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| Turkana County Ambulances. Photo Credit: SIMON IDEYA |
I strongly admire the philosophy behind devolution. Devolution - I believe - is the magic bullet that will liberate this nation and finally put paid the struggles of the majority poor dotting all corners of this country.
A quick reading of the Constitution clearly paints a picture of a Kenya whose steps are marked with progress, prudence, and the centrality of Kenyans. To achieve these, the Constitution declares, a bright line must be drawn between laissez-faire managerialism and development tinged with a clear understanding that resources are finite.
What is laissez-faire managerialism? This is a managerial thinking based purely on non-intervention. To put it into perspective, this form of managerialism (as regards governments) engenders a culture of "do nothing, change nothing, and improve nothing as long as the flow of taxes remains uninterrupted."
Wait, it will be foolhardy to claim that this sin is committed by our county governments alone. This monster stalks our governance edifice from head to toes. We are all partners in this narrow-minded, one-sided managerialism.
Which leads to some painful questions: Can't we deviate from this road to Hell and redraw our own path to success as envisioned in our beautiful Constitution? Or, are we determined to soil the good interventions of our supreme law for fear of thinking outside the box?
Just the other day my people celebrated the purchase of new ambulances in what proponents claimed was a step ahead in improving health care in my home county, Turkana.
Though a good move, I tend to think that its execution is ill-advised and is doomed to fail.
You can't just dump ambulances at hospitals and shout all over town that we are headed to a brighter future. I refuse to stomach this fallacy! We must cure this resource-dumping disease before we embark on washing clean our tarred health-care system!
Many lessons abound. Effective emergency services - ambulances, fire departments, cleaning services ad infinitum - must be detached from "the parent consumers" of their services.
Let me explain what this means. Under this stand-alone concept, hospitals (for the case of ambulances) are left to carry out what is squarely their job - treatment.
Doctors, who in our case, double as hospital administrators are spared the burden of thinking about conditions of ambulances under their control, the welfare of personnel attached to the ambulance services etc.
Consequently, doctors are left with what falls squarely in their domain - taking care of the sick.
The Kingdom of Morocco is an interesting case study on how to manage hospitals (as far as non-medical functions are concerned). This Kingdom boasts a highly professional emergency services entity whose sole mandate is to deal with what we have just cited above.
Deployment of emergency response teams as well as management of resources attached thereto is centrally under its wings. The general public and hospitals are left with one simple duty: Call the agency when in need!
Services like provision of food stuffs to patients, cleaning services, and private security services among others do not belong to hospital boards. Hospital boards must be preoccupied with ensuring that our patients get timely treatment.
To achieve this, hospitals must be left alone. We must move an extra mile and outsource these non-medical functions to bodies that are better placed to perform them.
Clinging on every function within our reach borders on mediocrity of the highest degree.
I am very much aware of the urgency to reach to populations. What disturbs me is that we risk sidelining the need to set up robust structures and institutions.
I am not so blind as to oppose provision of ambulances just because one or two are grounded. We cannot just stand aside and watch. We shall not assume that leaders will rectify these wrongs on their own.
Turkana County has many challenges than the billions at its disposal. We have many poor people to uplift. We have endless streams of poor children to school. We have tattered roads to pave. We have a thirsty population looking up to us for answers.
When you have this load to shoulder, you clearly have to be prudent in your management of resources. It is time we set up a central agency to manage our emergency services.
Governor Nanok must move with speed and partner with the Turkana County Assembly and set up this badly needed agency to save our billions from waste. We are tired of patching and crowding services on over-stretched institutions.
Leave hospitals alone!
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