Our nurses are on strike once again. The sorry images of abandoned patients are on our screens again.
It is barely two years since the last major health worker strikes and here we are again. What is it about our human resources for health that we can’t seem to get right?
There have been multiple debates on healthcare in Kenya. The biggest yet, has been on the devolution of healthcare. That boat sailed many years ago, but despite so much focus, the health sector is still bleeding miserably.
How is it that our frontline health workers are so unhappy? How is it that we cannot seem to get lasting solutions in such a sensitive sector?
So much investment has gone into health infrastructure with billions worth of medical equipment being launched; restructuring in key state health corporations such as the Kenya Medical Supplies Agency (KEMSA); and building and expansion of hospitals, but there has not been any convincing investment in human resources for health.
How is it that such a key building block in the provision of such an integral service remains so disorganised? I would be very wary if the nurse changing my bedpan was so dissatisfied with her work environment that she would have to down her tools every other year, just to be heard.
Do our decision-makers ever realise just how much they fail the taxpayer?
How is it possible that after all these years of having a formal health system, we cannot seem to figure out just how important these nurses are to all of us, handle their matters conclusively and put an end to these unnecessary strikes?
It is pretentious to look at this matter from the financial angle only. The deep dissatisfaction presented here is beyond money issues. It stems from a deep feeling of being unappreciated as a service provider and not having space to have your opinion heard and considered.
Nurses go on strike for the most basic of things. They do not demand for luxuries. They are asking for allowances to be able to afford the uniforms they must wear to work, failure to which, they would be in contravention of their code of conduct. They demand that they should be compensated for the high risks they are exposed to when serving patients. This is not even remotely luxurious! Nurses have contracted diseases and died in the line of duty.
It cannot be that in the same country, there is a county that has been able to keep their word and implement the collective bargaining agreement, while another claims to have no budget for it. Does this not point to unresponsive and irresponsible leadership?
These are the failures that keep building the case for a centralised health service commission.
There is no guarantee that it will resolve all pending problems, but it will definitely make it easier to hold one office accountable for the mess happening countrywide and get answers.
It will definitely be much easier to replace non-performing office holders.
With sterling examples such as Makueni County, it is obvious that devolution can work well when those tasked with implementation do their job.
It is unfortunate that the oversight function in health does not seem to exist. It is incredible that a function that is directly determines life and death is left unattended to the point that we keep creating mini-holocausts that cause death to hundreds of patients.
What exactly is the definition of a shared function? Who will crack the whip on counties going rogue in healthcare, resulting in unnecessary deaths? Who will hold counties accountable when they do not pay their debts to KEMSA, resulting in suspended provision of essential drugs to hospitals?
Who will demand answers when expensive equipment goes to waste because there is no county budgetary allocation for servicing and provision of reagents in the laboratory, yet the leases are faithfully serviced.
This predictable circus of strike notices, unconvincing responses, actual strikes, court orders declaring the strikes illegal, intimidation, arrests and eventual sit-downs is getting really old.
How can any leader worth their salt fail so miserably to the point that workers have to go on strike to demand implementation of agreements signed jointly and outlining specific timelines?
It is time to take stock and make tough decisions. We cannot be advocating for universal health coverage with interruptions of such magnitude.
There must be a comprehensive review of how health workers will be managed, to realise this basic right.
In addition, as we continue to view this as a devolved problem, we forget that key national functions are also compromised.
Immunisation programmes are implemented by nurses, and without hem, we are exposing the entire population by compromising public health interventions.
As we advocate for recognition and remuneration of community health workers, we must first sort out the workers we already have. It does not matter how many machines are procured if there is no one to utilise them to improve patient health.
Nursing care is the mainstay of hospital care. Once the nurse exits the equation, everything else collapses.
We cannot continue being this casual about the negative impact of the industrial unrest to the health of our country. Can we stop paying lip service to this problem and resolve it once and for all?