This is a message to health workers in Kenya, first posted on the main Doctor’s Facebook group on 25th October 2019.
CORRUPTION IN THE HEALTH SECTOR
Chances are that if one of us posted a reveal on “big” corruption on this page, there would be an uproar of sorts. Afya house this scam, County B that scam, and so on and so forth. However, I want us to know that there is nothing like big corruption or small corruption. Corruption is corruption. What differs is the level of access. Therefore, the person corrupt in handling one thousand shillings will be corrupt in handling two billion shillings, if they had access to it. Still, allow me to make a distinction of corruption in healthcare as this kills faster. And no, I will not be talking of the abhorrent “big” corruption, I’ll be talking of a cancer among us: health workers.
People, a distasteful corruption culture is quickly taking root and if we don’t stop it, it threatens to be a norm. This is the culture of kickbacks for referrals, or for utilization of infrastructure and equipment and so on. As a result, thousands of Kenyan patients who trust us to help them get better are being taken through unnecessary investigations, procedures and admissions, not because their conditions require it but because there is corruption money exchanging hands, christened incentives. And this practice is present across cadres: doctors, nurses, clinical officers, ambulance drivers…you name it. We are not incompetent nor dumb as a lot. We know that exposing patients to any form of treatment or procedure is a risk in itself. We know that doing so when it is unnecessary is an unnecessary risk. We know that these risks sometimes become material adverse events, including death. Therefore, doing it nonetheless in exchange for money is an unmitigated tragedy.
No single Kenyan healthcare worker should do or be allowed to do this. This matter is grave enough for us to call upon help from outside the sector to assist in firmly entrenching deterrent measures. Therefore, we should all purpose to welcome investigative authorities: DCI and EACC for example to project actions that result in judicial processes, as well as the regulatory bodies to prune our professions of those who allow themselves to betray our duty as health workers and as citizens.
And no, the fact that our leaders are corrupt to the bone does not excuse us or give us the moral right to do this. It is also not a gray area: it is an unethical, corrupt and criminal practice that should result in the loss of license and time to reflect in an appropriate, custodial setting.
Kenya is a beneficiary of skills transfer, entrepreneurial lessons and advancements in technology from foreign partners who help us move forward and are integral to our continued development. We are a welcoming country and should continue to extend this warmth that benefits us in many ways. I am very much aware, that unfortunately, mixed in this group of blessings are a few enemies of this country , who despite Kenya being good to them, cannot tell the difference between trade in cabbages and trade in health and therefore lead the corrupt kick-back culture. This is their primary modus operandi, which substantially derails the national health agenda and should also be dealt with.
Finally, we should partner with our respective regulatory bodies to ensure that there are stringent measures in place to confirm the veracity of presented qualifications and also the competence of those applying to handle Kenyan patients.
I dare say that at least in Kenya, Kenyans are as important as any other citizen of any other country. Regardless of their social status, race, or country of origin, the treatment we offer any sick patient who purchases care from us, should be the very same care we would want for our own families.
Please colleagues, let us not allow ourselves to be agents of our own destruction as a country. I urge us to go a step further and actively fight this emerging scourge. It is a stench that has no place among professionals in this sector.