The evolution of surgery and medicine has seen great strides made in terms of improvement of care. Theatre interventions in particular have been helped by the advancement over time in anaesthesia and perioperative technique (this also includes intensive and advanced life support care).
As a result, mortalities previously associated with surgeries and trauma reduced, particularly those specifically attributable to “non-surgical” theatre causes. Complex heart, lung, kidney, brain and even in-utero surgeries are now every day procedures.
Looking at Kenyan data, there are a few concerns raised by the directive from the Ministry of Health suspending all sponsorships for specialising doctors due to disagreement and ongoing doctors’ strike. The truth is that such a move is a double edged sword likely to harm society and patients in marginalised counties more.
On average, the desirable optimum training level of anaesthesiologists (doctors specialised in anaesthesia) is needed in each of the 221 or so theatres in the public hospitals. This is not only because of their low numbers but also due to labour market and economic dynamics.
As a skillset in high demand from the private sector, ensuring adequate numbers in public hospitals is tricky. A mix of both good remuneration, training opportunities and work satisfaction is needed.
According to data from the Kenya Society for Anaesthesia (KSA), there are three cadres in anaesthesia; nurse practitioners, clinical officers and specialised doctors. Each has varied training and complexity of cases handled.
The KSA membership data shows Kenya has 152 anaesthesiologists of whom 110 are based in Nairobi County. If you take metropolitan towns of Thika, Kiambu, Machakos and nearby Kajiado, this number rises to 132. This is more than 86.8 percent of this skillset in just three counties. The rest of the country is left to share the remaining 42 anaesthesiologists. It also indicates that 29 counties do not have an anaesthesiologists and the theatres are staffed by the lower cadres.
Striking doctors demonstrate in Nairobi to press for better pay. The Ministry of Health has suspended all sponsorships for specialising doctors. Photo courtesy