Last week, NTV ran a special investigative feature that
awakened a horror that most people had buried under the carpet. James Mugo
Ndichu, popularly known as Mugo wa Wairimu, the suspect in court facing charges
for 11 different offences, ranging from rape, to operating a clinic without a
license, impersonating a doctor and selling drugs without a license from the
Pharmacy and Poisons Board, was back on our television screens.
Mugo is currently released on bail as his trial goes on. But
from the look of things, he seems to have violated every rule in the book
regarding bail. He is back in business, operating an illegal clinic, preying on
unsuspecting Kenyans. The expose by NTV revealed that not only is he a danger
to the public, he is also a danger to himself.
To most of us watching the feature, it is beyond
comprehension how anyone in their sound mind would even consider entering such
a dingy-looking place in search of health care. That one would turn a blind eye
to the obviously drunk person purporting to treat them and feel safe enough to
trust them with their health.
Illness is a state of extreme vulnerability for all of us. In
a moment of extreme pain and helplessness, one is desperate for help,
irrespective of who is providing it. When one is hovering between life and
death after an accident, they will not be in any state to ask about the person
attending to them.
To a patient, the most forgettable care team usually comprise
the emergency department. Most of the time, the patient in the emergency room
is either barely conscious, in intense pain or desperately scared of dying that
they hardly register the person caring for them. This is in contrast with the
ward care team or the regular outpatient clinic staff.
In this regard, most small clinics in the neighbourhood tend
to be familiar to the users and the proprietor becomes well known. The
attending health worker becomes well known to those who use the facility and by
virtue of their position, is generally well respected. No one questions their
authority, credentials or even legal status.
This scenario may then set a dangerous precedence in the case
of quacks. They make up for their lack of real medical knowledge and skills
with good customer relations that sway the masses who end up following them blindly.
The community becomes protective of their “doctor” and will go to great lengths
to defend them. On several occasions, villagers have come out to attack the
health regulators when they seek to close down quack establishments, in defence
of their “hospital”.
How did we get here? What went so wrong that Kenyans are not
able to distinguish between a genuine medical facility and an unfit one? While
empowered patients will take to social media to call out medical facilities for
issues relating to customer relations, billing, prescriptions and hospitality;
majority of Kenyans in the rural areas and informal urban settlements are more
likely to be contented with receiving treatment from quacks.
Quack clinics continue to mushroom all over the country in low
socio-economic population-dense areas. The naïve populace is taken advantage of
by dangerous criminals who continually endanger the lives of Kenyans without
remorse and get away with it. Despite killing and maiming Kenyans, they
continue to thrive.
A few years back, we received a mother in our facility, who
had been admitted to a local unlicensed facility in labour. She was in labour
for 26 hours before she finally got to deliver. Unfortunately, her baby had
hydrocephalus, an abnormality of the head where there is excessive accumulation
of cerebro-spinal fluid within, causing it to massively enlarge.
The baby was born in breech (feet coming out first) and the
head got stuck inside the womb. The quacks, not knowing what to do, decapitated
the baby, leaving the head inside the mother. They then referred the mother to
us for further care. The quacks escorted the mother to the hospital but took
off once she had entered the labour ward. She was left with her baby’s body in
a polythene bag next to her on the stretcher.
Poverty is a huge driving force behind the existence of
quacks and their establishments. It is incumbent upon the government to ensure
the presence of adequate facilities to march the population demands in all
areas, so as to drive quacks out of business. This is the end vision of
universal health coverage. That all persons shall access at least the minimum
package of health benefits without exposing them to financial hardships. Quacks
exist to rip the poor of their hard-earned money. If no money is changing
hands, they have no incentive to exist.
There must be a concerted effort to educate the public on how
to identify a real practitioner from a quack and how to ascertain the
registration status of a health facility. Armed with information, the public
shall effectively police their own neighbourhoods to rout out quacks. This can
only happen when they appreciate the danger these quacks put their lives in.
Arresting Mugo wa Wairimu will take more than the department
of criminal investigations’ efforts. The public must also assist in tracing
him, as they would any other criminal offender. In addition, the criminal
justice system must come out strongly to protect the population by decisively
dealing with people who endanger the lives of others for gain.
Just as we are encouraging the populace to speak out against
reckless drivers in public transport, the same must take place in the health
sector. The proposed amendments in the Medical Practitioners and Dentists’
Board act (Cap 253), seek to impose stiff penalties on imposters purporting to
be doctors, as a deterrent to those intent on misleading the public.
We also need to change our perception with regard to health.
It does not make sense for a lady to spend a tidy sum of money on hair and
beauty products without missing a beat, but find it expensive to invest the
same in seeking health services. As long as our individual perception of the
importance of health remains warped, we shall continue to be exploited by
quacks who dangle the prospect of cheaper options. In the end, cheap will kill
you!
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