Strikes in Kenya: From The Rare Normal to Common Normal

Strikes in Kenya had changed from the rare normal to the common normal.  Health workers have had more than a fair share in this aspect. Other recent industrial action disputes have included teachers, university lecturers etc.  Currently Nairobi County health workers were on strike.

Where I work as a health sciences academia, services could be interrupted by any or a combination of  the following : health workers’ strike, lecturers’ strike, students’ strike.  This has happened many times in the recent past. Some students during their clinical years have been in campus  a year or so longer for these reasons.

Tame industrial unrest for those offering essential services

Taming industrial unrest especially in the health sector was a key concern for any government.  Indeed most people would agree tackling health professionals’ strikes  was an essential part of health system strengthening.  However, my attention has been drawn by particular happenings. This week the Labour Relations Bill 2019 is doing its rounds in the corridors of parliament, the drafters were toying with the idea that there were essential and non-essential services.  I have done a full article on this elsewhere on safeguards against strikes and lockouts by health care workers.

What has essential got to do with it

Let me try to put it into context.  To begin with strikes do indeed violate moral as well as professional ethics. But it is a dilemma between the potential of causing harm to patients, and minding the welfare of the staff as well as agitating for safe working environment.

This was what Barbara Schutt (then editor of the American Journal of Nursing) wrote concerning industrial action ‘… few nurses will use strike weapon easily, and if they do, they will use it responsibly – with adequate notice and plans to provide emergency care’. This was soon after delegates to the American Nurses Association (ANA) in 1968 did away with No-strike policy.

The general observation was that many health facilities had literally been closing down during strikes.  Every move by the nurses in Kenya was being watched by all.  Could nurses cross the picket line to help handle emergencies, with the full approval of the union?

Are there some who try to do it differently?

However there were a few exemptions, around February 2017, over 300 nurses from the AIC Kijabe Mission Hospital downed their tools, demanding a 36.7 per cent pay rise. The caregivers, who were members of the Kenya National Union of Nurses, also alleged mistreatment by the hospital management. They had taken the necessary measure to prevent loss of lives at the facility “We don’t take chances with our patient’s lives. We had agreed that HDU, ICU, maternity, nursery, the emergency ward and all the critical areas were working normally,”

The AIC Kijabe Mission Hospital had in its intents and purposes worked more like a ‘tertiary’ hospital of its own kind, receiving referrals and performing class super-specialty surgeries.  In the 102 years of operation the hospital had not closed its doors before.

Altruism

Google dictionary describes altruism as selfless concern for the well-being of others…benefits another at its own expense. This observation was somehow becoming a remote reality, especially in Kenya.  Strikes had changed from the rare exception to become the common norm in recent years.  The employers must realize HRH can no longer be actively maintained as the naïve, altruistic cadre of workers. The human resources for health had become a crisis, a system of some sort.

Picture showing empty hospital beds during a nurses’ strike ‘literally’ closing down the facilities

Since 2013, Kenya’s public health sector has been affected by frequent short strikes, culminating in nationwide 100 days doctors’ strike from 5 December 2016 to 14 March 2017 and then the nurses’ strike lasting 150 days (from 5 June to 1 November 2017) which adversely affected the public health sector in the country.  A total of 250 days lost in barely 11 months.

The human resource for health had come full circle

Coming full circle means we now have some level of maturity compared to 1 or 2 years back, as to whether a strike ought to be the new normal in our profession, or we can continue and plan for the next strike during the strike? We do have a postscript.  Especially what emanated from the five-month long strike of 2017.

There are no ‘magic bullets’ to avert all problems that can arise due to health workers’ strikes.  Reactive measures such as court battles and sackings have not done much.  It could almost be said that build resilience instead, very paradoxical.

It seemed that the government was trying to get around this through taming. Coming up with a law to bar civil servants offering essential services against picketing.  This was in a renewed effort to tame industrial unrests.  But this would infringe on the constitutional rights of workers.  If the government through parliament has its way, the Labour Relations (Amendments) Bill 2019 will soon be law.

Was there a better way?  Its a systems issue but its played politically so it depends on the goodwill of the government in power. I always felt if we had a health service commission it might settle a big chunk of the challenges like disparities in remuneration, promotions and postings. That way noble causes like Universal Health Coverage (UHC) might have a chance of taking root from the stakeholders support.

Was there a better way?  Its a systems issue but its played politically so it depends on the goodwill of the government in power. I always felt if we had a health service commission it might settle a big chunk of the challenges like disparities in remuneration, promotions and postings. That way noble causes like Universal Health Coverage (UHC) might have a chance of taking root from the stakeholders support.

If you got sometime to spare you can have a look at this article http://www.compleathealthsystems.com/…/every-move-from…/

 

 

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