By Wandia Njoya
Sequel to Cruel scalpel as the sick man’s money fuels health crisis
2017 will be a tense year for Kenya. It begins with wananchi suffering from lack of health services in the country's public hospitals due to the doctors' strike, and huge dissatisfaction with the runaway corruption that has plagued the Jubilee government. And yet, it appears that the Jubilee government is sabotaging the ability of voters to express that dissatisfaction through the ballot, especially after bulldozing amendments to the electoral act. But when it comes to healthcare, all sides of the political divide are amazingly united in shunning the public healthcare facilities they are supposed to build, and in seeking treatment in private hospitals or abroad. They then console us with philanthropy for services our taxes are supposed to cover, as our taxes disappear through corruption. Meanwhile, the journalists reporting the stories miss the ironies of the politicians' treatment choices.
I decided to take an audit of the positions of politicianson public healthcare indicated by their actions in government and in seeking treatment. In most of the cases, the public funds the politicians' policies and even treatment, especially abroad, but the politicians return the favor through philanthropy.
The problem with philanthropy is that its focus is on the benevolence of the individual donating charity, not on its effectiveness on healthcare for the Kenyan people. The absurdity of philanthropy is evident in the report of the ground-breaking ceremony or the Tesla Cancer Care Center by the First Lady in August 2015. The report says that "the facility will also establish a foundation through which deserving but under-privileged cancer patients will be taken care of." In other words, philanthropy decides who deserves healthcare and who doesn't. And the middle class will never get healthcare unless they pay through their noses, because inevitably, the foundation will never consider anyone with education and an income "under-privileged," even when they cannot pay medical bills.
So, as we vote this year, let's ask political candidates not what they will do for healthcare, but where they stand on
a) universal healthcare for ALL Kenyans
b) a law requiring elected officials and their immediate families to seek treatment in Kenya's public hospitals
c) the Collective Bargaining Agreement that the government signed with the doctors
Name: Beth Mugo
Current position: Nominated Senator
A niece to the current president, Beth Mugo was Health Minister in the Kibaki Govt when, as she testifies, a lump had been spotted in her breast. She flew to the US where the tests were done, and she was diagnosed with stage 1 cancer.
The irony of a health minister seeking treatment abroad aside, Mugo's story embodies the magnitude of the inequality that is cancer care in Kenya. Most Kenyans are diagnosed with cancer at stage three and four because of a dire lack of pathologists and laboratories to do the biopsies. But Mugo got not just her treatment, but her diagnosis done in the US. In the interview, the best that Lillian Muli could do to highlight the socio-political implications of Mugo's treatment was to ask the Senator the monotonous question of what she was doing to "give back to society." To which the Senator replied (suprise, suprise) that she was launching the Beth Mugo Cancer Foundation to promote awareness on the most common cancers in Kenya. The foundation credits Sen. Mugo for "the development of the National Cancer Control Strategy (2011-2016), the enactment of the Cancer Prevention and Control Act (2012), and the establishment of the National Cancer Institute of Kenya" during her tenure.
Name: Prof Peter Anyang' Nyong'o
Current position: Senator, Kisumu County
Under the Kibaki-Raila government, Prof Nyongo was the coalition partner of Beth Mugo as Minister for Medical Services. He was diagnosed with prostate cancer and sought medical care in California, USA. In the interview carried out by suave journalist Johnstone Mwakazi, no mention was made of the irony of the minister seeking treatment abroad. Soon after, he founded the Africa Cancer Foundation.
Name: Ruth Odinga
Current Position: Deputy Governor, Kisumu County
A sister to Prime Minister Raila Odinga. In an article on how politicians would be spending their Christmas in 2015, she was reported to be nursing a fracture while in St. George's Hospital in London, but at least she remained true to her ODM party by requesting an orange cast. The writer, Kevine Omollo, made no mention about who was footing the bill for her treatment in London.
Name: Isaac Ruto
Current Position: Governor, Bomet County
In November 2016, Governor Ruto was hit on his face by a teargas canister when fracas broke out at a football match. He was airlifted to Nairobi, after which he headed to South Africa to complete treatment. He become the butt of jokes and memes on social media through the Isaac Ruto Challenge, including from the crew at Larry Madowo's show The Trend. At least this time, the media pointed out that the trip was an insult to Bomet voters. In December 2016, Governor Ruto was reported to have assaulted striking doctors meeting in his county.
