The problem with philanthropy is that its focus is on the benevolence of the individual donating charity, not on its effectiveness on healthcare for the Kenyan people. The absurdity of philanthropy is evident in the report of the ground-breaking ceremony or the Tesla Cancer Care Center by the First Lady in August 2015. The report says that "the facility will also establish a foundation through which deserving but under-privileged cancer patients will be taken care of." In other words, philanthropy decides who deserves healthcare and who doesn't. And the middle class will never get healthcare unless they pay through their noses, because inevitably, the foundation will never consider anyone with education and an income "under-privileged," even when they cannot pay medical bills.
So, as we vote this year, let's ask political candidates not what they will do for healthcare, but where they stand on
a) universal healthcare for ALL Kenyans
b) a law requiring elected officials and their immediate families to seek treatment in Kenya's public hospitals
c) the Collective Bargaining Agreement that the government signed with the doctors
Current position: Nominated Senator
A cousin to the current president, Beth Mugo was Public Health Minister in the Kibaki Govt when, as she testifies, a lump had been spotted in her breast. She flew to the US where the tests were done, and she was diagnosed with stage 1 cancer.
The irony of a health minister seeking treatment abroad aside, Mugo's story embodies the magnitude of the inequality that is cancer care in Kenya. Most Kenyans are diagnosed with cancer at stage three and four cancer, when it is almost or already too late to save their lives, because of a dire lack of pathologists and laboratories to do the biopsies. But Mugo got not just her treatment, but her diagnosis done in the US. In the interview, the best that Lillian Muli could do to highlight the socio-political implications of Mugo's treatment was to ask the Senator the monotonous question of what she was doing to "give back to society." To which the Senator replied (suprise, suprise) that she was launching the Beth Mugo Cancer Foundation to promote awareness on the most common cancers in Kenya. The foundation credits Sen. Mugo for "the development of the National Cancer Control Strategy (2011-2016), the enactment of the Cancer Prevention and Control Act (2012), and the establishment of the National Cancer Institute of Kenya" during her tenure. Nothing about increase in actual cancer care facilities, and Muli didn't ask the Senator about the work she did for which the "society" had actually employed her.
Current position: Senator, Kisumu County
Under the Kibaki-Raila government, Prof Nyongo was the coalition partner of Beth Mugo as Minister for Medical Services. He was diagnosed with prostate cancer and sought medical care in California, USA. In the interview carried out by suave journalist Johnstone Mwakazi, no mention was made of the irony of the minister seeking treatment abroad. Soon after, he founded the Africa Cancer Foundation.
Current Position: Deputy Governor, Kisumu County
From an article meant to tell us that the sister to Prime Minister Raila Odinga was missing her family over Christmas, we got to know that Ruth Odinga was nursing a fracture at St. George's Hospital in London. Our consolation prize was that she remained true to her ODM party by requesting an orange cast. The writer, Kevine Omollo, made no mention about who was footing the bill for her treatment in London, but to fill the quota for social consciousness, he threw in a few lines about the lack of women candidates for governorship. Thankfully, Ciku Muiruri wrote in the Nation that the trip to the UK was an indication that that politicians think they are better than the people the serve. I also wrote a piece on the same, and it is my most read to date.
Current Position: Governor, Bomet County
In November 2016, Governor Ruto was hit on his face by a teargas canister when fracas broke out at a football match. He was airlifted to Nairobi, after which he headed to South Africa to complete treatment. He returned toa warm welcome at the airport and a homecoming ceremony the following day. He become the butt of jokes and memes on social media through the Isaac Ruto Challenge, including from the crew at Larry Madowo's show The Trend. At least this time, the media pointed out that the trip was an insult to Bomet voters and all Kenyans. In December 2016, Governor Ruto was reported to have assaulted striking doctors meeting in his county.
Current position: President and First Lady of Kenya
LONG READ ALERT (So much to say)
The president's party's manifesto for the 2013 presidential election reads like a manifesto for the commercialization of healthcare in Kenya. Even though it eventually mentions free maternal care and improved working conditions for doctors, it starts by talking of turning Kenya into a medical tourism hub like India.
In my book, tourism symbolizes exploitation and lack of creative economic thinking. But also, there's no country with universal healthcare that is also a medical tourist destination. India, the Kenya government's role model, spends only 4.2% of its GDP on health care, and 70% of its population has little or no access to healthcare. In other words, the Kenyan middle class complacency, which sends them to India for treatment, is colluding with the denial of healthcare to not only the Kenyan poor, but also to the Indian poor. If we the middle class have values and a conscience, we should not agree to be complicit in denying the dignity of health care to the poor anywhere in the world.
Within a few months of taking office, the president attended a ground-breaking ceremony for Nairobi Hospital's anticipated Sh 2bn campus in Machakos, hosted by then CEO Cleopas Mailu. By November 2015, Mailu was CS of the Health docket, and is currently presiding the government's silence on the doctors' strike. In December 2016, as the strike continued to bite, the president awarded CS Mailu with the honor of Elder of the Golden Heart at State House.
