Too Poor To Get Sick

If you are too smart to pay the doctor, you had better be too smart to get ill. ~African Proverb

A couple of months ago I had the displeasure of meeting The Kenyatta National Hospital. For many years, KNH has been nothing short of a bus stop to me. Well that, and a place to hang out with my sister and her doctor friends. I stepped into the eery building when she was in medical school and lived and worked there. Still, that wasn't quite like the encounter that I had two months ago.

My diabetic mother suffered a stroke while upcountry. Let me give you a picture of my family to help you understand how we ended up at KNH. I am the third born of five children. My two elder siblings live outside of the country and both are eking out a living especially given the recession and the toll it took on the outside world. This therefore makes me the eldest child present. Next on line is my sister; the doc. And then there is our baby brother who is in Uni.

My mom is a widow and retired. I stopped working full time last November. My sister just started a new job after graduating from med school. Between me and her, we are all the help that my mom can get. Because she is diabetic, we have been unable to get her private medical insurance as no one wants to cover an pre-existing condition. Even though we were willing to beg, borrow and steal to make sure she had some form of basic insurance.

Anyway, so this March day, we get a call from my Aunt and she says that my mom had a stroke while upcountry. By herself. I cannot believe how long that day was. We tried to figure out what to do. The nearest hospital was Bondo District Hospital. A government clinic really. With one or two medical staff at best. With no form of transportation available, we had to call an Uncle who lives in Kisumu, about 2 hours away, to rush to our home and take her to the hospital. How dramatic was that? Eventually, they settled on going to Kisumu Provincial Hospital so that she could get specialized care. While there, my sister managed to talk to the doctor who explained that he was releasing her to us, so that she could come to Nairobi to be admitted and treated.

So we quickly went through all the options available. She had no insurance. The treatment could be prolonged based on the initial prognosis. We didn't have the deposit needed to have her admitted at a private hospital, let alone the doctor's fees etc. Our best bet, was the infamous Kenyatta National Hospital. We consoled ourselves that if we got her into the private wing, it wouldn't be TOO bad.

We went ahead to the hospital to begin the process of checking her in as we waited for her to arrive. I will NEVER forget the horror of the Casualty department when we walked in. My sister was used to it. I, even in my wildest imagination, never thought it would be THAT bad. Patients lying on cold metal beds, some with drips, some bandages, some looked unconscious. Their relatives running after ANYONE in uniform. "Daktari, wangu ako na Meningitis". They called out the diseases that they thought would get the doctor's attention quickest and get them some help. I could not believe I had been so sheltered. So lucky to be born on the right side of town, where I could sit on a leather seat, watch DSTV, wait for a "ding-dong" and have my number called to be seen by a calm doctor, have tests done in a super way and walk out with my meds in hand.

My mom arrived at about 8pm. It would be another two-hour wait before her doctor arrived at the hospital. Thankfully, the strong jaluo woman in her convinced him that she could be an outpatient and refused to be admitted. Even more thankfully, she fully recovered after a few weeks (and was back on the bus to upcountry much to my chagrin).

Still, that trip taught me that we will all at one time or the other (unless you are Catherine Elizabeth Middleton William Louis George) have our Kenyatta National Hospital moment. That decisive moment when you will have to make a choice that lands you in a government hospital or clinic. Ever thought of where all the car-crash victims on Nairobi-Nakuru highway, or enroute to Mombasa are taken? Nope, not Nairobi Hospital. You may one day find yourself (God Forbid!) at Sultan Hamud District Hospital. Sharing a bed with two other people, in a facility with no CT Scan, no X-Ray machine, 1 professional doctor and two nurses, no private bathroom, no ambulance. And the only thing that will be standing between you and the afterlife, is a doctor. A Kenyan doctor.

Did you know that there are places in Kenya where the ratio of doctor to patients is 1:270,000? Did you know that the average Kenyan doctor working for the government earns Kshs40,000? Ever ask yourself why they quickly quit the government program after the mandatory year to move to the private sector, or out of the country? And you know what, I would do EXACTLY THE SAME THING. Okay, last one, did you know that the CT scan machine at Kenyatta National Hospital was outdated in the US, over 20 years ago?

Did I say last one? I have more. Did you know that some kidney failure patients are advised NOT to start dialysis, because they cannot sustain it on their income? It costs about 4,500 per session at KNH. You need three a week. Do the math.

Kenyans are simply, too poor to get sick.