Kenyans expect Uhuru to reopen economy soon. Is it safe to do so?

This week, Dr Chibanzi Mwachonda, the acting secretary-general of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), responds to your questions. Compiled by Elvis Ondieki

Medical practitioners should place service to society ahead of self-interest as per their oath. What is the union doing to ensure more ethical conduct when advocating for better employment terms? Sam Kibunja, Nairobi

Medical ethics remain the guiding principle of the union. However, the responsibility of ensuring an enabling environment for medical practitioners and healthcare professionals is upon the government. Health practitioners, who are the drivers of healthcare services, must be taken care of at all times for the common mwananchi to access healthcare services uninterrupted.

How is your organisation dealing with corruption in the health sector? Francis Njuguna, Kiambu

Corruption is a systemic problem in Kenya. It affects all sectors, health included. Its impact on the lives of the common mwananchi is devastating. Majority of the citizens seek services from the public healthcare system; they are, therefore, denied basic healthcare services when funds allocated to strengthen the health system, hire more healthcare personnel, provide essential medicines and equipment in the facilities are looted. KMPDU has been largely involved in the fight against corruption in partnership with other organisations through publications and advocacy against the vice. The public must also stand up to enforce zero tolerance to corruption.

The increasing cases of patients-to-medics infections in respect to Covid-19 is a matter of great concern. What are you doing about it? Dan Murugu, Nakuru

KMPDU has not only advocated for personal protective equipment but has also collaborated with several other organisations—M-Pesa Foundation and GlaxoSmithKline Kenya—to provide much needed PPEs to its members. There are several ongoing trainings courtesy of a partnership between the union and associations in the health sector on occupational safety and health for the frontline healthcare workers funded by the Equity Group Foundation and Kenya Covid Fund.

There have been reports of donated equipment and funds being stolen. How has this impacted health workers? Jotham Ndung’u, Nairobi

The efforts by the government to equip healthcare workers are commendable. However, the government at both levels needs to do more to equip healthcare workers with adequate and quality personal protective equipment in all facilities across the country due to the widespread community transmission, ensure 100 per cent of the health workforce is adequately trained on case management for Covid-19, provide psychosocial support, provide comprehensive medical cover and compensation for all healthcare workers and remunerate all healthcare workers fairly. Stealing PPEs meant for health workers is akin to murder of the frontline soldiers by those in authority.

What measures have your union put in place to ensure county governments provide decent working conditions for healthcare workers? Jotham Ndung’u, Nairobi

Kirinyaga County remains one of the few counties that have been hostile to doctors. Others are Taita Taveta and Laikipia, among others. KMPDU has legally binding collective bargaining agreements (CBAs) with the national and county governments that prescribe the required terms and conditions of work for the doctors. A majority of the county governments are yet to fully implement this agreement, and the union has filed a dispute with the Ministry of Labour on the non-implementation of the CBAs. Nevertheless, the union is continuously advocating for the improvement of the terms and conditions of doctors and industrial action is undertaken where there is complete failure of addressing the issues.

A majority of Kenyans are expecting that come next week, the President will reopen the economy. Do you feel it’s safe to do so now? Dickson Murimi, Kirinyaga

The reopening has been phased so far, which is the standard way of managing a pandemic of this magnitude across the globe. It has largely been informed by the medical data from disease surveillance and the disease burden in the country. Unlike six months ago, there is now more information and experience of the disease. As a country, we should not let our guard down and celebrate because the virus is still present. The caution is that our healthcare system cannot handle a surge. The safety of a full reopening is upon our collective actions going forward as Kenyans. This applies to everyone, from political leaders to the common mwananchi.

What is your advice to Kenyans who have already started ignoring the Covid-19 regulations? Dickson Murimi, Kirinyaga

Covid-19 is still very much at large in the country. We must continue adhering to the preventive measures such as wearing masks in public spaces, washing our hands and sanitising, avoid unnecessary travel and large gatherings. The disease is not tired unlike many Kenyans who are tired of adhering to the preventive measures.

 What are some of the solutions that you feel the government can put in place to upgrade the healthcare facilities across the country for improved delivery even after the Covid-19 pandemic ends? In terms of workers’ remuneration, is the government doing enough to retain skilled personnel in public health facilities and training others? Jotham Ndung’u, Nairobi

The Covid-19 pandemic has presented a rare opportunity to the government to strengthen the healthcare system to serve the needs of Kenyans who depend largely on the public healthcare system. Improving the infrastructure by expanding bed space in our facilities; scaling up ICU capacity for provision of critical care services in all national and county facilities; creation of a Kenya National Ambulance Service for provision of emergency medical care for all citizens regardless of their socio-economic status — this gap has been highlighted by the curfew and containment measures — and the rollout of home-based care. More importantly, investing in the human resources for health through hiring of more doctors, nurses, clinical officers, public health and laboratory personnel; and investment in our laboratories to equip them to conduct PCR testing which is an essential test for many other diseases other than Covid-19. The government has failed to retain more healthcare personnel due to the poor terms and conditions of work and remuneration. A good example is the hiring of healthcare personnel under inferior contract terms for UHC, with no social protection. The ultimate solution is centralised and standardised management of human resources for health through the creation of a Health Services Commission.

In your view, how is the country prepared for the Universal Health Coverage scheme and how is it going to be insulated from corruption scandals which have continued to bedevil the Health ministry? Komen Moris, Eldoret

The responsibility to insulate UHC from corruption squarely lies with the executive and legislature. The government has an opportunity to make UHC a reality for the common mwananchi. This will require a more co-ordinated effort between the national and county governments. Focus should be on the four essential pillars of UHC: A robust financing strategy; well-trained, well-motivated and efficient health workforce; availability of essential medicines and vaccines; and, an efficient health information management system. These are the basic components that will enable the mwananchi purchase health at an affordable cost.

A number of hospitals, and specifically Shalom in Athi River and St Teresa in Kikuyu, have been involved in medical malpractices and negligence. They were shut temporarily and after a short while they are back in operation. Why? Kirima Mwariama, Nairobi

Kenya Medical Practitioners and Dentists Council (KMPDC) is the regulatory body that is charged with regulation of practice, claims of malpractice and negligence are investigated professionally and the reports made public. Further information is available on its website, www.kmpdc.go.ke

Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) is the trade union that represents all medical doctors in employment and labour relations with an aim of improving doctors’  welfare.

The union also engages actively in health advocacy with an objective of ensuring Kenyans have access to high quality healthcare. Further information available on the website, www.kmpdu.org.

Your union recently served the national and county governments with a 21-day strike notice due to the too many workplace challenges including promotions, delayed salaries, failure to implement insurance cover for frontline health workers and inadequate provision of personal protective equipment (PPEs). How will the strike resolve the issues you are raising in view of the present financial crisis? Dan Murugu, Nakuru

The welfare, occupational safety and health of all healthcare workers are paramount and have been the rallying call to the government by KMPDU. There are ongoing deliberations on the issues affecting healthcare workers. It is our hope that all these will be resolved to avert any crisis. Industrial action is the last resort when all concerns have not been addressed and given priority.