Why striking health workers are so misunderstood

What you need to know:

  • The key actors at both county and national governments have calcified in their ways; health workers are facing the same issues and are reacting the same way.

It is strike season again in the health sector. Health workers are announcing work stoppages in county after county, saying they are tired of mistreatment by both county and national governments.

The most heartbreaking tales are, for all intents and purposes, reminiscent of slave labour. Hundreds of doctors and other health workers have reported working for four months or more without pay.

Those on the payroll report being paid up to three weeks later than they should.

While governors are busy launching dispensaries and flagging off lorry-loads of paracetamol, and the national government is controversially launching equipment for county facilities, the workers expected to run these facilities are picketing in the streets, lamenting poor working conditions.

In all this, the national government has declared zero responsibility, insisting that “health is a 100 per cent devolved function”. County governments are also emphatic that they are in total control of the health sector, and claim constitutional support for their position, forgetting the fact that the constitution creates a national health system and a county health system, separate but intimately interdependent.

One would even venture to argue that health is indivisible — when one gets polio in Turkana County or cholera in Nairobi, it threatens the health and well-being of the entire country.

There is no way anyone can claim that the national government has no role in the delivery of health care services. A preventable death anywhere in the country must be placed at the door of the national government, even if the county government might bear some responsibility.

AGREED SCRIPT

In analysing the root cause of unrest in the health sector, one comes away with the impression that the key actors have calcified in their ways and are unwilling to listen to health workers.

It is no coincidence that health workers in all counties are facing the same issues and are reacting the same way. There seems to be a script agreed upon by both county and national governments about how to deal with the workers.

At the national government level, all senior officials seem to have been drilled to say they have absolutely nothing to do with health care delivery. When pressed, they are willing to concede they do have a role in developing and implementing health policy.

Very few are willing to concede that the national government is expected to actually run some health facilities and employ some health workers. In fact, anybody who openly says this risks being branded “anti-devolution”.

At the county government level, the accepted script is that health workers are against devolution and do not want to work or be supervised by county officials.

The narrative continues that health workers are lazy, preferring to spend their time in their own private facilities at the expense of county clinics.

Some even go as far as accusing health workers of being thieves, stealing supplies and drugs for sale in private clinics and pharmacies.

As a result, no complaint by health workers is considered genuine.

What we forget is that these health workers are also Kenyans, and the majority of them voted for and fully support devolution.

It appears that, due to the fixed positions at different levels of government, health workers are deliberately being misunderstood.

Prof Atwoli is associate professor of psychiatry and dean, Moi University’s school of medicine; [email protected]