When Mugo wa Wairimu was arrested for allegations of rape,
the media was awash with stories of the ‘Fake Doctor’ and the horrible things
he was accused of having done to unsuspecting women who sought gynaecological
services from him.
It was a tough time for doctors across the country. They were
angry that one more time, a white coat had been used to tarnish their title by
the alleged perpetrator, the media and by the public at large.
Not every person who wears a white coat is a doctor! Every
doctor in practice has had to use this phrase over and over. During the Mugo wa
Wairimu saga, doctors repeatedly corrected the press to no avail. Mugo was not
a Doctor, period. The use of the terminology ‘fake doctor’ served to reinforce
the stereotype that criminals purporting to be doctors were actual doctors gone
rogue.
Cap 253; The Medical Practitioners and Dentists’ Board Act
categorically declares it an offence liable for prosecution, to use the title
‘Doctor’ unless you have a degree in MBChB, BDS or their equivalent; or you are
awarded the title by virtue of being a PhD holder.
But in Kenya, the title has been reduced to any person of the
male gender wearing a white coat within a medical institution. The public does
not seem to be aware that the white coat is a protective gear, worn by those
who come into contact with patients or laboratory samples for purposes of
infection prevention.
This means that, within a hospital setting, doctors,
pharmacists, clinical officers, male nurses, physiotherapists, occupational
therapists, nutritionists, morticians, records officers and radiation
technicians will all wear the white coats or hospital scrubs.
In private practice, doctors, clinical officers and nurses
are eligible to open a consulting clinic or a health care facility of various
levels, based on the expertise they possess and the services they are eligible
to render. The facility owner may also not be a doctor/clinical officer/nurse
but may engage their services on a contractual basis, to provide a given
specialized service to their patients within the facility.
The biggest challenge is that the service consumers are not
aware of the differentiation of cadres and their scope of service, to the
extent that they fail to even recognize the quacks when they come into contact
with them. Sometimes people are inclined to choose health care providers who
are unqualified on the basis of cost implication. They do not realize that
quality healthcare is very expensive and if one wants safe, quality care, then
one must dig deep into their pockets. Otherwise, one may easily fall prey to
criminals using ill health for monetary gain.
The lack of awareness is further instigated by traditionally
held cultural beliefs that doctors are generally male. Every female doctor has
had to grow accustomed to being called ‘Nurse’ even when she is the only doctor
in the room! Hence it becomes easy to fall prey to unscrupulous male characters
out there who will put on a white coat and confidently masquerade as doctors.
Also, due to the long duration that doctors spend in training, most people
expect them to look far more elderly than most are. What they may not be aware
of is that, after the basic degree training of six years, every other training
that a doctor undergoes, is in-service training, hence they are eligible to
provide care. This is from the mandatory one year internship training, through
postgraduate specialist training and the super-specialization fellowships.
Kenya has only seven thousands practicing doctors currently,
of which, a thousand are in internship and a further 800 in specialized
training. Another 2,500 work in public hospitals and another 1000 work in
special programmes, research and health management. There aren’t too many
doctors sitting around in small clinics across the country in facilities where
they are not able to use their skills for lack of equipment. So the next time
someone claims to be a surgeon, it is common sense that they demonstrate which
hospital they will be using to perform major surgery on you.
How do we mitigate this? For the last few months, the health
regulatory authorities (the Kenya Medical Practitioners and Dentists’ Board,
the Nursing Council of Kenya and the Clinical Officers Council) have come
together, with the support of Intra Health, Funzo Kenya programme of USAID, to
develop a professional identity card that identifies the professional, their
cadre and their registration number. The use of technology will curb fake cards
and the quacks can be easily exposed.
However, for this technology to be successful, the service
consumer must step up and make it work. Call out quacks by asking to see their
identity cards as soon as they are rolled out and where forgery is suspected,
alert the authorities and refuse to accept the services.
It also helps for the
public to know the jurisdiction of each service provider according to their
skill level and registration. For instance, a doctor may be a good orthopaedic
surgeon, but however skilled she is in treating conditions of the bones, she is
not qualified to open up your heart. That remains the jurisdiction of the
cardiothoracic surgeon.
The law must also be enforced. It is alleged that Mugo wa
Wairimu was arrested severally before the rape scandal but was always let free
without due process being followed; until criminal charges were levied upon
him. This is unacceptable. Any person purporting to be a doctor must be dealt
with to the fullest extent of the law, otherwise, they will get on with their
fraud and in the process, cost this country lives.
Together, let us make this right. Know your doctor!
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