Many opinions have been expressed on what needs to be done in response to the ongoing Covid-19 pandemic.
Some Kenyans think we are overreacting to a ‘mild’ viral infection with a low case fatality rate and a huge rate of asymptomatic infection.
They advocate for an abandonment of the stringent containment measures currently in force and a return to ‘normal’ life.
Other Kenyans think that the current measures do not go far enough, and that we are facing a catastrophe in the days to come if we do not completely prevent any movement across the entire country.
The government’s response has been somewhere in the middle of these two positions, with occasional bursts of irrational emotion-driven decisions and long periods of evidence-based decisions that may be contributing to broader health system improvements.
Decisions to recruit more health workers and prioritise supplies to make the health sector more responsive help to address problems related to the historical neglect of the sector for several decades.
Many of the pandemic control measures – including enforcement of physical distancing, health promotion messaging, and isolation of heavily affected areas – serve to reinforce the primacy of intelligent decision-making based on actual evidence.
No matter where we stand on the magnitude of the problem or appropriateness of the response, a couple of considerations must guide our decision-making.
Firstly, we must as much as possible avoid temporary solutions to this pandemic as our first reaction.
We must begin by strengthening existing health structures in the recognition that the demand for health services will continue and perhaps even increase after this pandemic is brought under control.
We must recruit staff for existing facilities, equip them appropriately, and strengthen governance structures in the health sector to ensure that it can deal with current and future demands.
Rushing to build temporary structures while existing facilities are still under-equipped and understaffed is a grievous mistake.
Similarly, recruitment of part-time and temporary staff to man these make-shift facilities only increases the burden on the health system without significantly improving its resilience and capacity to deal with future threats.
Secondly, we must, now more than ever, recognise that we are never going to be safe or completely healthy as long as the most vulnerable among us are not protected and provided for.
As long as an infectious agent has access to the poorest among us, it retains the potential of turning into another epidemic, or even pandemic.
We cannot fortify ourselves in mansions in the leafy suburbs of our big cities and expect to ride out any threat to our collective health.
Going forward, we must design a robust public health system that responds to the needs of all segments of our society, from the poorest of the poor to the wealthiest tycoons in our midst.
These principles apply not only in the Kenyan context but also in the international arena. No country in the world can afford to ignore the health systems of other countries, no matter how far off or how different the demographics are.
What starts off as an isolated illness in a remote corner of our planet can spread like wildfire and devastate even the most advanced countries with otherwise robust health systems.
If we learn nothing else from this pandemic, we must learn just how much our well-being depends on that of the most disadvantaged among us.
Lukoye Atwoli is Associate Professor of Psychiatry at Moi University School of Medicine: [email protected]
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