Will be on duty over the holidays, while others will have to wait for health care

Will be on duty over the holidays, while others will have to wait for Health care.  This is not the only time this has happened.  Holidaying when we should be working I believe is one of the unique characteristics of resource-constrained settings like we have here in Kenya.  By the way now that we are headed for the holidays, welcome to the medical profession where any day is workday and holidays don’t matter…

Someone just posted on my wall that today is 3 days to Christmas unless you work in essential services like medicsm and EMS.  Everyone is already excited that it will be that season for short weeks, but you can’t relate to that… because you are a nurse.

Soon and very soon the leadership both in health care or otherwise will be off for holidaying while Kenyans wait for health care. Shouldn’t such sporadic work be anchored somewhere in the constitution?

This is part of the series: Unique characteristics of sub-Saharan Africa’s health care settings , turbulence and number of beds and cots could lie while we wait. We also explored lay caretakers. In another post we explored the case of health care in Kenya, comparing it with Uganda on this aspect of holidaying.

Holidaying without health care

What else could be adversely affected by holidaying is beyond the scope of this article? But, healthcare obviously was one of them. Health care is a custodian of life. It being an essential service notwithstanding, many people in resource-constrained settings knows for a fact that less than optimum care to nil care was offered during odd hours, weekends and holidays. So, for purpose of this argument holidaying moments might mean the same as odd hours.

Picture shows Kenya has great attractions as a holiday destination like Giraffe Manor.

(Picture courtesy of Giraffe manor)

Taking every opportunity to holiday

At every opportunity, it became normal in some settings to operate at a bare minimum, if we could get a valid reason to do so, and a gazetted public holiday was one of them. Why has it to take 54 years after independence before realizing that we need health care on a 24/7 basis? What do we mean by essential services, does it mean the same as operating at a bare minimum? #Every 5 days, surely we seem to lapse into it, not to mention that it most likely happens every night in the public health facilities.

Really? Why should more than 1/2 of the medical staff be working 8am-5pm, Monday to Friday from the day they got employed to the day they will retire yet they worked in an essential services sector called health? Were they not essential or what? Moreover the Hivos study of 2013, as well as 2019 one, agreed with several other studies before it that showed absenteeism (and even when present, a good number) of providers spent less than half of their time in patient care. The reader can share some of their views here.

There should not be lower standards of patients’ safety on public holidays, weekends or nights. Unfortunately, patient care would be expected to fall short during some days and even some shifts. The ratios of the patient to staff were usually dismally low. It was like the norm that we would be having inadequate adjunct staff during these times. Imagine lacking the services of a physical therapist because it was a holiday or a weekend and more often at night in critical care units and acute rooms.

The long-weekend holidaying

The ultimate test of care coordination and care delivery systems was patient care that takes place from Friday 5:00 PM before a long weekend. Woe unto you if there was some issue pending just before the long weekend!  Even a patient’s discharge process could pend for this long. An investigation likewise. You will be forgiven for thinking that people were literally taking off from their place of work on such an afternoon.

With the upcoming short weekdays coupled with long weekend, everybody should be able to understand why – the bosses will pack their bags and bolt out, either hope nobody calls them back or deliberately become unreachable ‘mteja wa nambari iliyopiga hapatikani kwa sasa’ or else from Swahili – the subscriber of the number you have dialed cannot be reached.


A clip art showing staff nurse on the night shift in a dingy-lit ward

(courtesy of the developer)

Official holidays

Whereas Kenya generally had about 12 official holidays namely: January 1-New Year’s Day, Good Friday – date variable, Easter – date variable, Easter Monday – date variable, May 1-Labour Day, June 1-Madaraka Day, Eid al-Fitr (End of Ramadan) – date depends on the sighting of the moon, October 20-Mashujaa Day,  formerly Kenyatta Day, December 12-Jamhuri Day, December 25-Christmas Day December 26 – Boxing Day. There were 4 elections related decreed holidays in 2017 alone.

We will continue to look at another aspect of holidaying where we also look at the case of Uganda.

Next year, 2020 is the WHO year of the nurse in commemoration with the bicentenary (200th) birthday of Florence Nightingale. Prepare for it, present something through NursingNow Kenya chapter.  Nursing is intrinsically linked to the ability of countries to address health priorities.

Happy Holidays all the same!!!!

image courtesy of dreams


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