Paper short abstract:

Drawing on hospital ethnography of cancer and diabetes care in Kenya, this paper explores Non-Communicable Disease care imbalances expressed in the movements of patients, technology and health care personnel.

Paper long abstract:

The increasing burden of Non-Communicable Diseases (NCDs) in Kenya represents the historical low priority given to control of the NCDs. Help-seeking trajectories among patients indicate the difficulties of managing the diseases in the context of inadequate supply and unequal access to appropriate expertise and technology. Scarcity of qualified personnel and equipment for NCD diagnosis and treatment characterize the unfruitful care-seeking journeys and multiple referrals, particularly at the chronic stages of the diseases. NCD care movements often involve different levels of the public and private referral hospitals and beyond; including the exits of health care personnel from public to private medical facilities and externally, abroad. The medical travel phenomena worsen the experience of inadequate NCD care. Attempts by the government to bridge inequities in the provision of NCD management resources to the citizens belie the reality of a dearth of health care expertise and technology. This underlies the flow of patients for better care and the exit of public health personnel for better training or remuneration. Drawing on hospital ethnography of cancer and diabetes care in Kenya, this paper explores the embodiment of local and international NCD care imbalances expressed in the movements of patients, technology and health care personnel. The paper makes reference to the Critical Medical Anthropology theory to analyze how help-seeking trajectories among diabetes and cancer patients. Health provider movements, and inadequate accessibility to available expertise and technology manifest unresponsiveness in NCD care relative to wider socioeconomic and political contexts of the health system.