Sunday, December 11, 2016

My Thoughts on The Doctors' Strike

So, the long awaited strike finally happened! I don't call it long awaited because I've been looking forward to it; rather, I'm just bringing your attention to the fact that we in the medical field always knew it was slated to happen. I remember thinking that it would be the reason that I would end up serving a lengthy internship. (In the end, I did end up serving a particularly lengthy punitive sentence during my internship, but that's another story for another day)

I can't figure out for the life of me how the nurses ended up involved in this bit of mass action as well, but it certainly will make the strike sting that much more. As I've mentioned previously, the nurses are the true backbone of the hospital, and you couldn't hope to run a decent hospital without their help.

I've talked to a few people about the issue, and they believed that the strike would only last a short period - a few days - because of the calamity that's likely to befall the common wananchi. However, I'm sticking to my guns and reasserting that this strike will definitely last for the stipulated 3 week period...if not longer. I have experience on my side to prove this.

Back in 2014 when I started my internship, I had gone 2 months without receiving a salary. This deserves a little context: here in Kenya, medical interns typically begin to receive their salary after having worked for the first 3 months. So, basically, you skate by on pennies until you get the bountiful "boom" payment. Having joined the service 2 months after my colleagues had already started, I was assured that I wouldn't be subjected to waiting for a "boom" payment, and would instead receive my 1st salary as expected. That didn't happen! I ended up going 2 months without getting a salary, and my friends had slogged out 4 hard months without any sort of payment. As can be expected, we ended up going on strike that lasted about one month just so we could get our dues.

With that little experience, I'm pretty sure that the government's response will follow a tried-and-tested formula.

  1. As usual, with all strikes we've had in Kenya, it will be declared an ILLEGAL strike. 
  2. Label the striking staff as senseless heartless human beings who place profit over the lives of their patients in the hospitals. Aren't these the same individuals meant to adhere to the Hippocratic Oath - doing no harm?
  3. Subvert the whole initial negotiation process
  4. When forced to eventually enter negotiations, they will drag their feet, stall the process further and insist that their isn't enough time to institute the measures required to bring the strike to an end.
  5. Remind everyone that Kenya is a poor country with an extremely huge public wage bill, and as such assert that the money required is not available.
  6. Make excuses hoping that public opinion turns against the striking staff, or at least the consciences or better judgment cause them to end the strike.
  7. Make some sort of concession, and agree to fulfil the rest of the agreement at a later date; which will of course set the stage for industrial action at a later date
  8. Repeat ad infinitum
As things stand, we've successfully toed the line from steps 1 - 3; step 4 is already underway. So let's recap. It really is strange how the government runs roughshod over court decisions that do not favour its position; it's even stranger that they somehow get the same courts to later on pass counter-intuitive measures that simultaneously contradict the court's standing, and victimize the aggrieved plaintiff (in this case the medical staff). The Collective Bargaining Agreement did not just appear out of thin air; a previous administration and the doctors' union are signatories of that agreement. It is an act of bad faith to suddenly plead amnesia and refuse to honour the arrangements set forth in the document.

It is even cheaper to try to turn public opinion against the doctors. Yes, we did agree to abide by the Hippocratic Oath, and we do care for the lives of our patients. There is more than just remuneration at the heart of our grievances. It is one thing to know how to save a life; it's a whole other thing to have the tools at hand to save that aforementioned life. I've come to terms with the fact that I will see a lot of people die; it's the nature of the business. However, when those deaths are preventable, it hurts; if you run across enough of those scenarios and merely feel helpless, then you become ambivalent. The deaths that are occurring every day this strike is maintained are indeed tragic; however, they pale in comparison to the total number of preventable deaths that we are exposed to on a regular basis.

I have no idea why the government can't seem to undertake any sort of negotiations without playing hardball. Keep in mind that they delayed the implementation of the CBA, and avoided arbitration that would have forestalled this strike. When I had gone on strike as an intern, I remember our Medical Superintendent making promises week after week that we would be paid. He was of course adamant in his position, and expected us to work come what may. During the strike, we made trips to Afya House, where we were given the same empty promises by the Director of Medical Services (DMS); of course, later on they would pass the buck and tell us that our money wasn't available because Parliament had not passed the supplementary budget that would allow Treasury to release our money.

The crux of the issue is that the people in power just do not care enough for the typical mwananchi. For goodness sake, my president and his deputy continue to frivolously campaign as the country sits on the cusp of a major crisis. It is ironic that the people who are strutting about so pompously and waxing lyrical are the most well paid of individuals (pay that is many times not commensurate to their level of education or work output). How can these people have the gall to remind us that we medical staff provide an essential service, yet undercut us by providing minimal funding for that very same essential service? 

All these talks are set against the backdrop of an administration which is so plagued with corruption that it seems to lack any semblance of credibility. In this regard, I feel like public sympathy will side with the doctors, if they play their cards right (which definitely doesn't include a boneheaded move like sabotaging Private or Mission Hospitals' ability to provide services to the sick).

I should remind you that I work at a Mission Hospital, so I am in fact still offering medical services to my countrymen. I would love to see this strike come to an end as quickly and amicably as possible. What Kenya really needed was a harmonization of all the salaries in the country. It is senseless for the political class to be making as much money as they do, considering that they do the least work to propel this country forward. However, the Salary & Remuneration Commission (SRC), which was meant to take up this role, is powerless to enforce any sort of meaningful change. So we're stuck between a rock and a hard place. Only time will tell how this bit of drama unfolds.

Oh well, strike week 2 rolls on. I hope things turn out better and sober minds prevail. If not, anticipate a progression similar to the 8 steps I laid out.

God Bless