(Continued from A Heart of Flesh II)
Rosemary is furious. She is so furious that she has completely forgotten that she was tired. Or that she was unceremoniously dumped by a boyfriend earlier in the day. Makali is a doctor. He took an oath to save lives. But all he does is to exploit the needy and to fleece them dry. Under the Gitonga administration, the county health care system was not exactly free. What Gitonga did was that he ensured that all households in the county were covered under NHIF. He had social welfare officers go around homes assessing economic activities. The poorest of the poor were enrolled into NHIF by the county government, which also paid their monthly contributions. But he also encouraged them to get jobs.
NHIF was initially reluctant to get into this arrangement with the county government, insisting that the County Government should finance the county hospitals. Gitonga, Irene, the CEC and a majority of the MCAs made noise in almost every media house and on social media, and the whole country rallied behind them. NHIF buckled under pressure and signed the agreements.
Gitonga had a whole docket dedicated to social welfare and co-operative development. The CEC for this docket was called Bruno, and he was Irene’s running mate in the last election. Bruno’s work as a CEC was to encourage the unemployed to get into income generating activities, mostly farming. People were lumped into groups and helped to get into poultry, rabbit and fish farming; other grew fruits such as melons and pineapples. Gitonga and Bruno lobbied hotels within and outside the county to buy these products. Businesses in the county were also encouraged to hire locals. Bruno partnered with officials of the various Saccos to not only offer loans, but to give financial literacy classes especially to the farmers. By the time Gitonga was vying for his second term in office, almost every household could afford NHIF contributions, and the county was paying for very few.
Because the county referral hospital and the health centers were getting reimbursements from NHIF, the system was self-sustaining. The county was spending very little in subsidizing health care. It is this system that Makali has been exploiting. Because everyone in the county has NHIF subscription, he gets them referred to his clinic, where he charges them exorbitantly. Sometimes patients are treated for diseases they do not have, and charged for medicines they are not given. Now, NHIF cover, like almost every other insurance cover, is not limitless.
What Makali’s fraudulent activities do is that they leave people who are sickly like young Mark vulnerable. When their cover is exhausted before the year ends, it means they cannot find help anywhere. What Rosemary has been doing is giving diagnosis whenever she could, and then sending them to private pharmacies with prescriptions to get medicine. It is cheaper that way than having them go to Makali’s clinic. If she realised that the medicines would cost a lot, she would advise them to go to the mission hospital, where they would be able to use their NHIF cards without being swindled. The fare they would spend going to the mission hospital is nothing compared to the cost of getting treated at Makali’s clinic.
Under Fancy, private clinics have flourished in the county. What Rosemary has heard, but cannot independently confirm, is that the governor and her husband have cut deals with these clinics. Having failed to install her husband as the CEC in charge of health, Fancy appointed another of her cronies called Ludwig to head the docket. She also appointed her husband and other thugs to lead all the health centers and the county referral hospital. These men and women do business with these clinics, more or less the same way Makali does at Kanyenje. Like Makali, some of them have started their own clinics using proxies. The Governor and her gang of thieves divert medicine meant for the county to these clinics and they get kickbacks. They also refer patients from the public facilities to these clinics, and they get kickbacks. Any clinic that is not in this fraudulent business has been crippled and driven out of business.
The governor has not stopped at that. The farming projects that Gitonga started are teetering on the verge of collapse because the current Governor now demands kickbacks from hotels and other institution who buy fish, eggs, chicken, rabbits and fruits from the farmers. Attempts by the farmers to sell these products without the involvement of the county hit a brick wall because the county imposes heavy levies and trade licenses on them. Since getting products from the farmers no longer makes commercial sense to the hotels and restaurants, these institutions have had to look elsewhere for their eggs, fish, chicken and rabbit meat and fruits. Because of this, many residents have defaulted on their NHIF subscription, and they are left vulnerable as far as health care is concerned.
The county that was once a shining example of how a devolved government should work is now the hub of everything bad, from poverty to corruption, fraud, hopelessness and failure. Alcoholism and crime have risen again.
This is what is making Rosemary furious.
