Why falling sick in Kenya akin to signing death warrant

Acute shortage of specialists, other health workers in public health facilities consigns many to early grave

Falling sick may be natural. But in Kenya, it is ill-advised to fall  sick if you are poor because chances are you will have nowhere or no one to turn to for help.

The situation makes nonsense of Article 43(1)(a) of the Constitution, which states that every Kenyan has the right to access the highest attainable standard of health.

The public healthcare facilities, which are the first  port of call for a majority of Kenyans, is indisposed: It is ill-equipped, ill-staffed and poorly managed. The few medical staff are overworked and inexperienced while some operate in a robotic, ritual mode.

And the dearth of specialists in public hospitals and poor distribution of the few is a major cause for rising fatalities linked to either misdiagnosis, or lack of it, which consigns many to slow, painful death.

The only people who are laughing all the way to the bank are quacks and inexperienced medical personnel who are thriving at the expense of the sick and their families.

A recent audit on the availability and distribution of specialist medics in the country reveals that rural and urban poor suffer the excesses of “medical mercenaries” especially for non-communicable diseases such as cancer, heart problems and diabetes.

And the numbers —  6,000 clinical officers, 5,000 doctors and 25,000 nurses—affirm the challenges in the health sector, one of the components of President Uhuru Kenyatta’s Big Four agenda.


This is way below what the Health ministry outlines as ideal: 16,278 clinical officers, 13,141 doctors, and 38,315 nurses.

The Kenya Medical Practitioners and Dentist Board (KMPDB) affirms the sorry state of the healthcare in the country with revelations that patients with chronic illnesses in counties such as Vihiga, Mandera, Wajir and Marsabit, which are worst hit by specialists crisis, face likely death after either being misdiagnosed or   are unattended to.

For patients in these counties with a combined population of more 2.5 million, they have to make expensive journeys to Nairobi and other counties to access specialised medical care.

According to KMPDB, there are only 2,591 specialists against a population of more than 45 million people.

The World Health Organisation (WHO) recommends a ratio of 23 health workers to 10,000 people or 40 clinical officers per 100,000 people, 32 doctors per 100,000 people or 95 nurses per 100,000 people.

“The board has registered a total of 939 and 27 foreign medical doctors and dental health currently working in the country,” says board chief executive officer Daniel Yumbya.

It  is against this background that the government, in a bid to shore up the numbers, struck a deal for 100 Cuban specialist doctors to be distributed to the counties.

KMPDB says the country had 10,638 registered doctors as at November 2016, but only 6,359 were active within the public and private health care system.

Of the 1,227 registered dentists, only 651 were active. This means 4,279 doctors and 576 dentists were offering their services outside the country.

According to KMPDB report, Nairobi has the highest number of specialists (1,340), followed by Mombasa (139) and Kiambu (102). Lamu with one, Tana River (one) and Isiolo (three) have the least.

The report identifies areas of specialisation most hit by shortages as including Occupational medicine, which has one specialist, Neurosurgery (13) and paediatrics and Child Health (375). There is not a single immunologist in the public health system.

Others are clinical medical genetics (one), emergency medicine (two), infectious diseases(two), general surgery(392), dermatology(30), psychiatry (85), plastic and reconstructive surgery (four) and public health specialists (54). The only specialist ophthalmologist are in private practice.

The gravity of the shortage of medics was captured in a 2016 KMPDB survey, which showed that there was one doctor for every 6,605 people and one dentist for more than 64,516 people.

WHO recommends one doctor for 1,000 persons, which should decrease gradually to one doctor for every 600 people by 2020.

Single digit

KMPDB says 50 per cent of Kenya’s specialists are mainly in four areas: obstetrics and gynaecology, general surgery, internal medicine and paediatrics.

Whereas the government has gazetted 24 specialities with a wide range of sub-specialities, most of them have only single-digit specialists or none at all.

Further, KMPDB says as at November 2016 the country had single-digit specialists for cancer, plastic surgery, neurosurgery, diabetes and kidney disease.

The country also suffers acute shortage of specialists in arthritis, immunology, haematology and digestive disorders.

The situation has been worsened by a wave of strikes which has resulted in more specialists leaving to seek greener pasture elsewhere.

“We are doing very poorly in terms of the doctor to patient ratio and the situation is getting worse as more doctors resign,” Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) secretary general Dr Ouma Oluga told People Daily recently.

Just this month, he said, one specialist doctor out of 12 who have been serving at the Makueni County Referral Hospital resigned citing long hours. However, county authorities have refuted the claims.

Oluga wondered how the government intends to achieve universal healthcare with the glaring deficit of specialists.

“They have to employ more if at all the beautiful initiatives have to make sense,” he said.

mission (EACC) officers ahead of being paraded in court this morning to face obstruction of justice charges.

However, the governor was later released on a Sh100,000 cash bail hours after he was dramatically arrested by the detectives in Parklands for pre-charge processing at Integrity Centre yesterday afternoon.

Wa Iria was arrested immediately after he visited a patient at Aga Khan Hospital.

This is the third time the embattled governor faced  arrest by EACC detectives following last month’s dawn raid at his Thika home where he had an altercation with EACC officers, whom he even detained. “He will be charged with obstruction of justice. It is a matter of procedure for him to be here  before being taken to court. A decision to release him on bond or not is yet to be made considering his past engagement with this institution,” a senior official said.

Wa Iria has consistently attributed his woes to political witch-hunt. He has on several occassions been grilled over alleged procurement flaws, graft and abuse of office. He also survived an impeachment motion by County Assembly Members last year. At the Integrity Centre, the governor was accompanied by  Kangema legislator Tirus  Ngahu, Murang’a Women’s Rep Sabina Chege, his lawyer Ng’ang’a Mbugua, a team of Murang’a County government employees and his supporters.


EACC zeroed in on the governor following a confrontation over last month’s scuffle at his home, where detectives were allegedly attacked by his supporters.  He accused EACC of mishandling him and his family members.

Sources at Integrity Centre intimated that crucial documents that could have aided investigations into alleged graft at Murang’a county were seized from EACC detectives by goons alleged hired by Wa Iria.

Documents and electronic data devices including cell phones were seized. He protested against how the investigators introduced themselves, how they carried out the search, and linked it to the county politics.

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