Kenya’s response to the fight against
Ebola has been appreciatively immense and of great value. The over Kshs. 100 million monetary
support and over 700 health workers will go a long way in wiping out Ebola, and
hopefully before mid-year, West Africa will be epidemic-free. It must be
commended that even though Africa’s collective response has been more reactive
rather than active from the beginning, the continent’s leadership has admitted
the many lessons to be learnt and the need to refocus our public health care
strategies. Expectedly, our Public Health Systems more-so regarding disease surveillance,
disaster response, staffing, preventive health budgeting and hygiene and
sanitation promotion are going to be strengthened.
Human resources for health has been one
of the greatest challenges to the response. With many governments struggling to
narrow the ratios between health workers and populations, we have seen huge
reluctance of health professionals to join in the fight and strikes have been some
issues that West African governments have had to face. For mobilizing, training
and dispatching 700 health workers to offer support to our kinsmen in the west,
the government deserves a strong pat in the back, regardless of the fact that
Kenya has one of the biggest health workers to patients/populations imbalances.
We some of the best trained health professionals in the continent and its
wonderful our impact has already been felt.
But my concern is in the constitution of
the delegation. From insiders, more than 90% of Health Workers being exported
to West Africa are curative professionals who will offer care and laboratory
services. They will be based in the management centers or laboratories to
support in the cure and diagnosing of cases. But does Ebola control need more
clinicians or Public/Community Health Workers? As a communicable air-borne
disease, does it elimination lie in clinical interventions or community based preventive
interventions?
But cure has not be the center of West
Africa's success story of recovery from Ebola. It has been prevention: The
simple hygiene and sanitation practices such as maintaining personal
cleanliness and proper disposal of human wastes. A disease free Africa will not
be realized in the health facilities but in the communities, community health
education and promotion deserve much better human resource investment. For instance, in Sierra Leone, Community Health
Volunteers have done tremendous work, creating strong community networks of
ownership of the response and recovery process. For any public health
intervention, Behaviour Change Communication (BCC) is the best strategy,
community mobilization for social change is the engine of societal acceptance
of any intervention and achievement of high impact results. There can never be
better people to be architects of health promotion and education than Public
Health Practitioners. We are dealing with more of a community problem regarding
cultural beliefs, attitudes and practices than a clinical problem, as much as
many will argue that the cure for the Ebola virus is not yet found. We the
people closest to the communities, the PHOs, are take the blame when
communities are unresponsive and continue to die from preventable deaths.
I therefore contend that Public Health
Practitioners ought to have been given high priority of deployment to West
Africa. But again, if the government had decided to export PHOs, how many would
have remained? Over the years, the broader government focus has been curative care,
maybe because of increased trade unionism by clinicians giving the government pressure,
contrary to PHOs whose even Association of Public Health Officers Kenya (APHOK)
is as good as dead. PHOs continue to be un-talked of heroes whose training,
employment and welfare are not taken that seriously, and in the end, other
professionals have grabbed the opportunity to be the sole leading public health
experts. There are roughly just 6,000 PHOs against about 5,000 doctors. This is
dangerous for a safer nation. Preventive
health care became the beneficiary of devolution with very high hopes, and we
need to evaluate if our gains have diminished or hopes of once again being at
the pinnacle of the public health sector are being realized. How committed are the two levels of
government to hire more Public Health personnel so that we can have enough to
export to epidemic invaded places like West Africa?. Kenya and Africa as a whole
must refocus and invest more in preventive health care, and more qualified
public health practitioners are the heart of any prevention program.
The
Writer is a Public Health Expert on Community Mobilization (Email:chrispory.juma@gmail.com)
