My home county Kisumu must be one of the most dangerous places to fall sick in the whole world.
Public health keeps lurching from one crisis to another, with work boycotts now emerging as bad a killer as HIV/Aids, malaria, tuberculosis or pneumonia.
Doctors in public hospitals in Nyanza region, which includes Migori, Homa Bay, Siaya, Kisii, and Nyamira, last week announced yet another strike over a pay dispute with the county administrations.
Rising labour unrest in public health facilities isn’t unique to the Nyanza counties.
Two years ago, services in Kenya’s public hospitals were paralysed by the longest-ever doctors’ strike that lasted over 100 days.
Each of the country’s 47 county governments hasn’t had it easy trying to keep its health workers happy amid ceilings in the pay structure imposed by the Salaries and Remuneration Commission and erratic disbursement of funds by the National Treasury.
But in places like Kisumu, the strikes tend to be more frequent and protracted, suggesting there are other issues at play.
HIGH DISEASE BURDEN
The doctors’ strike comes hot on the heels of another protracted one by the nurses.
Patients there must be beginning to ask themselves: Why always us? Why always Kisumu?
The county’s relatively high disease burden, for instance, is well-documented.
Official health surveys have consistently ranked it among those with the highest prevalence of the top killer diseases, including malaria, HIV/Aids, TB and pneumonia.
The area also has a very high presence of medical research institutions, and health-focused non-governmental organisations.
While Kisumu’s high disease burden continues to put a heavy strain on public health facilities, it is opening opportunities for private clinics.
The declaration of a health workers’ strike by union officials often sparks sickening scenes at public hospitals, with emptying wards and desperate relatives frantically trying to transfer patients to private facilities.
Needless to say, many of these private clinics are owned or run by the same striking health workers.
For the record, the employment terms for the public health workers don’t seem to expressly prohibit private side hustles.
But it weakens the county government’s hand in trying to negotiate a fair deal on behalf of taxpayers.
A Kisumu doctor or a nurse, guaranteed of an alternative source of income in a thriving private clinic business, can hold out for a pay raise for as long as it takes.
Worse, there is a possibility that such freedom can serve as an incentive for work boycotts, with very grave consequences to the public health system.
Doctors everywhere expect the society to view them and their actions through a professional lens or the ritual proclamations from the Hippocratic Oath.
But one has to try very hard to see anything noble in the behaviour of those ones in Kisumu and elsewhere waiting for the slightest opportunity to abandon patients in public hospital wards and follow them to private clinics.
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