On Cuban doctors, their Kenyan foes have a plan – sabotage

What you need to know:

  • Whose idea was it to import Cuban doctors to Kenya? Whichever way you look at it, the decision to invite 100 foreign doctors to ostensibly come to alleviate and therefore ameliorate a deteriorating healthcare system in the country was a horribly ill-informed idea.
  • Uhuru Kenyatta must be in the know about the importation of the Cuban doctors: In March 2018, he was in Havana meeting with Fidel’s brother Ramon and the two must have talked about, among other things, the issue of the Cuban doctors.
  • The clinicians are miffed that the government finds it fit to pay foreign doctors exorbitantly, but will not do the same for Kenyan doctors, who toil hours on end with scarce resources and badly equipped hospitals, because resources meant to buy drugs and equipment have been squandered – by the politicians themselves, their friends and relatives.
  • The Kenyan medical personnel I have been talking to – consultants, clinical and medical officers, nurses, physicians and registrars have been telling me one constant thing: “These Cuban doctors will come here and their much taunted specialist work will collapse like a house of cards. They will not succeed.”

Whose idea was it to import Cuban doctors to Kenya? What was the rationale that informed the idea? Was the idea a collective decision by people who understand how the health sector functions, or was it an idea individually driven by people who thought they needed to “teach” Kenyan doctors a lesson? Was the idea informed through a well-thought-out proposal, perhaps on a (critical) need-basis expertise, whose viability was supported by professionals in the health sector, or was it made by a partisan political group engaged in a retributive and vengeful contest?

Whichever way you look at it, the decision to invite 100 foreign doctors to ostensibly come to alleviate and therefore ameliorate a deteriorating healthcare system in the country was a horribly ill-informed idea. Make no mistake: Cuban doctors are some of the best-qualified and best-trained physicians you can find anywhere in the world.
After the Cuban Revolution in 1959, Fidel Castro, who went on to rule the tiny socialist island of close to 12 million people for about half a century, set upon a socialist programme that would equip Cubans with three things: a (totally) free education – from nursery to university – that was suited to the needs of the Cubans; decent housing that enabled Cubans to live with dignity like human beings; and, most important of all, again a (totally) free healthcare system that ensured that no Cuban would die because he or she could not afford medical care.

HOMEGROWN SOLUTIONS

Is it a wonder today that Cubans have one of the best healthcare systems in the world? Is it also a surprise that Cuban citizens’ average life expectancy for both sexes is 79 years, ranking the island in the top 35 countries in the world?

The healthcare of Cubans was at the heart of Fidel for most of his working life as a president, till he resigned due to poor health in 2008. (Note, unlike many African and some Latin American countries’ despots, who seek medical treatment abroad – read USA and Europe – Fidel was treated by home-bred Cuban doctors until his death in November 2016. Why? Because the state had massively invested in the training of highly educated and trained medical staff and equipped state hospitals well).

Apart from ensuring that Cuba had top-notch medical experts and specialists, Fidel’s socialist government took it upon itself to make its own medicines – suited for the Cuban environment and diseases. In his heyday, Fidel would make it a point of his presidential duty to visit pharmaceutical factories and industries and engage drug scientists, impromptu, so that they could bring him up to speed on their latest inventions.

Of course, one of the “push factors” that led the socialist government to be self-sufficient in healthcare facilities – to the extent that it reached a point they would “export” their expertise – was the economic embargo that successive US governments had imposed on Cuba, until 2014, when Papa Francis brokered a year-long détente between Fidel and Barack Obama. Look at the heavy investment of a state that cares about the health of its people. Look at the many years of hard work of a state that was intent on coming up with home-grown, local solutions for its local problems. And here we are, a resource-rich country in the medical field, going to a tiny country to beg for 100 physicians. For what?

