PROFESSIONAL DIGNITY

Finally, the nationwide doctors’ strike was called off. This came after standoff lasting 100 days!

It has been a rough 100 days for all involved. The doctors stood steadfast in their quest to have their collective bargaining agreement registered and implemented and this was certainly not easy.

The doctors had to contend with the jailing of their leadership, withholding of their salaries, social media propaganda from the government communication team, the knowledge that their patients were dying for lack of access to healthcare and even backlash from the public. But none of these weakened their resolve to achieve what they went on strike for.

The fact that majority of the public did not and probably still don’t understand the genesis of the standoff, served to rouse social media wars as the doctors were been painted as selfish and greedy in their quest for better pay. This notwithstanding, the doctors did not relent for several reasons.

While it may appear that the war got down to a staring contest to see who will blink first between the doctors and the government, the government was pushed by the need to not appear weak. The government in power could not be seen to back down to demands of a small section of the population. It was hugely about pride. That the president would possibly feel somewhat slighted because the doctors turned down his 40% pay increment.

Meanwhile, the doctors were also all about pride. The only difference is that their pride is of a totally different tangent. Theirs is all about the profession.

Let us look at different professions in comparison. When architects go to school in Kenya, they learn under poorer conditions than they will practice in. They will design fancy, modern buildings that will forever be their legacy. It won’t matter who owns the building, whether it is a public office block or a high end privately owned hotel. Their pride is in their skills.

When information technology students are in class, they may not have all the computers with the most attractive specifications but it won’t stop them from going on ahead and getting their own laptops and inventing the most fascinating software that goes on to change lives big time.

Lawyers may study for years, reading and cramming rulings made in their past but coming out of law school and going into practice only serves to open doors for them to create their own landmark rulings to be quoted for generations to come.

So, what do doctors have? Doctors in Kenya can only content with having a vast array of medical conditions that they come across that their counterparts elsewhere can only read about. The only time a doctor gets to have bragging rights is when you are able to bring relief to your patient. This happens in three ways:

·         by being able to treat the sick patient

·         being able to prevent disease and promote good health

·         being able to invent new more efficient, less expensive, less uncomfortable treatment options through research and innovation

Unfortunately, in Kenya, the healthcare system has stagnated in the treatment aspect for so long with negligible preventive medicine being practised and almost no research being carried out that is locally driven. Our well trained doctors, and yes, they are very well trained, are reduced to working in unacceptable conditions with inadequate resources to fully put their skills to use.

They are reduced to improvisations that sometimes border on witchcraft, figuratively speaking. The number of times I have cursed under my breathe when I have had to cut up wrist-length gloves to join them together to cover up to my elbows, just so as to enter the womb and remove a retained placenta and stop a woman from hemorrhaging to death, are countless. I shake my head and remind myself that this isn’t what I was trained to do.

The shallow thinking that if one is unhappy, they can leave the public sector does not hold water. It is telling us that those who patronise the public health facilities are unfit for quality attention. This, by all means, is discrimination of the highest order.

Within the confines of a hospital, even a private hospital, there is no doctor’s office. Doctor’s plazas do not count as those are private offices for doctors who rent them and pay the hospital as a landlord. Once the doctor reports to work, they report to the department where they are due to work. If it is at the accident/emergency department, they are on their feet, moving from curtain to curtain to see patients. In the outpatient clinics, they sit in consulting rooms and see patients for the duration they are on duty. In the wards, they move from one bed to the next and eventually sit at a desk to write notes and case summaries. In the operating room, they literally stand around the operating table through the surgery.

Asking for better working conditions means that no doctor wants to have to stand in a ward with dirty chipped floors, smelly toilets, broken plumbing, torn curtains and creaking rusty beds holding more than one patient. No doctor wants to hear that the scan they ordered for can’t be done because the machine broke down a week ago, or the lab test can’t be done because the reagents have run out and the supplier has not been paid for a year hence he won’t deliver a fresh batch. No dentist should have to use a wooden stool for her patient when doing a tooth extraction because the hospital has no functional dental chair. There is a reason it is called a dental chair. No pharmacist will have to keep turning away patients for lack of drugs in the hospital pharmacy because a tender has not been awarded out of sheer inefficiencies.

Every one of these components is what comprises better working conditions for the doctor. And since the only time the doctor has a job is when someone is unwell, the patient therefore automatically becomes the greatest beneficiary of better conditions.

Anyone who goes to sleep in their bed at night after a long hard day of work must surely be able to understand that the junior doctor in the hospital who is first on call needs a clean bed in a private call room to lay down even if for two hours when the ward has settled down and patients have slept. Or that this doctor probably lives five kilometres away and with no  place around the hospital to eat after dark, it is only human to provide him with a decent meal and a cup of tea when he has to be in the hospital for 24 hours every fourth day. In the rest of the world, these amenities are expected and provided for. It is hypocritical as Kenyans to say that asking for these amenities is selfish.

After investment of Ksh. 38 billion in medical equipment for county health facilities, it is immoral for these equipment to lie idle for lack of personnel to utilise them. Therefore, the government that spent money must be willing to spend more to employ the requisite specialists to utilise the equipment for patient benefit.

Alternatively, it would be cheaper to train those in your employ to acquire the necessary skills to come and utilise the equipment. As a trained gynaecologist, however great my skills may be, I could never be able to save my own life if I got a life-threatening bleed after delivery. Therefore, my skills are only useful to others. Investing in specialised training for doctors should never be a matter of disagreement.

In the same breathe, our very own home-grown research findings are sorely lacking. Why are the Mount Kenya region inhabitants so prone to metabolic diseases compared to their lake region counterparts? We must stop defining our epidemiology of disease based on research done elsewhere and look for answers here at home. For this reason, research is not a luxury and requires adequate funding.

All the Kenyan doctor wants is to be fairly remunerated and be allowed to enjoy doing the work they are trained to do in its fullest extent of the range of their skills, in an environment that is conducive. This is in accordance to the labor relations act and why unions exist!

 

Dr. Daisy Korir will always be an inspiration to many!