We cannot expect to prosper on IMF loans and poverty-inducing policies


When Christine Lagarde, the chief of the International Monetary Fund, paid a courtesy call on President Uhuru Kenyatta shortly after he was declared the winner of the 2013 elections, I knew that this country was heading for deep financial trouble.

You see, the IMF and its sister organisation, the World Bank, had lost some of their lustre under the Mwai Kibaki administration, which understood that no country in the world has prospered under IMF loans that inevitably lead to lethal, poverty-inducing austerity measures and neoliberal policies.


After being shunned by the Kibaki administration, which kept the World Bank and the IMF at arm’s length as part of its economic recovery strategy, the IMF went on a charm offensive in 2013 to bring Kenya back into its fold.

Indeed, in just two years, the IMF has managed to convince the government to lay off civil servants, cut back on public services, and strangle the trade union movement which has gained strength and credibility under the eloquent, tenacious, and conscientious teachers’ union leader Wilson Sossion.

The recent tragic story of Alex Madaga, the young man who died after a road accident because no private hospital would admit him without a hefty deposit and because the country’s largest public referral hospital did not have sufficient beds in the intensive care unit to admit him is a classic case of how public health services deteriorated since the IMF-imposed austerity measures on Kenya in the 1980s and 1990s.


At that time, going to a public hospital in some parts of the country was like being sent to a prison where you were punished for being sick.

As a result, an increasing number of Kenyans turned to the private sector, including clinics run by religious institutions and witch doctors, for treatment.

Private clinics, some run by unlicensed and untrained quacks, also mushroomed.

This resulted in many preventable deaths, from botched abortions, for instance, to misdiagnosed ailments.

The only good news was that HIV treatment became affordable, thanks largely to the United States-funded PEPFAR initiative.

Health care became the preserve of the rich.

Top private hospitals and doctors in the country began charging whatever they felt like because they knew that their rich patients were insured or had no other choice.

Because the public health care system was so broken, even middle class and not-so-rich people began relying on private hospitals.

Many harambees were, and continue to be, held to pay for the exorbitant fees charged by these hospitals.

It is ironic that when celebrities in Kenya fall sick, star-studded fund-raising events are organised to collect money for their treatment.

Yet, when ordinary people with no health insurance, no money, and no connections fall sick, they are pretty much on their own.


The public education sector suffered a similar “structural adjustment” when 8-4-4 was introduced.

The children of the rich began going to ridiculously expensive British curriculum private schools where they learnt more about the British monarchy than they did about the Mau Mau.

This created a two-tier education system in Kenya — one for the rich and one for the poor.

Until Kenyans discovered affordable medical treatment in countries such as India, it was not unusual for Kenyans to choose not to undergo any treatment because it was too expensive to do so.

In Kenya, one night in the intensive care unit of a good private hospital can set you back at least Sh100,000.

In India, ICU charges in top private hospitals cost about one-fifth of that or less.

Open-heart surgery in India, including hospital stay and doctors’ fees, costs about Sh1 million.

In Kenya, fixing a broken leg can cost more than this. How does one explain this discrepancy?

The quality of public health also seems to be deteriorating under a devolved system.

Doctors and nurses have been fleeing county hospitals in droves, which means that there are fewer trained medical personnel in the counties.

Meanwhile, many doctors are being denied employment in county hospitals because they are from the “wrong” tribe. That is how ridiculously tribalist we have become.

Countries are judged by the quality of their public health and education. Even Ms Lagarde knows that as she comes from a country where both are top class and absolutely free.