Below is a guest post by Dr. Peter Mburu. What are your thoughts? Let us know via the comments or email your response to info-at-mzalendo.com blog
I just got home from a long day at a privately owned and run hospital in Nairobi where I am a doctor. I am sitting watching the news of the doctors’ strike for the umpteenth time, images of young people in white coats walking peacefully, displaying placards and chanting – they are my colleagues in the public sector. In the background, the voice of the reporter repeating how the doctors want a 300% pay rise over and over. That mesmerizing figure – 300%.
I try to imagine being an ordinary Kenyan, listening to this and wonder what I would think of the action by doctors to abandon their posts leaving desperately ill patients in hospital wards across the country just because they want to make more money. I am a little crestfallen but I remember that that is not all the striking doctors are asking for.
I think of the 13-point petition submitted to the Ministries of Medical Services and Finance, the offices of the President and Prime Minister and even Parliament. Only 2 points mention remuneration of healthcare workers (not just doctors but Pharmacists, Dentists and Clinical Officers are also included). No mention of the other 11 items on the petition submitted to the government as reason for this strike action seems to reach the ears and eyes of the watching public. I think of all the things I have been reading on social media. People, mostly young middle-class professionals, asking why doctors think they deserve all that money. The money thing again! How we are creating a culture of wage-beggars and unnecessary industrial actions. Don’t other professionals work just as hard, if not harder serving the public? And aren’t government employees generally poorly paid? What makes them so special?
What makes us special? Well, over generations, yes generations, healthcare workers have worked and continue to work in atrocious conditions without complaint and largely, without regard to our own safety. We have worked unacceptably long hours for years due to understaffing! We do not have a decent medical plan being exposed to all manner of risks. We have suffered through everything from poorly stocked drug stores, constantly broken down operating room and laboratory equipment, lack of basic amenities like gloves to poorly maintained hospitals and everything in between. It is demoralizing when you cannot offer the best available care to those who deserve it. It is worse when you cannot offer medical care to your own loved ones when they need it!
It’s outrageous when the public, majority of who cannot afford insurance or to go to private doctors or institutions like the one I work in, suffer needlessly due to cuts in healthcare funding each passing year. They don’t get the benefit of having complete work-ups and/or appropriate treatments. It’s unacceptable to send a patient’s relative outside the hospital to buy basic medications that should be available in hospital. They don’t have the benefit of basic and prompt surgical care. They do not have the benefits of care from well-trained specialists, most of who flock the major cities or go abroad seeking better opportunities. They don’t have the benefit of health education because there aren’t enough healthcare workers to go around. The tax-paying population deserves all that.
In the past, the government had a program to train post-graduates in the two public teaching hospitals but over the years there has been a steady decline in the funding for this program. In the last few years, there has even been a hushed rumour of memos circulating with talk of shutting down the program completely – for post-graduate doctors to continue to fund their own education by working in these hospitals without pay and somehow also fend for families. Never mind that the old program had numerous flaws like mandatory bonding to public service for years for poor pay, pre-requisites of X number of years served in public hospitals before enrolment and hindrances in registration as specialists once one has completed training.
Through all this, the system has still managed to churn out reasonably well-qualified, professional individuals –mostly because they have to adapt to those horrid conditions and improvise as best as they can. The varied improvisational skills have made for good ‘war stories’ whenever two or three doctors have gathered, we all beam at our triumphs despite the challenges. We reminisce good outcomes. We speak sadly of the ones who didn’t make it despite our best efforts. Many have gone beyond the call of duty and continued to uphold the Hippocratic Oath; the same oath now thrown in our faces as some sort of guilt-trip by the media, politicians and even some of the public we have long suffered for. Many have questioned the morality and ethicality of this strike. We have been scorned and told off for “taking too quickly to the streets”. No one mentions the past year when every effort to engage the government has borne nothing. No one mentions the apathy that the middle-class and the rich, who can afford insurance, hold towards their fellow Kenyans who can’t and who are the most affected by the ailing system. No one mentions that while this strike action is on-going, doctors have also been raising funds for one of us who is admitted at the National Hospital but cannot afford in-patient care.
No one thinks it was enough that we had years of quarrelling and discussions amongst ourselves about what should be different. But we have generations, yes generations, of firsthand experience and knowledge of what is wrong with the system and what needs to be done to fix it. And the time has come for that change.