Today is 48 Years After Independence but Kenyan Doctors are Living in Poverty
The Decline of Kenyan Trade Unions and the Current Doctors’ Strike
Mr. Okoth Osewe’s recent article (KSB December 9, 2011) was spot on in depicting the plight of helpless Kenyan workers in the hands of trade unions that don’t represent them according to the country’s Labor Laws. It is true that Francis Atwoli, Secretary General of the Central Organization of Trade Unions (COTU) cannot speak for workers because he is in the category of wealthy Kenyans.
Billy Muiruri wrote the following about Atwoli in an article published on May 6, 2011 in the Saturday Nation newspaper: “Atwoli’s lifestyle is one of the most privileged in the country. One of his Mercedes Benz cars has a 5000cc engine and is said to be the only one of its kind on Kenyan roads. It was delivered to him last year at a cost of a cool Sh30 million. Only months earlier, another was imported from Germany.
He is a man in love with the Mercedes Benz brand. One of the most remarkable features of his latest car is that it changes colour with the weather. His personal assistant, Adam Barasa, recounts his experience with the car on a typical journey to Nakuru. “When you are in Limuru, it is metallic blue; it changes to black when you approach Naivasha, while it becomes reddish by the time you are within Nakuru town. It marvels us,” he told Saturday Nation.
“Kila kitu yangu ni mzuri. Huwezi kwenda kwa matajiri na koti imeraruka na unaenda kuulizia watu mshahara? (Everything I own is good. You cannot face employers with tattered clothes and yet you are bargaining for higher salaries).
He is not just in love with the Mercedes. He has worn gold ornaments for over three decades and, as he says, “gold is a great material.” His watch, bracelets and a chain are just some of the conspicuous ornaments he dons.”
Decline of trade unions
Global trends indicate that the decline of trade unions is partly a reflection of how multinationals and financial institutions like the World Bank and the International Monetary Fund (IMF) impose conditions that render them useless. For instance, since the 1980s when structural adjustment programs (SAPs) were recommended for most developing countries, part of the conditionality has included contractual placements in their labor markets which offer no chances for workers to become unionized. Therefore, many still suffer under the framework of Export Processing Zones (EPZs), which are controlled by multinationals that offer unfavorable contracts shutting out labor unions. Such corporations are exempted from local employer legislation. Unfortunately, these governments readily turn a blind eye to the horrible conditions in sweat shops created for mass production, in the name of inviting foreign investors to create employment.
According to a 2004 report by the International Confederation of Free Trade Unions (ICFTU): “Until 2003, workers in Kenya’s EPZs were banned from joining trade unions. Attempts by unions to organize workers were severely repressed. After a series of bitter strikes in the zones in 2003, the government agreed to allow zone workers the right to join unions. At least 15,000 workers in Kenya’s textile sector, most of whom were women, had gone on strike with a long list of grievances, including pay below the minimum wage, no medical schemes, no right to sick leave, trade union repression, excessive working hours, sexual harassment, and unpaid overtime. One person was killed and many injured after anti-riot police attacked strikers with clubs and tear gas. Following the government’s U-turn, the Tailors and Textile Workers’ Union (TTWU) began organizing workers and negotiated a collective bargaining agreement for more than 10,000 employees in nine factories in the Athi River EPZ, near Nairobi.”
The well-established capitalist system in many countries is also a contributor to the decline of labor unions since it is concerned with exploiting workers and amassing wealth without care. In almost all sectors (public and private), Kenyan workers still remain voiceless with shocking slave wages inherited from the exploitative colonial labor system. Corporate executives and policy makers are not doing much either to close the ever-growing labor market inequalities that range from gender disparities, to wages that are not commensurate with the costly living standards.
