Why the doctors’ strike is more than meets the eye


Youth Senator, Kitui County

Now stretching close to its 90th day, the developments on the Kenyan doctors’ strike have not shown a sign of resolution. With doctors and the government at an impasse, patients are overwhelming private hospitals. Some have resorted to private clinics and herbalists. At worse, they have resigned to fate with over 120 deaths (recorded) so far.

Much as that is so, the bone of contention between the concerned parties has been a subject of government propaganda and shrouded in controversy.
The executive has been at pains to disavow the very agreement it signed and the doctors have had to defend the legality of their strike. The quarrel has caused untold misery in hospitals and drawn in the other arms of government as well as the Central Organization of Trade Unions and, Law society of Kenya and the Kenya National Human Rights Commission.
However, for all the sound, fury and chest-thumping, the sick and dying in Kenyan hospitals have little explanation for their calamity. The government has had a privileged spin over substance and confusion over clarity regarding the CBA on which the dispute centres.
In 2013, Kenya’s government agreed to increase salaries for doctors, dentists and other medical professionals in a CBA signed by KMPDU and the Ministry of Health. Currently, starting doctors earn as little as Ksh. 60,000 monthly. Medical facilities, patient and doctors’ welfare are also critically ‘ailing’.
The CBA agreement was also intended to bolster Kenya’s public health system, setting aside money to fund medical research and to provide doctors with ongoing training to improve their skills. It would also create 400 new residency positions, establish overtime pay, create a grievance procedure for equipment shortages, and hire 1,200 new doctors each year for four years to address the severe nationwide shortage.
But four years on, the GoK still hasn’t begun to implement any of those changes.
The government first claimed the CBA would be too expensive to implement, then argued that the document was not a legitimate agreement anyway since it had not been registered, then that the doctors were not its employees but those of the county governments and it was only playing a “facilitation” role; and finally that the CBA was illegally signed by an illegitimate official on behalf of a ministry that did not exist.
These mental gymnastics merit some attention. It is not the first time the government is making offers to its workers to avert industrial action that it later claims are too expensive to implement. Far from it. In fact, it is a tactic the state has developed into something of an art.
While the government insists it cannot afford to meet the doctors’ demands, an internal audit from the ministry of health last year showed more than 5 billion shillings in diverted funds. In 2015, half the proceeds from a $2.75 billion Eurobond (Ksh 270 bn), which marked the country’s debut in the international bond market, also went missing.

Whereas the government claims that the doctors want a one time 300% salary increment, the KMPDU take on the matter reveals the dark side of the issues at hand. The rejection of the 40% salary increment arises from the argument that the grievances are not exclusively on remuneration but more on hospital facilities, patient and doctors’ welfare.

The issues unsolved

The doctors want
150-180% increase in their Basic Salaries, Risk and Medical Allowances
Training of more doctors in specialties whose expertise patients seek abroad
Reduced working hours to ensure proper rest and accurate service delivery
Increased annual doctors’ hiring to meet World Health Organization (WHO) doctor-patient ratio recommendations
Proper promotion guidelines
Improved medical and life support facilities to minimize mortalities
Clear dispute resolution mechanism with the employer
Signed CBAs amendment guidelines
Mechanisms for amendment of the signed CBA

Ill intentioned fight
The government has sustained an online propagandist fight against the doctors. This has stretched from #MyGreedyDoctors to using parody accounts of KMPDU officials to instigate inflammatory messages on their ethnicities. Alleged discomfort of young doctors claiming egocentric intentions from senior doctors in the face of the strike have also surfaced.

To stir the dispute further, Cotu was selected to head negotiations aimed at arm-twisting doctors to accept the government offer or face deregistration at Cotu. Claims from the law and engineering student societies that the pay rise could lead to public service remuneration inequalities edges on painting doctors as a greedy lot.

The inconsistencies in negotiation procedures and brawls between the Cabinet Secretary and Principal Secretary have denied conduciveness on resolving this matter. The Council of Governors, KNHCR, and LSK among others have come on board and help with the negotiations which have been dampened by the government’s non committal stand.

The effects
Patients’ health is at stake as it worsens by day. The private hospitals available are extremely expensive, and overwhelmed by the influx of patients. The doctors, as they fight for better terms of service have gone without earnings and their officials were jailed.

With training of more doctors remains a critical part of the contentious issues, medical students cannot train without the healthcare facilities and professionals. The time lost is irrecoverable. Currently, there is one doctor for more than 16,000 Kenyans. This problem may worsen with reports that around 4,000 doctors, nearly half of the sector, have left for either greener pastures abroad, administrative jobs or have left medicine altogether.

With the standoff still on, the national and county governments have lost billions in revenues from health service delivery.

In my capacity as a representative of the many young residents of Kitui County at the National Youth Senate, I implore on the government machineries to step up and resolve this matter with haste. It is sad to have a situation where Kenyans will have to sell property or incur debts just to afford a basic need.

The Youth Senate Kenya (YSK) will participate in the Global Goals Agenda event at the Global Goals World Cup. Our YSK Queens Team was selected among 24 others to compete in the 5th March, 2017 event. The competition will take place at Impala Grounds, starting 1:00 pm.

This tournament consists of 5-8 women and adolescent girls aged over 16 that represent an organization that supports (like YSK) the Global Goals Agenda. Our team will play Global Goal No.3 – Good Health and Well-being to encapsulate the current Kenyan situation where millions cannot access affordable healthcare services.

By competing in the event, we shall raise awareness on the necessity for a speedy resolution of this crisis and petition the government to act accordingly.

This event is supported by the UN Foundation, Safaricom Foundation and Save The Child Foundation. Nairobi County leaders among other partners have promised their presence.

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