Over and Out With the Kenya Nurses’ Strike

The nurses’ strike is over after 151 days. Lisilo budi hubidi paraphrased from Swahili – it was futile to resist the inevitable, and that was calling off the strike. Whether or not it had achieved the set out goal was no longer the issue. Hopefully this ends all the remaining contentious issues between the parties. The reality may be the strike is over, while the dispute may not be.

In the opinion of a good number of the striking nurses and other stakeholders, it was a matter of time before the strike dissipated. The steam had gone out of the members and the greater proportion comprised those who had resumed duty. Out of a possible 500 nurses in one particular county only 47 remained on strike.

They were coming back a battered army with bitter lessons. There were many begging question:

  • How do we face betrayal, those who chickened in early, the timid who filed in at the earliest opportunity?
  • How to relate with a new crop of those who had capitalized on the strike to get themselves a job?
  • How to model for the new generation of nurses joining the profession?
  • How to relate to every other health discipline who counted it too risky for them to be on strike

The nurses’ union still had a full in-tray. There was need to bank on the remaining goodwill to close in on the pending issues. The unfinished business included delivering the Collective Bargaining Agreement (CBA) within 30 days.  Some nurses had not been on pay for the last couple of months, yet they were expected to deliver optimal care upon resuming duty. The union was expected to facilitate payments of pending salaries by 30th November 2017.

Some union branches continue to ring bells of industrial action even as they resume, promising battles with their respective counties. Other counties insisted they would not pay for work not done or else did not have the money. A few had replaced the striking nurses with new ones e.g. Murang’a’s 492 nurses.

Borrowing from the doctor’s strike, it was not until 18th September that KMPDU had their CBA finally filed in court of law, this was 287 days after it was signed (which was 200 days since the 100 days strike began or rather 100 days after the strike was called off). The nurses’ CBA if it saw the light of day, and it should was likely to deliver in staggered doses, titrated towards the next financial year. This meant time and patience with lots of give and take.

                                                       Photo showing agitated nurses in the recent strike

[Photo Courtesy of Kenyannews.co.ke]

The public confidence

Even though the nurses’ strike was over, many Kenyans also know that signing the CBA was one thing. Getting it implemented could be the beginning of another round of industrial action. It was unfortunate that this seemed to be the language employers understood. The current public universities lecturers’ strike which resumed for the 3rd time this year was about an already concluded, signed and filed in court CBA.

What about the patient? Certainly the patient had fallen through the cracks as they say. There was an apparently ‘insensitive’ public, which had been brutalized by the frequent strikes, who knew for a fact that it will happen again. This kind of resilience was not for anybody’s good. Reports had indicated that demographic health statistics had already taken a nose dive in the turbulent times as several gains were lost.

It will be disappointing for the public if the concerned parties were to let the matter drift towards the resumption of the total shutdown again. Instead the public should remain hopeful that a milestone had been achieved not just for the nurses but for the country’s health system as well.

What has changed?

Above: picture  of  an empty ward characterized most public hospitals during the nurses strike 

[photo courtesy of citizentv]

After calling off the strike, will the nurses be going back to a more conducive working environment? Back to normal for many meant to the old improvisation, shortage of staff and stuff. More likely it was back to the same beaten infrastructure, some which had been vandalized in their absence. Problems and trials would continue.

They would be meeting a new governor in some places, and a new lot of chief officers. The counties outfit would be experimenting on several things including human resources.  Trying a no-nonsense supervisor (in Swahili nyapara type) on nurses the way some of the county governments had started going about it would be the last straw that broke the camel’s back. Which would in effect emancipate the production of everyone else.

See the other posting on nurse as fulcrum.

What we could expect in the weeks ahead?

An influx of patients and clients seeking their services was obvious. The system would be strained beyond limit once again. See  Health digest   http://riftvalleyhealth.blogspot.co.ke/2017/11/patient-influx-overwhelm-hospital-as.html

The ripple effect of the strikes in the health sector would continue to be felt in the short and long term, in the years to come.

The promise

The promised deal that brokered the calling off the nurses’ strike included:

  • uniform allowance of KSh15,000, which will be increased by Sh5,000 each financial year. This allowance has been increased from the KSh10,000 they had been receiving.
  • a risk allowance of between KSh20,000 and Sh25,000, depending on job group, in the next financial year.
  • risk allowances will be increased to KSh30,000 in the 2020/2021 financial year.
  • a nursing allowance of between KSh15,000 and KSh20,000, to be implemented in two tranches, 60 per cent beginning January and the rest from July 2018.

The union

The nurses’ union should be commended for the achievement of a return to work formula (RTWF). Nevertheless there were some prickly observations that perhaps cost the union dearly.

This is the era of emotional intelligence. I believe there was less one could achieve as a leader by ‘cutting off the ears’ of those representing the employer, statutory bodies or institutions set by the constitution for that matter.

Arguments may not always be won on the basis of what was said, but people watch the how, the manner one responds to those who they disagree with without going overboard. They will respect or thank you for expressing yourself in a thoughtful manner. As a result they too were likely to support your effort and increase your reach without questioning your ability to lead.

‘Fire spitting’, “flapping in the air” and infighting officials could have derided the image of the profession more than enhanced it. This could result in a low trust ranking of information coming from the union and association concerning health policy issues in the future.

Unionist posturing in politics would continue to hurt it for some time. But then the leaders had no one but ourselves to blame, that’s the nature of Kenyans.  Political proofing of union issues was going to be a big task going forward. Playing victim would not work. Union issues are political issues some argue, nevertheless it makes sense to run with the government in power at any given time. After all it is the employer.

Rebuilding the nurses’ union would be necessary, perhaps usher in a new crop of visionaries. Those who could create some optimism in order to command the same or a better following next time. Certainly there would be a next time some short distance away.

Take a rest

After calling off the strike, it was realistic to expect the nurses to take a rest from social media. Not throwing in whatever post and comment as had been witnessed during the strike. Voices of reason were likely to persist or take over in a more sober manner. Hopefully they would make it their priority to heal the divisions within the nursing fraternity using a methodological and deliberate approach.  Try and put this ghost to rest sometime soon.

It was expected that there would be a push and pull favouring out-migration especially among the younger, specialized nurses. Undisclosed sources had indicated that a handful of them were waiting on the wings; to take the factored accumulated arrears (if it ever came) in one hand and resign from public sector with the other.

Lessons learnt

There were numerous lessons learnt from the just called off strike.  Seemingly there was some disproportionate negative energy among the striking unionisable comrades in relation to the gains accrued from the strike.

To this extent some pundits felt that after 100 days the doctors finally settled for (more or less) what the government had offered them on Day 2 of the strike. It would not be surprising if the nurses had followed suit and took the risk allowance and uniform allowances and RTWF they had been offered on 5th June (or rather Day 1 of the resumed strike). But then it was not all about the money, it was about a better health system.

The other reality was that there was a lot of work in progress with devolved health care with no low hanging fruits for county public service board employees (including nurses). It makes sense to also see the harsh economic  and political realities the country was going through.

The timing of the last industrial action whether it might have been anticipated or not was a fodder for drawing some lessons. In future this ought to form a critical basis for trade unionists as to whether to call for a strike at such a season. Bbut more opportune was when to change strategy if they found themselves in such a crisis. Calling for ‘a mother of all strikes’ in the health sector many will agree was not tenable in future although it cannot be ruled out.

What do you see in the times ahead? Do you feel it is over and out with the nurses’ strike? Share with us in the comments below.

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