By the Secretary General, University of Nairobi Medical Students
We have seen lecturers, teachers, nurses and now doctors in all levels (interns, registrars, MOs, and doctors themselves) strike for better working conditions and better pay. But why do doctors have to fight for their pay yet no one can work for free? Has society and culture made us feel that wanting to earn a living should dictate our choice of profession? The so called “noble” professions are seemingly not so any more. They more than most are repeatedly taking to the streets demanding better pay and improved working conditions. “Who is to blame?” we ask; and then we quickly point fingers at each other. The Ministry of Medical Services wants Kenyans to perceive it as immoral and selfish for doctors to go on strike. In my point of view, there are two ways to look at it:
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Either our society had become so materialistic that it reflects clearly on these professions OR
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. The leadership of our country is becoming questionable in its priorities regarding public interest.
OUR GOVERNMENT’S EXTRAVAGANCE
So maybe doctors are being immoral and selfish. But if doctors are as we judge them, could it not be that it is because of what our leaders expose us to as a nation: Kshs. 400 million vice-presidential mansions, gas guzzlers whose weekly fuel needs could power a small village for a day or twenty, exotic vacations at the sunniest sandiest resorts at the coast, Kshs. 200,000 seats – that are used for only a few hours every week… And as if to mock our collective intelligence, the speaker of the National Assembly goes ahead to say that MPs should receive a salary increment because they are “…paid peanuts…” Such extravagance is not just limited to the August house. At the recently concluded London Olympics, Kenya sent 32 world-class Olympians – whose glory was then watered down by a whopping 200 officials in the name of support. Said supporters were nowhere to be seen when our sportsmen and women needed a much needed morale boost. In fact, the officials apparently travelled earlier to Bristol leaving a part of the team behind training. If provided with this evidence, and that of the countless scandals through which our leaders have siphoned off billions of taxpayer money, the average Kenyan would infer that there is in fact more than enough money to cater for the needs of this country, or that the little that should get the job done is being stolen as they watch.
In light of the government’s extravagance I am forced to ask myself whether the priorities of the government are in the right place.
THE LONG AND TEDIOUS JOURNEY OF A MEDIC
Currently the longest undergraduate degree to qualify for in Kenya is the medical one. It takes 6 years for one to become a general practitioner, who while very capable of addressing a majority of ordinary health concerns, has no capacity to deliver specialized care. For one to acquire specialist skills takes another 4 – 5 years of post-graduate training (compare with 3 – 4 years undergraduate degree training and 2 years post graduate training in most other disciplines- with the option of working, since most of these programs are evening classes).
In Kenya, admission to a post-graduate program in medicine requires at the very least, an impressive academic record and excellent clinical skills. In Kenya, one must either be government or self-sponsored. To receive government sponsorship, one must work for at least 2 years in the public sector before being considered eligible.
After having spent 6 years in undergraduate training, a 2 year hiatus followed by 5 more years of intensive full-time training might appear too great a sacrifice. This, together with the competitiveness of earning government sponsorship (and the demand for specialists) leads many a student to choose to fund their postgraduate training. Once admitted, the registrar- as the post-graduate student is now called; begins a journey of apprenticeship and ceaseless practice. Inasmuch as they are taught through instruction and demonstration, a large part of the learning experience at this level is practice. In simple terms, registrars perform most of the procedures in teaching hospitals. In spite of the patient being charged for these procedures, the registrars receive no pay for the service they render.
In total, one will spend between 11 and 13 years between beginning medical school and becoming a specialist in a medical field in Kenya. During this time, one – who might be married and have started a family- will not have earned a single cent from applying their skills.
But enough of all this immorality and selfishness – wherever it may come from. Something is a-festering somewhere methinks, and someone should attend it soon.
A BIG PROBLEM
In the recent months, we have seen how much more it would cost us if Kenya failed as a nation. In Mombasa, the youth – turned mercenaries – resorted to treasonous acts and hurled grenades at their countrymen. The very fabric of patriotism unravelled as they kissed the foreign hand that fed them, and bit the cruel hand that bred them. It is said that their thirty pieces of silver were a paltry ten dollars per grenade. Everywhere in Kenya these past two weeks, doctors, teachers and lecturers have abandoned their posts in actions that popular opinion would call heretical. Apparently, the care of the sick and the education of a nation’s youth cannot be abandoned at any cost. Apparently also, patriotism and all things black, red and green are immutable, blood-borne and forever. Why then are our young people so easily sold to the enemy? Why then are the most noble of our public servants so ready to leave their posts? If the government will not respect a (self) empowered group such as lecturers, doctors and teachers- in terms of education level, work ethic in building the society and appreciation by the society; how much less can they care about as vulnerable a group as the youth who unfortunately may not have the same opportunities? It goes beyond just immoral and selfish medics Mr. Nyong’o. It goes down to the fundamentals of the government that you represent to protect the rights of its honourable citizens. And so we are frustrated and angry and abandon principle.
Is there a country in the world that doesn’t pay its registrars? In Malawi, interns are given free housing. Hasn’t Rwanda, a country that is yet two decades old from being war torn, ensured that they treat the healthcare industry much better? Aren’t there on going, serious violations of rights to health (especially maternal and child health) in Kenya due to its policies- perhaps the reason why the country’s maternal and under 5s mortality rates are barely improving? Of poor policies, hadn’t our current National health policy become outdated in 2002? It is the job of the government to spearhead these policies. There are not enough paediatricians and obstetricians (both post graduate degrees) at rural levels yet Mr. Nyong’o can’t help but fire those in training. Instead, isn’t it only rational to motivate Kenyans to empower themselves into taking up these responsibilities? They want it to seem that healthcare practitioners issue threats, yet, it is them who passively threaten everyone.
Private Doctors are concentrated in major cities of Kenya. There is a siege of highly qualified doctors in the environs around Kenyatta National Hospital (still a result of poor government policies). They are operational. Maybe this is the reason why Mr. Nyong’o is not shaken. He either visits these doctors or flies off to America for treatment. Never the government hospitals he represents. What does that say of his faith in a Ministry he heads? Can it be he asks himself for what reason is there to educate our own if the policies the Ministry made aren’t meant to function? Leaders lead by example- it is implicit. Can we really afford to be led to follow considering the evidence that the government’s priorities are not in its people’s welfare?
No matter which way one looks at it Mr. Nyong’o, governance is to blame. I only have two questions for you Mr. Minister: If you had the choice of picking any government profession in the current situation of our country (on condition that you are not to pick your current one). Which one would you? Would you then be ecstatic and thrilled to build the nation for free?
About the Author: The Secretary General, University of Nairobi Medical Students
The Greatrnk 