There is a health centre in Kenya which has only one worker, who doubles as both the medical and non-medical staff.
For the avoidance of doubt Mr. Edward Munene is a qualified doctor posted to the health centre, but also doubles as the nurse, midwife, pharmacist, counselor, cook, cleaner and receptionist that should have posted there as well but have not been.
The Loreng’elup Health Centre, about 60 kilometres from Lodwar Town, the capital of Turkana East County, serves more than 3,000 people from 11 hamlets.
Pregnant mothers walk dozens of kilometres to consult the young graduate of Murang’a Medical Training College.
“It is very challenging”, he acknowledged “but somebody has to do this job.”
For miles around, he is the only government “doctor”, but he has no regrets.
“Every day, children line up here for immunization; pregnant mothers come to me in pain and I treat all manner of sick people. At night, there are always emergencies and I always have to be alert,” he said.
On a typical working day, Edward, who works seven days a week, opens the health centre at 7am to find the sick already in a queue waiting for him. He serves up to 30 villagers a day.
“Some spend the night in a neighbouring village so that can arrive there early a get a good position on the queue”, he said.
Besides immunizing babies, he also distributes nutritional supplements, treats children with malnutrition and helps pregnant women to deliver.
“Occasionally, I have a traditional assistant when I am overwhelmed; they have been trained on basic testing and handling of sick people,” he disclosed
.“Currently, I have 18 pregnant women under my care and I deliver four or five babies on a monthly basis. When I encounter serious cases, I send them to the referral hospital in Lodwar.”
Despite the convenience of delivering at the health centre, where services are free, many mothers opt to give birth at home in line with their culture. That, however, is not his biggest challenge.
“According to the health standards, there should be a reasonable doctor-to-patient ratio. A health centre like this should have at least four nurses and a doctor for a day to interchange with others in the night shift,” he said. That is the ideal.
He is used to working alone and has forgotten the luxury of work-free weekends.
The public institution uses equipment donated by the Safaricom Foundation.
The mobile-phone reception in the area is weak, which means he is practically isolated as he cannot communicate with his family in Nakuru.
He lives in a single room next to the new maternity wing and travels to Lodwar once a month for food supplies.
When that happens, the health centre has to remain closed, even when a woman in labour walks there.
“This hampers my efforts to encourage them to deliver in a hospital,” he said.
And though the Loreng’elup Health Centre is a ray of hope for ailing villages, whose only other option is traditional medicine, it is ill-equipped.
“I can admit only one or two critical patients, but then again, we haven’t had constant supply of safe drinking water for the last three months. We rely on a local organization to supply us with water every two weeks, and I also don’t have a budget that caters for food for the in-patients,” he said.
With doctors going on strike in some counties over their pay, Edward urged the government to involve doctors in making decisions that affect the management of the health sector.
“It is not possible for somebody seated in an air-conditioned boardroom to understand what I am going through here in the hardship area. Medical staff have real issues and it is only when you work in such conditions that you understand what we go through,” he said.