Kenyan public hospitals continued to turn away patients for a third day on Wednesday, as a nationwide strike by both doctors and nurses hit the country’s poorest hard.
President Uhuru Kenyatta said the death toll of patients who died because of lack of care over the course of the strike has risen to 20, and urged healthcare practitioners to return to work.
According to local reports, two crash victims were denied emergency care at the largest teaching hospital in Iten, western Kenya, while a woman died in Mombasa after her condition rapidly deteriorated. Also on the coast, a 40-year-old patient was reportedly discharged into the care of his family – despite being in a coma.
And there was outrage after a photographer for Kenya’s Standard newspaper found a paediatric ward in Kisumu County completely deserted – except for a single orphaned baby girl who had been left alone by nurses.
Photojournalist Denish Ochieng wrote on Facebook that the sick baby had been abandoned at the hospital by her mother in September and “abandoned again in the ward” when the strike began on Monday.
The Standard identified her as Hope Awiti, and said she suffered from stunted growth that meant she was the size of an eight-month-old baby, despite being four-years-old. She requires regular medical attention, the paper reported, but was left to be tended to by cleaners.
A doctor has since broken the strike to retrieve Hope Awiti and take her into his “private care”, after the case was highlighted in the national media.
Many Kenyans continued to express support for the doctors’ strike on social media on Wednesday, pointing out recent scandals involving alleged corruption in the health ministry and the relatively low pay of public sector health workers.
Kenya’s lowest paid doctors receive just £460 a month. Unions say this is one seventh of the salary of equivalent workers in South Africa or Namibia, and a third of the pay of a doctor in Botswana, resulting in thousands leaving Kenya to work elsewhere.
But a prolonged strike will continue to test public resolve – and there seems no prospect of a resolution any time soon. One Nairobi-based doctor, who asked to remain anonymous for fear of reprisals, said the strike would likely go on for three weeks to a month before those on the medics’ side start to give in.
“The hospitals are paralysed, people are dying and more are going to die,” the doctor told The Independent. “While private hospitals are making a killing from those who can afford to pay, those who cannot are just going home because they have no other option.
“I feel sorry for them – but this is necessary to make the government pay attention.”
Those who have died during the strike include the sister of Stephen Mwaura, a 28-year-old woman, who was diagnosed with meningitis but in good condition when she was brought to the Coast Provincial General Hospital in Mombasa on Friday.
She was pronounced dead at midday on Tuesday, however, with no doctor or nurse by her side. “The strike is to blame because the patient who is my sister was in a good condition and was improving,” Mr Mwaura said.
The doctors’ union is demanding the government act on its 2013 promise to grant a 300 per cent pay rise to doctors and a 40 per cent pay rise for nurses. It says they have received nothing so far.
But as new talks broke down on Tuesday afternoon, health minister Cleopa Mailu implied it was the fault of medics, in particular nurses, for refusing to attend the discussions.
A statement said the government “deeply regrets” the strike and “deeply values” the work done by Kenya’s doctors and nurses.
Unions in turn accused government officials of not turning up to the talks. KMPPDU secretary-general Ouma Oluga has said doctors need pay to reflect the nature of their skills and training, and urged the public to think on this occasion of “doctors’ plight”.
“The government of Kenya will either have to pay doctors or will have none of them,” Mr Oluga said.
The Senate Health Committee said the blame lay with the government, however. Committee chairman Wilfred Machage accused the health ministry of “holding onto funds” instead of releasing money to individual counties, thereby failing to “accept that the health function is devolved”.
But speaking to the nation, Dr Machage also urged the Kenya Medical Practitioners, Pharmacists and Dentists’ Union (KMPPDU) to be sensitive to patients’ suffering and give the talks a chance.
Kenyans are to some extent used to having to work around doctors’ strikes and the threat of strikes, which has loomed since before the supposed pay increase agreement was reached in 2013.
The only hope for medics this time round is that the election coming next year will increase the incentive for Mr Kenyatta to make the popular move of giving doctors and nurses better pay.
Yet while the international community might become increasingly shocked as the death toll from the strikes rises, there is a more sinister reason why it might not have such an impact on the government here.
“I don’t think it all means much to the middle- and higher-earners,” the Nairobi-based doctor said. “They have good insurance and can afford better hospitals. [Poor] people have been dying, but I think we have become hardened, it is just news. I don’t think the doctors [or the government] will give up on that basis.”
It is no coincidence that the strikes have begun at the start of the month. Doctors earn so little in Kenya that they mainly operate from month to month, saving little of the pay packet. The real test of their resolve will not be when the bodies start piling up – but when the bills do, at the end of the month. Until then, the situation is likely to get a lot worse before it gets better.