Although minimum wages have increased since 2003 when President Kibaki took over, consumers cannot meet the ever-rising prices of various goods. In addition, very little has improved within the unionized workforce. It is important to note that a large portion of government’s expenditure is incurred within the Executive and Legislative arms. They form the rich class which takes home high salaries in a country that belongs to the Less Developed category. A Kenyan Member of Parliament earns a monthly salary and allowances of around Kenya Shilling 851,000 per month ($9,300), while the average income for other Kenyans is about $730 per year. The majority still earn less that $1 a day. The wage inequality in Kenya’s labor market is one of the highest in the world.
Meeting Vision 2030 will remain an illusion for the Kenyan government unless radical reforms are pushed to curb widespread corruption, disproportionate allocation of public resources, unequal infrastructural development and most recently, revelations of illicit capital flight reminiscent of former Dictator Moi’s era, and so forth. John Kiarie wrote in The Standard newspaper on December 9, 2011 that a report titled: Bringing the Billions Back, “shows the accumulated illicit capital flight from Kenya hidden in over 40 tax havens amounted to a staggering Sh566 billion (US$6.369) billion as of last year. Ironically, this is almost the same amount required to clear Kenya’s total external debt stock, which, according to the World Bank amounted to Sh662 billion (US$7.44 billion) in 2008.”
Poor health care system and doctors’ strike
It is shocking to note the low salaries paid to Kenyan public medical doctors. In addition, the health care system is so bad that most top government officers don’t seek treatment in public hospitals. Instead, they do so in expensive private ones, or travel abroad preferably to Western Europe. Kenyan public health doctors are currently on strike demanding better remuneration and more hospital equipment, among other things.
Hats off to the brave and eloquent young Dr. Victor Ng’ani, spokesperson and Chairman of the Kenya Medical practitioners, Pharmacists and Dentists Trade Union (KMPDU). He is a true patriot and a champion of human rights. His interview clips at the Power Breakfast show on Citizen TV posted on KSB under comments 3-5, revealed a lot of rot in the health care sector. He presented his colleagues’ grievances very well and endured Mutegi, the bully male interviewer, who was too patronizing with silly questions. Dr. Wambui Waithaka (KMPDU’s National Treasurer) also gets accolades for keeping us informed on how they use the social media to reach colleagues in remote areas of Kenya, to update them about the strike. Generally, there is hope that KMPDU will revive the lost glory of trade unions in the country.
Kenya’s current generation of young doctors seem emboldened by the New Constitution and talk openly about Impunity as a great factor behind the horrible state of health care system. This is a strategy that should be emulated by other employees to bring tangible reforms within the public sector. It is quite annoying that doctors are being intimidated by the powers that be, to accept useless terms of remuneration. On the down side, they are criticized for participating in private practice with the same public hospital equipment they complain are obsolete. But almost all Kenyan public workers moonlight to supplement their poor salaries. Hopefully, and with an improved pay package, doctors will concentrate more on their public jobs.
It is impressive that KMPDU members keep abreast of basic health requirements prescribed by the World Health Organization (WHO). For instance, Dr. Ng’ani mentioned that our system lags far behind that of a small country like Rwanda, which has made major strides in improving her citizens’ quality of life. Kenya’s new breed of doctors is up-to-date with global health care data and information required to serve Kenyans perfectly, but gets no support from our thieving politicians who prioritize corruption for personal enrichment. There is hope that the strike (which is the only way), will change the government’s attitude. Some of the working tools demanded by these doctors are basic in their profession, yet the government cannot adequately supply them.
It is absurd that after 48 years of Independence, our country still has around 5000 doctors only for both public and private practice, serving a population of around 40 million. Around 2,300 serve in public health facilities. Their poor terms of employment encourage mass migration to better paying countries, thus reducing the patient-doctor ratio. But the worst is Kenya’s internal brain drain among trained nurses that cannot be employed. The following was published by the International Centre for Human Resources in Nursing (ICHRN) in 2010, about the nursing workforce:
“Kenya’s case is unique. Over the past decade, it has been reported that there are over 7,000 unemployed nurses. Over 1,300 new nurses graduate annually from local colleges. At the same time, almost every functional health facility is understaffed with over 500 of Kenya’s 2,122 (2007) dispensaries throughout the country did not have a single nurse. In addition, an average of 500 nurses have been retiring annually at age 55 and between 300-400 nurses migrate abroad annually. Key factors responsible for shortage of nurses at service delivery points include fast-expanding health care delivery network that also experiences inadequate recruitment and maldistribution of staff. Contributing to the shortage are an aging nursing workforce, lack of proper workforce planning that includes skills analysis and distribution, and lack of up-to-date, accurate and comprehensive data sets to assist in remedying the workforce planning situation.”
