NAIROBI, KENYA – It’s a normal Saturday evening in Nairobi. Laughter and happy chatter fill the warm air. But it is soon disrupted by a scream of agony and pain.
“Someone help me,” a woman cries out in Swahili.
" The Kenyan health system is for the well-to-do."
Crowds begin to throng outside the gated office building where the woman is sprawled on the sidewalk. Her hair is unkempt, clothes tattered, and face stained with dust, grime, saliva and tears. She reeks of alcohol.
She waves what looks like an ultrasound report. Her screams grow louder each time, and she raises her skirt as if she’s about to give birth.
Five women rush to assist her. One woman calls an ambulance as another, with no surgical gloves available, wraps her hands in plastic bags to help the woman deliver. She prods the woman to push. The street woman screams and says the baby is coming. She pushes once more then falls silent as her legs cave to the ground.
Responding to the commotion, the security personnel of the building call the Nairobi City Council to report a public disturbance. One bystander runs to a nearby office building to call a doctor, as the ambulance still hasn’t arrived.
The doctor, Dr. Omondi Kwaye, arrives with his surgical gloves and receives a quick rundown of the events of the past 10 minutes. He asks the woman her name. She says Mercy Achieng’.
Achieng’ reaches feebly toward a yellow folder with her name on it and the ultrasound report. The doctor flips through them then asks her to raise her legs once again.
This time, he pushes back what crowds thought was a baby. Achieng’ lets out a bloodcurdling scream. The doctor tells the team of Good Samaritans who had rushed to her aid that it was her uterus – not a baby – that was coming out of her body.
A prolapsed uterus is when the uterus falls from its normal position in the pelvic cavity to the vaginal canal.
The city council personnel arrive in a dilapidated vehicle ready to whisk Achieng’ away to jail for causing a public disturbance, as one woman pleads with them not to take her and calls the ambulance service persistently. It has been 20 minutes since the first call, but the ambulance has not yet arrived.
Despite calls from Kenya’s ministers and an international pledge to increase the percentage of the budget allocated to the health sector, the government reduced it in the current budget. Doctors say that universal health care and local networks are the solution to increasing access to the millions of Kenyans without health insurance. Kenyans say that high costs and low quality currently deter them most. Others say a welfare system is the only way to achieve health care for all.
As in many developing countries, universal medical care in Kenya is still in the debate stage. The Kenyan government has allocated just 6.5 percent of the 2010-2011 national budget of 1 trillion shillings, $12.5 billion USD, the largest budget in the country’s history, to the health sector. Although this almost doubled the health budget, it is a drop in percentage from the previous year’s allocation of 7 percent of the budget of 512.7 billion shillings, $6.1 billion USD, according to a budget analysis by the Kenyan-German Development Cooperation, a joint government development agency.