SUBTERFUGE AND PARADOX

“What is 100 doctors?” a Kenyan consultant physician asked me. “This is a drop in the ocean. But that really is beside the point, tell me again, why is the government importing doctors?” What are the 100 Cubans coming to solve? Are we bereft of medical specialists? There are so many Kenyan doctors working in Botswana, Canada, Namibia, South Africa, the US and the UK that if the government was serious in addressing the “shortage” of medical specialists in the country, it would first begin by enticing those very Kenyan doctors largely trained at universities in Kenya and working abroad as expatriates to come back home. The consultant reminded me that the cardiovascular department of the national referral hospital in Windhoek, Namibia, was set up by a top Kenyan cardiovascular surgeon – “and here is a government that has it priorities all screwed up”.

But no, the politicians who decide how many meals ordinary Kenyans will eat a day must first engage in subterfuge, then wiggle in paradox. In a video that has been doing the rounds in WhatsApp groups, President Uhuru Kenyatta is captured campaigning on the theme of local solutions, for local problems. And it is not local problems but foreign solutions that he accuses his then political nemesis Raila Odinga of propagating. Partisan, political campaigns are one thing, clear policymaking devoid of parochial politicking is another. “Is President Uhuru not speaking from both sides of his mouth?” Asked the consultant physician.

Uhuru Kenyatta must be in the know about the importation of the Cuban doctors: In March 2018, he was in Havana meeting with Fidel’s brother Ramon and the two must have talked about, among other things, the issue of the Cuban doctors. The Kenyan medical personnel I have been talking to – consultants, clinical and medical officers, nurses, physicians and registrars have been telling me one constant thing: “These Cuban doctors will come here and their much taunted specialist work will collapse like a house of cards. They will not succeed.”

'GOVERNMENT KNOWS NOT'

I asked them why. “Because we’ll sabotage them. The government will not bring into the country foreign doctors (and not for want of local expertise), after they have mistreated our brothers and sisters, just because the government cannot be seen to back down on an illogical political decision made at the height of the state’s recalcitrant stance. The doctors were asking for just pay, commensurate with their work. Industrial action in this country is a right, enshrined in the Constitution, but instead of addressing the doctors’ grievances, the government decided to act in a high-handedness manner.”

The clinicians are miffed that the government finds it fit to pay foreign doctors exorbitantly, but will not do the same for Kenyan doctors, who toil hours on end with scarce resources and badly equipped hospitals, because resources meant to buy drugs and equipment have been squandered – by the politicians themselves, their friends and relatives.

“Let me tell you how it’s (the sabotage) going to happen,” said a consultant. “A Cuban doctor is in the middle of a procedure – let’s say, cardiovascular surgery of the left ventricle of the heart. He asks for his surgical knives and scissors and scalpels and the (Kenyan) nurse tells him or her, ‘I’m sorry doctor so and so, but the sterilising machine is out of order: it’s not working.’” Is it the problem of the anaesthetist or the nurse that the sterilising machine is broken? Already, there is a video clip doing the rounds that caricatures the efforts of the Cuban doctors: Always available to offer a helping hand, a Cuban medic decides to carry a patient to his wheelchair – apparently because his Kenyan counterpart is seemingly reluctant to do so. He carries him on his back only for them to fall, after sliding on the gradient floor. Undeterred, he picks up the patient, who cannot walk because he has a cast on his leg. As he places him on the wheelchair, they both fall backwards, wheelchair and all.

“We have nothing against the Cuban doctors – they are the most competent, hardworking medical staff you can find anywhere, patriotic and all, but they will have been caught up in a pawn game played by a government that looks down upon its own medical staff, whose resolve not be cowed down, will pity the hapless Cuban doctors, who will be caught in-between,” said a consultant periodontist.

“If the clinical staff decide they will be uncooperative to the Cubans, what are the Cubans going to do? If they (medical staff in the radiology department) decide the radiology machine will not work, therefore the Cuban doctors cannot read the scanned X-ray results, hence cannot properly diagnose the patient, who is to blame? Medical facilities, especially in public hospitals, are always breaking down – will the Cuban doctors blame the subordinate staff? Will the government come to police the medical staff, so that they don’t sabotage the Cubans?”

In what has come to be parlance in Kenya’s political lexicon, the consultant told me, “Serikali itajua haijui”, literally to mean: the government will realise it knows not.

Mr Kahura is a senior writer for 'The Elephant', a Nairobi-based publication. Twitter: @KahuraDauti