Nakhumicha's troubled run at Afya House

Former Health CS Susan Nakhumicha. [File, Standard] Bubbles... very weird things whenever they burst, just as immediate former Cabinet Secretaries have now discovered, even as some now wish that the sparkle wasn't so fragile. So, when Susan Nakhumicha - the former Cabinet Secretary for Health - joined her colleagues to thank the president for the opportunity to serve after President William Ruto unsurprisingly announced the dismissal of almost his entire cabinet, it was like the last encore that summed up an anti-climax. "I am grateful to H.E President for giving me the opportunity to lead the rollout of Universal Health Coverage(UHC), which is one of the Government's flagship programmes," she wrote on X on Thursday night. "To those I didn't meet your expectations; I take it that life is a learning experience." Nakhumicha became the CS for health in 2022 and had been spearheading the implementation of the Social Health Insurance Fund Act 2023 (SHIF), a tendentious programme that has been one of the antecedents of youth-driven protests that have placed Kenya on the global map. Like a stinker that seemed to follow her, the project was declared "null and void" by the constitutional court on July 12th, barely a day after the cabinet was sent packing. This verdict came on the day the National Health Insurance Fund (NHIF) sent notice messages to all its subscribers, stating that SHIF would provide health insurance services effective October 1st. In the ruling, Justices Alfred Mabeya, Robert Limo and Fridah Mugambi, suspended any further actions undertaken under SHIF. "A declaration is hereby issued that the entire Digital Health Act 2023 and the Primary Health Act 2023 are all unconstitutional and therefore legally null and void," they ruled. "Within that period, the Acts shall remain suspended," the judges further stated, sending the matter back to Parliament for rectification, serving as a final blow to Nakhumicha's pillar project. Before the anti-corruption and anti-tax protests that have since electrified Kenya's public in the last few weeks, Nakhumincha's docket was wrought with complaints, controversy and worker's strikes. Her appointment in October 2022 as a CS in one of the most critical dockets raised eyebrows, in part because beyond her diploma in pharmacy and another in healthcare management, her academic background remains smoggy. However, what drew everyone's attention was her purported 'transfer' of an OCS in Trans Nzoia nine months after taking office. "I am giving an order, county commander, if you're here or you can hear me from wherever you are by tomorrow, the Matisi OCS should be gone," said the CS during a burial in Trans Nzoia mid-last year. This directive, obviously outside her mandate, brewed a storm of ridicule that persisted through her less than two-year tenure. She animatedly defended her stance, saying it was within her powers under Ruto's "one government approach" to transfer an OCS. A few months afterwards, the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), representing more than 7,000 members, went on strike demanding payment of their salary arrears and the immediate posting of intern doctors, among other grievances. The CS came under heavy criticism when she said it is impractical to pay interns Kshs 206,400 a month "since the cost of the internship had steadily surpassed the available funds." She had previously said other public service interns earn KSh25,000 per month. Nakhumicha said over the past 20 years, there has been an "exponential increase" in the number of public and private educational facilities that teach medical professionals. At the height of the industrial action by medics, the CS made a thrilling appearance on KTN News, interviewed by news anchor Ken Mijungu, where she discredited the 2017 Collective Bargaining Agreement entered between the doctors' union and the state. In her animated pose, she vowed to renegotiate the deal, despite it having been agreed on and deposited to the court. The situation in the health sector would later be aggravated by clinical officers and laboratory technologists who joined the strike. Interestingly, amid deaths and suffering by patients in the counties, clinical officers inked a deal with the government days before Nakhumicha's departure. Throughout the crisis, Nakhumicha seemed to take a backseat as Felix Koskei, the Head of Public Service, engaged the striking doctors until they reached a deal on May 8, 2024. It was also in the same TV interview that she asked Dr Patrick Amoth, a man who has been acting as the Director of Medical Services for at least five years, to 'apply like the rest' for consideration for the post. During an inter-denominational church service at Kimililki, Bungoma, Nakhumicha, clad in a flowing religious dress complete with a conservative head kerchief, would regale the head of State and the crowd with hearty political talk, before being caught up in a brawl at a funeral attended by National Assembly Speaker, Moses Wetangula. Wetangula was, and still is, embroiled in supremacy battles with Trans Nzoia Governor and former administrator, George Natembeya. Nakhumicha was blamed by opposition leaders for playing politics at funerals instead of concentrating on her ministerial duties. A later poll by Tifa Research would reveal that the public placed the most blame for the dysfunction in the public health sector squarely on the CS. In her dying days as a Cabinet Secretary, unposted medical interns camped and protested at Afya House airing frustrations over years of waiting for their official posting after completion of their studies. They also called for Nakhumicha to step down, a prayer that would be answered, not by her resignation, but through the mass firing that followed days later.

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