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ONE-ON-ONE INTERVIEW WITH DR. GITHINJI GITAHI – GROUP CEO FOR AMREF HEALTH AFRICA.

Since the first Covid-19 case was announced in Kenya, the country has taken various steps in combating the pandemic. How would you rate Kenya in comparison to other countries in Africa in terms of our response?

The Kenyan government has consistently shown that it can follow science, and it has followed the advice of experts. That’s why we’ve taken the necessary measures right from the beginning; closing of borders, isolation, quarantine and all those things up to now we have the curfew. The challenge has been the same government, though listening to experts, has not complied with its own policies. We have seen politicians hold big rallies, even though the government has laid out very clearly procedures. On the side of the public, there has been a high level of social fatigue to follow the rules and therefore you see the number of people wearing facemasks decreasing while the number of people who are attending political rallies increasing because there’s no fear. Generally, Kenya has performed better compared to other countries but we still have serious compliance challenges. 

How is the uptake of the vaccine and why do we still have resistance and myths against the vaccine?

We’re not used to vaccinating adults. The same people we are begging to go receive the jab have taken their children for vaccination before. Right now, because it’s the adults themselves, and all the misinformation they are collecting on social media, there is this kind of posturing that they want more information on why is this vaccine manufactured so quickly. Some of them I think is just due to fear of the injection. People also don’t realise that there are people who for a very long time have consistently been anti-vaccination. These are people who raise money to create fear around vaccines. Once we realise that it is deliberate misinformation, then people can start to look at it differently. Many a time in my own experience is not absolute ‘No’. It’s not denial but just hesitancy. This means that you have to provide the right information from the right sources for the hesitancy group to receive the vaccine. We have to work with people, find credible sources at the community level with people they trust for us to overcome hesitancy.

As we head towards the election period, we’ll see a lot of public sensitisation on matters elections like voter registration and a lot of emphasis is put on. However, the same has not been the case concerning vaccines. From where you sit, what advice can you give to the government on sensitisation around vaccines?

You would expect the government to raise the same if not even more kind of level of campaign activity. The challenge is in how the government operates. In the policies, the government has documented that public awareness and community mobilisation is at the centre of the success of public health measures for Covid-19 and also vaccination drive. But moving from that documented policy to action is not the strength of the government. We are hoping that organisations like ours can find funds and then facilitate the mobilisation. But we have to crowd in partners to be able to do proper public communication and that’s the only way to go.

In the wake of Covid-19 people have lost their lives and livelihoods and this affects people/families in many ways. What is your comment on the need and importance of self-care and wellness during this period?

We keep saying health is not made in hospitals, health is made at home by individuals, where they live, work and play. And this is the role of self-care and wellness. The majority of people (over 95%) are born healthy only a few people are born with congenital diseases.  It’s your way of protecting your health by saying ‘I want to care for myself through the things that I do, eat and drink and get the right information to take care of myself so that I don’t need to wait to be sick get treatment. That is about consciousness. I think the question is; how do we create consciousness in people, certainly those who are being drawn to a place where their lifestyle, could result in disease. How do we create consciousness in them through the workplaces, how do we create consciousness because that’s all you need? Consciousness needs to go beyond the physical body. Consciousness is created not only by ourselves, but our workplaces, the people we work with, and the information through digital platforms because now it has become more available, so we must print the right information for people to make decisions for their lives.

You have mentioned that the state of your mental health affects your physical health and in return that affects your productivity in the workplace or whatever you do. How can human resource professionals/practitioners be able to instil and emphasise the need for wellness and self-care, especially during this period?

It’s one thing to tell people what to do and it’s another to show them what to do and to support them to do it. I think this is the role of HR professionals. There’s a huge mental health burden. The question is; even after informing and creating the consciousness on self-care and wellness, how do we enable it at the workplace. The role of HR practitioners is to provide safe spaces for people to speak, avenues for people who don’t feel they can speak openly, connections and networks, for example, therapists that people feel comfortable and can reach out without necessarily having to go through the HR. That information should be freely available and people should consciously use it without feeling stigmatised. Because the big issue with mental health and the challenges we are facing is stigma, that when you say you are struggling, then you sound weak. 

