A Coffee with the Doc

The last time I met a doctor was over six months ago. I was fortunate enough at the time to have a health insurance package that allowed me to go to spendy health centers like the Aga Khan University Hospital where the consultation fee is over one thousand bob. Something common Mwananchi would have problems forking, especially for something as minor as rashes on the face. The doctor said it was a bacterial infection and gave me a colorless gel and told me they should clear within the week and if not, I would have to see a dermatologist which my insurance also covered. That was long before the doctor’s strike which has lasted well over sixty days now and which has turned into a thorn in the soles of our feet and which our government has turned a blind eye to.

We’ve all been sick, we know how it feels to depend on someone else for care. We’ve all had a sick relative and know illness is not a joke. At its worst it leaves us dented and desperate. It takes and takes, strips us bare and eats us to the very bone. Some of us end up selling belongings to fund the ever unsatisfied appetite of health costs. The question then is, why? Why should the citizenry have to go out of their way to spend insane figures and hold never-ending Harambees for good health? Why should doctors be underpaid and hospitals unequipped yet we pay our taxes?

The next time I met a doctor was in the weekend, not for treatment but for coffee. I caught up with Dr. Kemunto Lyndah: a towering, slender woman working as a medical officer in Kisii County, formerly at Kisii Teaching and Referral Hospital. We sat down at Java Prestige for a coffee. I asked her a few questions and we had a chinwag about the current health crisis in Kenya. She’s very animated about the health sector. She has a talent for zeitgeist, a think tank who talks with vivid clarity. The clarity you sometimes find in a waterhole in the morning. I sat down, kept my mouth shut for the most part and allowed her to fill my glass.

Being a doctor is something we sung about while we were kids even though deep down we knew it was like chasing waterfalls, what made you take the plunge and stick with it?

Being a doctor was not something that was in my mind. When I finished High school, I toyed around with the idea of being a pilot or an aeronautical engineer. I was also good in math and business related subjects, so a career in business was another option. Medicine is something I found myself in after my dad convinced me. Seven years later and I love the job. You can grow into a career even without passion to begin with.

There has been a lot of backlash between the government and the citizenry at large. The feeling that public sector doctors can walk out and not feel the pinch because a lot of you are also stationed in private hospitals and a majority have private clinics that they attend to?

The average doctor in a public hospital attends to about a hundred patients a day. Each patient pays a consultation fee of about a hundred and twenty Kenyan shillings. That means a doctor makes over three hundred thousand shillings per month in consultations only for a public hospital. This amount is exclusive of procedures like C-Sections. Why then, should a doctor be paid forty thousand bob as basic salary? An amount that cannot even cover for an immediate HIV PCR test when I get pricked by a needle while attending to a patient who potentially has the virus? The cost of such a test is around forty five thousand bob. Should I take antiretroviral drugs for 28 days or deplete my entire monthly check trying to get screened?

I have been pricked twice myself and had very bad side effects taking ARVs. Those were punishing times.

(Sighs)

Did you know most doctors can’t afford the very services they offer? We have NHIF, yes but in some counties NHIF contributions are not being remitted. My County for instance, has put me on the national scheme instead of the civil servants’ scheme. I cannot even enjoy the full benefits.

You might think doctors are paid extravagantly in private hospitals, they are not. Private clinics and side jobs are just a way to supplement their income and try to uphold that costly expectation of having the title doctor. We’re not many, we’re about five thousand doctors in the country and we’re not asking for much, just the implementation of the CBA.

What do you think about this Kenyan mentality, that I have sometimes fallen victim too, of, “As long as I’m not affected I’m fine?”

You will need this public services some day. You might get into an accident and the first place you are taken is a public hospital. I always give the example of the late Malawian president, Bingu Wa Mutharika who got a heart attack and the first place he was taken was the country’s central hospital. He needed resuscitation and that couldn’t be done because the most basic medicine for resuscitation, adrenaline, was not available.

The middle class, especially have their heads buried in the sand. You have your car that you can fuel and if fuel prices go up you complain a bit but still pay. You will walk in town where you’re even scared of removing your phone. You will sit in traffic for hours and do a rant on Twitter and it will be business as usual the next day. You will get sick but it’s no big deal, after all you have health insurance. I don’t see why you should be okay with any of it. Just because you have a little money and you feel like you are protected from the system doesn’t mean you will always be protected.

We have seen cases where insurance bails when your job comes to an end or when the bill is too hefty. Spend a day at Kenyatta Hospital chemotherapy clinic and you will see so many of those cancer patients with the same story of insurance abandoning ship.

The Elections are looming just when it feels like everything’s falling apart in the country, do you think that your vote will make a difference?

Yes, I believe my vote counts. I don’t have a presidential candidate to vote for but I will still show up and vote for my governor, my senator and women rep. I feel now more than ever we need educated people in government, people who truly care for Mwananchi and her needs.

When have you been most tested as a doctor?

There was this one incident of a boy who had fallen and suffered a severe head injury. The child could not breath on his own, he needed ICU care and our hospital had only two ICU beds, both of which were occupied. There were no ICU beds in all the other public hospitals we contacted. His family was there wailing and desolate and it got to us. We stayed up all night, almost 18 hours helping the boy breath manually, taking turns bagging him, until a bed was available. Available after someone else had passed on. Unfortunately, the boy too did not survive.

There have been so many times that I have been tested but the worst of them are those times when I feel as if I’m playing God because you can’t focus on one particular patient for too long when there are ten or more lined up. When I have to decide who goes to theatre first when they are all critical patients. Or who gets the only oxygen port remaining.

What have you learnt about people?

People are people, diverse, and we need that diversity for society to function. We need to leverage on our strengths for better coexistence. We cannot all do the same thing but we can all learn from each other.

People also need to speak up about things that are affecting them. Be it in your workplace or the spaces you’re in, because other people are usually thinking the same things you’re thinking, but they are just afraid to voice them. Speak and speak about things that matter. Sometimes I get into social media and I feel sad because people focus on the wrong things. It’s always things like, who is screwing who, when there are crucial matters to discuss. I agree, there should be light moments but they shouldn’t dominate such spaces. Speak about issues, you don’t have to be an expert or analyst to voice things that affect you.

(Sighs)

Social media sometimes feels like a village where politicians go to bribe people to vote for them and peddle their dogma.

What do you do to unwind?

Aerobics, though I haven’t indulged since the strike started. I travel a lot as well. Once in awhile I go swimming, attend concerts, and go out for a dance.

Any questions for me?

(Taps her long, crimson red nails on the table in a musical cadence.) No! (Flips her hair to the back.) You get to get away from this one without a question.

We sat for about two hours and talked about a catalog of things and at the end of it my coffee was cold and barely touched. It was a lot to take in and a lot to think about. Some tales were heavy and I was aghast, open-mouthed in shock. The ball was tossed in my court a few times and I definitely felt that enough hadn’t been done and more could still be done. To quote RR Martin: “We are the watchers on the wall, the light in the darkness.” So let’s step up and speak up on issues and let’s carry these conversations beyond the comfort of our living rooms.

Editor Credit: Shiku Ngigi

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