("If these people (media) were fair, they would also report that nurses and other carders of healthcare workforce are not strike, and that most routine health services across all levels of the healthcare system are running normally.")

By Francis Gitahi Njenga

Anyone visiting Kenya today would likely get an impression that everything about the country's healthcare services delivery has collapsed or ground to a halt, and that all health facilities have closed down, courtesy of a deliberate disinformation by the press.

Sample this... East Africa's widest circulating newspaper, Daily Nation, Wednesday, April 17, 2024, without stating figures, had this screaming headline: Ping-Pong as deaths rise. The subtitle of the story was even scarier (Paying with their lives: hundreds of Kenyans are dying at home or in private hospitals and villages dispensaries as weeks-long grandstanding between doctors, governors and the government over the posting of interns escalates).

Except for 24-year old Maxwell Maronda who died receiving treatment at Kijabe Mission Hospital for advanced congenital bone marrow defect, the entire content of the headline story is devoid of figures, incidences, dates, people, or places.

Yet every day during the course of the doctors strike, my spouse who's a nurse, rises up early every morning and rushes off to work, only to return back home late in the evening, drained!

"How's that so if nothing is really happening out there?" I ask her.

"Who said nothing is happening out there?" She wonders.

I point at the story and other images of images of empty hospital benches splashed around by the media. She sighs and says, "That's only one side of the story, the small side!" She continues, "If these people (media) were fair, they would also report that nurses and other carders of healthcare workforce are not strike, and that most routine health services across all levels of the healthcare system are running normally."

Indeed, to the media, when DOG BITES MAN, that's NO STORY. But wait until MAN BITES DOG, that's a scoop and headline news. This principle has advertently been applied and carefully advanced to the ongoing doctors’ strike, and has brought with it some serious consequences. Worse, the government and counties' communication systems are barely functional, saying nothing about the continuity of other readily available health services.

Due to the media blitz given to the doctors’ strike, and a resounding blackout of ongoing services, there are people who believe that health facilities have since closed down. These has caused some clients to miss out on family planning appointments and some are those already bearing burdens of unplanned pregnancies; some mothers are yet to take their babies for routine and critical immunization, and worse, families have chosen the exploitative and expensive private hospitals while emergency services are available in all public hospitals!

Curious and suspicious of biased media reporting, I drop my spouse off at her place of workplace, a town based busy Health Centre in Nakuru City. To my surprise, mothers are streaming in and out of the health facility with their babies on their backs, cards and medicines in their hands. As I linger around, a heavily pregnant mother in labour is helped into the facility's maternity wing, and I am just in time and in the right place to hear a shrill but a clearly healthy first cry of life from a newborn baby!

I ask around this facility and I am told that, as a Health Centre, as in all Health Centres facilities across the country, there has never been a Medical Practitioner (doctor) here. All healthcare services here are provided by four (4) Clinical Officer, 8 nurses, a Pharmaceutical Technologist, a Laboratory Technologist, and a Nutritionist. The only affected services in this facility are in the consultation rooms served by Clinical Officers who have since joined the Medical Practitioners in the strike. Even then, once in a while, the clinicians steal their way back into the facility to attend to the very needy. However, all other services (80%) are running normally. Nobody has ever died here since commencement of the doctors' strike.

I do not stop here but run to the County's Level 5 Nakuru PGH Referral and Teaching Hospital. At first I had expected to see a ghost and deserted health facility but I am surprised that both human and vehicular traffic are overwhelming.

I get into the ultramodern Margaret Kenyatta Mother and Baby Hospital and the place is as packed as ever, with tens of nurses, doctors, and students running around. I peep into the gynae ward, post delivery, new born unit, and the post Caesarean wards, all packed and services running normally. I ask around and I am also told NO DEATH in the last 24 hours!

I detour and visit the Casualty and Emergency Department. A lot of staffers here know me and we exchange pleasantries. Though not as packed as I always knew the place, clients are lined up and receiving services, with the observation ward beds almost full to capacity.

Shortly, I passed by the X-Ray Department, where many clients are lined up and receiving services; same thing as the Laboratory Department, while the Maternal and Child Health Clinics are bustling with human traffic with different service delivery activities in progress.

What about in-patients services? Could this be the place the media is reporting paralysis? I pass by the main entry gate together with so many other people. It's already 1.00pm and time for "Visiting Hours". I pass by the Nyayo Wards, surgical and female wards. Surprisingly, all have patients, and are busy with different service delivery activities. By the way, a visitor coming here for the first time wouldn't easily know that there is an ongoing doctors’ strike.

Impressed, I chat up a Senior Health Services Supervisor in the facility. He quite agrees that normal health services delivery have significantly been curtailed by the ongoing strike. However, he said that the hospital management had laid down a comprehensiveness strategy that has seen basic and crucial services offered to any deserving person.

Of the 148 service delivery tasks in a standard healthcare system, doctors routinely perform only about 15%, nurses take 65% while other healthcare professionals take the last 20%. To completely shutdown a healthcare system, a hospital for instance, you only need to remove all the nurses, since even doctors and other healthcare workers largely rely on nurses to accomplish their different tasks.

In Kenya, and across the world, healthcare services are mainly organized and delivered in levels 1 - 6 (1: Community, 2: Dispensaries, 3: Health Centres, 4: Hospitals, 5: Regional Referrals, and 6: National Referral Facilities). While nurses work across the entire strata of healthcare delivery system, Medical Practitioners, dentists, and pharmacist are only found in levels 4 - 6; in very low numbers compared the rest of the healthcare workforce.

Nakuru County, for instance, has 220 public health facilities. Out of these, 14 are hospitals where about 150 doctors are deployed; 48 are Health Centres served by Clinical Officers and Nurses, the rest are Dispensaries scattered across the county and primarily served by nurses.