Kenya’s deepening healthcare crisis

KENYAN medical workers during a strike.


KENYA is currently gripped in a prolonged political standoff that has left the East African country reeling in uncertainty.

The present situation remains all the more volatile given that the ruling Jubilee party went ahead with the repeat presidential election even though the Raila Odinga led opposition NASA gave it a wide berth.

But underneath this political quagmire, there is an issue that has engulfed Kenya for a considerable period of time now, exacting even more agony to the citizens. The country’s healthcare situation is in crisis.

2017 began with a countrywide doctors’ strike which went on for a couple of months, forcing healthcare services to ground to a halt. This pushed many in need of treatment to seek medication from neighboring countries.

At the time, the government was forced to look for a quick-fix resolution to a problem that was almost getting out of hand, in a bid to remedy thousands of suffering patients.

A deal to contract 500 doctors from Tanzania easily comes to mind. But the deal between Nairobi and Dar es Salaam fell through as it was soon quashed by a Nairobi court. Kenyan doctors sued to stop the state from hiring foreign doctors arguing that there were many trained local medics who are going to remain jobless.

The doctors’ strike was later resolved, but no sooner had the dust settled than another strike was in the offing. Nurses and other health care workers embarked on work boycotts beginning June.

Since then, nurses all over the country have been on strike for a record 5 months now. The bone of contention remains a contentious Collective Bargaining Agreement (CBA) signed between the government and the nurses’ union back in 2012 and which the later claims has not been honored.

Barring any intervention, under the present political climate, it’s highly unlikely that the situation will change anytime soon. The Kenya National Union of Nurses (KNUN) has vowed to continue with its strike until the collective bargaining agreement signed with the Ministry of Health is honored.

The government and the Council of governors, in whose docket the health function rests, have attempted on more than one occasion to reach a settlement with the striking health practitioners.

Ultimatums and sack threats from government have been the order of the day. Yet the nurses’ umbrella body has defied every plea to return to work accusing the government of insincerity on the matter.

KNUN Secretary General Seth Panyako in fact insists that the national and county governments are not keen to see an end to the raging stalemate which has crippled normal medical activities in public hospitals leaving the sick at the mercy of relatives and caregivers.

The situation is so dire especially as it appears pregnant women have suffered the most.

The nurses’ union places the number of women who have so far died at 856 for lack of medical attention during critical hours of delivery.

Furthermore, areas that are traditionally hit by drought are counting the losses given the high malnutrition rate and the situation may deteriorate due to the ongoing tiff. The unrelenting nurses say they will soldier on with their industrial action until their issues are resolved.

Among other grievances, the striking nurses want issues revolving around their wages, allowances, working conditions and promotions addressed promptly. “We will not go back to work until our Collective Bargaining Agreement is signed and registered in courts.” Panyako reiterated.

The nurses are particularly displeased by the wage structure developed by the Salaries and Remuneration Commission (SRC), the body charged with the responsibility of setting and reviewing the benefits of all state officers.

SRC is further mandated to advice the national and county governments on the remuneration and benefits of all other public officers. KNUN is unhappy with the way SRC has handled the nurses’ misgivings accusing the Sarah Serem led body of applying double standards when dealing with collective bargaining agreements.

“SRC approved CBAs for doctors and university lecturers, which cost Ksh.8 billion and Ksh10.2 billion, respectively, while it refused to endorse that of nurses which was only Ksh7.8 billion and instead opted to politicize the matter,” the union lamented.

Asked by parliament to respond to questions raised by the nurses regarding its handling of the matter, SRC’s Vice- Chairman Daniel Ogutu told lawmakers that the commission was not responsible for the nurses’ strike.

The salaries body instead said the job boycott by the nurses was beyond the salary increments and job evaluation that it undertook. Ogutu says the nurses pay dispute has been hijacked by persons with vested interests alleging agitation by KNUN officials to pressure government into creating a commission to oversee the health sector in general.

These claims have been rebuffed vehemently by the nurses who have termed them “unfounded gossip.” The council of governors has since adopted a reconciliatory approach urging all the parties involved to agree to dialogue as a way out of the current impasse.

According to the council’s chair and Turkana Governor, Josephat Nanok, time for grand standing on a matter as sensitive as healthcare is over. “The Council reiterates that it is committed to the conclusion of this process in a manner that is legal, acceptable and registrable.

There is no point in any side of the negotiating teams putting pressure on other partners. The negotiating team is awaiting just for a no-objection and then the process of signing will start.” Nanok stated recently.

The ministry of health is however reading mischief on the part on nurses’ union leaders. Health Cabinet Secretary Dr Cleopa Mailu expressed frustration that a myriad of meetings called between stakeholders to iron out outstanding issues have not yielded any fruits. He is blaming this on the union which he says has not been fully open on the matter.

“We had good discussions with the union and agreed on what we can and cannot deliver. The union leaders requested for time to seek guidance from members but they have not come back.”

A dejected Dr Mailu said recently at a press conference. The health minister says nurses should embrace structured talks with government if they are to end the stalemate that has dragged on for so long.

KNUN’s Panyako says the union is ready for dialogue but wants the president at the heart of these talks. The outspoken secretary general argues that the nurses have ceded more ground and was quick to state that the matter can be resolved if the president invites his team for talks on the matter.

During a recent demonstration staged by nurses in Kenya’s capital Nairobi, Panyako said and I quote..“Tunakuomba wewe kama rais. Tuko tayari kuja kukaa na wewe, tukule nyama, kwa sababu ulituambia utatupea nyama kule statehouse, tuongee na wewe halafu tukubaliane, halafu mgomo uishe” end of quote.

Translated in English (“We are asking you Mr President to call for a meeting with us, to eat meat, because you said you will give us meat at statehouse. Then we embark on talks, we reach an agreement which will end the strike.)

It will be interesting to see whether the head of state will shift his focus from the ongoing political stalemate to have the said meeting and address the deepening crisis in the health sector in a bid to end the protracted citizens’ agony.

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