The Kenyan education system considers medical doctors, including dentists and pharmacists, to be our best and brightest. In our competitive—and elite-making—public education system, medical doctors are the cherry on top, the prize, those who have proved themselves worthy. Medicine is not considered a vocation; I write this understanding how the term “vocation” can be misused to obfuscate important questions of labor and compensation. To be a medical doctor is to have achieved a dream—to have received a crown. These days, a paper crown.
Kenyan doctors are on strike.
Rather, Kenyan doctors who work in the public sector, in government hospitals, are on strike.
They are on strike because they do not have the equipment, facilities, and supplies to perform their jobs. They lack drugs and bandages and clean needles and sterilizers; they lack dialysis and MRI machines; they lack adequate medical insurance to keep themselves healthy; and they lack adequate compensation that values their contributions to Kenya. Indeed, to stretch a metaphor: the government has equipped Kenya’s doctors, the best and brightest, with First Aid boxes and told them to heal the nation.
And so our doctors are dying because they lack access to medical care and Kenyans who rely on public hospitals are dying because the doctors do not have the facilities to treat them.
Meanwhile, the Kenya government is twiddling its thumbs and buying expensive chairs (each Kshs 200,000, approximately $2,000). And saying, perhaps rightly, that there is “no money.” We are fighting a war so there is “no money.” Even as we set up more and more and more expensive “very necessary” committees to run the country.
If nothing else, the weeks of the PEV violence proved that Kenyan politicians are mostly indifferent to ordinary suffering. We killed each other as our leaders played “who has the biggest dick.”
More to the point: Kenyan politicians and their cronies do not need public hospitals and the doctors who work in them. Kenya has very nice, very expensive private hospitals, for those who care to be treated here. If not, South Africa, India, the U.S., the U.K. For those with money, public hospitals are a rumor. A place where one’s domestic servants might go if they require care.
As doctors strike to improve public healthcare, those of us who rely on private healthcare blithely move on with our lives. There is no crisis. Nothing to see here. And if doctors choose to strike, if our best and brightest try to argue for a more ethical, more humane medical environment, well, clearly, they did not get the memo: in our new era, “best and brightest,” “medical school degree,” “public health,” these are all nice phrases to be used in polite company and when we solicit money from donors.
The promise of the “best and brightest” has always been that they will provide the leadership we need to “improve” the country. Even as our history demonstrates that we would rather treat the “best and brightest” as unpaid or poorly paid laborers, people who work because they believe in “sacrifice.” That is our benign history. We also like sending them to jail and into exile.
What we forget—what the government forgets—is that Kenyan doctors in the public sector have chosen to work for Kenya. They could go abroad, seek other opportunities, leave our already depleted medical services even more depleted. We have, I believe, 2,300 public medical doctors for a population of 40 million. More eloquent writers can say more about the medical situation.
This medical situation raises an ongoing question about what it means to work in Kenya’s public sector. And, more specifically, why it is that the people I have long admired as the “best and brightest” do not work for the public sector. I wonder, also, why average people like me do not work for the public sector. What does it mean to envision public sector jobs as sites of intense, ongoing struggles to survive, let alone thrive? What does that struggle mean for Kenyan academics? And why do we expect academics and public sector workers to “sacrifice”?
“Sacrifice” becomes more than metaphor when patients and doctors are dying because they lack adequate supplies.
It’s not clear to me why the government would praise education and laud those who are well educated—as it does—only to ignore their needs and recommendations. Why should it be “unrealistic” for the government to ensure that public hospitals have adequate supplies? This at a point when, if Raila Odinga’s figures are to be believed, Kenya is spending 200 million a day to fight a needless war.
And what happens when the “best and brightest” and the “average and lucky” choose to leave public service and work elsewhere? I am not arguing that the public sector is the only place from which one can work for Kenya; I am interested, however, in what happens when the public sector becomes an impossible space for the “best and brightest” and the “average and lucky.”
What happens when the designation “best and brightest” is rendered meaningless by government action and inaction? How might this reverberate through an education system that is already in a state of crisis? What might it mean to devalue what is considered the pinnacle of academic achievement in Kenya? And what might it mean to tell those who want to dedicate themselves to public service that their education, their achievements, and their labor has no value?
Many messages are being sent by the government: messages about the value of education, about the value of public service, about the value of human life. None of these messages are the least bit encouraging.