The healthcare workers strike has been on for 10 days now
and still there is no progress in terms of reaching a mutually satisfactory
arrangement. This is despite the unions approaching the government several
times in the past 6 months and in turn issuing a strike notice 6 weeks ago that
requests a stay of human resource devolution to the county level and
implementation of the Collective Bargaining Agreement struck in July 2012.
The nationwide strike has resulted in thousands of
healthcare workers downing their tools and a complete paralysis of public
health facilities at the county level. The recent high court ruling against the
unions further escalated the stalemate. Sadly, President Kenyatta’s statement
soon after this ruling did nothing to reconcile the situation.
The county governors now have permission to hire other
healthcare workers to replace the striking force. This sort of directive just
shows the level to which this government completely lacks coherence of the
issues at hand. There are no other healthcare workers (HCWS) to hire; in fact
Kenya is dismally short of HCWs by a massive shortfall of at least 50,000
doctors and hundreds of thousands of nurses and other cadres.
So this plan to hire other workers is just ridiculous and of
course will not work. The main thing that such directives do is place the blame
for patient suffering squarely where it rightly belongs, at the feet of
insensitive and incompetent government officials.
One of the recurring accusations from the government towards
the unions is that the HCWs are causing patient deaths and should go back to
work for the sake of their patients. But this argument is just a baseless guilt
trip that has no bearing in reality. Does the government care about patients
ONLY when HCWs are striking? As one medic states “You cannot chronically under
invest in health and at the same time talk about how you care about Kenyans,
the two are incompatible. While the government has the luxury of pretending to
care about patients, we (HCWs) who have to care for the patients “all the time”
do not have the luxury to fail patients in future. We know this irregular
devolution will hurt the patient in future, why should we go back to serve the
patient today and forever fail the patient due to poor staffing?”
We voted in a new constitution with the hope that the
transition and devolution of services would be done in a structured and
systematic manner. This means that even in the devolution of health services,
proper policies and legislation must be in place such that the process is
implemented across the country in a manner that will genuinely deliver
healthcare services to all citizens and for the foreseeable future.
Instead, this government chooses a hard line position that
completely ignores the concerns of the healthcare unions and harasses and
intimidates the HCWs with no regard whatsoever for the public.
Healthcare is one of the most sensitive institutions and
services that this government is obliged to provide. It is just criminal
negligence on the part of government officials to reject a call to follow the
law and order the devolution process in a responsible and considered manner.
While the governors choose to sack and hire HCWs through the
media, the propaganda machinery is hard at work to blind the public from the
grave realities being presented by this situation. Firstly, the governors did
not hire the HCWs thus they cannot fire them, they cannot evict them from government
housing and there is no pool of unemployed HCWs from which to source HCWs.
Politicians should not be allowed to interfere with
healthcare in such a manner, their utter ignorance of how sufficient and
effective healthcare systems are established ultimately creates collapsed
facilities. The best example of a devolved hospital that has been graphically
mismanaged due to incompetent political leadership is Pumwani Maternity
hospital, the country’s largest maternal care facility. Pumwani is currently in
a consistent state of collapse, barely able to cater to the thousands of women
who attend this facility each year and the maternal and infant mortality rate
is unfortunately very high because of this.
While political leaders claim that the HCWs strike and in
particular the doctors contravenes the Hippocratic oath, its best to remember
that such claims are rooted in clear ignorance of the doctors’ creed. Kenya’s
medical fraternity does NOT administer the Hippocratic Oath which incidentally
is an outdated oath to the god Apollo and other goddesses. Rather, they
administer the Geneva Declaration also known as the Physician’s Oath which was
developed by the World Medical Association in 1948 and was revised as recently
as 2006. Moreover, medicine is a PROFESSION and not a CALLING, so to claim that
doctors should treat patients without consideration of their own needs by the
government is absurd.
In fact it is the words of the Physician’s Oath that
absolutely justifies this HCWs Strike, as it clearly states that : “I will not
permit considerations of age, disease or disability, creed, ethnic origin,
gender nationality political affiliation or any other factor to intervene
between my duty and patient; I will maintain the utmost respect for human life;
I will not use my medical knowledge to violate human rights and civil liberties
even under threat, I make these promises solemnly freely and upon my honor.”
The refusal by this government to structurally and properly
implement the devolution of health services to the nation is a violation of citizens’
human rights and a complete disregard for human life. Were the doctors to
resume duty in decrepit, mismanaged, underfunded and under resourced
institutions that are in a constant state of collapse, it would be a violation
of human rights and a continuation of needless deaths of patients who have
consistently been denied proper medical care by a callous leadership.
Moreover, the decision by the national government to pass on
new payroll to the county level that includes a slashing of gross salaries by
up to 45% is not only illegal it is a further abuse of HCWs civil rights. With
all the propaganda flying around driven at turning the public against their own
medics, it is a shame that these truths concerning the health sector are
ignored. It is for our own sake that these doctors are insisting on the
formation of a Health Service Commission and the implementation of the
Collective Bargaining Agreement which would inherently establish the exact
structures that ensure consistent and effective medical services for all
Kenyans. It’s time for the public to wise up to the lies being propagated that
seek to deny them what is rightfully theirs!
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