A big shoutout to Gen Z for claiming their right to health

Last week and yesterday we saw an unprecedented era in Kenya. The closest we have come to the demonstrations we witnessed in this country was probably in the single-party era in the early 1990s when Kenya fought for multiparty rule and the right to a fair election.

 To say that I am impressed by the Gen-Z would be an understatement! We must give it to the young people who peacefully exercised their right to demand that the finance bill be rejected in totality as it did not address their rights. These young people have made me take note in several fronts. First, they have focused an entire demonstration on issues rather than politics. They categorically stated that they pay no heed to tribe, class, political affiliation or gender.

Secondly, not only did they read the proposed bill, but that they also appreciated the nuances of the same, the details that many may have assumed that would go unnoticed, and how this was going to impact them as Kenyans and future taxpayers, if not already on that bandwagon.

Third, I have never seen a more efficient civic education done in record time. In communication, we always stress that the recipient of the information must be able to not only get the message in a language they understand, but also understand it as it was intended, without a part or the whole of it being lost in translation.

That they were able to disseminate the messages, not only in a timely fashion, but in real time; for continuous decision-making, is off the charts! The put to use all the tools at their disposal in an extremely efficient manner to ensure the message got home. And while at it, they managed to disabuse the notion that it takes a distinct leader to make things happen! It is possible to be led by a pack of leaders!

I am still in awe. As captured by Carol Kimutai on LinkedIn https://www.linkedin.com/feed/update/urn:li:activity:7209420062976331776/, I have not seen such clarity in policy communication. 

These young people used AI tools in record time to break down the contentious clauses in the finance bill in a language and presentation that not only Gen-Zs, but also the entire population could easily read, understand and identify with. With such amazing creativity, they highlighted taxes on obscure things such as delivery services, diapers, menstrual products, pension earnings and mobile money transactions.

So, while the rest get down to reviewing the demonstrations and their impact, the wheels in my head are turning like a Ferrari engine. How do we exploit this talent? Why did we never engage these young people during the Covid-19 pandemic to handle the health education and information dissemination? I am mortified that this level of talent was left wasting away in the house for a whole year because institutions of higher learning were closed, while our Ministry of Health and the Ministry of Interior bungled up public health messaging and communication!

Many a time I have questioned the outright discrimination of women’s health when it comes to medical insurance; where ridiculous caps are put on medical procedures and treatments that solely address the women. This gender discrimination was further perpetuated in the National Health Insurance Fund (NHIF) scheme; and it has just hit rock bottom with the Social Health Insurance Fund (SHIF) and the rest of the package.

With the figure of Sh11,200, applied to a vaginal birth, I wonder whether we are delivering human babies or puppies. The cap of only two nights at the hospital for mothers who have a normal delivery leaves me weeping for all those women with pre-eclampsia needing admission in the wards for days as we delicately balance their lives against that of their baby with an aim for a chance at survival for both.

I think about that mother form Garbattullah with post-partum haemorrhage who has to stay in hospital for the next two weeks as we not only transfuse her, but also provide life-saving dialysis as her kidneys give in due to the haemodynamic shock occasioned by the bleeding.

We haven’t even started talking about the Sh32,600 allocated a caesarian section. We have given a free pass to greedy health facilities to butcher women without fear or favour. I am not assuaged by the disclaimer made by the scheme to allow per diem rates to take effect if the 48 or 72 hours are surpassed. What is the provision for the mother who came in for a normal labour and we have to abandon ship after 12 hours for a caesarian section due to complications? How do we account for the cost of care before caesarian section? Who pays for that?

I find it incomprehensible that the scheme has lumped antenatal and post-natal care with other outpatient services at a tariff of Sh900 per person. The minimum cost of Anti-D, the serum that protects Rhesus-negative mothers from getting sensitised and affecting their future pregnancies, is to fit into this budget. Kindly note that this life-saving intervention currently costs at least Sh5,000 per dose. Also, take note that the mother requires this at 28 weeks of pregnancy and a repeat dose at the delivery of her baby, 12 weeks later. Let us not even discuss the cost of the lab tests required before we intervene.

I am no economist, but no amount of mathematical modelling is going to make these figures work. And before we, as health care providers, protested this, the Gen-Zs beat us to it. There is no image more powerful in the past week’s demo than the pregnant Gen-Z walking away from the teargas smoke, to demonstrate just how insane these figures are.

Allow me to reiterate Article 469(1)(a) of the Constitution of Kenya 2010: Every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care. It is a pity that we continue to abuse this clause wantonly because we can get away with it! Our future lies with the Gen-Z. May they sustain the candid resilience, order and call to action that they have shown us this past week.

Remember, for one to fight for their health rights, not only do they need to be alive, but also healthy enough to put up the fight. Rights are a distant third. Let us start by keeping our mothers alive!

Dr Bosire is an obstetrician/ gynaecologist