Protest is when I say I don’t like this. Resistance is when I put an end to what I don’t like. Protest is when I say I refuse to go along with this anymore. Resistance is when I make sure everybody else stops going along too.” –Ulrike Marie Meinhof
It has been over 90 days now since the doctor’s strike began.
That is a short or overbearingly long time to be without public healthcare depending on where one falls on the social class divide- poor or rich which for majority of Kenyans, it is the former.
Kenya boasts one of sub-Saharan Africa’s fastest growing economies and a national budget amounting to well over One trillion Kenya shillings.
In 2015 more than a quarter of that budget went missing entirely and only 1 percent was spent legally, according to a comprehensive audit by the independent auditor general.
Of the amount that disappeared, a substantial amount about Kshs five billion came from Kenya’s health ministry.
Doctors therefore argue if government officials can swindle that much money, then the government surely can come up with the funds to implement the 2013 CBA agreement.
The Genesis of the CBA…
In 2013, Kenya’s government agreed to increase salaries for doctors, dentists and other medical professionals.
The striking medical practitioners want a 300% pay rise from their current salary of up to Kshs 130,000 and walked of the job in December after the government refused to implement a three year old joint Collective Bargaining Agreement (CBA).
The agreement was also intended to bolster Kenya’s public health system, setting aside money to fund medical research and to provide doctors with ongoing training to improve their skills. It would also create 400 new residency positions, establish overtime pay, create a grievance procedure for equipment shortages, and hire 1,200 new doctors each year for four years to address the severe nationwide shortage.
Over four years on, officials still haven’t begun to implement any of those changes.
Interestingly, during the same years in which the government was deliberating over whether to raise doctors’ salaries, Kenyan politicians voted repeatedly to raise their own. Kenyan Parliamentarians now earn about Kshs 532,000 per month and thousands of shillings more in annual perks. They are the second most highly paid politicians in the world.
There is something unsettlingly dystopian and truly disturbing about a country having both some of the world’s highest paid legislators and doctors who have little to no equipment, medication and facilities. The same could be said for other professions such as teachers, nurses etc.
Is the CBA legally binding?
The argument of the government has been that the CBA is indeed illegal,; that it is yet to be registered.
However, in a relatively recent turn of events, Justice Monica Mbaru declared the CBA binding and asked the parties to discuss Article 4 which had been suspended pending SRC’s evaluation and input whose report is now out. The Court declared the strike illegal, not the CBA.
There was a case before Judge Hellen Wasilwa of the Employment and Labour Relations Court that was brought forward by the council of governors to try and stop the strike, not the validity of the CBA.
The judgement issued on 6th October 2016 directed that the CBA is binding and to be registered as it is after 90 days if the parties involved didn’t iron out the issues in Article 4.
The government appealed specifically against the automatic registration at the Court of Appeal pending hearing and not against the validity of the CBA.
The long and short of it is that the CBA is legal and binding.
Government response to the strike?
The government has chosen a roughly callous approach to attempt to end the strike. From threatening doctors with sacking letters, with-holding salaries and even boldly threatening to import foreign doctors from countries such as Cuba and India.
Union leaders have been jailed for contempt of court. The sentencing prompted the Kenya Medical Practitioners and Dentists Union to say it was calling off talks with the government. Doctors have rejected a government offer of a 40 percent rise, saying it falls short of promises made in a 2013 agreement including staff shortages and a lack of equipment etc.
It is quite unfortunate that such measures have to be resorted to by the government that is knee deep in one financial scandal after another . . . some of which have details as incredulous as public money being carried in sacks and being taken to stone quarries.
Meanwhile, the average Kenyan suffers. . .
Millions of Kenyans have been unable to access care in public hospitals. Several have passed on as a direct result of lack of proper medical attention and access to public health care.
In the current strike, doctors have clearly outlined the benefits of their demands to the general public and the government. These demands include better equipment, training and more doctors for the healthcare sector in the country. Data from the Ministry of Health shows that there were only about 9,734 registered doctors to attend to a population of 44 million plus.
A much bigger responsibility as compared to the WHO recommended standard of one doctor is to 600 civilians.
The CBA will also cover healthcare financing. The National Hospital Funding falls spectacularly short of providing universal healthcare to citizens of this country.
This whole debacle then raises the question; is it not the duty of the government as the custodian of our taxes to provide proper healthcare for its citizens? Is it thus unreasonable for doctors who have shared stories as grotesque as performing surgeries using flashlight, working very late into the night several days a week due to lack of enough personnel; receiving paltry enumeration and little to no equipment to demand better?
The doctor’s strike ended at the 100-day mark after doctors reached a deal with the government. It is not clear how much of the doctor’s demands were met but dozens died without care during the period of the strike._
AGCP- Kituo cha Sheria.