A distinguished banker was recently nominated by the president to be the cabinet secretary in charge of health. There has been uproar amongst us, the healthcare professionals, that 'outsiders' are being appointed to positions that should be the reserve of 'medical professionals'. Kenya Medical Association (KMA) responded almost immediately after the announcement. What was not clear was if KMA would have been happy still if the nominee was, let's say, a pharmacist.
I'm a pharmacist, and I really believe in us (all healthcare professionals). This view is not shared among the different cadres of health and healthcare professionals. Nurses are in support of the new secretary of health, not because they like him, but clearly because he is not the 'domineering self-centred all-important full-of-himself' doctor.
The society at large perception does not help us either. They visit public hospitals and wonder why they are that poorly managed. When they are told the top manager in the hospital is a doctor, they associate any failures with this individual. When hundreds of hospitals are managed in the same way, they conclude that this is just but the way doctors are trained - to care less and mismanage. When they hear billions that are squandered at the policy level, with little to show on the ground they write us off completely. Sooner or later, our bad reputation flows upwards in the political circles, and end up at the president's desk. The president does not even need to depend on this information flow. Before he became the country's chief executive, he was first a Member of Parliament (M.P.) who gets information first-hand from constituents suffering from the healthcare we or we don't provide. The face of this poor healthcare is a the healthcare provider on the ground and his immediate manager, the Medical Superintendent or the DMoH (is that still their title?).
So what do we need to do to get out of this?
First, let's dissociate ourselves from the greed,
inefficiency and little concern for patients' welfare that has been associated
with us. Let's shake off this tag - it begins with me and you today. Just having
management degrees beefing up our CVs will not shake that tag. They will look past it
and appoint others who they think have better clarity of purpose. We have just allowed ourselves to supervise failure for too long. We know the problem is bigger than us, but outsiders do not know that.
How do we turn this trend around, at least for 2018?
Let's write down indicators expected for change in health
attributed to us and our presence before we consider other inputs that make
healthcare. Let's be less wasteful. Let the few managers we have be exemplary.
It begins with something as simple as this. What if from today we said we will
not tolerate the bad septic hospital smells? Private hospitals have hacked it
with the same amount of Jik and liquid soap that district hospitals buy. I'm
yet to see/hear doctors, nurses or pharmacists saying enough of the pungent
rotten smell of our wards and boycotting work until it is sorted. No one
disinfects and clears patient vomit immediately it happens. Patient clothes are
not disinfected and laundered. Soiled linen is left to culture more colonies of
bacteria and putrefy further. Even the fact that the Medical Superintendent is a physician or
surgeon doesn't seem to matter. If you condone it, you are part of it. If you
tolerate these little avoidable discomforts, your value is revised downwards.
It is those guys who fake it until they make it that will take up our jobs.
If you hang in there, in civil service, because of salary
and nothing else, you are also in the same category. Opportunities are not for
those who can clearly and passionately describe the problem; but for those who
have a solution, however simple, in absence of other inputs (resources,
equipment, money, medicines etc.) The fact that different health professionals
are in constant collision and frustrate team work makes it difficult for the
president to appoint one of them.
What do we do at Afya house?
We are missing in action when
it matters. We occupy spaces we do not deserve. Just as an example. The Chief Pharmacist is, in all
my perception, absent. Yet he is supposed to be one of the top
managers in pharmacy, and even a policy maker of the position equivalent to the
immediate former posts of the Treasury and Devolution cabinet nominees at the
Ministry of Finance. This means if the Chief Pharmacist knew what he was doing
and his achievements could be seen and testified by all, then he could be
appointed a health secretary. What’s more? We work in silos and secretly
forward bills to the minister to be passed to laws without sharing with
colleagues. We then expect other health professionals, affected by the laws we
crafted in hush hush behind closed office doors, to obey and follow them
without caring for their input. And they always turn out to be bad laws, no,
terrible laws!
We cede our power by accepting mediocrity. The question is, will
the mediocrity continue to have an explanation or will we finally learn?
