Burn out, indiscriminate transfers of doctors hamper efforts to improve service delivery in Gusii Hospitals
“We are trying but the burning out is intense , ” a doctor at the Kisii Teaching and Referral Hospital said.
The Star found him racing against time to save the life of an accident victim.
The patient had been wheeled in with a fractured spine. .
He was the tenth in the schedule for an emergency operation
Here, the doctor said, they work in small units to save lives but with more patients checking in every other time , the bones can give way.
Around him are pockets of other staff, mostly nurses and two clinicians, all .
stung by a burn out.
The doctor says he at times feels overwhelmed, feeling trapped and defeats.
Sometimes they are not sure if they are doing everything right.
“There is no pill for a burnout, possibly adding more staff can do ,” he told the Star in confidence..
The nurse assisting him said they battle fatigue the same zeal they fight ghosts of death off critical patients.
“There is often no room to say i want to rest when an accident victim is wheeled in. We have to persist, sometimes that perseverance gives hope to him, sometimes we get everything wrong, it is the nature of work,” she said.
Kenya Medical Practitioners and Dentists Union officials say the burnout among medics can be intense.
Burnout is a common syndrome includes emotional exhaustion, depersonalization, and low personal accomplishment.
They have already raised similar sentiments with the county bosses with favorable responses hardly coming by.
At most County hospitals, doctors barely cope with work, Aggrey Orwenyo the Union Secretary told the Star.
The syndrome may increased the risk of medical errors and decrease job satisfaction, said Orwenyo.
It can get worse with major break out and the health teams are small to adequately respond.
Orwenyo says inadequate staff predisposes medics to situations of burnout.
The situation is the same in the neighbouring Nyamira County’s flagship hospital.
Here, doctors on duty intersperse curses on the devolution subject.
Most opine, strongly, that handing over the health docket to counties was the mistake of the century.
“We hope one day a book will be written on this miisadventurlism,” said one medic doing a suture to a male patient who injured himself after he slipped onto a ditch in his farm.
At the hospitals, the doctors agreed to speak on condition of anonymity saying . reprisals from the authorities can be severe if found out.
They spoke of working for long hours with little to show for it.
Orwenyo said there is neee for additional recruitments of staff.
Kisii alone , he said, needs an additional 100 doctors to make things even.
Nyamira with its 47, it needs at least 57 more to beef up services.
The doctor – patient ratio across counties still continues to remain dismal.
In other regions, one doctor attends to more than 22,000 of their residents.
The dearth is sigficantly acute in some key departments at the regional health facilities. .
Some are not manned at all leaving residents at the mercy of cartels.
These deprives the counties of critical opportunities to improve health care service delivery..
“This definitely poses sigficant challenge to the health care industry in this region, we have already flagged it as an area of extreme concern ” ,states Orwenyo
With the 6 million plus population, Nyanza is served by a paltry 600 doctors.
Orwenyo says the figure already way below the standard threshold recommended bythe World Health Organization.
The World Health Organization (WHO) prescribes the ratio of 1:1000, that is, one doctor for a population of 1000 individuals.
“Going by these statistics, each doctor averagely attends to 10, 000 of the population which begs the question if we are on the right track when it comes to efforts aimed at improving the health care service in our country,” said Orwenyo.
The Union has since written to County bosses in the region asking them to address the disparity.
To be safer, the County bosses need to engage around 5600 more medics to make the situation even.
Kisii County Health Executive Leah Bwari says the issues raised by the union would be addressed as time goes by.
She however said the huge wage bill lies on the way to meet all the obligations within the short term.
“It is something we happily want to do,” she told the Star.
Iindiscriminate staff transfers also appear to had miffed the doctors no end in her county.
Union officials especially now question the wisdom among the executives in okaying the transfer of :’high valuable specialist doctors’, to far flung health facilities where their skills are least exploited.
One such case was a senior nutritionist was dispatched to a dispensary days after a change of administration.
“These are some things that make mock of the efforts by the government to slash down wage bill,” said a doctor on duty.
He questioned the rationale of :dumping’ a specialist doctor in an isolated health facility in the middle of nowhere.
Orwenyo says wisdom was not applied in the transfers.
The transfers have since been questioned by the Public Service Board officials.
The letters said the board, were signed by the former County Secretary Patrick Lumumba and not the chief officer as law dictates .
“Any transfer and deployments for officers above group Q must be recommended to the County Public Service Board for sanctioning through Clunty Human Resource Management Advisory Committee,” the board chief Agnes Nyamwange wrote to the County Governor Simba Arati.
Most affected was Kisii Teaching and Referral Hospital.
There had been case of an oncologist dispatched to outlier health facility.
There have been a string of other specialists idling in more other remote health facilities.
The oncologist for instance has not attended to a single patient since he landed there .
Lack of equipment to aid these specialists at the health facilities they were sent out to compounds the problem afflict the doctors the more.
There had been reported resignations in other areas.
Some say they are opting out to where their services are needed the most adding that this will do the justice to public money as well.
“it does not make much sense to me earning money while idling at a deserted health facility’,” said one of the affected medics.
He has since tendered his letter to check out of the service.
The letter is awaiting approval.
“I am hopeful they would release me ” he told the Star.
The spoke of enmess drug disbursement that fail to meet as per need threshold basis.
“They become a waste at the end,” he disclosed
The morale among the cadre still remains extremely low, he said.
Meanwhile, Orwenyo says the medics would may walk out of offices if counties go ahead to implement an edict by the Salaries and Remuneration Commission to scrap off their non-practice allowance.
” Should the directive be effected in our payslips, doctors will immediately withdraw their services without any further notice,” said Orwenyo .
He termed it as a tactic by the government not to fully commit itself to the negotiations with regard to the doctors 2021 – 2025 CBA.
” It is in bad faith, and in the long run, patients will be the ones who’ll suffer at the expense of such reckless directives, of which key stakeholders such as our union were not consulted.,” said Orwenyo.