Uhuru’s few options as country takes stock, three months on

The most urgent public health emergency that Kenya has faced in its recent history continues to expose its ill-preparedness for outbreaks, even as the disease’s mitigation nears 90 days.

Slow testing, an initial disjointed national and county response as well as squabbling over funding, coupled with half-hearted attempt at a total lockdown of the country have left Kenyans with more questions than answers on how they should respond to the threat of Covid-19.

Projections from the Ministry of Health show that we are yet to see the worst of the pandemic that has so far killed 79 people and infected another 2,474 as at yesterday.

But as Kenyans are warned daily to prepare for the worst, it is increasingly looking the population will soon be left to mitigate the effects of this highly contagious disease on their own.

Now, after nearly three months since the first case was detected and on the day of a highly anticipated presidential address, the Saturday Standard takes stock of the hits and misses of our collective response as well as the positives and shortcomings of our crumbling healthcare system.

There have been some marginal gains. After years of push and pull, the government finally employed more nurses. A key response in the early days of the virus was to bump up the figures of healthcare workers. Health workers’ unions however maintain that the numbers are still not adequate and more workers need to be employed.

Political will

We might not have the technical capacities of China to put up a multi-billion-shilling hospital in a matter of days. But Kenya has now seen that when there is political will, critical infrastructure can be set up in record time.

On February 28, President Uhuru Kenyatta gave an order that the country’s only isolation unit, which had been under construction since early 2018, be completed in seven days. A project that had taken years to get to where it was then was completed in a matter of days and was soon receiving its first batch of patients.

This points to the fact that key infrastructure needed in our public health facilities -- at times it is as basic as running water or a functional toilet -- can be set up, the only problem being political will.

To date, some 250,000 households have been identified as potential beneficiaries of a cash transfer programme that had initially been bogged down by allegations of bribery and corruption, with ghost beneficiaries receiving checks meant for the vulnerable.

Probably for the first time in Kenya’s history, the vulnerable have not just been defined as the old, disabled or sickly, but also as a section of professionals whose main sources of income have been affected by the spread of the virus.

And, as if by sheer luck, the national government realised amid the pandemic that money can be sent directly to the beneficiaries without really going through intermediaries. It mattered little that mobile money transfer services have been here for close to two decades.

There have been some positives during these trying times, but again, the negatives are never really far off.

Key research facilities have proven to be miles away from global research trends. The Kenya Medical Research Institute (Kemri) which has some of the most brilliant scientists in the region, if not the world, has been peripheral in the ongoing Covid-19 research. Its voice has been conspicuously absent in the debate for controlling and mitigating the spread of the virus even though it has representation within the national Covid-19 response team.

When Kenya needed science to step up, internal organisational wrangles were tearing the institution apart. In early May, one of its top researchers was axed from his position and transferred to another department. It mattered little that Kenya was in the early days of a pandemic few understood.

Kemri, once the bedrock of cutting edge research in the region, had no voice and thus few answers to the most basic tests it was being put through – the acquisition of test kits.

Research facilities

Amid the pandemic, our research facilities have been exposed to be nothing but brick and mortar, making people might think they are still stuck in traditional research areas. New challenges, such as the Covid-19 outbreak, might have just knocked our researchers off their pedestals.

To date, there has been no visible direction from the organisation and the whole narrative is run by Afya House mandarins. Neither has there been any voices from the multi-billion-shilling National Influenza Centre.

Then there is the economy. From dreams and ambitions of double-digit growth promised by the Jubilee administration in 2013 to an almost snail’s pace, the virus outbreak has been merciless on our economy.

Potential job losses stand in the hundreds of thousands. Business plans of large businesses have been disrupted while many small and medium-sized ones have practically collapsed, the shock of a constricted business environment too much to bear.

“We cannot relax in our efforts to conquer this invisible enemy and to put our economy on a strong growth path. Because, if we do not, we could lose upwards of half a million jobs over the next six months. We must do whatever it takes to minimise, if not to fully contain such loss in jobs,” President Kenyatta said in his Labour Day speech.

A report tabled in Parliament days before the president’s address indicated that, already, more than 133,000 jobs had been lost at the time. The president’s estimation stood at the possibility of 500,000 jobs being lost between May and December this year.

Yet, to date, little to no incentives have been given to SMEs to help them withstand the global shocks. Tourism and agriculture, key to foreign exchange, remain stuck in the mud, players unable to untangle themselves from the Covid-19 tentacles as the government offers more promises.

There have been efforts to cushion the population with the reduction in the Pay As You Earn tax as well as marginal reduction in the Value Added Tax. But these have not had the intended effect on the economy.

The slowed growth has been singly affected by a half-hearted attempts at a lockdown that was meant to stem the spread of the virus. Data however show the partial lockdown of sections of the city as well as some counties might have had near negligible results on the spread of the virus.

On April 6, President Kenyatta announced the cessation of movement in to and out of Nairobi and three other counties – Kwale, Kilifi and Mombasa – to try and stop the movement of the disease from these counties that at the time had the greatest disease burden.

“The cessation of movement within the Nairobi metropolitan area shall be for an initial containment period of 21 days,” the president said in a televised address.

By that time, Kenya was already in the throes of a dusk-to-dawn curfew to contain the virus that had infected 158 people from 1,950 samples. Deaths stood at four.

This translated to an infection rate of eight per cent. Then, only four counties had registered positive cases.

By Thursday, Kenya had recorded 2,340 cases from 85,058 tests, translating to a 2.75 per cent infection rate, a significant drop from the early days.

However, now more than 35 counties have recorded positive coronavirus cases, meaning that either the travel restrictions have been flouted and are not working or that by the time the measures were being put in place, disease spread was wider than the Ministry of Health understood it to be.

Now the State has announced plans to transfer positive asymptomatic cases from government facilities to home-based care and letting Kenyans take charge of preventing themselves from contracting the disease. Will that help?