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Culture Spotlight on a Kenyan Hospital: Good Health is Your Choice

October 24, 2012

For this week’s culture spotlight, I wanted to take a moment to highlight a Kenyan medical facility, Homa Bay Hospital. As our perceptions of Sub-Saharan Africa is shaped by high rates of disease, I thought it was appropriate. Unfortunately I don’t have any pictures as it would have been highly disrespectful to take any. However, I did find a video in the Daily Nation about Kenyan doctors returning to work after a 10 day strike and it’s a good representation on how the Homa Bay Hospital looked.

Road-side shops dotted the road up to the hospital. It was a large area with many light blue buildings with open hallways between each building. I noticed the phrase “Huduma Bora Ni Haki Yako” was painted on the walls of nearly every room and hallway in the hospital. It means “Good health is your choice” in Swahili. It’s fitting to address the concern that many Africans choose not to seek treatment for various illnesses, such as HIV, but after walking through the hospital, the disadvantages are apparent.

The hospital was clean and kept up with 280 beds, 30 of which are located in the maternity ward. Lights were kept off during the day as much of the hospital was in the open air, with walls not quite reaching up to the ceilings. Everywhere, there were stickers and signs for AIDS awareness “Discuss AIDS, save your life”, malaria medication, tuberculosis, and various other illnesses. Prices were painted on the walls like menus, 200 shillings (2 American dollars) for an x-ray, 500 shillings to deliver a baby. They have an open-air operating room.

We had the privilege of sitting down with the principal of the hospital, as well as a nurse.  The hospital primarily treats malaria, tuberculosis, with incidents of road accidents, HIV/AIDS, and diabetes on the rise. There is no mental health program currently and most patients treat these illnesses traditionally which the hospital does not support. As a district hospital, patients will be referred to a larger city like Kisumu or Nairobi if the illness is beyond their capacity, a specialist is needed, or they need an ICU. As an institution, they receive employees that are assigned by the government and as a result, they are understaffed with a high turn-over rate. Nurses do most of the work because of this problem.

The principal was very adamant about the fact that the hospital does not work or associated with traditional healers, nor do they work with midwives. He condemned traditional healing practice by saying “they just don’t work”.  According to WHO, 80% of Africans rely on traditional healing so I wonder how much of the population is under-served because of this ideology and how that impacts disease prevention. (These initial thoughts eventually led to a research paper which I will blog about at a later time).

Some patients have to travel as far as 28 kilometers to receive help. The government does its best to supply prescription medication, mostly imported from other countries. He said they also receive boxes of expired or nearly expired medication from the United States and other countries. As a doctor, he was insulted at the idea he would give his patients expired medication. Here is just one of the many flaws with foreign aid, the idea that we don’t want it, but Africa will take it. Even after reading my own worlds, the open operating room, the heavily under-staffed hospital, and I think to myself, what can we do to help? What have we done to help? We donate clothes, knit blankets, collect donations, and send over medical doctors and interns. All of it is well-meaning but sometimes, it’s not all positive.

Let’s think about the costs of a college student interning or volunteering at a medical hospital in a developing world like Kenya. Their plane ticket for starters. I’m going to assume they are paying for food and boarding. But who is going to train this student? A nurse or doctor would have to teach them, train them, consent to be shadowed which takes away from time they could spend treating patients. In addition, the cost of training and caring for this individual does not go back into their “economy” so to speak. The student will return to the United States with a brighter resume, but with the cost of training this student, the facilities could have been used to train a native doctor or nurse, who would stay at the hospital, have a job, get an education, which would provide money for their family, and continue to treat Kenyan patients. With this in mind, I am not saying volunteering in another country in this setting is not a worthwhile experience. Or that you couldn’t come out of it as a more active citizen. But these are things to keep in mind when we think of how to best help a developing country with the least amount of damage.

In addition, confidentiality and patient respect is another concern. Africans need better health care, clean drinking water, medicine, trained doctors, etc, in order to save the many lives affected by AIDS, malaria, and other diseases of poverty. But when I visited another health clinic in the village, the record books with every patient who had visited the clinic in the last two years was handed to us to look through. Would this happen in the United States, somebody walks into the clinic and looks through your records or sits in the room with you? Why do we think it’s ok for us to do so in a developing country? It’s hard for us to fight for better health care and practices in developing countries if we see no problem in ignoring human dignity and basic rights because it’s Africa. And had I not been told to look out for these things, I wouldn’t have caught it either.

It’s a grim picture but it’s necessary to recognize the problems before we work towards solutions. Short term, yes, Kenya needs immediate medical assistance. However, if we want to break a cycle of poverty and dependency in the long run, we need to devote more resources so that Kenyans may actually choose good health.

2 Comments leave one →
  1. May 13, 2013 3:14 am

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  2. May 29, 2013 1:46 am

    Very good article! We are linking to this great article on our website.
    Keep up the great writing.

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