Many a times we think of ill health and death as private matters and we take on these burdens individually and only find solace in the divine promise of eternal life in the hereafter. We rarely get to question the role that a failed government system and unequal opportunities play in preventable and unnecessary morbidity and mortality of our loved ones. Financing exorbitant medical bills and burials are burdens borne by grieving families and if lucky harambees come to the rescue. There is a common street saying in Kenya that one is only one major illness away from poverty.

But when COVID-19 pandemic struck, we realized that governments should be the ones leading the health agenda of her people and that protecting us from sickness and death is their supreme responsibility. A sick and dying population cannot work and it finally takes a toll on the economy. A healthy nation is indeed a wealthy nation. Access to quality healthcare is a public good and a basic human right enshrined in article 43 of the Kenyan constitution.

There has been talk about COVID-19 taking a toll on our healthcare system but the truth is that the pandemic just exposed how broken the public healthcare system is in Kenya and in many poor countries. There have been lessons learnt and that is the gist of this opinion piece, some of them include:

1. Need to stop over reliance on private healthcare providers to cater for us. It is inadequate, it's costly and if we're paying taxes, we shouldn't have to be paying for these costs privately - we should be getting adequate public healthcare! The only way for this to happen is if we spend on it. Private entities cannot out invest government and thus the best services both in infrastructure and in manpower should be found in the public sector. We have NEVER allocated more than 7% of our total national budget on healthcare yet we committed in the Abuja Declaration to spend at least 15% annually. World over countries which had publicly funded and driven healthcare systems responded and managed the pandemic a lot better.

2. Even as we call for increased spending  on public healthcare, we must also insist on accountability for those funds. As we allocate the funds on the more financially and corruptly rewarding brick and mortar like  Isolation units, ICU beds, and more drugs, we must also ensure that we invest in the less exciting aspect of human resources for health. Corruption in the procurement process of these must be punished severely because it undermines any efforts we make on healthcare.

We must also upscale our local manufacturing ofhealthcare commodities. When the pandemic struck our main pharmaceutical supply chains in India and China were cut off as countries withheld the products for their own use. This created a shortage of essential products like Personal Protective Equipment and led to unnecessary infection and deaths of health workers.

The need to practice data driven interventions in healthcare. This can only be possible if we strengthen our healthcare reporting mechanisms all the way from the household level upwards. Many a times decisions were made blindly and this only worsened the situation especially on the restriction of movements and burial rites.

Finally, we must treat healthcare workers as the heroes that they truly are. World over the frontliners put aside personal fears, to not only serve patients but do so selflessly knowing that with the shortage of personal protective gears they were not just endangering their lives but also of their loved ones. While most governments appreciated these sacrifices and rewarded them accordingly, the same cannot be said of Kenya. Kenyans were treated to constant threats by the workers to down their tools due to inadequate and poor quality of PPEs, delayed salaries, lack of health insurance cover and poor work environment.

When Dr. Stephen Mogusu,a young Kenyan Medical Officer who worked in a COVID isolation center succumbed to the same in February this year, he was just 28years old and he had not been paid for five months and did not have a medical insurance cover and could not afford the very services he had offered to hundreds of patients from Machakos county. He left behind a young wife and an infant child. Sadly this was not an isolated but rather the norm in the many Isolation centers in the country.

The 100 day doctors strike in 2017 was one of the longest and most devastating workers strikes in Kenyan history alongside the nurses 150 day strike. But many of the concerns they raised then are the same now and the way the union leaders have been treated including threats of imprisonment for peacefully demonstrating is an indictment of the state of our healthcare even now, four years later.

Kenya loses thousands of healthcare workers annually to countries willing to pay and treat them better. And for those who remain, the National and County governments refuse to  implement even the already signed collective bargaining agreements. Instead they choose short term solutions like  hiring Cuban doctors at over four times the cost of what we would have paid a Kenyan doctor.

My co-author who is the Deputy Secretary General of the Doctors’ Union opines that the state of Public healthcare is not just accidentally failing but that it is rather being systematically dismantled to pave way for profit driven private healthcare which could never cater for us all. It is the worst form of state capture.

Finally, if this pandemic has not taught the political class that a time comes when even the wealthiest cannot fly out of the country for medical treatment and that we should do more to build our public healthcare systems. Then what more will it take? The Universal Healthcare Presidential agenda will just remain hollow talks which makes no sense to the ordinary mwananchi.