The information above is grim to say the least, yet we lack medical personnel to meet the required ratio per patient. Touch Africa International has posted the following data on its Website:
Statistics reveal that:
– Population 17.3 Million female; 16.3 Million male; total 33.6 Million
– No of doctors; 5,443 (6,062 persons per doctor)
– No of dentist 841 (39,992 persons per dentist)
– No of pharmacists 2,570
– Infant mortality rate; (per 1000) 77 for children under the age of 5. 115 for all children in general.
Rising child mortality
A KTN reportage in November 2011 revealed that pregnant women could not be attended to at Lamu District Hospital because there were no delivery kits, and in case of emergency, most women could not afford to pay KES 6000 for a boat trip to Malindi for better care. The end result was they resorted to traditional midwives and chanced surviving with their new-born babies.
Kenya’s infant and maternal mortality rates are still high in rural areas and in poor urban communities, yet the Government keeps boasting about 5 per cent economic growth. How can it be proud of figures that don’t trickle down to its citizenry? Tell our Members of Parliament and Ministers about salary hikes and opulence, then you will be listened to. The current gang of MPs is nothing but a blend of hyenas that will possibly “extract” money from free-flowing air to line their pockets.
In Mozambique, maternal and child mortality rates have been reduced drastically because of an unconventional model used to train midwives in surgical skills applied during emergency situations. As noted on pbs.org under the title Birth of a Surgeon: “After the country declared its independence from 400 years of Portuguese rule in 1975, a civil war raged for 16 years, killing a million people and wrecking the country’s infrastructure. By the time the war ended in 1992, the health care system was devastated and one in ten women died in childbirth. There were only 18 obstetricians for a population of 19 million. Since then, Mozambique has cut the maternal death rate in half.
As the figures now stand, the country is one of the few countries on track to achieve the fifth United Nations Millennium Development Goal to reduce maternal death rate by 75 percent by 2015. In 2004, Mozambique introduced a new health care initiative to train midwives in emergency obstetric care in an attempt to guarantee access to quality medical care during pregnancy and childbirth.”
Kenya, like many other African countries, suffers from an acute shortage of specialists in women’s reproductive health. In an article penned by Susan Anyangu-Amu on August 13, 2010 at ips.org, it was reported that: “Kenya has only 340 registered gynecologists serving a population of 38 million. The shortage of these highly qualified personnel is exacerbated by the uneven distribution of the few who are available.” She also cited Professor Karanja of Nairobi University who said: “With so few specialists, it means women in rural and peri-urban areas have no access to a gynecologist because the few who are available are concentrated in urban areas and they are expensive”.
Sections of a report titled: “Countdown to 2015: The role of Parliamentarians in accelerating the attainment of MDGs 4 and 5 in Kenya” were published in the Sunday Nation October 26, 2008 as follows: “The report paints a grim picture of the situation, casting aspersions on the ability of the country to attain Millennium Development Goals (MDGs) 4 and 5, which aim at reducing child mortality and improving maternal health respectively by the year 2015.
This, according to the report, is because child mortality has been on the increase in the last 19 years and maternal mortality deteriorating within the same period. According to the report, child deaths increased from 90 in every 1,000 births in 1990 to 121 in 2003. Maternal mortality stands at 560 in every 100,000 births. The report says the situation can be rectified if there is political will among parliamentarians and other groups.”
Good luck to all Kenyan workers during the 48th “Jamhuri Day” celebrations on December 12, 2011 and thereafter, in their quest for a better quality of life.