By Daniel M. Yumbya
One of my favorite philosophers Mahatma Gandhi once said “It is health which is real wealth, and not pieces of gold and silver”.
His sentiments ring true to this day and might explain why patients are always seeking better health services and if they can afford, are willing to spend millions by traveling abroad to seek treatment if promised favorable outcomes when their health is on the line
This could be one of the reasons why medical tourism is a multi-billion industry.
The Ministry of Health (MoH) estimates that Kenyans spend $15 million on medical expenses abroad.
In any given year, hundreds of Kenyans troop to hospitals abroad in search of treatment. Between January and December 2019, more than 400 patients were cleared by the Ministry of Health and the Kenya Medical Practitioners and Dentists Council (KMPDC) to travel abroad for treatment.
The numbers recorded in 2020 are slightly lower due to the lockdown imposed to mitigate the spread of Covid-19.
The few patients who seek clearance from KMPDC are those who need the National Health Insurance Fund (NHIF) to help with their medical bills abroad. Hundreds of other people, especially those with private insurance, go directly without authorization from the Council.
According to our data, the most common referrals are those to do with oncology, heart disease and organ transplants. Although some, if not all of these services are available in health facilities in Kenya, a number of patients genuinely travel for services unavailable in the country.
While going abroad for treatment is no guarantee for better health care, it has been sold as the ultimate option for medical care. This is not always true.
Whereas the treatment expenses overseas in some cases may appear pocket friendlier than the costs in Kenyan hospitals, many patients travel oblivious of a myriad of added costs resulting from travel. Besides the hospital fees, patients pay for accommodation, air ticket and food as separate bills. In most cases, family members accompany the patients adding onto the costs.
Such costs make treatment abroad extremely expensive and many patients, unable to meet these expenses, end up detained in foreign hospitals for unpaid medical bills. This only adds more suffering to families already strained by medical bills and anxiety over the health of their members.
A patient also needs to plan for any needed aftercare upon returning home. One must talk to their doctor to plan for medication and other post-operative needs that may arise from treatment to ensure that the treatment received is indeed working well.
It would be quite difficult for a practitioner abroad to physically follow up on a patient who sought treatment from them.
For reasons elucidated above and several others, the Kenya Medical Practitioners and Dentists Council in 2017 developed rules for referral of patients abroad. Under these rules, a medical or dental practitioner may refer a patient for medical or dental management abroad where; there is evidence of inadequate expertise or medical facilities to handle the condition locally; when referral is the most cost-effective option available for the patient; and when the patient opts to pay for medical intervention abroad.
The rules determine the procedure for referrals and eliminate sporadic or unwarranted referrals that fleece Kenyans. This means that Kenyans who want to seek treatment abroad must inform the Ministry of Health and KMPDC about their intent.
This is important because it will help reduce unnecessary referrals when the services can be received in the country at a lower cost and, in the unfortunate event a patient loses their life while receiving treatment abroad, the Kenyan Embassy at the country which one is seeking treatment is in the know of such an eventuality, making it easier to help in the transfer of a body from a foreign country.
In recognition of fissures in the current regulations, the National Assembly is seeking to amend the Health Act by introducing a new section in the law that will establish policy guidelines in the regulation of oversees medical referrals.
Sponsored by Kesses MP Dr. Swarup Mishra, the amendments make the referral of a patient abroad a multi-agency affair. KMPDC, NHIF, Association of Private Health Institutions, Kenyan Embassies and consulates will play a part in vetting the referrals.
The rules, as proposed, stand to benefit the people but nobody should mistake them for a panacea to the menace. KMPDC is committed to ensure that Kenyans get quality healthcare available in the country and in the event that they are referred abroad, their safety and healthcare concerns are well taken care of.
Patients must however commit to play their part and seek advice from the Ministry of Health and the Kenya Medical Practitioners and Dentists Council before travel. The forms and other requirements are on KMPDC’s website www.kmpdc.go.ke.
The Article has been written by Daniel M. Yumbya, MBS, the Chief Executive Officer of the Kenya Medical Practitioners and Dentists Council and Management Committee Member, International Association of Medical Regulatory Authorities (IAMRA)