“We have no FARE”
Health workers need to be listened to, not just shrugged off as an unnecessary nuisance
A few days ago, complaints from the doctors that they did not have fare to report to work let lose a new barrage of criticisms and caricatures from all over the internet-sphere. People seemed to forget that, at the very least, they were exercising their freedom of expression, one of the great foundations on which the Kenyan democracy rests. But it goes beyond that.
I am not a dissenter, but I think it is prudent, as in all cases, to look at the other side of the coin. Over the years, we have been fed with information about how medicine is a noble profession that requires selfless individuals who are not in it for money but are out to serve humanity. Consequently, some have ended up making decisions based on the enteric nervous system, only to face the true picture of the ailing health sector once they enter it.
To the vast majority of Kenyans outside the medical cadres, the idea of the doctors’ strike was insufferably unethical. Let me not push myself into a corner but it cannot be that every time there is a strike some bigwigs innovate on how to intimidate the leaders of the strike to withdraw their statements. If rules are given precedence blindly under the inescapable obligations of justice and charity, fanaticism, a mockery of morality, arises.
I am troubled because many people generalized the objectives of the strike without listening to the real victims to diagnose the underlying injury. There was a misdiagnosis because they saw it as a mere “fare” problem. As a path towards different diagnosis, I will treat FARE as an acronym for Facilities, Attrition, Remuneration, and Embezzlement. Of course, these are not exhaustive of the problems surrounding the strike, and the approach is not the only way to view it, but they give an idea of the underlying conditions.
Looking at finances, there is no doubt that the Kenyan government has shown a commitment to improving the sector with an investment of over 98 billion shillings on specialized equipment. But that is not the point. What is the essence of having all that equipment without an adequate capacity building program? Whether it is a matter of dumbness or blindness, I find it hard to believe that impressive programs like the Beyond Zero Campaign can lack finances with all the “fat cats” around.
Finances are closely related to the attrition problem. The song about the billions spent in equipment for managing cancer, surgical, and renal replacement therapies have filled our ears. However, they have failed to tune it with the number of health workers employed in proportion to the population, leading to burnout among the existing staff.
The commissioning of more universities and colleges for capacity building has even made the music louder to deafen Kenyans to the plight of the unemployed majority. Even if a quack opens a clinic, they say, he or she will have the clientele. As the saying goes, even donkeys are not trained, but they can never miss a job. After all, you should be dumb to voice your unemployment status with the high demand of health workers.
If you have not heard about free maternity services, then probably you have been living under a rock. More patients have flooded the hospitals to receive care from a limited number of health workers. This has translated to a health worker to patient ratio that is alarmingly out of proportion, and compromised on the quality of healthcare. It is not surprising to find patients sharing beds and delivering on the floor even in referral hospitals. As usual, the health workers receive all the beating when they are called to answer for their “violation of the patients’ rights.”
Remuneration is the third component if the FARE problem. The majority believe that health workers are some of best-paid employees. Unfortunately, once in a while when the forced hiring freeze is slackened, abject penury dawns on those who make it through. Some end up being consumed by the worries of privation as they have to stay several months without pay. I thought part of the spirit of poverty is taking care of what you already have. The overlooking of needs of the health workers and signing of a back-to-work formula after a strike only preludes a major problem.
Embezzlement of funds and the whole spectrum of corruption has infiltrated and closed ranks around all the scandals facing this country. Health workers thought that the ambitious devolution initiative could address the embezzlement challenge, but it seems it is a 47-headed impedimenta. The empty threats levelled to keep the sacred cows of corruption alive have allowed their hybridization to species which threatens anything that so much as stands in the way.
It is high time the FARE problem weighed heavily upon the concerned people and induced them to re-examine the case. The consequences are slowly going off on a tangent. It cannot be that every time health workers exercise their rights, it becomes an opportunity to reactivate a senseless and derogatory social media trend.
