 |
Many will accuse me of being
green with envy for the practitioners of the noble profession. Far from it! All
the same, I must aver with unquestionable conviction and unerring contrition
that I have never had any aspirations to be a doctor and as such I habour
nothing but awe, appreciation and adoration for the practitioners of this trade.
For me a spattering of blooded cotton wool is sufficient cause for
institutionalization for trauma let alone witnessing a squirting of the
life-sustaining body fluid from a severed limb! You may have realized I used
the word ‘trade’ instead of ‘calling’ as it should be. It is not a misnomer but
a pointer to the great value that should be accorded to the medical profession
but is not. As a player in this field, you are no less second to only the
Almighty in the words of the saying, ‘Doctors treat but God heals.’ You carry
our lives in your hands at the moment we are most vulnerable and have the
propensity to either nurse us back to health or at the drop of the surgical cap
consign us to the morgue and ultimately the 6 Sq. Ft confines of the nether real-estate!
This is vital more so in a developing nation where human capital is the
principal factor of production and progression of enterprise. We need men and
women in good health to drive the often poorly-lubricated cogs of our economic
gear. However in Kenya, mostly in private hospitals this is treated as more of
a trade than a calling which is objectionable.
Let me go through the
chronology of qualifying as a doctor in Kenya. As stated before you have to be
one of the bright intellectual outliers of your generation able to score an ‘A’
in Mathematics, the two national Languages, the three sciences and almost any
other course you will take to hold up your aggregate mean. Then you are
admitted to a registered and chartered University to slug it out for 6 years
through courses like Physiology, Anatomy, Pathology and Parasitology. (There
are others intentionally omitted with a view to provide you an abridged insight
instead of an encyclopaedia for a blog!) In short you have to be adroit at
internal medicine and what the French call ‘Chirurgie’ - Surgery to make it
through. Afterwards, you graduate with a
Bachelor of Medicine and Surgery Degree (MB. ChB). During your graduation
ceremony, there is a session specifically to recite and promise to ascribe to the
‘Hippocratic Oath’ for the preservation of Human life no matter the myriad distractions
that may attempt to lay an incursion on your path. This is just the preliminary
stage! You then must serve a compulsory
residency as an Intern under consultants for a period not less than a year.
Following that, one works as a General Practitioner (GP) for some time, gauging
their strengths, weaknesses, passion, opportunities and threats before deciding
to master and specialize in one of the fields he best desires or is apt in
performing. Then, one may decide to go for a sub-specialization on the field.
Afterwards, you take an exam to ascertain your suitability to serve under the
ambit of your professional licensing body, the Kenya Medical Practitioners
& Dentists Board. This entire process may take as long as 12-14 years from
the time one is admitted to University to when you are finally licensed to do
all that pertains to nursing humanity back to health.
Noble as it may seem, there are
others who will look at the period they spent in school as one of lost
opportunity for the age-old ‘primitive accumulation of wealth’. They will cast
their eyes far and wide and espy the jet-set lawyers, the Engineering
braggadocios, the architectural aficionados, pilots and commerce practitioners
seemingly reveling in corpulence and vain symbols of status. Riding in Toyota V8s
or Range rovers, they will suffer the ignominy of seeing beside their
contemporaries a beautiful bride; two healthy and rambunctious children
admitted to the local versions of Ivy-league schools, pilots traversing the
world enjoying life while getting paid by the truck-load. Their age-mates own
land, real-estate, businesses and property almost to the moon! They find
themselves muttering under their own breath, the quintessential Jomo-Kenyatta
query, “woe is me, what have I done for myself by the ripe old age of 33?”
Apprehension sets in as Medical Practitioners are caught scrambling to catch-up
with their peers. They rent a backstreet alley; lo and behold, the Private
practice has been set up. To remove any untoward elements from this narration
for any aspiring doctor, it is never always like this; however, This is Kenya! (https://www.youtube.com/watch?v=lug6cupwmIw ) and
(https://www.youtube.com/watch?v=T7uzheM1nGk )
Warning: I pay credence to the gifted owners of all copyright to the material
ensconced within the two URLs above.
