Doctor V Goes Over The Sea

The healthcare system here in Kenya is facing a new challenge this week – a strike by the doctors employed at the public or government-run hospitals. This includes Moi Teaching and Referral Hospital here in Eldoret, one of the country’s two major referral hospitals for specialty care, medical school training, and very sick patients. Technically, it is the interns and medical officers who are on strike, the more junior doctors who are still in training – not the consultants or faculty doctors who are employed through the university and are part of a different union-like organization. Nonetheless, many of the faculty are participating in various ways, including suspending their own rounds or services in the hospital so that the chaos intended to be caused by the junior doctors’ strike is allowed to reach its full fruition.

I am actually quite sympathetic to the concerns being raised by the striking doctors. They are requesting a 300% pay increase, which sounds like a lot, but these junior doctors currently only make about $8,000 per year and the Kenyan government only allocates 5.5% of its budget to healthcare. The junior doctors earn significantly less than their counterparts in surrounding countries like Rwanda and Tanzania. The newspapers are full of stories of doctors who fall ill and are unable to afford the care that they themselves need. The Rwandan, Tanzanian and Ugandan governments also invest much more in healthcare – 12.4%, 8.9% and 10.1% of their budgets respectively – and there is a strong argument to be made for the ways in which the Kenyan government needs to invest significantly more in the healthcare system if they want to see the gains in health, productivity, security, and economic growth that they want. These Kenyan doctors are overworked, underpaid, and, in many instances, forced to try to take care of patients without very basic supplies such as gloves to protect themselves from infection. In contrast, the Kenyan government pays their MPs very well at $165,000 per year, most of which is exempt from taxes, and the government is fully able to pay for things like the legal fees for the politicians currently on trial in The Hague for instigating the post-election violence.

On the other hand, the true pain of this strike is borne on the backs of patients across the country who are unable to get adequate healthcare at the public facilities where the physicians are striking. The wards are full of sick children and adults, with no one to order medications for them or make sure that they get the tests and treatments that they need. It is bad for the patients currently in the hospital, and many patients are not coming to the hospitals at all because they do not know if they will be able to receive adequate care. And there are a few of us caught in the middle, trying to make sure that sick patients do not die, while not meddling too much in “things we do not understand.” Frankly, the idea of physicians striking and leaving patients without care is anathema to how we are trained in the US. The strikes are expected to go on for at least a week, and the North American side of our partnership is struggling to figure out how to balance support for our colleagues calling for change with still taking care of people in need.