When Paul Yator's only daughter caught pneumonia, he was forced into a difficult position: He could bring her to the local health center and hope their meagre facilities could heal her, or he could take her to a private one where the price of admission alone is 350 shillings.
With his daughter's life in danger, this smallholder farmer chose the latter--and ended up with a bill of over 2,000 sh.
Healthcare in Kenya is difficult, to say the least. As the country continues to develop, the gap in adequate care grows. Now, for a population where diseases like malaria, pneumonia, and HIV are common, the choice is often between insufficient care and bankruptcy.
In Rongai center, two hospitals try to bridge that gap, with varying levels of success: Rongai Health Center, a public facility on a small compound in town, and Sisto Mazzoldi Dispensary, a private clinic on the outskirts of town that refused to comment for this story, citing patient confidentiality.
When we arrived at Rongai Health Center, the receptionists were out to lunch and did not return for over two hours. In their absence, the sick--coughing, wheezing, pale in the face and slumped over on benches--waited in the midday sun. According to John Kikwai, a lab technician, around 80 people visit the clinic on a given day.
The Health Center bills itself as a one-stop shop, with doctors' offices, a diagnostic lab, and a pharmacy all on location. Mr. Kikwai said that patients can meet with a physician to check out their symptoms and receive a diagnosis, head to the lab to run some tests and confirm the results, and drop by the pharmacy to receive the appropriate drugs--and, he brags, the whole process takes only 30 minutes.
To some, 30 minutes might be a sceptically brief amount of time to be examined, diagnosed, and given drugs, but Winnie Cherop, a lab technician in training, saw it as a benefit for working patients.
"The majority of those tests are easy to run," she said. "It takes so little time for us to get results, so we can let patients know right away."
Costs are relatively low as well. There is a one-time fee of 20 sh to pay for one's 'health book,' a personal record for future visits, and a 50 sh fee for all lab tests except tuberculosis and HIV. Those tests along with visiting a doctor, what was once rare for Kenyans out in this rural community, are now free.
The Health Center is kept affordable by its government funding. It receives an annual budget of 240,000 sh, which supports employee salaries, lab equipment, and other expenses. That budget is supported in part by tax dollars and by the fees collected at clinics across the country. Those fees enter a fund managed by the Ministry of Finance, which then redistributes the funding by need to health centers in each district.
But what separates--and elevates, to a certain degree--Rongai HC from others nearby is the community's involvement. When the center was short-staffed and it began to affect patient care, the locals chipped in to pay for an additional employee's salary. A modest investment, that effort continues to pay off, allowing more patients to see the doctor and receive medicine.
Still, for all the small successes, there are many challenges left to face. Just days earlier, the community mourned the death of one neighbor who had been battling cancer in Nairobi: Rural hospitals are still not equipped to treat such major illnesses and disease, let alone detect them early enough in the first place.