How can HR professionals create an environment for their members of staff to come out without feeling intimidated?

There’s a lot of career competition at the workplace. People want to look stronger so that they look like the better ones and therefore, they never want to be the weak ones.  Because of these fears, people want to stay with their problems, and they don’t want to open up because they fear it will work against them. So, we’re talking about creating an environment of psychological safety that people feel that they can express themselves. That’s not easy to do because it doesn’t happen through a memo or a policy, it happens through engagement between individuals, between their managers and peers. But I would imagine that creating circles of people support systems, creating hotlines, or counselling lines where you can call anonymously and get help. Creating systems that are confidential for people to be able to raise issues and admit their vulnerabilities without necessarily exposing themselves. 

In this situation, you find innocent children are losing their lives in circumstances that could be avoided. What can we do to protect the vulnerable, especially the young ones from the dangers that come as a result of these situations?

Societal pressures are happening to our children when society is also rapidly changing. The traditional support structures that we used to have do not exist anymore due to the urban migration. Because the digital platforms are now widely available, I think what we need to do is create accessible digital platforms that young people can use as self-care and wellness for themselves, without necessarily having to seek support from an older colleague because then they feel they could be judged. Hope is the last thing you lose before losing your life. Therefore, creating hope in the system is important. This means that there should be a wider socio-economic conversation about creating economic opportunity.

Currently, we are dealing with a medical situation that comes with a huge toll on finances. Bearing in mind that a good percentage of people lack medical insurance. What is your take on Universal Health Coverage? 

We have seen that whereas we wanted to get as many people in the Universal Health Coverage as possible, we have not gotten there. The pilot program did not work because instead of using the self-declared approach of getting everyone on NHIF, we went and decided to give people free services without going through NHIF. The pilot program also did not offer any additional movement towards the goal of getting everyone in NHIF. There has been some political interference with the fact that health is devolved and whether it should be financed by the national or county governments. The final point is that health annuity is a political choice and if we don’t make that political choice, we’ll never achieve it, we’ll keep talking about it.

The private sector is supporting the government in the vaccination exercise. What’s interesting in this discussion is the issue of fake vaccines. What is your take on this?

The issue of fake vaccines is not a Kenyan phenomenon. We have had challenges in other countries too. It is actually a free market problem. It is people trying to make money. Now the only way to protect against that is to improve the government capacity to regulate and to enforce compliance. We also need community policing and post-market surveillance.

We have seen in other parts of the world like Europe stadia are full and live is also almost back to normal. Are we on the right track to achieve that target in our country?

This is a question of the globalisation of injustice. The challenge we are having as countries in Africa including Kenya is not a challenge of affordability but supply. What we are demanding and calling for is for the rich countries, that are ahead in the long queue occasioned by the shortage of supply, to give up their position to those countries that have not vaccinated enough like Kenya and are behind the queue. 

If you can just demystify the myths because a section of the population who do not want to be vaccinated. Why is there a need for everybody to get vaccinated? 

Vaccines are not new. We have used vaccines for centuries to save the lives of people. Vaccination is proven to be historically the best medical invention of all time. The Covid-19 vaccine is not different. The evidence is very clear now that a person who is vaccinated has minimal chance of getting a severe disease, and move into a hospital than somebody who is unvaccinated. Right now, we are seeing data from countries that have vaccinated a huge population that if you’re vaccinated, you’re 11 times less likely to get a severe disease than a person who is not vaccinated. 

Your parting thoughts on this? What is your advice to the HR practitioners on this topic of wellness and self-care?

The responsibility for self-care and wellness is an individual responsibility. But our responsibility as a society at a workplace and as HR professionals is to deliberately create the consciousness to awaken that personal responsibility. There are many ways which include getting the conversations going, getting experts to talk to individuals or offering digital platforms and positive reinforcement – there has to be an incentive programme to show people that when you go less to the hospital, then you get a certain benefit and that benefit. This is where we want to go. We want to go into a place where people see insurance as something you need for a rainy day, and the healthier you are, the better for your insurer because then they will spend less money and give you a less premium next time.

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