Last week, I buried one of my uncles who’s death followed many months of illness. I remember the worry on everyone’s eyes when he first fell sick. I remember how he was bounced around hospitals, the momentum only stopping when we got him seen by a certain doctor who is our long-time family friend. He was okay for heartbeat. I saw the strain on everyone’s face every time he needed a restock of his medication. When he fell ill again, we took him to a certain public hospital and it is there that he drew his last breath. I saw the hospital bill and later the funeral expenses. May his soul rest in peace.
The reason why there was ‘bouncing’ from one hospital to another is because they either did not have the technology to diagnose him, or we did not feel the intentional care of the nurses and doctors, or we did not trust them, or the charges were extremely high. The reason we consulted a doctor we knew was because we felt that they would be more careful with my uncle (who was also autistic). We were somewhat convinced that they would charge us a reasonable amount and they would do their best to improve his health. His medication was expensive because we struggled to get the best medicines locally and so we had to buy them abroad because we really needed my uncle to be okay.
Looking back, I see realise how privileged I am. Only a handful of Kenyans have the wherewithal and time to bounce around hospitals looking for someone to save their dying loved one. Not many have a doctor on speed dial. Very few can import medicines and even fewer know how to import anything. Having said that, the question that occurs in my mind is this: If in my privileged position I am frustrated by Kenya’s healthcare system, how much worse is it for the less privileged folk?
Healthcare is perhaps the most emotive of services any government can offer to its citizens. And while this is the case, many countries, especially in the global south, are struggling to provide their citizens with good quality, affordable healthcare services. In Kenya, for instance, a year does not end without incidents of strikes by doctors and nurses. We have become accustomed to hearing stories about understaffing, lack of proper equipment, poor pay, corruption etc. As for wananchi, a visit to the hospital is characterised by frustration, hopelessness, tears and a huge bill that will require a harambee to settle.
Be that as it may, I am excited that such narratives are about to change. In 2018, our government launched the Universal Health Coverage (UHC) initiative. When in full implementation, UHC will mean that you and I will access quality healthcare at a price that we will not struggle to raise, so no more harambees. We will be able to walk into public hospitals that are well equipped and well staffed and get treated with utmost dignity and care. We will be treated or admitted or transferred to another hospital and later discharged feeling that we have been adequately served. Healthcare workers will also enjoy their work, as issues such as working in underwhelming conditions, the pressures of being understaffed, poor pay among others will have greatly reduced.
To be honest, it sounds quite like utopia, and that scares me. And it is not that I don’t trust our leadership, but you and I know how such stories go. I am keen to understand the government’s plan of action in detail for me to completely buy into the vision. One of the things that I am doing is trying to understand what exactly happened in the 4 Counties (Kisumu, Machakos, Nyeri and Isiolo) that UHC was piloted, seeing as reports indicate success. Be on the look out for the details in one of my next blog post.
Although the UHC is good, there is a critical gap. Citizens do not know about it. They do not know what UHC means, what it is, how it benefits them and what they can do to contribute to its actualisation. I did not see politicians going round counties telling people stories about UHC. I did not hear enough of it on Tv and in Radios. I did not see social media campaigns led by the government to create awareness. So now, the government has this superb plan for us that we do not know about – yet we are still the ones who will finance it through taxes. How effective!
I work for a development communications agency, Thellesi Co., and it is here that even I learnt of the term ‘Universal Health Coverage’. Had the client not come and said “Get people to know what UHC is and get them talking about it, ” then I bet I would have waited another eternity. Now imagine someone in the village who does not work for any agency, where will they get the brief from?
I have written before in this blog that many problems arise from a lack of discussion. Governments and citizens have to dialogue. I strongly think that for UHC to work, both government’s and citizens will have to collaborate. It it not just the government’s project, it is OUR project. We have to go to government and ask “what is this UHC thing that we are seeing you guys want to do? How does it work? How much will it cost? Who will manage it? How do we plug in? etc” and the government must come provide us with all the answers.
The question that is bugging my head right now is this: how do we get people (especially young people), at the ward level to participate in the actualisation of the UHC dream? How do we get them to see how beautiful it is, so much so that they own it and push it? I will be exploring the answers for these questions in my future blogs, as well as trying to see how behaviour change can be applied to achieve the best possible outcomes. As for now, see the beautiful work that Thellesi Co has done in so far as creating awareness about UHC is concerned.