A GEMBA and a Coke please
What is it like to be a patient (or as they say in Bungoma, a client) of the County health service?
A question posed to me a short while ago and one I think I can now attempt to answer.
Well, first of all you have to get yourself to your nearest facility. In the remote areas of mountainous Mount Elgon area this can be a challenge in itself.
Most of the the roads in Bungoma have no tarmac and have been carved out by earthmoving equipment. These dirt roads can quickly become potholed and rutted as the water of the heavy rains carves rivulets across their surface. The red soil of Kenya also becomes muddy and slippery after the rains. And it is hilly in Mount Elgon!
I arrived during this rainy season, and the heavy downpours come almost every evening after dark without fail. It has also been cool (26 – 27°C during the day) and so I’ve been pleasantly surprised at how comfortable it has been.
But the rains cause issues. The roads become impassable to all but motorbikes and 4×4’s.We visited Koshok Dispensary in Mount Elgon and this turned out to be the most inaccessible so far.
Eventually even Martin, our skilled driver, had to give up and we had to walk the last 3K up the hill to the facility.
Imagine having to get there when you are full term and your waters break.
Then when you get to the facility, the smallest of which are called dispensaries, you find it is only manned by one solitary nurse. Victor, seen here beside a Save The Children/GSK donated rainwater butt, was in sole charge of Lunakwe the day we visited.
Finally, you wait your turn to see the nurse, receive your diagnosis but are then told the dispensary is out of stock of the medicine you require. Unfortunately, it is apparent from the series of GEMBA’s we have concluded, that this is not unusual. The facilities have few resources and have devoted little time or attention to monitoring and managing their stocks.
Bizarrely it seems, you can always get a Coke! As we descended from Koshok we met a young entrepreneur carrying his full crate of sodas uphill, presumably to sell to the waiting clients. We duly relieved him of a few bottles, and he went on his way, but it seems some supply chains are robust and well.