Devolution of health in accordance with the new constitution was not only wrong because the infant county governments had no systems to handle it but it was also done hurriedly without following due course. To silence the governors baying for its blood the central government threw the millions of the health docket at them. Yes, health and lives of millions of Kenyans was reduced to a pacifier for the infant governors. True to the fears of the health workers who at the time mounted a revolt to stop the hurried devolution of the health docket the governors saw only the money and not the reasons for its dispersal. They saw just the manna, not the poor whose plight the gods have heard when they sent the manna down.
Three years later with exception of one or two counties health is in a sorry state across the country. Though the central government had its shortcomings too in delivery of health care, especially in the North Eastern region, there were some basic services that were always in place. Contrary to expectations, under the county governments even those basics have been withdrawn. By basic here I refer to services that make a hospital by definition deserve its name, the likes of basic drugs, cleanliness, basic laboratory services.
The Upper and North Eastern counties are the most afflicted by this evil. There is one county in particular that has proven it has no respect for the lives of its people: Isiolo county. I have witnessed the situation in this county first hand as I have worked as a medical officer in the Isiolo county referral hospital for a year. Except for the board carrying its name at the entrance and the age-old structures inherited from the central government there is nothing in the main and the biggest hospital in the Isiolo county to make it a referral centre. It is has been reduced to a large dispensary with over qualified staff that have nothing to do but helplessly watch their patients suffer.
During the one year I was at the hospital the county has not added even a dot to what it inherited from the central government. Well, of note there was a multi-million perimeter wall, as if that was what the sick needed first, which was falling apart just days after its completion. There was constant lack of necessary drugs, clean gowns for theatre, blood for transfusion. The patients who are reviewed at the facility were constantly sent to the clinics and pharmacists in the town to do vital tests and buy necessary intravenous drugs.
As a doctor it was heart-wrenching to review a patient, sometimes at wee hours of the night, and then wait till the next morning to start treatment because the patient hast to go buy the drugs from pharmacists in town. To confirm the diagnosis we had to draw the patients blood, give it to the patient’s next-of-kin to take to clinics in town for basic tests. Sometimes the patient does not have the money for the tests or even the medications. Sad. The county laboratory can only carry out malarial parasite tests routinely. Vital yet basic blood works such as full blood county and blood biochemistry are not available. There were on and off services for checking hemoglobin and blood sugar levels. To treat a diabetic patient in an emergency status due to critically high blood sugar levels without the necessary lab services for measuring the blood sugar levels as they drop is a medical nightmare!
Mothers have lost unborn babies because the theatre had no clean garments for caesarean sections and even lost their lives because there was no blood for transfusion. The delivery wing of the maternity wards smelt like a garbage site during the weekends, the explanation for this has always been “Daktari, hakuna sabuni ya kuosha.” Yet we continued to deliver the mothers in that stench because the alternative (of refusing to deliver in those conditions) is violation of basic human right as it will put the lives of the mothers and their unborn babies in danger! Then there was only one oxygen-concentrator per ward yet we’ll sometimes have 2 or even more in need of oxygen at a times. The fiasco that unfolds at such times can be anyone’s guess.
To cover its deficiencies and help it act like all is normal the county government appointed loyal medical superintendents only to kick them out in just months as frustrations slowly but surely forced the doctors who take up such positions to face the truth and tell the county bosses the lie is too big to cover. One Dr Mohamud was up beat to play politics with the state of affairs and appease the county bosses. The situation was so bad at times he had to rush patients to Meru referral for treatment and borrow theatre garments from neighboring missionary hospital by his own initiative, using his own time and resources. Heroic but unnecessarily stupid.
The situation got so worst even ultra-basic services like cord clamps, basic antibiotics (penicillin), theatre spinal anesthetic needles were lacking. It was then that the hospital came up with a mediocre way of giving the superintendent’s office a few thousands to buy basic services in the hour of need. The office will buy two needles here, a vile of antibiotics there which then leaves the question “who gets the services, who doesn’t as there were always more sick than the items bought?” If it is sickeningly comical and sounds like a policy of miserly husband it is because that is what it is. Only that it is happening to citizens of a sovereign nation and involves one of the most basic rights: Health!
Lately in the news, even in the national news, the aforementioned doctor is championing the rights of the people, laying bare the truth about the health in Isiolo county. Having seen him in office the first few months I can’t help but be shocked, that even Dr Mohamud has lost faith in Doyo’s pathetic county government and the neglect of the health ministry is a bold statement. So, when the governor, Mr Doyo, leaves his high office and slaps Dr Mohamud in the corridors of the pit that is Isiolo county referral hospital one can’t help but wonder where is the central government which is the overall custodian of the rights of the citizens? Is Mr Doyo and his government so heartless that the mothers and babies dying in the wards because of lack of basic services does not disturb them?
Where does the millions sent to the county for health docket go? How about the free maternity millions? If the county government cannot sustain even the poor state in which they inherited the hospital but sink it further then they should, for the sake of lives of mothers and babies, close the hospital until such time when it can save lives rather than end them! That is if, of course, their misplaced pride wouldn’t let them return it to the central government!
The views expressed in this article are the author’s own and do not necessarily reflect Marsabit Time’s editorial policy.