Rosemary has not been paid for three months. But even three months ago she only got half a salary. She has not been paid in full for two years. She knows that it is because she not only refused to work in Makali’s clinic, she also refused to sleep with him. Gideon, one of the two good nurses at the health centre, has not been paid for four months. Anne has been getting her salary, but that is because she yielded to pressure and agreed to sleep with Makali. But Rosemary does not judge. She knows that the only reason she has been able to work without pay is because her brother Arnold has been supporting her. Rosemary has a twin brother who studied medicine and now works in the United States. When she shared her tribulations with him, he encouraged her not to quit, and promised to be paying her what the county government had been paying her under Gitonga.
“What you are doing is missionary work in that community, siz. You are the local population’s beacon of hope, and I am willing to support you so that you can continue doing the good work you are doing.”
Arnold is also the one who bought her this car. Gideon, on the other hand, comes from a well off family. His father has been supporting him the same way Arnold has been supporting her. But Anne has no one to support her. In fact, her family looks up to her for financial help. She cannot afford to go without a salary. Rosemary understands why she gave in to pressure. She also knows that Anne is a good woman and that she genuinely cares for the patients. Rosemary’s heart bleeds for her.
One hour after they started their journey, Rosemary drives into the mission hospital. The hospital is in a neighboring county so Fancy and her gang of thieves have not been able to touch it. Rosemary parks the car just outside the casualty area. Mark’s uncle carries the boy in his arms and rushes into the casualty area, with Hilda on his heels. Rosemary and Anne follow. Rosemary quickly briefs the clinical officer she finds in the casualty room and then retreats with Anne so that the new medics can take over.
“We have been fired, haven’t we?” Anne asks quietly, when they get back to the car. They stand outside the car and lean on it. It is a warm, moonless evening.
“No Anne. It is just me who has been fired. He cannot fire you.”
Anne is silent for a while.
“You know I do not like sleeping with that fool,” she says finally. “He thinks he is God’s gift to women and treats us like trash. The sex is always painful because he doesn’t care about how I feel or whether I am ready. It is always about him getting his release. I am always left with painful bruises whenever I am with him. I don’t want to mention the nauseating things he makes me do to fulfil his sexual fantasies. And what do I get for my trouble? It is not like he does me any favors. I still have to slave every day at the health centre to get my salary. He doesn’t give me even a cent more. Not even a bunch of roses or a bar of chocolate. Not that they would make the situation better, I am just trying to show you that it is not out of choice that I sleep with…”
“It is okay, sweetheart,” Rosemary tells her. Anne has started crying, so Rosemary hugs her tightly. “I am sorry if I sounded judgmental. I don’t judge you at all. I know Makali is the criminal.”
“I have made applications to many hospitals outside the county but I have not been successful. Sometimes I wonder if he and his wife have been sabotaging me.”
“Something will come up, trust me. Just keep the faith.”
“It is difficult, Rose. Every day I wonder if I am HIV positive because the idiot doesn’t use protection, and we all know he sleeps with anything in a skirt. I don’t have the courage to take the test, but it is driving me insane. I used to take emergency pills the way one takes paracetamol but I finally accepted my fate and took a long term contraceptive. I can’t handle getting pregnant with this stress, and without knowing my HIV status. I try to look cheerful around the hospital for the sake of patients, but I am dying inside. I have even thought of committing suicide. What is the point of living if this is the kind of life you get?”
“Don’t say that honey. I am sure God will provide a solution soon.”
“Which God? I don’t think I believe in Him anymore.”
“Don’t say that. The Bible says that the wicked will be cut off like chaff…”
“I know what the Bible says. But why did God get me in this mess in the first place? That same Bible says that no government is formed without the authority of God. Doesn’t that mean that God approved when Fancy and her backers rigged out Irene and Bruno? If Fancy is the leader that God decided we should have, why should I continue believing in Him? Look at how people are suffering. Where is God in all this?”
Rosemary does not have an answer. She is a steadfast Christian, and she truly believes that God will intervene, but the questions Anne is asking have been bothering her as well. She has asked God many times in prayer. She hasn’t gotten answers, but her faith hasn’t been shaken yet. But then again, she is not the one who has had to put up with an arrogant sexual predator to earn a living. She doesn’t say anything else because she knows it might come off as insensitive. Instead, she just continues holding Anne tightly until the nurse stops crying.
Image by Aravind Kumar from Pixabay: https://pixabay.com/photos/women-sunset-silhouette-dark-black-1463199/
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