Kenya: Health Workers Protest Repression, Govt Failure to Meet Demands

The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has announced it will ramp up industrial action in the coming days, as the government has failed to meet its demands for the assignment of interns and the payment of postgraduates’ fees. This announcement followed weeks of intensified demonstrations by the union. 

During one of the most recent protests in Nairobi, on February 29, KMPDU Secretary General Davji Bhimji Atellah sustained a head injury when the police sprayed tear gas on the protesters. The trade union reported that 25 more protesters were injured in the stampede. While Atellah was taken to the hospital, most of the other injured were forced to take care of their own injuries, as they have no valid medical insurance, KMPDU said.

The violence experienced during the protest led to further outcry against the government’s behavior and even stronger mobilization among health workers. The reaction culminated in a new demonstration in Kenya’s capital on Monday, March 4, and a series of expressions of support from health associations and trade unions across the continent, including the Association of Professional Societies in East Africa, the West African Health Sector Unions Network, the International Trade Union Congress (ITUC), and many others.

Currently, over 1,000 interns are still awaiting placement. This situation is stressful not only for the interns, some of whom have been waiting for several months or even a year, but also for patients, who could face a decline in the standard of care due to the shortage of personnel. The government has a direct obligation to ensure that all interns are placed in health institutions, as previously stated by the KMPDU. Action on this issue could also be seen as an indicator of President William Ruto’s administration’s willingness to take steps toward actually protecting health rights not long after significant criticism over a recent healthcare reform package.

The delay in posting medical interns makes little sense in the broader context of Kenya’s health workforce. The existing staff shortage has led to the overburdening of workers in the system and raised questions about the stability of care standards. In a petition delivered to the National Assembly on March 4, KMPDU pointed out that the health workforce crisis has already had a negative impact on access and quality of care, including by leading to longer duration of hospitalizations and growing waiting lists.

Kenya has a higher staff-to-patient ratio compared to other African countries, but these ratios are still below international thresholds. In 2022, the country reported shortages across all health professions, with the Ministry of Health citing a lack of over 2,000 resident doctors, 1,000 pharmacists, and 38,000 nurses, among others. The situation is further complicated by the unequal distribution of health workers between different counties and between the public and private sectors. 

At the same time, working conditions for workers in the public health system remain precarious: health workers are often employed on fixed-term contracts, and their salaries remain well below the increasing cost of living. All of this, according to KMPDU’s analysis, points to the fact that the Ministry of Health is not giving health workforce issues adequate attention. In order to even start addressing the situation, the trade union stated, the government would have to “redefine national human resources for health as a form of development, to allow and provide for the deployment, usage and management of the national human resources for health.”

While there may not be enough interns to fill the existing gap, their presence in hospitals is crucial for providing care. It is hard to believe the government does not understand this, especially considering the widespread actions organized by trade unions to raise awareness. Nonetheless, the Ministry of Health has postponed action on this issue, even after reaching formal agreements with KMPDU, citing a lack of funds due to delayed payments from the Treasury.

Securing adequate funding for health services in Kenya has been a longstanding issue, largely due to the influence of international financial institutions such as the World Bank and the International Monetary Fund (IMF). The pressures from the IMF and World Bank are also linked to the government’s response to health workers’ protests, like those coordinated by KMPDU. These institutions encourage governments to cut public spending and privatize essential services, including healthcare, and to limit the space available for trade unions to criticize their policies.

“These policies are being implemented in many countries, not only Kenya. But it appears that the Government of Kenya is taking them to the letter, weakening public services that families and communities depend on and attacking fundamental pillars of democratic institutions – including labor rights,” Public Services International (PSI) commented on the recent events in Nairobi.

Daniel Bertossa, PSI General Secretary, reiterated the importance of securing funds for the placement of interns, criticizing the violent response to KMPDU’s campaign. “Unprovoked attacks on doctors taking part in peaceful and authorized actions in support of Kenya’s health system is totally unacceptable. Subjecting health workers to violence for attempting to improve the healthcare system for us all, is despicable.”

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.