Saturday March 17, 2018

By Anne Kiruku
East African News Agency, Arusha
This week, Kigali will host the second e-health and telemedicine workshop; this is happening at a time when the health sector is going through a myriad challenges that, if not tackled with urgency, will leave it a shell of its former self.
Just a fortnight ago, the largest referral hospital in East and Central Africa – the Kenyatta National Hospital – was embroiled in a horrific scandal where a wrong a patient was operated on the head, provoking anger from the public.
The Chief Executive officer and the operating team were suspended pending investigations, even though the latter were reinstated soon thereafter following industrial action by their colleagues.
As the investigations continue, the Health Cabinet Secretary has also come under fire, with calls for her resignation as well.
The workshop in Rwanda, which is being organised by the East African Science and Technology Commission (EASTECO) in collaboration with the EAC Regional Centre of Excellence in Biomedical Engineering and e-Health (CEBE) and the East African Community Secretariat, is the second of its kind in the region.
As the participants seek to improve the technology and infrastructure for e-Health systems, they must also seek solutions to challenges of lack of facilities and diminishing staff at local health facilities.
It is unfortunate that over 50 years after independence, the region’s health sector is still understaffed despite the numerous health personnel being trained.
In Kenya, for example, there is only one nurse for every 1,000 people, and these nurses are poorly distributed across the country; most of them are concentrated in urban areas and in private facilities, leading to low quality treatment in rural areas.
The brain drain in pursuit of greener pastures and better working conditions has done a great disservice to the already ailing sector.
Fifty years after independence, it is unacceptable that patients must travel to distant lands in search of treatment.

India has become the regional destination for treatable diseases due to lack of technologically advanced equipment as well as professional expertise.
As all this is happening, the health sector has been reported to be one of the most corrupt across the region.
Cases of corrupt dealings, especially in acquisition of drugs and medical equipment, are rampant in all the partner states.
Provision of affordable quality healthcare to all citizens is the responsibility of governments. The private sector can only chip in to supplement what governments are offering.
Abandoning that responsibility to the private sector is detrimental to the health of the citizens and exposes them to exploitation.
Universal healthcare, which is one of the pillars of the Sustainable Development Goals, is a key aspect to realisation of economic, social and political growth in any country.
A country that cannot take care of the basic healthcare needs of its citizens is at the verge of collapse.
It is frustrating that more than 30 per cent of total expenditure goes to health, yet more than 80 per cent of the region’s population depends on this for their healthcare.
Private insurers and out-of-pocket payments account for almost 40 per cent of health expenditures, sadly benefitting less than 20 per cent of the population.
The statistics show that bilateral partners and other international donors cater for almost 30 per cent of healthcare funding.
It is irresponsible that such a huge percentage of funding should come from donors.

Recurring health sector turbulence caused by poor human resource management has also led to frequent strikes by health workers, further aggravating the problem.
It is the duty of the governments across the region to ensure the myriad challenges facing the sector are dealt with.
Revamping the sector to ensure that equitable distribution, effective deployment, motivation and retention of workers in the public sector are done is crucial in ensuring stability of the workforce.
In the same vein, the region should accelerate talks aimed at implementing public-private partnership initiatives for creation of sustainable models for health financing, with the overall aim of achieving universal healthcare.
It is paramount for the region to ensure the poor, marginalised and the vulnerable are protected from exploitation by the health insurers.
To this end, provision of universal healthcare is a human right and the region must invest in a strong primary healthcare system if it is to be at par with the rest of the world.