Last Updated: 2018-05-02
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An NNN-Kemya Broadcasting Corporation Special Report by John Kioria

NAIROBI, May 2 (NNN-KBC) -- Cuba's healthcare system is rated among the best in the world with its citizens accessing free medical care, including cancer treatment and organ transplants.

So organized is the Caribbean island nation's provision of healthcare that the country is recording zero maternal deaths with an obligation that doctors whose acts of commission or of omission which result in death should step aside.

Kenya is seeking to borrow the Cuban healthcare model, beginning with its engagement of 100 specialist doctors from Cuba who will arrive in the country by the end of June.

Not much is known in thie country about Cuba with its independence struggle spearheaded by the late Fidel Castro and its communist approach which is enshrined even in its national Constitution the most pronounced feature.

However, the island nation has one of the best healthcare systems in the world, fully run by the government effectively locking out private practice and the operations of private clinics.

Why the success, one may ask? The system is designed with a hierarchal division, at the top being the Minister for Health and the lowest being the Family Doctors division.

The unique nature of the system is exemplified by the polyclinicos division, which is the equivalent of a hospital providing services to people in an electoral ward in Kenya.

A recent visit to Cuba with the Health Cabinet Secretary (Minister), Sicily Kariuki, included a tour of the Vedado polyclinic on the outskirts of Havana, Cuba’s capital.

It’s a walk-in centre whose sole mandate is to provide curative care but with a bigger emphasis on promotion, prevention and rehabilitation.

The polyclinic offers services such as mother and child programmes, control of communicable and non-communicable diseases, genetic services, x-rays and minor surgeries. But it has the capacity to investigate medical emergencies such as a break-out of diseases and to fully contain it while proposing medical solutions for the same.

Cholera outbreaks in Kenya continue to be a headache to medical personnel in this country, often resulting in fatalities.

And while cancer treatment is free in Cuba, the polyclinics have developed a cancer vaccine meant to rid the country of cancer completely.

Well aware of the dangers that could predispose one to cancer, the Cuban government has made it mandatory for its citizens to visit a polyclinic once a month for a free check-up. As part of creating awareness and advocacy, the Cuban government, through the polyclinics, insists on physical fitness which does not exempt the old.

Road pavements are reserved for physical exercises as well as some of the parks being dedicated to physical exercises to citizens as old as 90 years.

In Kenya, referral hospitals such as the Kenyatta and Moi Teaching and Referral Hospitals have to deal with an influx of walk-in patients who do not have referral letters, straining their capacity and delivery of services. But the influx can perhaps be explained by the lack of capacity and specialists in level four hospitals in the country.

Cuba on the other hand pumps 27 per cent of its annual budget into healthcare with an emphasis on capacity building at the polyclinics.

So popular are the polyclinics and Cuba’s healthcare system that 11 per cent of the island's gross domestic product (GDP) is from medical tourism.

The polyclinics are also a training ground for medical professionals who earn degrees and post-graduate degrees from training at the polyclinicos.

Doctors in Kenya spent the better part of 2017 on strike demanding for higher pay and the improvement of working conditions. In Cuba, a doctor earns 24 US dollars a month, the equivalent of 2,400 Kenya shillings but with all other services, including housing and education for their families, fully provided for by government.

A Kenyan doctor at the entry level earns a maximum of 81,000 shillings (about 806 US dollars) a month, excludong allowances.

Medication is free in the polyclinics and is also subsidized by the government in the event patients have to buy it from a pharmacy.

Doctor Rodriguez Lao, a family doctor in Vedado in Havana, works from morning to 1 p.m. seeing patients. But from 1 to 5 p.m. her routine changes to making medical visits to families in Vedado.

She tells us that residents in Vedado are placed under medical classifications which include, Healthy Appearance, Risk Groups, Chronic Non-Communicable Diseases and Chronic Communicable Diseases. The classification informs the doctors planning visits to patients.

The doctor is housed with the community for the sole purpose of accessibility in the event of medical emergencies.

Before the scheduled visit by the doctor to a family, one is allowed to visit the doctor for a check-up. Those aged 65 years and above must visit the doctor regularly for check-ups to pick up any disease or likely old age health complication. Men and women between the ages of 24 and 64 must also undergo regular check-ups for prostate and cervical cancers.

Contracts for the 100 Cuban specialist doctors coming to Kenya at the end of June were signed last week by Kariuki as well as the co-operation agreement between Kenya and Cuba signed by Kariuki and her Cuban counterpart, Roberto Morales Ojeda.

Among the doctors coming to Kenya are nine specialists dealing with critical care, nine orthopaedic surgeons, five plastic surgeons, five Nephrologists, five Urologists, three Neurosurgeons, 47 family physicians to be deployed to each county, four radiologists, six general surgeons, two oncologists, two dermatologists and three general cardiologists.

Homabay County in western kenya currently does not have a single gynaecologist while the entire Rift Valley region has not a single neurosurgeon. The Kenya Medical Practioners and Dentists Union is opposed to the specialist doctors coming to Kenya arguing that there are unemployed doctors in Kenya.

But the National government and the Council of Governors are united in their resolve to bring in the doctors while insisting that their engagement in Kenya for two years will in no way mean that the government will stop employing Kenyan medical personnel.

In fact, Kenya is the only country within East Africa which had yet to sign an agreement medical co-operation with Cuba.

Cuban doctors are serving in 37 Latin American countries, 33 African countries and in 24 Asian countries, including economic powerhouse Japan.

During the visit to Cuba, Kariuki visited the Medical Co-operation Centre to meet some of the doctors who have undergone the rigorous process of interviews and vetting by the Kenya Medical Practioners and Dentists Board, a process activated immediately after President Uhuru Kenyatta’s state visit to Cuba mid March.

With Cuba having successfully eliminated malaria in 1960, Kariuki signed another co-operation deal on the control of Malaria vectors as Kenya seeks to up the war on Malaria. -- NNN-KBC