The article that probably best articulates the cynicism with which the Jubilee government is exploiting the sick, is in a piece in the New York Times. The article is about an investor of the Abraaj group seeking to cash in on the Nairobi middle class by providing private healthcare. When asked by a medical intern at Mama Lucy Hospital (yes, our doctors care) whether he will provide healthcare for the poor, who have the greatest need, the investor replies: "We can’t go to that part of the population because the business is just not sustainable.”
One cannot avoid concluding that the point of the government remaining mum on the doctors' strike is to protect private healthcare investment profits. The first way to do that is by preventing the formation of a doctors' union. And on reading the CBA, nothing confirms that more than the fact that the first item of agreement after the preliminaries is the doctors rights to unionize. The right of the union to represent doctors in not only labor relations, but also in the formulation and implementation of healthcare policy, is something that private investors would like to avoid. Without a union, and with a broken public healthcare system, the private healthcare business can literally dictate healthcare policy in Kenya, including tying doctors' hands in terms of the care they give to patients.
The president knows the power of the unions only too well. And he also knows the power of crushing the unions. When former prime-minister Margaret Thatcher died on the morning of his swearing in as president, he sent a message of condolences that made Thatcher sound like an angel. He said: " the late Lady Thatcher was a decisive and firm leader who will be remembered across the world for the frontline role she played in championing free market economic ideology." Among Thatcher's most notorious achievements was the crushing the UK miners' unions, and, whole towns and families with them. Ironically, she was accorded a state funeral funded by the very public she so despised.
It is clear that the First Couple speak as if they are interested in public health services, but in reality, they are more keen on the private ones. Through the Beyond Zero marathon, the First Lady has been raising funds for the very maternal healthcare her husband had promised would be free of charge, earning great admiration and sponsorship even from the Ministry of Health, which is supposed to provide the services for which she runs the marathons. And most of the runners are, funnily enough, the Kenyan middle class. In August 2015, she launched the construction of Tesla Cancer Hospital in Ridgeways. The state-of-the art private center intends to tap into what is considered a Sh 10bn market, and there will be a foundation to take care of patients who are "deserving" but cannot afford the services.
When it comes to media performance, the president and the first lady have basically enjoyed a clean slate. To my knowledge, the mainstream media have never questioned the president's obviously neoliberal economic ideology. On the Beyond Zero marathon, questions about the public position of the officials using private means to solve a public problem were overwhelmed by admiration of the First Lady running into her husband's arms. And the fact that there were TV ad campaigns by the Beyond Zero secretariat may also have something to do with the media silence. Even I was intimidated and wrote a tortured blog on the marathon. The opposing views of bolder Kenyans were restricted to social media. As is always the case, anyway.
Current Position: MP, Tigania East, voted in on an ODM ticket, defected to Jubilee
Already days into the doctors' strike, Hon Aburi got involved in a scuffle in Parliament over the amendment to the electoral laws. He flew to Germany for specialized treatment. The report, which is not from one of Kenya's main newspapers, says that Aburi "was forced" to seek medical attention abroad due to the doctors' strike.
Current Position: MP, Embakasi South, ODM
In the same parliamentary fracas that sent Aburi to Germany, Hon Surma was also injured and sought treatment at Nairobi Hospital. Once again, it's not clear from the newspaper reports who footed the bill.
While both parties fought physically and with insults over Jubilee's unilateral amendment of the electoral laws, none of them seemed to see the irony of taking a break from the holidays to return to parliament but not talk about the poor dying for lack of treatment, or of the personal and business interests preventing the resolution of the impasse.
Current position: Governor, Nyeri County
I am pained to write this one, because Governor Gachagua is currently battling leukemia, unlike his fellow politicians who went abroad or to private hospitals for frivolous things like getting a bandage removed or for a plaster in party colours.
It so happens though, that before I left the house this morning, I posted a tribute on facebook to a colleague, George, who struggled in his final days with leukemia. His insurance ran out.
UPDATE (24/2/17): The Governor passed away in a London hospital this morning. May he rest in peace.
Senator, Migori County, and Chairman, Senate Health Committee
On 1st February, almost two months into the strike, Senator Machage led the Senate Health Committee in a belated intervention in the doctors strike. He admitted that the crippling of public healthcare disadvantaged the wananchi, majority of whom cannot afford private healthcare, but still dismissed the CBA as illegal and said that doctors should come up with another document. The Senator essentially sat on the fence, which is to be expected of politicians.
Less than a week later,he scolded the KMPDU officials who appeared before the Senate, essentially suggesting they were stupid to not take the money the government was offering and let go of the larger discussion about the public hospitals and the working conditions. In what are some of the most selfish remarks to date from a politician, he told the doctors: "Learn from teachers... they achieved something and put it in their pockets." The Senator's remarks are deeply insulting for Kenyans, because they essentially suggest that doctors should take the money and let Kenyans suffer because we do not deserve better healthcare. And they come as no surprise, given that the Senator owns Pastor Machage Memorial Hospital in Migori.
But the remarks also reveal the typical politician mindset: that public service jobs are not about service to wananchi but about putting something in one's pocket. No wonder the politicians reward themselves with hefty pay perks while wananchi cannot access healthcare.