Society / Health & Science
Wednesday, 01 Mar 2017 09:56 EATnewsdesk@kenyafreepress.com
The state of health care provision in Homa Bay County is at its worst since the advent of devolution, thanks to rampant corruption and inefficiency in the country’s ministry of health. Last week, the county’s health care workers went on strike over the non-payment of a Sh20,000 health service allowance and Sh10 for emergency call allowance for clinical officers as had been agreed between their trade unions and the Council of Governors which represents the interest of all county governments.
The demonstration by more than 300 workers was led by Kenya Union of Clinical Officers Deputy Secretary General Austin Oduor, who said the county had been issuing allowances to two cadres of health workers and ignoring the rest. Deputy Governor Hamilton Orata addressed the striking workers and set up a meeting with the workers' representatives for Monday February 27 where their grievances would be addressed.
Mr Orata and the minister for health Dr Lawrence Oteng’ met the union officials on Monday as promised and the two sides agreed on some quick solutions, according to sources who took part in the meeting. Mr Philip Oluoch, the secretary general of the union and Kenya Health Professionals Society in Homa Bay County, told this website that the main grievance of non-payment of the health service allowance had been addressed. Homa Bay is one of a handful of counties which had not implemented the agreement.
However, other sources maintained that the larger challenges in the county's healthcare system broached in the meeting will take longer to address given that Homa Bay is lagging behind in more ways than implementing the allowance scheme. The county has only about 30 doctors, among the lowest in the country, with one doctor serving a population of more than 150,000 people in some constituencies such as Mbita, Kabondo Kasipul and Ndhiwa.
According to a comparison by the Kenya Free Press, Homa Bay, which carries the highest HIV/Aids caseload in the country and is susceptible to periodic outbreaks of cholera and other waterborne infections, has the lowest number of doctors in the entire Western Kenya. Such sparsely populated and poorer counties like Elgeyo Marakwet and Narok have employed more doctors.
The county does not provide a number of basic necessities at its hospitals, and patients are normally forced to buy such items like surgical blades, gloves, medicines and disinfectants to get treatment. This is unlike neighbouring counties like Kisii where most necessities are catered for by the county government. Given the high cost of medical care in Homa Bay, some residents who live in border areas seek services from neighbouring counties.
Discontent has also been running high and doctors in Homa Bay went on strike one month before the national strike began. Most hospitals have been operational because of the support of clinicians, but a number of deaths related to non-existent services have been reported, including during last week's strike by clinicians.
The acting spokesman for the county government did not return our calls to respond to allegations that service standards were at their worst since 2013. According to interviews with workers in the county’s health facilities, corruption is entrenched in the system. As this website reported in January, the county chief pharmacist is the wife of the county secretary, and the two have uge influence over medical purchases.
To get their relatives into office, the senior staff do not shy from abusing employment regulations. One senior official is reported to have ensured his daughter was employed as a graduate when she was still studying in the university. As a result, the county is reported to have a high number of non-performing staff, in part due to cronyism. Some staff who are not related to superiors had to part with huge bribes, sometimes as high as Sh200,000 for mid-level jobs, and therefore find no motivation to do their best.
Thirdly, many top officials in the health department are said to have little understanding of what the sector requires. Doctors have criticized the appointment of people without the skills or background in health care provision. “Homa Bay is the only county among those I know of, over 30 of them, which has a non-professional in charge of the healthcare sector,” one doctor told us, divulging that the chief officer for health in Homa Bay trained as a teacher.
Such political appointments trickle down. The county has overemployed cadres that are not needed. They are called community health workers. “Community health workers play an important sensitization role but they cannot supplant the work of doctors or nurses,” said a doctor, explaining that some of them are retained by partners like MSF.
The health minister is alleged to prefer working with nurses rather than doctors or clinical officers. The filling of a recent vacancy caused tensions between the different cadres. According to a union official, the county had until recently an HIV/Aids coordinator, a doctor, and his deputy, a clinical officer who did tremendously well in raising awareness on the disease, seeing mother to child infection from 10 percent to 5.1 percent.
When the medical officer took a study leave, it was widely expected that the deputy would be promoted to the job. However, the minister went ahead to bring in a nurse as the new head and told the staff that she was politically correct. The appointment raised a furore among clinical officers and was among the issues discussed at the Monday meeting.