Uhuru and Margaret Kenyatta
Current position: President and First Lady of Kenya
LONG READ ALERT (So much to say)
The president's party's manifesto for the 2013 presidential election reads like a manifesto for the commercialization of healthcare in Kenya. Even though it eventually mentions free maternal care and improved working conditions for doctors, it starts by talking of turning Kenya into a medical tourism hub like India.
In my book, tourism symbolizes exploitation and lack of creative economic thinking. But also, there's no country with universal healthcare that is also a medical tourism destination. India, the Kenya government's role model, spends only 4.2% of its GDP on health care, and 70% of its population has little or no access to healthcare. In other words, the Kenyan middle class complacency is colluding with the denial of healthcare to not only the Kenyan poor, but also to the Indian poor. If we the middle class have values and a conscience, we should not agree to be complicit in denying the dignity of health care to the poor anywhere in the world.
Within a few months of taking office, the president attended a ground-breaking ceremony for Nairobi Hospital's anticipated Sh 2bn campus in Machakos, hosted by then CEO Cleopas Mailu. By November 2015, Mailu was CS of the Health docket, and is currently presiding the government's silence on the doctors' strike. In December 2016, as the strike continued to bite, the president awarded CS Mailu with the honor of Elder of the Golden Heart at State House.
The article that probably best articulates the cynicism with which the Jubilee government is exploiting the sick, is in a piece in the New York Times. The article is about an investor of the Abraaj group seeking to cash in on the Nairobi middle class by providing private healthcare. When asked by a medical intern at Mama Lucy Hospital (yes, our doctors care) whether he will provide healthcare for the poor, who have the greatest need, the investor replies: "We can’t go to that part of the population because the business is just not sustainable.”
One cannot avoid concluding that the point of the government remaining mum on the doctors' strike is to protect private healthcare investment profits. The first way to do that is by preventing the formation of a doctors' union. And nothing confirms that more than the fact that on reading the CBA between the government and the union, the first item of agreement after the preliminaries is the Union's rights. The right of the union to represent doctors in not only labor relations, but also in the formulation of healthcare policy and implementation, is something that private investors would like to avoid. Without a union, and with a broken public healthcare system, the private healthcare business can literally dictate healthcare policy in Kenya, including tying doctors' hands in terms of the care they give to patients.
The president knows the power of the unions only too well. And he also knows the power of crushing the unions. When former prime-minister Margaret Thatcher died on the morning of his swearing in as president, he sent a message of condolences that made Thatcher sound like an angel. He said: " the late Lady Thatcher was a decisive and firm leader who will be remembered across the world for the frontline role she played in championing free market economic ideology." Among Thatcher's most notorious achievements was the crushing the UK miners' unions, and, whole towns and families with them. Ironically, she was accorded a state funeral funded by the very public she so despised.
It is clear that while the First Couple speak as if they are interested in public health services, they were more keen on the private ones. Through the Beyond Zero marathon, the First Lady has been raising funds for the very maternal healthcare her husband had promised would be free of charge, earning great admiration and sponsorship even from the Ministry of Health, which is supposed to provide the services for which she runs the marathons. And most of the runners are, funnily enough, the Kenyan middle class. In August 2015, she launched the construction of Tesla Cancer Hospital in Ridgeways. The state-of-the art private center intends to tap into what is considered a Sh 10bn market, and there will be a foundation to take care of patients who are "deserving" but cannot afford the services.
Name: Mpuru Aburi
Current Position: MP, Tigania East, voted in on an ODM ticket, defected to Jubilee
Already days into the doctors' strike, Hon Aburi got involved in a scuffle in Parliament over the amendment to the electoral laws. He flew to Germany for specialized treatment. Although the report is not from one of Kenya's main newspapers, the article says that Aburi "was forced" to seek medical attention abroad due to the doctors' strike.
Name: Irshad Surma
Current Position: MP, Embakasi South, ODM
In the same parliamentary fracas that sent Aburi to Germany, Hon Surma was also injured and sought treatment at Nairobi Hospital. Once again, it's not clear from the newspaper reports who footed the bill.
CORD and Jubilee
While both parties fought physically and with insults over Jubilee's unilateral amendment of the electoral laws, none of them seemed to see the irony of taking a break from the holidays to return to parliament but not talk about the poor dying for lack of treatment, or of the personal and business interests preventing the resolution of the impasse.
And while they distracted the Kenyan public with fighting over elections (that's the issue on which they always make us wananchi fight), both parties quickly passed a bill that will reward every MP with Sh 10 million each when they leave parliament this year. I guess "ushenzi" doesn't apply when the rich are ganging up against the poor through denying them the right to healing and to life
