Opinion

MALPRACTICE: EA leaders ‘neglect’ our hospitals

East African Whispers

Wednesday March 14, 2018

By Isaac Mwangi

East African News Agency, Arusha

A recent case at Kenyatta National Hospital – in which the wrong patient’s head was opened up in a brain surgery – has attracted worldwide attention and once again shined the spotlight on the health sector in the region.

While this is perhaps the most serious mishap of late considering the nature of a brain surgery, it is by no means an isolated case.

In Uganda, for instance, in 2015, the High Court in Kampala awarded Ush450 million ($125,000) in costs and damages to a mother whose baby suffered brain damage during delivery at Mulago National Referral Hospital.

Burundi and South Sudan have experienced civil turmoil in recent years. In those conditions, quality healthcare is not to be expected. In such circumstances, it may also be difficult to obtain information on the strengths and weaknesses of their health systems.

Reports from Rwanda, too, indicate that there has been a sharp increase in cases of medical malpractice, which doubled from 12 in 2014 to 27 in 2015, rising further to 34 in 2016. This trend is by no means restricted to Rwanda, and it ought to be a cause for concern to the whole region.

A number of factors may be said to contribute to these rising cases. Unlike previous decades, the recent past has been characterised by an information avalanche – every single event of any importance is quickly brought to the public limelight through the Internet, especially social media.

That alone may account for a huge increase in the perceived cases of malpractice, which would have remained known to only a few people in previous years.

Kenya National Hospital

Moreover, the increase in the population, coupled with greater access to health services in the region, has led to higher patient numbers.

Naturally, with the higher numbers, it is also expected that there will be more opportunity for errors to occur, especially considering the low ratio of health workers relative to the population.

And that is where the rubber meets the road, for neglect of the health sector has meant that the few qualified health professionals and limited equipment are now constrained to serve a rapidly growing population.

Beyond summits and blueprints across the region, little has been happening on the ground to ensure a properly-functioning healthcare system in our countries.

When Kenyan health professionals went on strike in 2016 and last year, they claimed to be fighting not just for better salaries for themselves, but also an improved healthcare system.

Unfortunately, few among the general public understand the issues involved. It, therefore, becomes easy to go for a public lynching of health professionals who are adjudged to have failed rather than try to fix the whole system.

Not that individual culpability should not be established and tackled according to established mechanisms. Far from it, but we also need to understand how the system works and deals with its weaknesses.

For instance, when doctors are expected to work long hours without a break, it is only expected that mistakes may occur due to human fatigue.

Emmanuel Mgaya (pictured), who had a tumor and a chronic migraine, mistakenly underwent a knee surgery at Muhimbili Orthopaedic Institute based in Dar es Salaam,Tanzania, while Emmanuel Didas had his skull opened to remove a nonexistent tumour. Mr Didas had been admitted for a knee operation after a motorcycle accident. Health workers though blamed the 2007 blunder on both patients sharing the first name, the government had to apologise to the victims in Parliament. PHOTO | AGENCY

They are also poorly remunerated compared with other cadres of the public sector, which tempts them to use their spare time working in other health institutions or in their private clinics rather than taking a break to recover their strength, ready for public service.

In addition, the corruption and mismanagement of the public sector has had a horrible effect on the health sector. A lot of equipment is obsolete or non-functional, while cartels continue to steal public funds with impunity.

Yet, despite the haemorrhage of public funds, governments continue to expect doctors and other health professionals to work out of compassion and a noble heart despite poor pay and the rot in the health sector.

That is why, for instance, a national referral hospital of the calibre of KNH still relies on students pursuing their Masters degrees at the University of Nairobi to run the bulk of its services.

And when those students eventually graduate, conditions force them to opt to work in the private sector or move abroad despite the public expense on their education, exacerbating the problem.

In fact, many senior leaders regularly travel abroad for medical attention for themselves and their families.

For those who have no option but to use public facilities, when these fail, the only option is to go for public fundraising initiatives, which have multiplied as people seek to send their loved ones abroad for treatment, principally in India.

Eventually, therefore, the region must get serious about resuscitating the health sector. As it is, our leaders probably need to have their heads opened up and thoroughly examined.

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