Kudos to Magufuli for decision on 500 doctors, but...

While I commend President John Magufuli for agreeing to send doctors to Kenya when they are facing a crisis, there is also a need to do a critical analysis of the issue on both sides of the border. The President’s decision is a practical one. We have unemployed doctors and if our neighbour promises to fairly employ them then why not?

Some may say it’s a political decision but even so there is no sin or crime in scoring a political point or helping thy neighbour. I intend to analyse this saga starting with the Kenyan side first.

The doctors in Kenya were on strike for 100 days and the common man suffered most. When I went to the medical school, on the first day of orientation we were told that in this sacred and almost esoteric profession words like strike or industrial actions do not exist.

With emphasis we were ordained that even an enemy who was in a process of killing you happens to need medical care, without any hesitations we were duty bound to provide the best available health care to the enemy. This was the training I went through. First I query the training of these Kenyan doctors, how could they strike for 100 days? Did they forget that they had taken in public the sacrosanct and inviolable Hippocratic oath?

But the second message that I am getting from the strike is that there is something grossly wrong in the equilibrium of the society. The doctors were striking because of low salary but their salary was much better than other civil servants. The issue at hand is that while other civil servants and particularly politicians have a parallel salary in the form of stinking corruption these doctors did not have such an avenue. Had this strike prolonged it may have created an African spring akin to the Arab spring. It is definitely in the interest of Kenyans to address the issue of rampant corruption.

On the Tanzanian side how come we have unemployed doctors while data shows that we need more doctors? Since when did we become diabetic (starvation in the midst of plenty)? I read that now we are producing more than 1,000 doctors per year, this is mass production and I recall it started some 15 years back at the Muhimbili University of Health and Allied Sciences (Muhas) and now is spreading in the mushrooming medical universities around the country.

We no longer teach but we preach to these young medical students. Why are we producing en mass when we do not have the capacity to absorb them? Is the quality of their education monitored and who is responsible to monitor. These are fundamental concerns. I wrote on October 26, 2016 in this paper about quality of medical education in Tanzania. I don’t think the Ministry of Health (MoH) or Ministry of Education (MoE) or even the Tanzania Commission for Universities (TCU) ever read that article.

TCU is supposed to monitor the quality of higher education in the country but in all fairness it has failed in this task especially in monitoring professional training like engineering and medicine. Perhaps TCU lacks competency but in the past it was definitely shrouded with corruption. How could TCU approve a postgraduate programme in family medicine in Tanzania hosted by a private university? Did the MoH or other government or non-government agency express the need for such a programme? Is this qualification within the countries health system and did TCU read the aim of producing a medical officer in Tanzania. This all reflects incompetency coupled with corruption in TCU. Some five years back Muhas embarked on the exercise of curriculum review of undergraduate and postgraduate programmes. There was a huge grant if I recall correctly from UCLA. The programmes were modularised, changed to competency/problem-based approach and a grade point average (GPA) system was included. The aim was to create curriculum that would produce a much better doctor and the attrition rate would be significantly reduced. This was a lost opportunity because instead of changing the curriculum we ended by adding action verbs and changing the semantics-there was no fundamental change in the curriculum and millions of shillings were squandered. The mass production of doctors continues and now it has become a commercial enterprise.

Some final thoughts-as a pilot initiative before sending these doctors to Kenya can a medical board either in Tanzania or Kenya administer a board certifying examination. This will reflect the competency level of these doctors and give us clues about how good is our medical education. Anything short of this then we are sending medical assistance to Kenya.