Men and women; supposedly the custodians
of our public health care systems, find themselves juggling the conundrum that
is their calling in Public hospitals vis-à-vis commercial interests. Some even
go the extra mile of burning the midnight oil as lecturers. Sooner rather than
later also due to economic pressure, commerce triumphs over calling as one
realizes that he will mint more money apportioning extra time to his Private
clinic as opposed to the well documented and predictably meagre pickings that
is the government salary. The hustle is real out here and many are oft
vulnerable to break-down under its weight and find themselves in the hallowed
waiting room of these private facilities. For salaried and unionizable employees
the allure of the fully-catered for medical insurance package is too coercive for
a private medical practitioner to resist. Cases of men who bumped their head on
the low-lying canopy of a ‘ma-three’, got a gargantuan bruise which had them
worried sick so they ran to their ‘family-doctor’ to have a check, had CT and
MRI scans recommended to them on top of the consultancy fees, were misdiagnosed
with brain damage and had to be wheeled into surgery have not been few and far
between. Besides, how callous can one get to recommend unnecessary treatment
merely for pecuniary gain! Who does that?
Costs for all medical
consumables like bandages, scalpels, splints, band-aids and the requisite
medicine are hiked ostensibly to take advantage of that much touted item of
good fortune, the NHIF. A deworming tablet sold over the counter at 20-30/- is
now extrapolated to the irreverent figure of 150/- . All this in an effort to
make hay while the sun-shines! In the week starting Monday 26th
November 2018, the social media platform - Twitter was awash with a trending hash
tag #JusticeForBentaOpande . This as told in the grapevine is the harrowing
tale of a lady who had incessant back pain that was rife on her to the extent
of seeking medical redress. She casually drove herself to hospital, had the
requisite tests and scans performed on her including the precursory X-ray just
to determine where the problem was. Things were not looking good. She had
slipped albeit weakened lumbar vertebrae that required firming and
strengthening. After a studious look of the results a neurosurgeon ostensibly recommended
the only course of treatment as surgery. To the untrained eye this may or may
not be an over-kill. I chose to believe it was all for the best. In an episode
as tear-jerking as any, on the appointed day the Civil servant drove herself
and her two young daughters to hospital. As they held vigil for her praying and
hoping, she was wheeled into surgery. In the ensuing macabre occurrence that
has blurred the frontier between surgery and the handiwork of a butcher man the
procedure was botched. Screws, washers, nuts and bolts were all fastened on her
spine callously disdaining her animate state. The aftermath is all too gruesome
to relate but I will try. The pain was amplified and as if this was not enough
she started losing sensation on her right-side. Her right leg absolutely
paralyzed if not utterly atrophied. Her distraught daughters could not stomach
their grief when they were finally allowed to see their mother. Tears streamed down
their faces as they surveyed the current convalescent state of dear mum. For
the daughters it was familial concern and empathy while for Mama Opande it was
mortal pain and infernal agony. To add insult to injury this exclusive private
hospital also withheld her title deed as collateral if she failed to clear the
bill! She had to be flown to India for more specialized care. The question I
must now pose is this: Was this surgery really required any more than advise on
posture, back pillows, proper comportment and popping of calcium tablets that
can be opined by an ordinary chiropractor? In the backdrop of the new X-ray
footage obtained, was the screw-up job performed by experienced orthopaedic
surgeons, interns or a run-of-the-mill wielder of the proverbial meat cleaver? Could
this be categorized as a case of medical negligence? Let the professionals at Kenya
Medical Alliance in concert with Dr. Oluga and the Dr. Orokos of this world at
KMPDU determine the case instead of opinionated albeit ardent Viu-Sasa medical-drama
junkies like yours truly on the court of mere hearsay!
I would wish this case was an
isolated one but not in the least I have one that hit close to home. In late
2009 my father was involved in a road accident that wrote off his vehicle and
saw him fracturing a right humerus. He was more fortuitous than most escaping
the ordeal with a slap-on-the-wrist style bruised thigh, clavicle and the
aforementioned vertebral tid-bit. Grinning and singing the token, “Hakuna Mungu
kama wewe…” number he was wheeled into theatre to fix the crocked appendage. He
stirred up in some agony but this was to be expected of any surgery. After one
and a half weeks he was discharged back to his solicitous kinsmen for some
tender loving care. Then after a week instead of the pain abating it ingrained
itself. Sleep became a luxury and analgesics became anything more than candy. He
was compelled to return to the same private hospital. Prima-facie; the joint
looked to be healing, but on close quarters it was clear the titanium plate had
not been well secured. Screws had been drilled into the bone but the plate was
still mobile and as such a second instance of surgery was required. After
surgery #2, problems persisted and a secondary opinion was sought.
