Irene Muhoro
As children, we grew up dreaming of the lives we wanted to lead. Some people wanted to be engineers, veterinarians, firemen, teachers or scientists. Some people grew up dreaming of saving lives, fascinated by the workings of modern medicine. These people are the doctors, nurses, lab technicians and other health workers of today. Save lives—that is the dream, the goal and the oath. However, the world turned on its head and suddenly, their jobs meant having to decide between facing the risk of being infected with an irremediable disease or letting those already infected go untreated. Well, their response has been to stay the course. To keep saving lives, no matter the cost, because that is what they dedicated their lives towards. It is a noble stance, a heroic one—even a patriotic one, but one they shouldn’t have to take. Underneath all the armour that makes them soldiers and the capes that make them superheroes, these health workers are just people. They have children that they cannot tuck in at night after a shift, parents they can no longer visit and friends that worry about them. Every day, they go to work, do their best and watch helplessly as their patients die anyway. The psychological toll this takes is crippling. They are not bulletproof. They live in constant fear, wondering whether they will be the next statistic on the 3 PM daily news briefing.
On December 31st 2019, China reported several cases of the spread of an unknown virus within the city of Wuhan to the World Health Organization. Within a period of one month, the virus became intercontinental. On 11th March 2020, WHO declared the novel coronavirus a pandemic. Thus, began the worldwide battle against corona virus. Nations were forced to go into a war with an incurable disease that continues to claim thousands of lives daily. A functional health system has proven to be the greatest defence against the onslaught of the disease, ergo they now depend on doctors, nurses, hospital staff and all other health personnel to keep the illness at bay. However, even with the enormous responsibility that falls on the shoulders of medical personnel, they continue to be set back by shortages of the protective gear they need to fight the illness.
Infections
The rate of infections among health workers has only continued to increase over time. As of 15th July 2020, Kenya had 450 reported cases of infections among health workers. At least 41 of these cases came from Pumwani Maternity Hospital. Additionally, 4 health workers have died as a result of the virus.
A glance at the global situation predicts a bleak future, given the tally of healthcare personnel that have tested positive for COVID-19. At the beginning of June, the International Council of Nurses had an approximate count of 230,000 healthcare workers it believed to be infected with coronavirus worldwide. It attributed the lack of a concrete figure to the poor records governments kept of the number of infected health workers. It has expressed great concern because it estimates the figure to be much higher than that, which does not bode well for countries like Kenya, where testing is not carried out as widely or frequently as it is in other states. Italy was once one of the worst-hit countries in the world, recording infection rates that surpassed those of China, where the virus began. When Italy was reporting 41,000 infections, 2,609 of them were health workers. It is obvious that health workers face the highest risk of infections, because their work requires them to be exposed to the virus. The alarming speed at which they are falling ill is reflective of the danger that they contend with.
The position of the law
The Kenyan constitution guarantees all workers the right to reasonable working conditions under Article 41(2). Further, the Occupational Safety and Health Act governs the rights of people at their respective workplaces. It aims to ensure the protection of the health and safety of workers from harm that may arise from the performance of their duties. As such, it is the relevant piece of legislation that applies to the current predicament of health workers in Kenya, given the increased risks they face at work. Section 101 provides that employers should supply their employees with protective gear like gloves, footwear, goggles and head coverings where the employees are exposed to ‘injurious or offensive substances’. The Act does not specify what constitutes the terms ‘injurious’ or ‘offensive’ but it states that a substance may be either natural or artificial matter, whether in solid, liquid or gaseous form. One may conclude that the bodily fluids through which coronavirus is transmitted can amount to an injurious or offensive substance, one that health workers should be adequately protected from.
Causes
The devastating rise of the rate of infections among health professionals has been attributed to a few common reasons. In fact, these reasons almost led to a strike in Kenya after healthcare personnel expressed concern over a lack of Personal Protective Equipment (PPE) despite the requirement that they admit coronavirus patients to health facilities. The government took swift action to prevent the strike and entered negotiations where they agreed to provide to health workers. Despite this, a study conducted by the Kenya Union of Clinical Officers (KUCO) revealed that 68.4% of health workers did not know how to properly wear or remove the PPE.
A lack of PPE or proper training on how to effectively use it advances another reason for the growing rates of infection among health service providers; reuse of PPE. Health practitioners around the world have begun to disregard the protocol for the recommended time they are meant to use PPE and have even started to clean single-use PPE for further use due to a lack of sufficient gear. Some make these mistakes because they did not receive efficient training, but many health workers are doing so as a method of last resort.
Corruption also continues to plague the country and cause further problems for health workers. Jack Ma, Chinese magnate and philanthropist made a sizeable donation of 100,000 face masks and 20,000 coronavirus testing kits in March 2020. These donations mysteriously disappeared from the airport and never made it to the health ministry or to the health workers that are now in desperate need of PPE. Investigations as to the theft of the equipment have so far been inconclusive and shrouded in secrecy. Allegations have been made by the Cabinet Secretary of Health, Mutahi Kagwe, that the donations had been stolen by corrupt officials belonging to the Ministry of Health but no individuals have been named as suspects. Mr Ma made a second donation in April, despite the scandal. Nevertheless, Kenyan leadership must be vigilant against corruption especially in the health sector, which holds the well-being of the population in the palm of its hand.
The Way Forward
To deal with the shortage of PPE, countries like Kenya which are falling short must align themselves with the manufacturers and suppliers of this equipment to fast-track the process. They have to come up with production plans and emergency strategies that will be able to accelerate the process of manufacture or advise health workers on how to safely get the most use of PPE that they have already been provided with, seeing as there are tentative guidelines for reuse or alternatives to PPE in dire situations. This has already begun, on a small scale. Two textile factories, Rivatex and Kitui County Textile Centre (KICOTEC) have stopped ordinary functions to start mass-producing surgical masks. KICOTEC even donated 20,000 masks to the County Government of Makueni to alleviate the demand for protective gear. This is progress in the right direction, but it must be amplified on a national level to keep up with the steep growth curve of COVID-19.
Training of hospital staff on how to properly put on, use and take off PPE should be mandatory when issuing any healthcare facility PPE. It is of little value to them if they do not know how to utilize it in a manner that protects them from infection.
Teaching them to effectively use PPE is the only way to ensure that the health service providers stay safe and that the dwindling supply of protective gear we do have does not go to waste.
More efforts need to be made, both worldwide and in Kenya, to stop the spread of coronavirus to health workers. The design of their task means that they face the highest risk of infections but there must still be an effort to minimize that risk as much as possible. The world we live in now makes health professionals soldiers on a harsh and unfamiliar terrain. The least we could do is provide them with enough armour to put up a good fight.
By voluntarily undertaking any exercise displayed on this website, you assume the risk of any resulting injury. All content and images used on this site are owned or licensed by Strathmore Law Clinic or its affiliates for use on this site only and that any unauthorized use is prohibited. Readers may not copy, reproduce, transmit, distribute, download or transfer the Strathmore Law Clinics blog content.
Comments