Sunday 11 December 2011

ABOUT THE ONGOING KENYAN DOCTORS' STRIKE

In the past few weeks, there has been one constant item in the news. That is the ongoing doctors’ strike. To the beginners, the story about doctors strike dates over two years ago. During this time, the relevant ministry had rolled out some repressive regulations concerning the welfare of doctors. This included among other things the requirement that medical interns get bonded in order to be posted in the public hospital for the meager pay they have been getting. That this came without proper consultation, it was viewed to be in bad faith by the doctors fraternity. It took lobbying and street demonstrations to have this directive withdrawn quietly. Then, came the issues of persistent intimidation by officers from the ministry of health headquarters. For as long as the medical fraternity can recall, the issue of harrassment and intimidation has been cited time and again. People have tended to use their offices to arbitrarily met out punishment to those who go against their will. There has been suffering imposed on families as a result of unprocedural transfers, interdictions and salary stoppages. While the civil service code allow transfer of civil servants to stations that need their services, it emphasis fairness and consideration. In the ministry of health, one can be in one station today, and then a few days later, you are pushed to the furthest corner without consideration whatsoever. The most recent problem witnessed was the withdrawal of funding for doctors to further their studies at the two postgraduate training stations, namely University of Nairobi and Moi University School of Medicine. Kenyan doctors were at one time guaranteed that they will serve the government for a number of years then the government will facilitate their training and pay their fees. This was slowly removed and in the year 2010, all the governement doctors were informed in the last minute that their fees will not be paid, those who did not have any saving, were coerced to return to their stations. This broke the hearts of many doctors who had served the country with dedication hoping they will benefit from this facilitation for further studies. All the above issues have been raised with the relevant ministries with no feedback whatsoever. The doctors concerns have been met with deafening silence even from the highest offices in the land. Such matters have been thrown to junior officers to dispense with; unfortunately, the junior staffs are not empowered to make binding decisions. The government of Kenya and indeed the entire Kenyan public cannot escape blame in this matter. The government has systematically ignored the plight of hard working and dedicated Kenyan doctors and other healthcare workers who devote themselves for long unappreciated hours to ease the burden of disease and disability. We have witnessed the ever diminishing funding of healthcare in this country with shock and grief. The Abuja declaration commits to allocate 15% of the national budget to healthcare, in appreciation that a healthy nation is a productive nation. On the other hand, a moribund nation is economically sterile and will always be a precipitant to chaos and conflict. Every year, we witness less and less allocation to health care. Currently, only a paltry 5.5% allocated to healthcare and a big proportion of this is embezzled. As a nation we get ashamed that Kenya cannot offer simple remedy like radiotherapy to the cancer patients, women deliver at homes due to long distances they have to travel to get skilled birth attendance. The unfortunate bit is that such afflictions predominantly affect the majority poor. Kenyans have been held hostage by the few rich elites who will do anything to ensure that the poor remain poor, impoverished and in turn keep inviting their leaders to fundraising activities and endless funeral services. These forums in turn become venues to political spurring, verbal gymnastics and making public incitements. Some creative leaders have bought hearses to help transport bodies as a way to reserve the right to address such gathering. There are very few who have provided ambulances in order to save lives! As Kenyans, we also stand accused for tolerating this kind of rot in the crucial ministry of health. In the early days of Uhuru, the country was focused on getting rid of three enemies: poverty, diseased and ignorance. Somewhere along the path, the track was lost. The country lost the gusto to fight these and instead embarked on promotion of ethnicity, corruption and segmentalization of the country. The deplorable state of our health facilities has developed over a period of time. As the citizenry of this country we have never risen to the occasion. We have ignored this developing rot and buried our heads like the proverbial ostrich. Fast forward to the current day. We are faced with the poorly motivated healthcare, lack of equipment, shortage of staff in public health care resulting to overworked few, dismal resource allocation and lack of government goodwill to resolve these issues. Politicization of healthcare remains a major hindrance. In Kenya today, the more you remain in school to refine your skills, the thinner you pay slip will be. That is why, a doctor will spend six years of hard labor, reading, sleepless nights, and scary escapades in order to graduate with a degree in medicine and surgery and on the first posting, he is paid peanuts and condemned to a life of living from hand to mouth. Any attempt to convince the employ to match their work with current inflationary trends is met with a reminder that medicine is a calling. On further insistence, one pulls out an oath written in the BC era and reminds you that you should not be money minded. Two things here come into focus: firstly, the society expects doctors to adopt a certain lifestyle. For sure, very few Kenyan will want to be treated by doctor who lives in a slum. It is expected they lives a dignified lifestyle. Secondly, doctors are subjected to same inflationary hardships, they consumer same commodities whose prices have been soaring by day. That one is a doctor does not mean they will not pay for water, electricity, rent, fuel and school fees for their children. Let’s face it, medicine is trade. One expects fair returns after hard work. Will you put all effort and end up in misery like most of Kenyan doctors today? Additionally, the medical doctors of Kenya united under the KMPDU sent a 13 point petition to the government to seek audience and have the cited issued dealt with. The issues included shortage of health facilities to cope with the population, lack of staffing in the available facilities, inadequate attention to staff training, intimidation of officers and victimization, lack of career progression, the poor working conditions of doctors and long hours at work, fair remuneration of doctors, and general under funding of the health sector. These issues are broader than it has been portrayed recently. The issues raised were aimed at raining the level of care in Kenya and in essence benefit the poor and marginalized Wanjiku who is not able to visit private hospitals or seek health care out of the country. The government has constantly isolated the point on pay of doctors while ignoring the other twelve points. This has been deliberately done to create a wedge between the public and the wide public and to portray doctors as greedy selfish individuals. This is very far from the truth, Kenyan doctors are saying, they are tired of presiding over dying patients due t lack of drugs and equipment. Give the equipment, drugs, right skills and a conducive working environment and pay them competitively, and they will stick to the hospitals and do what they are trained to do and love doing. Treat the patients. That the government sat on these issues and decided not to act despite various attempts to send reminders, it is humanly justified to suggest that doctors can result to industrial action as a means of having their issues given the attention they deserve. There is not a doctor, am sure who yearns for demonstration. In fact, doctors, manage to conduct themselves in a noble manner, are able to cover their own persons problems and listen to your complaints as if you are the first person they are meeting in the morning. This is the epitome of patience and professionalism. Indeed doctors must be the most patriotic people this country can boast of. They wake up when all people are dead asleep, they touch things which other people run away from, they risk their own lives to alleviate the afflictions of fellow citizens. After the strike eventually took off, there have been half hearted attempts by the government to negotiate with the doctors. I must hasten to add that this process has been punctuated by sideshows and unnecessary distraction. Intimidation and harassment of the union membership has been rampant. This has ranged from salary stoppage, dismissal of staff, letters of intimidation, and arbitrary transfers of staff. This clear demonstrates lack of good faith. As we move to the next level of unlocking the stalemate to reach an amicable solution, the two parties must engage constructively and realize that the main sufferer here remains WANJIKI who inevitably has to depend on these public health facilities for their day to day health service.