaigana ni Ciaigana” (Enough is Enough) and downing the tools to seek better work conditions and better compensations is the only option they had. So 60+ days after the commencement of the doctors strike in Kenya you have to wonder whether the 5000 doctors in the country are possessed by “Madimoni” or if the cause they aspire for is a noble one that will bring positive change to our communities and better healthcare for all.


It is enough that doctors have to contend with poor pay and working conditions but it’s unacceptable not to listen to them when they call out for help. Negotiations on the validity and implementation of the CBA has constantly been derailed by a government side with some help from the “independent” judiciary trying to arm-twist KMPDU into accepting a return to work that would involve entrenchment of the status quo. This is a formula bound to fail as it would imply a defeat of the pursuit of better healthcare for all Kenyans irrespective of social class.


There are other factors which have also prolonged the strike and brought healthcare service provision to its knees, with an agenda that resonates well with the vultures of Wall Street and current governing party’s manifesto.i.e Privatisation of Healthcare. The current ruling party has made it clear that its intention is nothing short of liberalization of healthcare service provision with no adequate subsidies to buffer those unable to pay market rate for healthcare. Truth be told, if the true market rate of healthcare was paid to doctors in either the public or private sector, not many would be able to afford. The only alternative left is to utilize the doctors and expertise they possess while recognizing the important role they play in ensuring a vibrant populace actively involved in development activities.I hope that with the resolute resolve of the doctors and Kenyans of goodwill #LipaKamaTender will be actualized and doctors given the necessary support to save lives.



What if we pay doctors their demands?


Assuming that the only contentious issue in the CBA is the doctors’ salaries, we have to be practical and evaluate the impact of such a move on the economy. In my limited economic theory class, I know the net impact would be positive in the form of greater uptake of mortgages, car purchases and other middle class luxuries by the newly appreciated doctors. The impact on the health indicators will also improve with better net effect on GDP. Therefore, unless there is an economic demerit on the move to pay doctors slightly more than now, let us refrain from thinking it’s a payout to faceless shell companies for no services rendered just like Anglo Leasing.   

It is gratifying to note that despite vilification by a section of the press who have tried to paint the doctors as greedy, the majority of public opinion is with them in the quest to fulfill a bidding agreement with the government in 2013 on various issues including staff compensation, equipping and staffing levels of health facilities and availability of quality healthcare including specialist care to all Kenya, including the ones in the most remote areas. The government either by design or oversight  failed to make adequate provision for the implementation of the agreement in the last 3 budgets and only realized the need to be reactive to the situation whens the doctors put down their tools.


After #LipaKamaTender though, we need an intelligent conversation on the National Health System. Bringing together health system researchers and practitioners and consumer bodies to discuss on the way forward to towards a better cost-effective and hopefully Universal healthcare system.


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