Healthcare crisis deepens as nurses' strike paralyzes hospitals

Maya Ong’are, the only patient in the female ward at Kisumu County Referral Hospital, says she has been left alone after her family abandoned her. Now, with the nurses’ strike entering its 40th day, she says her struggle has become even harder as she waits for care and appeals to her family to come to her aid  [Rodgers Otiso-Standard]

Kenya’s public health system is coming under increasing strain as the nurses’ strike enters its 40th day, with health workers warning of worsening disruption to essential services and accusing authorities of failing to resolve the dispute.

Maternity units in some Level Three and Four public hospitals have been closed because of the shortage of nurses, while mothers seeking antenatal and postnatal services are being turned away.

Children have also been affected, with some unable to access routine clinics and immunisation services as the prolonged strike continues.

Health workers say the situation is becoming increasingly difficult for patients who rely on public hospitals and cannot afford private healthcare.

Maimuna Mwinyi said the disruption of maternity services was putting mothers and children at risk and urged leaders to intervene before the situation deteriorates further.

“It is very disappointing and frustrating that we are having our maternities at public hospitals being closed simply because our nurses that are supposed to be attending to us are on strike. We are seeing mothers going for antenatal care and not getting the services they need in hospitals, while children taken for clinics are also not getting the services,” she said.

“Our leaders should not sit down and watch our women suffer. Let us all sit down and find an amicable solution to ensure our nurses go back to work,” she added.

But while the impact on patients grows, nurses insist they will not return to work until the main issues behind their strike are addressed, with the 2017 Collective Bargaining Agreement remaining the biggest sticking point.

Addressing journalists during Tuesday’s demonstrations, Kenya National Union of Nurses and Midwives officials said they had held several formal and informal engagements with authorities but accused the Council of Governors and the governors of failing to move with the urgency required.

“The elephant in the house, the matter that has not been resolved is the CBA,” KNUNM Deputy Secretary General Maurice Opetu said.

The union says it wants the agreement signed by the governors and taken through the necessary process for registration before nurses can resume duty.

Opetu said the union had made some progress on other demands but warned that the pace of negotiations remained too slow.

“We have met several people, several bodies and several authorities. We want to say that although we have had some progress, the speed is too low. And this is a concern to Kenyans because we have Kenyans who need our care,” he said.

He said the prolonged absence of nurses was affecting patients requiring maternal and newborn care, dialysis, emergency treatment and elective operations.

“Nursing care is critical care. Nursing care is essential care. Nursing care is the backbone of the healthcare system. Forty days without nursing care is a broken health system in a nation of high standards as Kenya,” Opetu said.

The union also claimed that the deadlock had persisted despite its engagement with the Salaries and Remuneration Commission. Opetu said union officials met the SRC chairperson and commissioners the previous week and were told that there was no agreement before the commission to act on.

“They stated very clearly that there is nothing before them to act on. Therefore, the people who are making this stalemate continue are the Council of Governors and the governors,” he said.

The nurses have also raised concerns over the staff being used to fill gaps created by the strike, with Assistant Secretary General Lucy Mburu questioning the deployment of interns and other inexperienced workers in public hospitals.

Mburu alleged that some unlicensed students and inexperienced workers were being used to attend to patients and emergencies, warning that this could put lives at risk.

“It is a shame for those governors who are taking interns who do not even have licences. When the mothers are dying, this is when you are coming running. When the qualified nurses are absent, the lives of our mothers and our children are at risk,” she said.

She said nursing required practical experience, particularly when dealing with emergencies.

“The people who are in our hospitals today, some are not qualified yet they are the people doing emergencies in our hospitals. What a shame. We are telling our interns, our contractual nurses and those who are not experienced to come out and fight for our CBA and our welfare so that we can have better nursing tomorrow,” Mburu said.

The nurses said the issue of Universal Health Coverage staff had been partly addressed but they were still waiting for Permanent and Pensionable letters and new contracts. They also said a committee involving the union and the Council of Governors was ready to review the career progression guidelines for nurses and customise them for county governments.

The reinstatement of nurses dismissed in Kisii County also remains among the union’s demands.

Opetu accused governors of failing to resolve the dispute despite interventions at the national level, saying the union would remain on strike until it sees the CBA registered in court.

“Until we see our CBA in court is when we shall go back to work,” he said.

The labour unrest in the health sector also spilled into Makueni, where a demonstration by clinical officers turned chaotic after suspected goons allegedly invaded the protest and assaulted several health workers.

The clinical officers were heading to present their grievances to Makueni Governor Mutula Kilonzo Junior, with their demands centred on the implementation of agreements contained in their return-to-work formula.

Among their demands is the establishment of a Director of Clinical Services position at Job Group R, alignment of their cadre with career guidelines approved by the Public Service Commission and implementation backdated to May 8, 2024.

The officers are also demanding enhanced risk allowance and arrears, as well as Permanent and Pensionable letters for eligible clinical officers serving under Universal Health Coverage programmes.

KUCO Makueni branch chair Mathew Sila said the officers were seeking P&P letters as part of their demands, while national treasurer Mary Bonface condemned the violence and called for investigations and accountability.

“The events of the day raise concerns over the safety of health workers exercising their constitutional right to peaceful assembly and expression. We are calling for investigations into the assault and demand that those responsible be held accountable,” Bonface said.

The county government apologised to the clinical officers and said it had made progress in addressing most of their grievances, asking them to be patient as the remaining issues were handled.

Makueni Chief Officer for Health Services Dr Mulei Mbithi, however, pointed to the wider staffing crisis facing the county, saying 171 dispensaries were each being manned by only one person.

“I have 171 dispensaries that are manned by only one person. That is a serious crisis,” he said, calling for adequate funding to enable counties to employ more health workers.

As the health workers’ strike continues, they are now calling for renewed talks to end the dispute before the disruption of public health services worsens.