A Scandal a Day Keeps the Doctor Away

(Reuters/Thomas Mukoya)
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As the doctor’s strike ticks past it’s third month, I sit here and can’t comprehend why exactly this has been allowed to happen. It’s simply a shame. I’m not even a doctor or a medical student myself, but I can empathise with my compatriots, seeing as we all come into contact with health institutions every now and then. As such, this is an issue that affects all Kenyans, affluent and impoverished alike.

 

There is, however, a lot of heat and public pressure on these doctors to resume their duties, in an attempt to mitigate the suffering and loss of life occasioned by the standstill at public health institutions. The biggest loser here is the common mwananchi, who has no ability to access the more costly services of doctors at the many private hospitals and clinics that dot the city. They are forced to pull their sick and injured out of hospital and ferry them back home, where, through the grace of God, they will make it through another night. Meanwhile, the affluent Kenyan can afford to access private healthcare from overseas institutions, and as such, does not feel the pinch of what is happening. What part of this is fair at all?

 

On a matter of principle, I feel obligated to defend the doctors on this one though. Their hardline stance, in my opinion, is entirely justified and necessary.

 

For how long can Kenyans tolerate this striking culture? It almost seems that, to qualify as authentically Kenyan, you have to strike at one point in time in your career. It’s shameful, because year in, year out, the likes of doctors, nurses, lecturers and teachers, all noble professionals, are constantly back in the streets demanding exactly the same things: better pay and better working conditions. Why aren’t these problems rectified aptly once and for all? We seem to have a government that is lethargic and more interested in stuffing their individual pockets than improving the quality of life of the Kenyans who have so much faith in them. Health Cabinet Secretary, Cleopa Mailu (formerly the Nairobi Hospital CEO) and Health Permanent Secretary Nicholas Muraguri are prime examples of the Government’s lethargy. Both men have continually frustrated negotiations with the doctors’ union, the Kenya Medical Practitioners Pharmacists and Dentists Union (KPMDU), by intentionally passing on the buck to junior officials, who in reality, have no authority to call the shots during these negotiations. As such, the negotiations get stretched out unnecessarily over time because no final, binding decisions can be made by these junior officers. They are intentionally frustrating efforts at finding a solution by being lethargic in a duty as simple as showing up. How are these two still clinging on to their jobs, when they are so obviously not even doing them in the first place?

 

The most painful thing to watch, however, is how corruption is killing this country. The Government’s chief excuse for not being able to implement the 2013 Collective Bargaining Agreement (CBA): we don’t have the money. This is the same government that has overseen billions looted in (among others) the NYS, Eurobond and Health Ministry scandals. For crying out loud, a certain infamous salonist was able to fraudulently withdraw from a bank Ksh.52 million and stuff it in three plastic bags, this being done without receipt of the transaction or a security arrangement for transportation. Public funds. Yet apparently…we “have no money”. Such blatant disregard for the most obvious of protocol shows you that some people have so much money that they aren’t afraid to lose some of it. Kenyans are being taken for a ride and they seem to be enjoying it because no one demands accountability. For one of the highest taxed states in the world, money should never be a problem. The funds are there. The question is, in whose pockets do they end up? Why can’t they just admit that it is our inefficiency that is starving us of funds?

 

I also think the media have a huge portion of blame in this. It has long been perceived that the media are “the voice of the people”, and that they will only give the people “what they want”. Reality is, contemporary media organisations are with-profit entities, run by money-hungry moguls (and at times, politicians as well). The media have realised the amount of power they hold, and they have blatantly abused it by errantly shaping public opinion by giving people what the people think they want and not what they actually need. They publish the story that generates the most buzz to make them the most money. Journalistic ethics and overall integrity is becoming a whisper in the wind. The Kenyan media have intentionally misinformed the Kenyan public by use of the typical magician’s bread and butter: misdirection. The CBA in question asks for more than just salary increments for all doctors, yet this is what the press has emphasised so strongly. The said CBA also calls for broad improvement in quality of doctors’ working conditions and better working relations with their employers. Why wouldn’t that be a good thing in a nation whose health sector is so incompetent that our own leaders don’t trust it? It also calls for the hiring of more doctors to help lower the doctor:patient ratio which currently stands at 1:4500 as per Ministry of Health statistics from 2015, despite the World Health Organisation’s recommended ratio of 1:600. So in other words, one Kenyan doctor does the work 7.5 doctors in compliant nations.  The media have intentionally set out to paint the doctors as pantomime villains by making them seem purely greedy, when in truth, their demands will benefit the fortunes of each and every single Kenyan. I shall attach a link to the CBA for those interested to read for themselves. Don’t let the popular press fool you. 

