SHA System in Crisis as Ruto Ally Michael Makarina Turns Critic After Medical Emergency

 

By Sysvoline Atieno

Michael Makarina, once a vocal supporter of President William Ruto and an iconic face of the Bottom-Up economic narrative, has made a stunning about-face — publicly condemning the very system he championed after a personal medical crisis exposed deep flaws in the country’s new healthcare scheme.

The Meru-based businessman and disability rights activist, best known for ending press appearances with the now-infamous phrase “System iko sawa!”, found himself on the receiving end of a failing system on the night of July 15. After falling seriously ill, Makarina was rushed to Aga Khan Hospital in Nairobi, only to discover that the Social Health Authority (SHA) — the government’s replacement for the National Health Insurance Fund (NHIF) — could not facilitate his admission.

“My wife was running up and down, trying to push things through SHA and SHIF. She tried. But nothing was moving. The system failed us in our hour of need,” Makarina wrote in a Facebook post from his hospital bed. The post quickly went viral, striking a nerve with Kenyans already expressing growing discontent with the new healthcare framework.

As Makarina’s health worsened and attempts to activate his benefits through the SHA digital portal faltered, it was former Directorate of Criminal Investigations (DCI) boss George Kinoti who stepped in, wiring the full hospital deposit. “Brotherhood still works faster than bureaucracy,” Makarina added, in a scathing critique of the government system he once defended.

Mounting Public Frustration

The Social Health Insurance Fund (SHIF), managed by SHA, has faced widespread criticism since its launch in October 2024. On day one of the transition, patients with chronic conditions — including those in Kisii, Garissa, and parts of Nairobi — were turned away from treatment centers. NHIF cards had become invalid overnight, while SHA systems lagged behind in operational readiness.

This week, a survey by the Rural & Urban Private Hospitals Association painted an even bleaker picture. Only 20% of clinics reported receiving full SHA reimbursements. Over one-third have taken out loans to keep doors open, while 13% of facilities are facing auction threats due to unmanageable debts.

Experts have also taken issue with SHA’s benefit structure, calling it “unrealistic and disconnected.” For instance, the dental coverage cap of KSh 2,000 per year barely covers a single filling in most urban clinics. Maternity packages, too, leave patients footing substantial bills despite being under the so-called universal health plan.

Political Fallout

For the Ruto administration, Makarina’s very public rebuke is more than a personal crisis — it’s a political bombshell. As one of the most vocal grassroots mobilizers for the Bottom-Up agenda, Makarina has long used his platform to dismiss critics and defend government policies, often branding dissent as “propaganda.”

His sudden disillusionment has triggered fierce debate online and within political circles.

“SHA is a sweet story in press conferences but a nightmare on the ground,” Makarina wrote. “We were told to believe. I did. Until I became the casualty.”

With doctors’ unions threatening industrial action and mission hospitals issuing warnings over mounting debts, the health sector appears headed for a turbulent season. Yet, Health Cabinet Secretary Aden Duale remains optimistic, insisting the system is “finding its footing.”

“We have over 9,000 facilities under contract and July reimbursements are being processed,” Duale said on Tuesday. “We ask Kenyans to be patient.”

But patience is running thin — and with Makarina’s defection, the government has lost a powerful voice in the public square. What once looked like a communications win for the administration has now transformed into a PR disaster.