Thursday, April 02, 2020

Change course or court disaster

When I was in Form 3, I suffered my first, of two, asthma attacks. All other asthma-related events had been mild, causing mere discomfort. This one was different. It had all the elements of malaria. So I obtained a permission slip from the school's nurse and took myself to Machakos District Hospital. Suffice to say that the next time I suffered an attack, I borrowed fare from my namesake and went to see the family doctor in Nairobi - quite against school policy. Seeking medical care at a public hospital in Kenya is quite often a desperate act. Facilities are inadequate. Health workers are demotivated. Medical supplies are in short supply. Hospital equipment is often broken down.

Since the devolution of healthcare to county governments, things have not improved never mind the much ballyhooed medical equipment leasing scheme that distributed state of the art medical equipment to all forty-seven counties. Doctors and nurses have been on several strikes, grinding essential services to a halt. Many patients have been seriously injured or died because of the strikes. It is not too much to wonder whether or not the health care system we have now has the capacity to effectively deal with the coronavirus pandemic. This uncertainty may explain the swift militarisation of the crisis, and placing the official government response in the hands of the securocracy. While the eloquent and affable Health Cabinet Secretary remains the face of the government, the situation on the ground is managed using national security tools - curfews and bans.

The post-devolution Cabinet Secretaries of Health have been disappointments. Leadership in the crucial sector demanded strategic foresight. What we got, instead, were business proposals designed to expropriate as much out of the national treasury in the shortest time possible, lethal consequences be damned. With the rapid global spread of the coronavirus, the thousands of deaths in its wake, and the destruction of economies, Kenya's healthcare infrastructure was not well prepared to deal with the pandemic. Senior government officials are deathly afraid that as it spreads in Kenya, and deaths occasioned by it rise, the coronavirus will lead to social unrest which will, in turn, lead to political instability that not only threatens the stability of government but also point a dagger right at the heart of the State. So they have fallen on the only tools they are familiar with: the coercive use of State power. This has had tragic consequences.

It is still not too late to fashion a coherent strategy to deal with the pandemic. First, obviously, is to classify the issue correctly. In my opinion, it should be dealt with as a health crisis in which case the public health authorities must be given the tools and resources necessary to deal with it. Secondly, its effects must be properly identified and correctly classified. Dr David Ndii has suggested what can be done on the economic front and no one has yet suggested that his proposals are unreasonable or impracticable. With regard to the upheavals the pandemic is likely to lead to, there are certain sectors that must be protected and supported - the supply of essential goods and services, for instance, and the reinforcement of the social assistance programmes currently being implemented.

This is not to say that the securocracy should put on mufti and slink on home. No. It still has a crucial role to play. There are those who will seek to take advantage of the situation to undermine government efforts, harm the people and generally cause damage. They must be identified and neutralised. But targeting children playing on balconies or assaulting delivery drivers because they have violated an ill-timed, ill-defined, ill-explained curfew is asinine and likely to lead to the social and political chaos that the curfew ostensibly sought to avoid in the first place. But the securocracy should not be in charge. It never should have been in the first place. It has neither the breadth of experience nor the intellectual flexibility to deal with the pandemic. It has a narrow focus on threats against the government of the day and limited tools to deal with that threat. Those tools are only tangentially related to public health. The window to arrest the public health crisis is closing fast. Armed responses are of no use.

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