 

It’s a slap in the face for all civil servants how the Government tends to hang the threat of dismissal on striking workers. Instead of focusing energy on resolving the impasses at hand, they quickly put together strongly worded ultimatums that compel workers to return to work, despite the right to picket being enshrined in the Constitution and notices of the intention to strike being made well in advance. Yes, return to work formulas have been signed  in the past in order to give time for implementation of pre-agreed pacts. However, that’s all a return to work formula does: buy you time. It is a quick fix, and after the quick fix, some sort of further, more long-lasting form of action is required…but here in Kenya, the quick fix is the fix. It just sounds like modern day slavery to me. Our own Head of State highlighted this embarrassing trait recently. The Telegraph, an Indian newspaper, reported that during a 2 day state visit to India in January, President Uhuru Kenyatta had discretely discussed with Indian Prime Minister Narendra Modi, among other things, the prospect of having Indian doctors hired by Kenya to ease the health crisis. Despite the fact that this is ridiculously expensive, who told the Government of Kenya that these very same Indian doctors won’t strike for the very same reasons as their Kenyan counterparts? Short term fixes. Needless to say, the Indian Government found this idea laughable. Which state, anywhere in the world, would offer up wholesale a group of its professionals to another country that is short-staffed because of striking workers? 

 

Lastly, we do have to agree that in Kenya, there is a huge discrepancy between services rendered and remuneration. Kenyan politicians are some of the highest paid politicians in the world, yet see how little development they actually collectively bring? According to a study by the UK-based Independent Parliamentary Standards Authority (IPSA) and the International Monetary Fund (IMF), the  basic pay of Kenyan legislators, which excludes allowances, is 76 times Kenya’s GDP per capita of Ksh. 84,624. To top it off, they are currently arm twisting the Salaries and Remuneration Commission for Ksh. 3.3 billion in salary compensation for the 8 months their terms will have been cut short. Mind you, these same politicians sought public office knowing fully well that their terms would be shortened, and the Members who will make it back into Parliament will have effectively been double-payed should this demand go through. The Sarah Serem-led Commission says it hasn’t been settled that the MPigs will be paid, but we all know it is only a matter of time before they get what they want, seeing as though they have already threatened to shoot down the country’s 2017/18 Budget. These greedy politicians are the very same ones using their political clout to label doctors as selfish. How does a thief have the audacity to label another thief as a thief?

 

Doctors are overworked, over-stressed and overburdened, yet strangely underpaid. Medical school takes around 6 years to complete in Kenya, after which there are countless years of training to do before one can even considering opening their own practice. MPs, as per the Electoral Act, on the other hand only require “a certificate, diploma or other post-secondary school qualification acquired after a period of at least three months study recognized by the relevant ministry.” It looks like this will continue to be the status quo as proposed changes to the Electoral Act by the Independent Electoral and Boundaries Commission (IEBC) are facing steep opposition from Members of Parliament and Senators, who will be required to be degree holders come the 2017 General Elections on August 8th should these changes be implemented. Our lawmakers themselves don’t want to be compelled to seek higher certification yet they want the fat paychecks. Do you see the blatant injustice?
Yes. The doctors strike does need to come to an amicable resolution. However, if we shove our issues under the carpet for short term gains, the problems that grip the health sector shall not disappear. Justice postponed is not justice at all. We can rush the doctors back to work…but if we do not get down to the root of the problem, the constant, foreseeable future strikes shall hurt our children, their children and their children’s children for decades to come. If you got involved in (let’s say) a car accident and you were bleeding and slipping in and out of consciousness…you would be rushed to the nearest public health facility where your last name, your money or your insurer can’t help you. In our sense of privilege, we may look now at public hospitals and laugh, but you may just find yourself there one day, clinging on to life sharing a paper-thin mattressed bed with a half-dead patient in an overcrowded, understaffed ward. Let them strike now to end this ridiculousness once and for all. The sooner we come to terms with this, the better for us all.

 

Link to 2013 CBA between the Government and KMPDU 👇🏾:

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