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"id": 6800,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/6800/?format=api",
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"type": "speech",
"speaker_name": "Dr. Nuh",
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"speaker": {
"id": 114,
"legal_name": "Nuh Nassir Abdi",
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"content": "“---which includes the right to health care services, including reproductive healthcare;” Mr. Temporary Deputy Speaker, Sir, this right that has been enshrined in the Constitution and described as “the highest attainable standard” is one that Kenyans have been yearning to have and the Government of the day should ensure that it is not just a promise that is put on paper, but is one that is implemented at whatever cost because Kenyans deserve it. In that endeavour, the Government has to look at the issue of equitable provision of health care services because currently, as it seems, health is now becoming a privilege when, indeed, it should be a right. It is only becoming a privilege that those who have the money are able to pursue, and that every other Kenyans who by virtue of, may be, where they live or by virtue of who their ancestors are, have remained poor for so long are unable to even access the most basic of these health care standards let alone, having treatment for complicated cases like cancer and others. Mr. Temporary Deputy Speaker, Sir, nowadays if a poor Kenyan is diagnosed of having cancer, it is like that Kenyan is sentenced to death. He or she is condemned and one has just to dash all the hopes, lie in bed and wait for death to come at whatever opportune time that person would expect. This is not a very good move. Kenyans should have hope that whatever ailments come to their face, at least, have an institution to run to; a Government shoulder to lean on and a friend, at least, to share with and say: “This is the problem I have” and that they would want it lifted. But in a case where because someone is poor and because cancer management requires some resources which sometimes are enormous, then that person is convinced that, may be, death is now imminent and even if he was a teacher teaching students, he would ask: “why belabor or why wait?” until he or she is resigned to his or her grave. Even if he was a doctor, he would ask: “Why pursue and treat many others with ailments” when his or hers is already a death sentence. Mr. Temporary Deputy Speaker, Sir, this Bill comes at an opportune time when many Kenyans are aware of their rights to attaining health standards that have been guaranteed in the Constitution. Many a times, we argue that we cannot afford to fully implement a health care service that is free for every Kenyan and we say that it is an expensive venture. But rights are expensive and they ought to be! This is because the same Kenyan who is demanding because it has been indicated in the Constitution as a right that they should attain the highest standards of health is the same one who is oiling the Government to have the resources to be able to run. Some may be contributing Kshs10 as tax a year while some may only be contributing their services in some way and paying back to society. They deserve all the support that they require. This Bill tries to address and put mechanisms and institutes in place and a body to manage it so that issues of cancer are addressed, at least, from a point of information. Mr. Temporary Deputy Speaker, Sir, when we talk about the three-pronged approach of prevention, diagnosis and later on of management or treatment, this can only be done in an environment where you have an institute that devotes all its time to, at least, that entity called “cancer”. But when we leave it to the myriad of other problems that are there as health problems and you want it addressed by the Ministry concerned, then the essence of tackling cases of cancer is lost. That opportunity does not come because the Ministry will be engrossed in fighting malaria, diarrhoea and many other diseases that are common place and which are passed on to others. Cases of cancer, whose transmission is mostly thought to be only through the gene type and the rest would be through habitual and others would be left unmanaged and even for those who would like to seek advice and information would not have access to that information. Mr. Temporary Deputy Speaker, Sir, when you have an institute that will deal with issues of cancer and, at least, create awareness within the public; that these are cases that predispose you to cancer; when, at least, we will have a Kenyan population that is more informed, that will make the right decisions at the right time to be able to prevent cases of cancer. When Nairobi created the bylaws as a City Council and said that you will have to create some free zones for smoking so that you do not predispose others to ailments that are related with smoking, among them cancer, at least, some percentage of reduction of cases of cancer would be seen in the near future. If we had this institute, it would have given capacity to the local authorities to be able to make some of these by-laws that will benefit in the prevention of cancer in the long run. If members of the public had that awareness that drinking or smoking cigarettes, for example, will predisposes them to cancer and this institute was able to avail the statistics and give the information that is required, at least, people would have reason to believe in it. This is an institute that has been created to deal with cases of cancer, so any information they give is reliable and that the public would be able to abide by it at least for their own safety. So, we need this Bill to be passed like yesterday. We need this institute to be able to see how Kenyans in the next generation are able to reduce cases of cancer within the population. Today, distribution of cases of cancer in country in the midst of us is not uniform. We have allegations and heard them before that in some places in northern Kenya like in Wajir or other towns, there has been dumping of some components that may predispose people to cancer. Some of them are talking of nuclear materials. These issues have not been ascertained. However, at least, that suspicion is there. These allegations are there. No one has come very bravely to refute them and, at least, avail evidence that whatever has been dumped there by some choppers which are seen to land even at night could be a dangerous material that could predispose the population to cases of cancer. Mr. Temporary Deputy Speaker, Sir, if we were able to have an institute that is able to provide data of how cases of cancer are distributed across this country, then we would have an affirmative action and a movement towards that region that is bedeviled by high cases of cancer rate. We could see even how the