How to Stop Endless Strikes by Doctors and Medical Workers

11 mins read

Doctors and healthcare workers in Kenya including pharmacists and dentists are on the verge of another strike as has been announced by KMPDU, the union that represents them, and as usual, it is about being paid fairly for the work they do for Kenyans.

The doctors under the Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU) want county governments to address; Unemployment and underemployment of doctors, better terms of employment, deteriorating Healthcare System, and poor working conditions among medics.

The real issue with healthcare in Kenya for the last 13 years since devolution is that the funding formula that each government in their budgets completely abuses the provisions in the Kenyan constitution where healthcare is supposed to be paid for by the county governments but our corrupt national governments grab a whole ton of that money.

In the Jubilee government and even worse now in the Ruto government the national government continues to allocate huge portions of the health budget to the national themselves which is bigger than what they give the counties combined while the national government does not pay salaries and benefits for the doctors and other healthcare providers nor buy medications and facilities needed in our hospitals. That is done by the county governments.

The Ruto budget of 2023/ 24 has been the worst ever as far as healthcare funding and budget are concerned. In Ruto’s first budget, he has allocated Sh. 32 billion from the health budget to his national ministry of health. What are Ruto people doing with that money when healthcare providers are paid by the counties? That is the question.

KMPDU doctors hold a peaceful procession from Kenyatta National Hospital (KNH) to the Council of Governors office on Tuesday.

KMPDU has said that the doctors and other service providers have low pay, they do not have enough doctors with many physicians unemployed and they do not have enough equipment and resources to do their job of providing the healthcare Kenyans need.

Instead of addressing those serious problems in the health sector right now when President Ruto is hoarding Sh. 32 billion from the health budget, the present chair of the Council of Governors, Anne Waiguru decided to lecture healthcare workers to accept low pay because of economic hard times. That is just nonsense. Are the economic hardships only supposed to hurt doctors and healthcare workers and millions of Kenyans who use public health services?

Then Waiguru talks about international debt. We know those are pet talking points for Ruto and his cohorts when they fail to provide services to Kenyans but for God’s sake what does the debt have to do with paying healthcare providers? Ruto and his people in government often think Kenyans are idiots who they can just dance around and keep laughing at but healthcare is a little bit more important than that. It is a matter of life and death for a whole chunk of the Kenyan population.

“While the Council of Governor’s appreciate the rights of medics, we also urge them to protect the lives of Citizens as entrenched in the constitution.” Waiguru Said.

She reiterated that the current demands for salary increase were not sensitive to the economic realities, noting that the country was struggling due to international debts policies and the Government was keen to ensure the nation recovered from the cycle of debts.

Simply put, Anne Waiguru is telling KMPDU members who are healthcare workers that she doesn’t give a shit if the doctors and others want to go on strike after all Anne and her fellow politicians will never visit a public hospital even for one day. They have state of the art private hospitals to take care of their health needs.

This is not about healthcare workers being sensitive to the economic realities. This is about Ruto hogging Sh. 32 billion of healthcare money and providing no services. As the chair of the CoG Waiguru should be telling KMPDU that the counties are opening discussions to have healthcare money hoarded by the national government released to the counties so the salaries and benefits of medical workers as well as health facilities in the counties are improved.

In fact the CoG if they were really interested in the welfare of Kenyans should have taken the healthcare funding issue to the ongoing National Dialogue Committee to revise the healthcare funding formula to reflect the reality on the ground. The bulk of healthcare services and resources in Kenya are paid for by the counties and it is a matter of common sense that the counties should get the bulk of the health budget not vice versa.

But Waiguru cannot tell Ruto to give health money to the counties instead of holding it in Nairobi because she is part of the Ruto choir where bottoms up does not apply to healthcare where money is held in the big offices in Nairobi instead of being sent to the counties to provide healthcare from the villages.

When I was in Kenya for the 2017 elections for three months before the election, the entire public health care workers in the whole country were on strike. They had been on strike for a long time even before that.

As our political leaders were fighting and shouting at each other about who should lead the country, not one single politician ever talked about the fact that millions of Kenyans could not get healthcare because healthcare workers were on strike in the whole country.

So healthcare services in Kenya are of no interest at all to the political power agents. Lately, we have heard a lot about NHIF funding to Kenyans who need health services, but it is vague and directionless. That is what our politicians love. Look busy and do nothing about important issues to Kenyans.

The nightmare in healthcare services in Kenya starts and ends with the funding formula for health services in our 2010 constitution. I know there are many Kenyans including my friends in the human rights movements who think the 2010 constitution is our new Bible and is unamendable.

In healthcare, the 2010 Katiba is a killer to all Kenyans who do not have tons of money to pay for their healthcare services.

Under the 2010 constitution, the Governors are responsible for paying all the medical staff in their counties. The counties have to pay the doctors, the nurses, medical specialists, medical health supplies, and a whole lot of other things.

That is fine except that in the Budget for the country, the national government still allocates a bigger part of the health budget to the national government. What is the national government doing with health money for Kenyans when all they run are a few hospitals.

What is the solution?

Very simple based on common sense.

If the county governments are going to run 90% of healthcare services in the country and pay the professionals working there and running the whole healthcare system then give the counties 90% of the health budget. This is not rocket science.

If the national government wants to run a big chunk of our healthcare then reorganize the katiba to allocate specific responsibilities to the national government in terms of paying for health care services and workers in Kenya. The national government can’t have it both ways.

The national government today is telling Kenyans that they will keep health money and ask the counties to run the healthcare system. That hasn’t worked and it is not going to work ever.

We have to do deal with real things to redeem and make our healthcare systems better and workable for all Kenyans. That is the humane thing to do. Not for politicians, I know, but for Kenyans it is.

The truth is that if you have money in Kenya you get excellent healthcare services. If you don’t have the money you are as good as dead.

That is not acceptable.

William Ruto and his friends are celebrating one year in office but for healthcare workers and millions of Kenyans who depend on public health services it has been one year of complete failure by their government and it is getting worse everyday.

Kenya has to address that as a country. We all want to go to heaven but nobody is in a hurry to get there. Let us address and find efficient and effective ways of delivering health services to Kenyans in the public health system which is pretty much every Kenyan with no big money.

Adongo Ogony is a Human Rights Activist and a Writer who lives in Toronto, Canada

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