By Jenny Luesby
Human error may be a given, but when lives are at stake, most societies, corporates and organisations build in extra checks and fail-safes to stop citizens dying on a single professional error.
The airline industry is a case in point. Never does a plane go down without the fullest enquiry into cause and remedy. No airline could be dropping planes, maybe one in ten, or even a third, and no-one grounding its operation for good until better safety was in place.
Yet when it comes to Kenyan lives, apparently dying is fine. Recently, in The Standard we have been looking at the distressing truth about the country’s medical system, where doctors, pathologists and medical industry players concur that misdiagnosis is running at almost 30 per cent of cases, across both public and private hospitals.
Many of the patients who are misdiagnosed or suffer other medical negligence go on to survive, either because they seek a second opinion, or because their condition was not initially grave. But as many as one in ten are currently dying or being deformed through medical error.
This is a simply colossal number of wrongful deaths and lives ruined.
Even something as basic as malaria diagnosis seems to be way off the mark — with the World Health Organisation reporting that around half of Kenyan in-patients being treated for malaria die, but that most of them don’t actually have malaria. Being treated for malaria doesn’t help if you actually have typhoid.
As it is, from diagnosis through testing, equipment, procedures and follow-through, it turns out that our hospital system is plagued by errors.
For sure, medicine is not an exact science anywhere, and errors always do happen.
Doctors sometimes cannot know to perform a hugely unusual diagnostic test for a very obscure and rare condition, and even where diagnosis is clearer, interventions carry risk. Sometimes, even tests and markers themselves can only suggest a certain condition, even one of many.
The reality is that doctors everywhere make errors in diagnosis and treatment.
No-one knows
But our country’s track record is nowhere close to global norms. We have far, far more errors than is normal, and over matters as simple as whether someone has malaria.
And the human cost is horrible.
Indeed, it was a rash of court cases that attracted our own eye to this issue: journalists, lawyers, and doctors losing their wives and children in botched deliveries; citizens coming in with cases of brain damage and lost limbs on seemingly ridiculous medical mistakes.
Yet dig deeper and it becomes clear just how it can be that our medical system is so very poor. No-one, apparently, is monitoring it.
We do have a board of doctors, paid for by doctors and hospitals, that is supposed to monitor cases of negligence. But files are sometimes, and seemingly frequently, never processed – we found cases where an error and complaint made five years ago was still classed as a provisional file.
Most cases that do get considered are dismissed, many are never brought, and the few where an error is found to have been made are resolved with a warning letter to the doctor.
This seems glib beyond reality, in playing ‘don’t care, won’t care’ with Kenyan lives. As if when an airline drops a plane, a warning letter to the pilot is an appropriate way forward.
Yet the biggest drop ball is in monitoring the hospitals themselves. The Kenya Medical Association argues that the figures given to The Standard are not correct, but when asked to offer its own figures responded that no data existed — that it was each hospital that kept its own data.
And the medical ‘policing authority’, called the Medical Practitioners and Dentists Board, claims that one of the problems in processing cases is that hospitals won’t provide the information: the same hospitals that are its funders.
So, no one knows which hospitals have which particular weaknesses that keep killing people, and no one has the right or the power to monitor hospitals’ results.
It makes one wonder what has to be in place to be allowed to be a hospital, if no one is allowed to know how many people you wrongfully kill.
Moreover, our investigations have laid waste to the idea that if you pay more, you will get better medicine. For years, I have viewed our medical industry as a potential economic driver, a cluster of expertise that can and should be part of our economic growth.
But we have now seen unlicensed doctors operating for private hospitals — and when we looked at the registration and how citizens can find out if a doctor is registered, that was slow, cumbersome and pricey too.
Even the administrative systems of the hospitals are poor
I have personally seen the evidence of considerable theft of funds by medical staff in one public hospital and one private hospital — all taken away from patients’ care. Former staff have walked from some, talking of ‘murder’ on systemic scams that are killing patients to extract more money.
Doctors, it seems, are killing more of us, all the time, than our police and all our criminals put together ever have. Yet while our headlines scream and our government acts on dozens killed in Bungoma, our hospitals are allowed to murder us every day, without comment or care.
Truly, our medical regulation is a travesty of justice.
The writer is Consulting Editor at The Standard Group.
jluesby@standardmedia.co.ke
