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latter as it summarizes how I feel for my country. I know a lot of people may not think of the word ‘patriot’ when they think of civil servants but if one could understand some of the extreme hardships they go through one may reconsider their position. When a person is employed by the civil service you sign an oath for state secrets and a letter stating that you are prepared to work in any part of the country. What the service does not take into consideration is what it costs someone to live in a hardship area or away from their family and there is no form of motivation other than some hardship allowance that can be as measly as a thousand bob depending on the job group. Many Civil servants have literally risked their lives to serve the nation and its people either directly or indirectly. We as the medical fraternity have always welcomed and will continue to welcome foreigners to come and exchange ideas and knowledge with us. Modern medicine is fast paced and to keep up we cannot close ourselves and work in isolation. So it is with this spirit that I will honestly say that we do not object to the coming of our Cuban colleagues. What we object to is the manner in which it has been done and the timing. Even as we speak some colleagues on contract are being threatened by their respective governors that they may have to renegotiate their terms downwards if they want them renewed. I genuinely congratulate the government for it has tried to educate its medical workforce and a few fortunate doctors have even been trained abroad courtesy of the Government of Kenya. The challenge has been that after the training, infrastructure and supportive human capital are either minimal or non-existent. Corruption has ensured that awesome projects and equipment are grounded hence services are either minimal or not available. Healthcare is expensive. To understand how expensive healthcare is, get a perspective on what the cost of healthcare is. A fine example is Switzerland and their retired citizens on pension are still expected to pay the equivalent of KShs. 100,000/= per month for a couple on their health insurance. This is not the least expensive and neither is it the most expensive insurance but that is the cost of healthcare. I genuinely congratulate the government for it has tried to educate its medical workforce and a few fortunate doctors have even been trained abroad courtesy of the Government of Kenya. The challenge has been that after the training, infrastructure and supportive human capital are either minimal or non-ex- istent. Corruption has ensured that awesome projects and equipment are grounded hence services are either minimal or not available We can’t change and become Switzerland overnight however why is it so hard for the government to implement the Abuja Declaration? 15% of the budget should be devoted to healthcare. Countries that have managed to do this have managed to improve their health indicators drastically. In Kenya the allocation ranges between 6-8% maximum and yet people want us to believe that there is a serious push to improving healthcare. Then there is free maternity, now called ‘linda mama’ and free services for under fives. These are all noble initiatives however you starve the hospitals of income or limit user fees and make services inaccessible as consumables are not able to be purchased. So how did we arrive at this current state of affairs where Cubaneros are more important than your current workforce? During the last doctors’ strike in 2017, that lasted 100 days and saw union leaders arrested and jailed the union was threatened with the arrival of Tanzanian and/or Cuban doctors. At that particular point the government was unable to recruit these said colleagues based on the requirements for foreign trained doctors to be accredited. Having trained outside for my undergraduate I remember vividly going through tough board exams and worse internship (done by all medical doctors in their respective countries). It was only after this process that I earned the honor to treat people in Kenya. Why is this being flouted to have foreigners treat us without undergoing any form of certification? What is so special about them and if this be the new way of doing things can all Kenyans who are studying abroad then be exempt from this rigorous process. Also can all Kenyans who have undergone this painstaking internship be compensated for the terrible torture we underwent while trying to get registration as medical practitioners. The government has stated that the process was consultative and involved stakeholders. Why then are we crying foul as we don’t know anyone other than maybe ministry officials and governors who may have been present during such “consultation.” For years the ministry has grappled with deployment of staff to hardship areas. Yet in the same regions such as Dadaab, Kakuma, aid agencies and NGOs have managed to deploy all cadre of staff and most importantly doctors up to specialist level. They have understood that people must be compensated appropriately. The perks our Cuban colleagues will receive are spectacular. Here again I agree with the government for recognizing the fact this is the pay grade at which doctors should enter and