Holidaying While Health Care System Waits in Kenya

We have already looked at the first part of holidaying: Will you be on duty over the holidays, while others will have to wait for health care? You need not worry, It has happened numerous times.  The season of short weekdays coupled with long weekends is fast approaching.

Decreed Holidays came often

Typically during a run-up to a long weekend, some companies and institutions generously gave their staff a week or so break to take together with the declared holiday.

In a typical electioneering year year that was 2017 for was characterized by politicking and labour  unrest from the health sector ended up giving Kenyans time out of work than was necessary.  A total of 250 man-hours that were lost that year.

After the elections of 2017 the Cabinet Secretary in charge of public service firmly instructed the workers to resume duties 4 days after the August 8th elections, but then, this was a Friday, and moreover, the presidential elections were yet to be declared. It was unlikely that there would be any meaningful response to this order until after the weekend. That meant 7 days since the election got contested or turned violent with period of uncertainty.

The Supreme Court ordered for a repeat presidential election. 25th and 26th October 2017 were the inauguration days add November 28th.   These came more or less just before a weekend. We had the long Xmas holidays (and New Year), with institutions and companies closing some days to weeks to the real day.

Watching and waiting as health care waits

This was our social order, doing literally ‘nothing’ else except watching and waiting for the voting, the tallying, the endless political gymnastics, listening and calling in to political analysts on radio and TV as we wait for the results  and continue some more on court proceedings thereafter.

The circumstances were a bit different this time in the health care sector. With the just ended nurses strike, it was unimaginable how the health sector was doing if at all the ‘state of the health of a nation’ was as important as ‘The State of the Nation’.

Nurse covering during holidaying

When the rest of hospital management is gone off, the whole institution is in the ‘Nurse Covering’s’ hands and he/she knows all is not well. This title does not exist as a hospital policy and did not come with an economic or otherwise incentive. It was one of the voluntold we referred to last time in turbulence. The general extraneous allowance was inadequate for such, in any case, other health care workers got it but did not have to go through the same.

The Nurse Covering must struggle to remain on top of things even if there were no ready answers to the issue at hand. One wonders how things are without the nurses. Never mind there were not many patients coming to public hospitals as such. See my previous posting on turbulence.

Suspending services

During holidays the systems sort of gradually glide to a halt. Vital deliverables have to wait and appointments canceled. It was during such times that one gets notices communicated in the following format … as you are aware we are in an unprecedented political situation that requires our response. A time to exercise our civic duty. In this respect, we have decided to postpone by one month… We regret any inconvenience caused. Studies have been suspended until a later date to be communicated.

Then we have to start all over when we come back. Not everyone took due diligence to ensure continuity and this was the common ‘understanding’ unajua ilikuwa sikukuu’  paraphrased from Swahili – as you know it was time out for holidaying.

(Picture courtesy of funny nurses)

Uganda: A typical case of too much holidaying

That’s about it for every other African country, more or less. Let’s consider the following as happens in our neighboring Uganda. The country had among others’: New Year’s Day 1st January; NRM Liberation Day – 26 January; Christmas 25th & 26th December(exact day varies); International Women’s Day – 8th March; Good Friday (exact day varies) Easter Monday (exact day varies) Labour Day – 1st May. Martyrs’ Day – 3rd June. National Heroes’ Day – 9th June, Idul Fitr (exact day varies).

The Ugandan’s Commissioner for Revenue was among the first authoritative figure to admit on 1st of August, 2016 that the many national holidays in the past one year did infact lead to less taxes being collected: Some Uganda Ush5b (approx. Kshs 150.4m) in taxes, was lost to the Uganda Revenue Authority (URA), each time Uganda had a public holiday. In an interview with The New Vision, the Chairman Board of Directors for Revenue  (URA),  Dr. Eric Adriko said, in their budget proposals URA had recommended that the government looks into the issue, by reducing the number of these holidays.

Incidental offs and holidays

If one adds up any other decreed holidays by the top leadership and any incidental offs by individual employees then the ‘holidaying’ phenomena could be escalating not reducing. Our systems have not coped well with these shocks. Why not make our systems work? There was the need to deconstruct these social order if we were to realize meaningful development in health and all other sectors. Next, we look at the role of lay caretakers in the hospitals.

‘Clearly we must return to work … work hard with vigour and commitment to make up for lost time’.  These were the words of President Kenyatta in the Address to the Nation on 25th October, the eve to the controversial repeat presidential election, which had been boycotted by the opposition. There were all indications that this was not likely to be the last time Kenyans would be going in for a repeat election in the coming months. This meant more days off work.Table above shared from 2017 Kenya which had a record breaking holidays of 15 (fifteen).

As I resumed work today 2nd after a long time which included the (lecturer’s and nurses’ strike since I teach in the health sciences).  You see teaching could not resume in the short time of one and a half weeks to Xmas after the strike was called off since the next break was just around the corner. So just like many a good Kenyan worker do we got some more time out.

Happy New Year 2020 my readers and followers. You have made my moments this year worth the while.

This time seriously lets work and make the most of our time. Lets build the nation, since health care cannot wait.

P.S.

This is part of the series – unique characteristics of Kenya’s health care settings , turbulence and number of beds and cots could lie while we wait. We also explored lay caretakers.

 

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