JAMILA’S MEMO: Doctors' strike, the vicious cycle

In one week, doctors across the country are expected to go on strike. This means withdrawal of services by the Kenya Medical Pharmacists, Practitioners and Dentists Union (KMPDU) in all institutions. Which also means hakutakuwa na huduma za afya katika hospitali za umma na vituo vya afya, mijini na vijijini. To make things worse, other health unions have also issued countrywide strike notices to relevant ministries, State departments and the Council of Governors (CoG)...they also have their own set of demands.

The effects of just one day of such a strike would be catastrophic, as we have seen in the past; loss of life, frustrations, and a near state of anarchy. Wakenya watalazimika kutafuta huduma katika hospitali za kibinafsi, na kupambana na gharama ya huduma hizo.

The medical practitioners want the government to honour a Collective Bargaining Agreement (CBA) and court orders. Another major bone of contention is placement of medical interns; the government saying the demands are unrealistic and that there is simply no money. On the other hand, doctors say the strike is on until all demands are addressed.

Things came to a head last week when the KMPDU Secretary General Dr. Davji Atellah was injured during demonstrations over the delayed posting of medical interns and payment of fees for postgraduate students.

The march was interrupted by police officers who dispersed the demonstrators injuring several of them, including Dr. Atellah. What is happening in the health sector? In fact the question is, what has been happening in this sector? For instance, in February, health workers in Busia went on strike saying their statutory deductions were being deducted but not remitted; this had gone on for 12 months.

In Kisii, a 14-day strike notice was issued to the county government to comply with demands of medical workers including alleged victimisation and stopped salaries to be reinstated.

In January this year, the KMPDU issued a strike notice to the Uasin Gishu County government for contravening the CBA they had signed. Nairobi County was also under fire in January following accusations of unfair treatment of young medics posted in the county including declining to renew their contracts.

These are just some of the headlines I picked randomly for this year. They’re an indicator of the many challenges facing the health sector. Let's look at 2023; ‘Meru health workers threaten to strike over promotions’ was a headline in June 2023, while in September the headline was ‘Strike threat: doctors ask government to address their concerns within 3 months.’ In December, health workers in Embu went on strike and remained out of work until a deal was reached. Again, these were just random news articles I came across.

Is it just me or maybe devolving health functions was not a really good idea? I mean, it is great that services are getting closer to the people. Some services are reaching counties for the first time ever, which is great; for instance Wajir had its first laparoscopic surgery done last year.

Counties say one of the main issues is that they depend heavily on the revenue from the national government to fund their health services. Their own county generated revenue contributes only a small portion to their health budget. Why devolve the functions if the funds will not follow? In my opinion, all attention should be diverted to avert the crisis in the health sector, for now. And then we can come back to the NHIF shift to SHIF process.