Incidentally, after the third surgery dad was fixed although he had to suffer
the ignominy of learning how to write with the left-hand in middle-age. On
aesthetics; post third surgery, the clean-cut incisions of the first surgery
were blurred such that his arm looked like tapestry out of a dog’s mouth! This
raises another red-flag. Can a GP or let’s say gynaecologist perform
orthopaedic surgery with the finesse of an experienced specialist? My Dad is
living proof they should not, though he regained functional use of the limb in
9 months’ time. Heavy lifting is proscribed though we proffer orison to the
Lord daily for that act of divine providence. But how many Kenyans can count on
such in the absence of financial muscle and the uncanny happenstance of finding
the right remedy? A drunk and bluntly honest sage once quipped, “The missteps
of an engineer are fortified but those of a doctor are buried!” (https://twitter.com/dennis_mukoya/status/1067365514526277632
)
It’s that stark.
In a latter post, I will
divulge the 1001 demerits of allowing Health care in Kenya to be a devolved function!
That was an ill-advised policy step, megalomaniacal at worst and pandering to
popular benightedness at best. Yes, I said it! But today I will delve into
characters of the ilk of Mugo wa Wairimu who has gained notoriety by tapping
into the gravy train that is Private Medical practice in Kenya. With absolute
disregard to any form of licensing, respect for neither the sacrosanctity of
human life nor limb, answering to no higher call of the Hippocratic Oath and
with stereotypical love for the lucre; he set up shop in Githurai 44, Nairobi.
No one would have realized the aberration in this circumstance if the monster
within had remained bottled up. Operating a gynaecological practice is not for
the faint-hearted and when I say this I mean it with all the fallibilities and
perversion that may come with it for the sons of Adam. As men we are
physiologically predisposed to be attracted and display manic affection for the
most favoured mate. Years of scholarly pursuit logged in the pedagogical
development of Medical learning, eon of wisdom thereby inculcated and a
new-found appreciation for professionalism are supposed to tame the animal
instinct in a man! A Doctor is duty-bound to abide by a higher sense of ideal
and morality than the ordinary man but not the aforementioned -wa Wairimu. On
the 1st of November 2014, a young woman sauntered into his clinic
coaxing within him a fire of the manner he was ill-accustomed to resist. Like a
hyena; the faux-medic sized up his prey, the unsuspecting victim eloquently describing
her symptoms in abeyance. In the back of his mind he already had a prognosis. A
dose of ‘sugarcane’ would do! He sedated the damsel, had her half-dead, licked
his lips, pulled down his trousers exposing an appendage that looked like a
half-consumed piece of firewood and in typical sociopath-narcissistic fashion
proceeded to hit pile-drivers into the woman if you get my drift. The ensuing
fiasco is all too graphic for the church-boy in me to countenance! When the lady
came back to her senses she had not been treated of her ailment, reeked of the
pungent odour of ‘human-seed’ and was absolutely slovenly in dress. What she
did not know was that a heinous crime had been perpetrated against her person
and she carried within her an impromptu zygote. You all know how it went when
the lady discovered this and pressed charges. Lady Justice was hot on his
trail. From Makuyu, to Thika and finally to Gachie where the long arm of the
law caught up with Mugo. He was nevertheless, in stupefying fashion let go with
nothing more than a whimper as retribution and continued his illicit medical
practice. In late 2018, the same character has hit the headlines yet again for
similar shenanigans! Apparently, the Kenya Medical Practitioners and Dentists Board
does not have anyone fitting his profile in their records and as such have no
jurisdiction to take any action on him, the allegations and his illegitimate
economic venture notwithstanding. What??? Also the limitations of statutes may
have lapsed and the legal arm has been decapitated against this predator.
Double what?? A case of moving rivers to escape the riparian reserve!
What makes private medical facilities
so attractive to everyone? The crucial stricture here is having a doctor who
takes seriously to the professional code of ethics, viewing his gift as a
calling and not merely a trade. The well-oiled establishments they man have a
24-hr fully functional medical team, an in-patient and out-patient unit, fully
furnished medical supplies repositories, well remunerated and fervent staff, a sufficient
number of well-spaced beds, no linen
reeking of urea, private suites for the contagious, presidential suites for VVIPs,
clean hospital wards, a well-articulated and thought out strategy for the
assimilation of health insurance, fully-furnished & serviceable ambulances,
an onsite morgue and milky-white walls with attractive signage. Accountability
is the common denominator. The most important thing is client referrals from
those who have enjoyed the ambience of the same and have lived to tell the tale
after visiting the facility. Keeping mortality rate low is an added advantage. I
reiterate and urge the current Health cabinet secretary to implement a framework
that will have Health reclaiming its lustre as a calling and not a cash-cow for
the uninitiated yet moneyed investor.
No comments:
Post a Comment