In January 2022, the Daily Nation ran a story on the state of the recently opened Nairobi Metropolitan Services hospitals in informal settlements in Nairobi. Beyond the pomp and color of opening those hospitals, it was reported that they have become brick and mortar installations devoid of the very services they were to offer to the catchment population. They were described as skeletons with no flesh because they lack basic drugs, non-consumables, laboratory testing kits and reagents.
The situation is the same in many parts of the country. In mid-2021, I was part of a team that was sent to Mt. Elgon to survey for a medical camp. We visited three public dispensaries in Mt. Elgon to ascertain the prevalent medical conditions in the area so that the right interventions could be prepared for the medical camp.
The common complaint in all the dispensaries was lack of essential drugs. Drugs for common ailments such as pneumonia, malaria, hypertension, diabetes and skin conditions had not been delivered in months. On the day of our visit to one of the dispensaries, there was a long queue of almost forty patients, mostly mothers and children sitting or lying outside on the grass, waiting. Almost all of them went home without drugs.
In my home county of Trans-Nzoia, the situation is not too different. Speaking to a medic at one of the level-4 sub county hospitals, shortage of drugs and laboratory reagents is the biggest challenge they face, they don’t even have films to print x-rays.
This begs the question, why?
Why is it that we can build a Kshs. 480 billion SGR and fail to have essential drugs in government hospitals?
Why is it that we can build a Kshs. 65 billion Expressway (now inflated to 87 billion) and fail to provide basic amenities like water to the people?
Do we lack discipline at executing projects that require many stakeholders and have many moving parts? What does this say about our priorities? Do we give attention to “things” more than people? If that’s the case, then who would use “the things” we prioritize?
Or maybe it’s just neglect. The people crying for drugs in public hospitals are not the rich or blue-collar employees who have private medical insurance. They are not government officials who enjoy super NHIF cover in private hospitals. Those who need water, those who are affected by the high food prices are the people at the bottom of the income pyramid, the low-income demographic, whose voices have been lost in the collective despair of the nation.
Why is it so hard to serve these people? If the economy is struggling and can’t create enough jobs for them, at least provide them with the basic services.
From the foregoing cases, it is clear that we are good at coming up with elaborate plans of things we can do but we can’t seem to deliver them on the ground. There’s no shortage of good policies, proposals and ideas gathering dust in government shelves. Like now, everyone is an expert at lowering food prices and the cost of living. Most politicians and experts are right at what needs to be done but watch out, it will all fall apart when those good ideas are to be implemented.
Don’t get me wrong, the SGR and Expressway are good projects.
The country needs infrastructure to grow but the country equally needs to provide basic services in order to alleviate people from poverty. When people can’t access services in government health facilities, they are pushed to private facilities which are expensive and for some rural areas, inaccessible. People end up spending more money for health services and food which leaves them with little to live by. You can spur economic development by simply providing essential services and lowering the cost of living. Because people remain with more money in their pockets and more time to engage in productive economic activity.
The proclivity towards big infrastructure projects is not without its murkiness when carefully scrutinized.
They are mostly funded by foreign loans, built by foreign contractors and some even serviced by foreign contractors. The input of Kenyans is minimal in the comparison to the scale of the project. And we can’t rule out corruption. It’s often that we hear how the cost of these projects are inflated so that its local architects and their cronies could benefit. These mega projects are more attractive and present more opportunities for people to illegally benefit as opposed to provision of basic services.
There’s a huge disconnect because those in leadership seem not to understand how ‘the country is a construction site’ but 4 out of 10 Kenyans cannot afford rent. They don’t get it when people complain about high food prices. They think the economy is only brick and mortar but in reality, they have killed economic productivity, incomes and opportunities for majority of Kenyans. This is the case where we have a road but the ability to use it has been stripped off from us. So it remains a good story, told through others.
In 2022 we need to elect leaders who will think beyond big infrastructure projects and focus on the basic needs of the people. We need leaders who will instill discipline and accountability in those trusted to deliver services, leaders who will get rid of entitlement in government offices and see themselves as servants rather than masters. As it is now, demanding a rightful service in a government office is often met with hostility and I don’t-care attitude.
In short, we need a leader who will put Kenyans first and have the government working for the majority of wananchi starting with provision of basic services.