diagnosis and the management facilities would be able to be shifted towards those regions at least on affirmative basis. That is when diagnosis and screening of cancer comes in. At least, if cases of cancer are diagnosed early enough, they can be managed in a better way and with less resource. However, when we have a case of cancer that has been long standing; that has gone almost to the dead end, then management of such a case becomes an expensive venture and that is when the patient even losses hope because they are unable to raise those funds. At times, it even reaches an instance where interventions will not help and the person is condemned. He is told that this case of cancer cannot be managed and that he will just have to wait for his death very soon. Mr. Temporary Deputy Speaker, Sir, again, the institute would see modalities of how early diagnosis can be of assistance at least in early management of cases of cancer. What would it help if you diagnose someone and told him you have cancer, but you are unable again to provide the management and therapy? You will only be resulting in that person having nightmares that he has a disease and he does not know where to seek medication or that he has a disease which he does not know its management or that he has a condition that he cannot afford. This is because management of such a condition would only be available in places outside this country or in institutions which are private in nature and charge very exorbitant prices. This common person would not be in a position to even step in and arrest the situation. These endeavours of having that information disseminated by this institute; of that data being collected at least for information and resource to be available; for diagnosis and early screening of these cases of cancer to be done and for facilities to be equipped so that we are able to manage cases of cancer in this country. We need resources to do so. We need money to be voted in to the Ministry of Medical Services. The Abuja Declaration that our country Kenya has also committed to, says that, at least, 15 per cent of the budget line has to be executed towards health. We are far much below that level. We are still at percentages of 4, 4.5, 5 and the figure keeps fluctuating every other year that you are not even certain whether a percentage would really increase or reduce. That is the case that we are advocating that at least this Bill should have incorporated issues of having money voted directly from the Consolidated Fund to this institute. Mr. Temporary Deputy Speaker, Sir, if you go to Article 15 of this Bill, it says that the funds of the institute shall comprise of:- (a) Grants – these are donations that the institute may receive as a result of public and private appeal from local and international donors or agencies for the purposes of carrying out its functions. This is far-fetched. We are giving an institute that has got a legal backing. An institute that we want to carry out an enormous task of having to deal with cases of cancer in this country; a condition that has become a killer condition at a very high rate and we want that the first budget line that this institute will be getting will be grants and donations that they seek. It does not look serious. The commitment just looks to be on paper that, at least, we have a law and an institute that deals with cancer. However, if we did not give this institute enough resources to be able to deal with the task that they have been given, then it is as well better having no institute because we would have hoodwinked Kenyans and those patients who have cancer that at least they are getting help when, indeed, we are not serious. So, an amendment has to come in either form that the Government has to commit funds and that this institute or this body has to be capacitated by the Government and that resources have to be allocated for them to be able to deal with these cases effectively. Mr. Temporary Deputy Speaker, Sir, that is when this institute will have teeth to propose that we have centres that are equipped and have the necessary expertise and personnel to be able to forge a way forward to see that cases of cancer are reduced in this country. When you hear the medical practitioners going on strike because they think they are very wrongly remunerated, I start losing hope as to whether the Government would be able to support this Bill to the end and ensure that the resources required are given. It is not far-fetched. It should not have taken until the medical practitioners announced that they are going on strike for the Government to have known that they are remunerated on standards that are way below their expectations. We tend to give excuses that the Government has a budget constraint; that resources are not enough; that we have a war at hand with Al Shabaab ; that we are facing many other issues and some meltdown of the economy that is worldwide. However, these are not enough reasons to ensure that the workforce we have is well motivated. With regard to the issues of personnel allowances, travel allowances and other emoluments that sort of look basic that we, as a Committee, proposed that they should have been included in the budget line for this year and even which was as well endorsed by the Budget Committee and passed at the recommendation of this House. However, they were not supported by the Government. What do you have in essence? You hear that personnel in Kenyatta National Hospital have downed their tools and are leaving patients by the bedside. They have done that because if you wait for the Government to respond and they never respond, then someone would see, what are the drastic actions that would make this Government listen and understand. In this line, I also want to urge the two Ministries concerned, that is the Ministry of Medical Services and the Ministry of Public Health to move with speed. They should not only talk in Press conferences and say that they are ready for negotiations, but to go ahead and engage the medical practitioners. They should ensure that an amicable solution is reached before 5th December, so that we do not have a disaster in this country. Ours is an ambitious plan of talking of how we will manage cancer cases; of how we will get the necessary expertise or more equipment. However, it is an ambitious plan that will go down the drain if, as a country, we will be unable to manage the basic medical staff that we have in hospitals just because of issues of remuneration that can be sorted out by the Ministry and the Government. I would urge the Government to move with speed and not wait for last minute ultimatums for them to respond but to be in touch with these associations because I know before these ultimatums and strikes were given, there must have been the under-currents that the Ministry must have known. With those remarks, I second the Bill."
}