Source:newsroom.maudhui.co.ke
Amidst the ongoing doctors' strike in Kenya, it is crucial to delve into the background of the situation to grasp the complexities at play. The strike, which entered its second week on March 14, 2024, has left thousands of citizens in dire circumstances as healthcare services remain disrupted. Previous negotiations between the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) and the government have centered on the pressing demands of the doctors. These demands include issues related to remuneration, working conditions, and overall healthcare infrastructure. Despite repeated calls for action, the government's response to these demands has been a point of contention, leading to the escalation of the strike.
Dr. Devji Atellah, the Secretary General of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), criticized the Ministry of Health for their "refusal to absorb these medical professionals, which he believed was depriving Kenyans of essential medical services. KMPDU had announced plans to hold a peaceful protest in Nairobi to address the delayed placement of medical interns and the payment of fees for postgraduate students. However, Dr. Atellah was reportedly shot and injured by police during the protest.
The government, represented by Health Cabinet Secretary Susan Nakhumicha, has responded firmly, warning the striking doctors that they could be fired if they do not return to work. Despite Health Secretary Susan Nakhumicha's firm warning that striking doctors could be fired, the medics have remained steadfast in their resolve, vowing to continue the strike for up to 300 days if their demands are not met. This standoff has had a devastating impact on Kenya's healthcare system, with thousands of citizens left without access to essential medical services. The situation has also highlighted the broader issue of brain drain, as Kenyan healthcare workers increasingly seek opportunities abroad; further straining the country's already overburdened healthcare system.
The brain drain of Kenyan nurses and doctors to countries like Canada, Australia, Germany, the USA, and the UK has been a significant issue facing Kenya's healthcare system. As the doctors' strike continues, the health system has descended into chaos, with protesters demanding better pay and working conditions.
This has left many Kenyans in dire need of emergency care abandoned and suffering. For instance, at a facility like Jaramogi Teaching and Referral Hospital; that serves a greater part of Nyanza and Western Kenya, it has been reported that accident victims were only attended to by the available interns who are incapacitated in handling critical cases, as narrated by some victims who sought anonymity. At Kenyatta National Hospital, clinical officers have been struggling to serve high numbers of patients, as families withdraw their patients from other public health facilities such as Mbagathi Hospital, hoping to receive medical care at KNH.
With the Labor Migration Initiative, there are push and pull factors. The push factors are such as adjourned placing of medical interns who contribute largely to the fulfillment of tasks at the public health facilities, nepotism, poor governance, violence at workplaces, poor and delayed wages whereby the salaries are delayed for a period of three-four months, dilapidated health facilities & poor working conditions.
With the push factors, there are also the pull factors: high incomes, improved working conditions and facilities, better exchange rate appreciation, high GDP per capita, higher living standards, lots of placement opportunities and better education advancing chances through enrolment into refresher courses and accessing modern library facilities.
Kenyan medics working abroad have fostered bilateral labor agreements between the duo, signing memoranda of understanding, encouraging good diplomatic engagements and facilitating temporary work programs via the work permit visa; whereby the medics have been able to access information on how to carry out visa applications and processes efficiently. Even though Kenyan emigrants benefit from the migration to abroad, this comes with its own set of inconveniences to Kenya as a state.
While the doctors and other medical practitioners are trained in Kenya, the knowledge, skills and experiences benefit the Global North who do not even compensate for the training of the medics, and this gladdens them as they save a lot of money that would be meant to train the doctors. Additionally, it is the Kenyan taxpayers who pay for the education of the doctors to a larger percentage yet understaffing in Kenyan public health facilities is the norm. Patients queue for a whole day at the hospital and are forced to go back to the facility the following day, when their health conditions are worse than the previous day. The migration contributes greatly to a loss of role models and entrepreneurs, who set up their private consultancies such as pharmacies.
The brain drain trickles down to economic loss. Investment capital is lost when Kenyan medics emigrate to the Global North. With the medics earning highly, they become the major contributors of the national savings which are then loaned to entrepreneurs for the purposes of investment. Loss of such enormous savings often takes place, unless the emigrant channel remittances back to their home country for investment. Moreover, Kenya undergoes net losses in tax revenues as medics are the major contributors to the country’s income tax collection; therefore, without the emigrants being conditioned to Kenyan tax administrations while abroad, their home country loses tax revenue.
Additionally, whereas there is a brain gain in the developed states and a brain drain in developing states, Kenya loses supervisors and superlative health services. The low ratio of Kenyan nurses and doctors to the population in Kenya is very low as compared to the WHO specifications of one doctor to 2768 patients. This impedes the input creation, health service production and responsiveness to patient’s autonomous expectations. Emigrating public health researchers who are among the few that are published and internationally recognized leave Kenya at a loss, as Kenya still grapples with local public health challenges- HIV/AIDS, Malaria and Tuberculosis. Vital professionals enrich the global North as expatriates, albeit the global South wallows in inadequacy.
A notable comparison can be drawn between the ongoing doctors' strike in Kenya and the healthcare crisis in the United Kingdom (UK) in 2016. In Kenya, the doctors’ strike has been ongoing due to issues such as pay, contract terms, and consultant promotions. The Kenya Medical Practitioners, Pharmacists and Doctors’ Union (KMPDU) accused the national government of taking the negotiations lightly. The strike has led to a crisis that has paralyzed the nation’s healthcare system.
Similarly, in the UK in 2016, junior doctors staged a series of strikes over working conditions and contract disputes. The healthcare system faced many problems, including political crises and relative economic decline. The situation was described as the worst year in NHS history. Both the Kenyan and UK strikes underscore the critical role of healthcare professionals in delivering essential services and highlight the systemic issues that contribute to labor disputes within the medical field. While the specific demands and contexts may differ, the core issues of remuneration, working conditions, and patient care quality resonate across borders.
As KMPDU remains unrelenting about the doctors’ strike while still making attempts to foster talks with the government; urging President William Samoei Ruto to listen to their concerns, there is an impending crisis as clinical officers set to join KMPDU in the strikes. The Kenya Union of Clinical Officers issued a one-week strike notice after persevering for long the predicaments under both the national and devolved governments. The big question is, shall there be a time in Kenya where medics are remunerated accordingly with enhanced working conditions? Citizens of the third-world state continue to witness the calamity as they cling onto a ray of hope that perhaps someday all will be well, as the medics agitate for changes.
Nice article
Great, article!