- How many doctors have mental health problems or are having family problems?
- Dr Stephene Mogusu died as his family and colleagues were struggling to raise money to help him pay for his bills.
- For most doctors, their fates are determined by popularly elected politicians who ironically, have limited education.
When a lady medical doctor quit her job to become a garment trader, I was left with many questions. Being a medical doctor is the dream job for every child and parent.
It comes with prestige, good pay, and respect in society.
But today, Kenyan doctors have been on strike for the past month demonstrating in the streets to at least get the ear of the government.
Their grievances are the government’s failure to employ and pay interns, wages, insurance, taxation, and their working conditions.
The government has been unwilling to listen to their grievances and is not letting up arguing that the doctors are being unreasonable.
One officer who is an urban planner said that the interns should go out and find their internship like she did for herself.
This reflects intragenic and the government needs to understand its doctor’s human behavior.
The government can understand the doctors’ behavior by using the Bronfenbrenner’s Ecological Perspective of micro, meso, exo, and macro structures.
Mental Health Status
The microstructure comprises the doctors’ families. Most of the doctors have families with basic needs. Their children need to be fed and taken to good schools, and hospitals for medical care.
They also need to be clothed. The doctors also need to spend time with their families. The family demands too weigh a lot on our doctors; they spend long hours in the hospital because of the acute shortage of doctors in the country and at the end, their pay is not even enough to meet the ever rising demands of their families.
The government needs to come clean and let us know how many doctors have mental health problems or are having family problems.
Also, to understand the doctors, the government needs to understand the nature of schools these doctors attended.
How democratic are they? How inclusive, friendly, and comprehensive are they? Do they allow the continuous growth of the doctors? Does the government have scholarships to support doctors who opt to continue with studies? How clean is the working environment?
The government needs assessment tests to know how many doctors ever become sick because of exposure to their clients, the patients. Do they have adequate insurance to cover them?
We all remember the case of the Machakos medical doctor who died from COVID-19 related complications after heroically working hard to save the lives of others yet, sadly, he did not have a salary or insurance for himself.
The 28-year-old Dr Stephene Mogusu died as his family and colleagues were struggling to raise money to help him pay for his bills.
His last words, captured in a post he made on WhatsApp where he told his colleagues to save themselves before it’s too late still ring louder, three years after he breathed his last.
Ethical Discussion
On the exosystem, the government is introducing many changes in the economy, practice, taxation, housing, education, and health care without taking time or adequate consultation with professionals.
Public participation does not involve adequate study of documents by professional and back-and-forth negotiations. This exosystem has affected doctors tremendously. It has affected their training and taxation.
Should a doctor who is pursuing continuous education and paying for themselves be tax-exempt? Should a doctor’s practice be taxed as a profit or a non-profit business?
Should the doctors be taxed for affordable housing? Will they be allowed to bid for affordable housing?
These exogenous factors affecting the doctors need to be discussed respectfully, ethically, and professionally.
The macrosystem factor affecting the doctors is the devolution of health services. Health as a devolved function is run and managed by county governments.
County governments were initiated following the promulgation of the Constitution of Kenya 2010.
Teething Problems
Their implementation has encountered a lot of teething problems including lack of adequate funds, lack of understanding of rules and regulations of management, corruption, and big man syndrome of defining who is in control.
For most doctors, with first and second degrees of education, their fate is determined by popularly elected Members of County Assembly (MCAs), who ironically, have limited education.
The majority of these MCAs do not understand what the medical profession entails. That is why they are handling doctors’ demands with threats of sacking rather than addressing the real problem.
It is not clear why the 2010 Constitution devolved healthcare. Were the doctors aware of the implications of healthcare as a devolved function?
How was research and procurement in health care going to be coordinated? Each county operates its health care independently without coordination with other counties.
But the doctors seem to be unified in their problems. They are well-coordinated and persistent in their resistance. They are unlikely to let go.
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The government needs to go through the law, again, with the doctors and see where it can be reviewed and come up with uniform policies for dealing with doctors and healthcare.
Will County Governments have their licensing laws to allow doctors to practice so that they will behave professionally, ethically, and competently?
The way this case is handled might be the demise of the public health system.
