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    "id": 569496,
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    "content": "equipment to have test labs, viral loads and so on. While some of the equipment is available in district hospitals and some health centres, it is not necessarily available in dispensaries. The whole idea of devolution is to take services closer to the people. The closest institution to the people in terms of health services delivery, both curative and preventive healthcare, is the dispensary followed by the health centre. I remember when I was MP for Kisumu Rural in 2003 – thanks to Sen. (Eng.) Muriuki when we first implemented Constituencies Development Fund (CDF) – we developed a programme of establishing health facilities. Following World Health Organisation (WHO) directives, we decided that nobody should be further than three or four kilometres from the nearest health facility. In this regard, we mapped the health facilities that existed then. We then decided to add 12 new dispensaries that would make every resident in the former Kisumu Rural not be further than four kilometres from the nearest health facility. Madam Temporary Speaker, in this regard, since the fight against HIV/AIDS should stepped up in certain areas where prevalence is higher, while devolving NACC institutions, we should also realise that devolution should go hand in hand with establishing these facilities closer to the people. That way, the testing of viral load, for example, should not be the preserve of district or sub-district hospitals and health centres. It should be devolved to the level of dispensaries because it is not rocket science. All our nurses who train at the Kenya Medical Training College (KMTC) are capable of being trained for this kind of tests. They are capable of working in dispensaries and dispensing these services. Finally, as universities keep multiplying in this nation, my proposal would be that before a student graduates with a medical degree in any private or public university, he must serve at least a year in rural health facilities. Nowadays, there are quite a number of universities training students in health discipline. They are graduating with diplomas, Bachelor of medicine, surgery level and so on. It must even be in the curriculum of all our medical institutions that they serve at a dispensary, health centre, sub-district or district hospitals. They need to have that experience of dealing with the prevalence of diseases at the local level if they will graduate as Kenyan doctors. Once they graduate, they can work anywhere in the Republic. This idea of having the so called “barefoot” doctors as they are called in China and “family doctors” in Cuba, is noble. In China, before you graduate from medical school, you must serve for three years while in Cuba, you must serve must serve in a local health institution. This gives them an opportunity to serve the people and to know the diseases which are prevalent in the community before they can dispense health services. Again, invoking the knowledge of my friend, Sen. (Dr.) Khalwale, you will realise that the spread of diseases is not uniform in all societies. Diseases occur as a result of certain environmental or dietary conditions and so on. Somebody doing a Bachelor of Medicine and Bachelor of Surgery (MBChB) in Morocco and doing their practice in the The electronic version of the Senate Hansard Report is for information purposes only. A certified version of this Report can be obtained from the Hansard Editor, Senate."
}