Let Us Close Down The Godamn Hospitals...

Being thankful about the gift of life is a constant reminder we encounter on the regular. Maybe daily! Even if the quality of life is poor there is always the insistence in hoping for better days. That the tide might change in our favor one coming day. But we have to strive to remain alive first!
Health is a broad entity that encompasses both physical, physiological, psychological, emotional and environmental characteristics that individuals possess and experience at any given time. It is without any doubt one of the key indicators of the quality of life. An emotionally upset person for instance is least likely to actually partake in the normal expected humanly pursuits or activities and even if he did is less likely to actually enjoy or end up with good outcomes. This applies to the other characteristics of being.
It is noteworthy however that most of these swings in health are transitory, tolerable and short lived. No one is able to maintain a perfect health status all the time! This being stated it is therefore logical to assume that ill health affects the quality of life if it is acutely severe or becomes particularly prolonged. Then the amount of material, financial and time resources that are diverted towards the illness are not to be ignored. Appeals for public help in offsetting sky-high medical bills is an all too familiar and common feature on both mainstream and social media networks.
If you want to enjoy good health then for heaven's sake do not get sick! Prevention is better than cure on many scores as the age old advice tells. As simple as this premise appears it is of utmost significance in this matter. But it is in human nature to ignore simple sounding advice...we have to learn to live with this inexplicable stubbornness!
The Kenyan public health care system devotes a proportionally big amount of resources towards the curative services. This may not be a deliberate strategy but might be prompted by lackluster success of the preventive strategies in addition to many other unique and varied factors that boil together to give a portent concoction of poor health indicators and outcomes.

Patients wait for services in a public hospital.

Deserted patient waiting areas during the recent strike.

What this scenario means is that our healthcare system is actually hinged on having our health care workers at their places of work all the time. We can hardly afford our doctors, nurses, psychologists, psychiatrists, pharmacists, physiotherapists, oncologists, laboratory technicians and all the coterie of health care workers vacating their positions in our facilities. The situation is however true even in the most advanced of nations.
These people have sworn a commitment to do their work in whatever conditions to all who need their services. It is thus the least of our expectations that we can ever come to a situation where they are withdrawing their services...
But it has happened. Again and again. Both at the national and county levels.
Health care worker strikes are a frequent occurrence here. That is the fact. But what happens when these people are away? How is the general health seeking public served?

Kenyan doctors' union officials under arrest.

Documented and accurate statistics are scant on the actual toll and casualties of these strikes but if the public outcry and lamentations during these times is anything to go by then we must have a situation of significant magnitude. The situation is compounded by the poor penetration of health insurance that may enable access to services at private health facilities. Even then the congestion and throngs that is usually observed at these facilities is not a good indicator of the bigger situation.
Working in any of the peripheral, faith based or government partner organizations will afford one a very clear impression of the situation. Getting stuck with patients who need lifesaving procedures or higher level treatments is traumatizing and emotionally draining. What is one supposed to do observing patients' cancers progress from stage to the other right under their own eyes because the only affordable oncology program has been shut down?
In a system heavily dependent on curative services procured at public health facilities it does not require genius to figure out where the majority of the patients end up. For one, these people prefer these services because they are either free or heavily subsidized hence affordable to a majority. Withdraw these services for one day and you get a fine serving of anguish.
One may be able to count the number of the dead or the ones whose conditions got out of hand due to the disruption in services provision. What is harder to quantify is the economic toll that is suffered.
The grey area in our jurisdiction is who to hold to account. When relations between health care workers and their employers sour it is the patients and other consumers of health services who bear the brunt. But who between the two is to be held to account?
Health care workers have a horde of issues they want addressed. Both the national and county governments agree that there are indeed issues that need addressing. The harmony however ends there. Conflicts arise on the 'how to'.

The twenty something old lady timidly entered the consultation. She had brought her nine year old daughter for attention. She was also clutching her infant son. It was at the height of the strike late last year. The daughter had fallen on her outstretched arm a day earlier and it being a Sunday she had waited for Monday to come to the facility. On asking why they had to wait;
"Government hospitals are not working!",
Me: But it is only doctors who are on strike, the others are on duty.
Her: what difference does it make, I have heard there are no services there.
Me: no, there are some services that are being offered. I know they will be able to handle this.
Her: but will I need to pay for anything?
Me: most definitely for the x-ray and maybe plaster application.
Her: how much?
Me: not sure how much.
Her: okay this is the thing daktari, I have no money and you have to assist me whichever way you can.

She is just one of the many many Kenyans who have to do without doctors and nurses and other health professionals frequently when these people go on strike.
What happens when hospitals close their doors is nothing short of a nightmare for the fickle health of the general public. Scenes of gravely ill patients being taken home can only remain so distant till a relative or acquaintance is affected. Then the stark reality that indeed something needs doing becomes very urgent.
And more innovative and captivating disease prevention and health promoting messages need to be adopted by the concerned bodies. There is no shortage of the creative resources that we need to harness in this seemingly overwhelming strategy of healthcare provision.
'To be alive first' remains my personal commitment because I don't want to have to contend with closed hospital doors when I certainly need them open!