Unable to afford the fees of private hospitals, they suffer and die at home
The protracted tussle over
implementation of the 2013 Collective Bargaining Agreement prompted the medics to down their tools in what’s turned out to be their longest strike since independence.
All health facilities, including the country's two major hospitals — Kenyatta National and Moi Teaching and Referral hospitals — and clinics have seen operations almost brought to a halt as both doctors and the government hold hardline stances.
Talks between the state and the medics continue to yield more failures than successes.
The doctors have stood their ground that the government must honour its side of the bargain, while the government has been using all means to reach a return-to-work formula without paying the striking doctors.
The government went to seek court orders to stop the strike but the Kenya Medical Practitioners and Dentists Union officials went ahead
to call for industrial action.
The KMPDU officials were later cited for contempt, but they shocked the nation by declaring they were ready to serve a one-month jail term.
DEATHS AND SUFFERING
At the centre of all the drama and confusion are thousands of Kenyans irreversibly affected. Poor patients who cannot afford treatment in private hospitals have been left with nowhere to turn. They suffer in their homes as others die unnecessarily.
When the strike started on December 5 last year, many patients were released from hospitals before healing. Among them is Pauline Mugure, a burns patient who had stayed at the Kenyatta Hospital for two months after her husband burned her with a kerosene stove over an SMS.
Pauline was discharged with open wounds and asked to go 'heal at home'. “All the patients in the ward where I was were discharged one morning,” Pauline said as she fought pain. Having come from a humble background, she could not afford private hospital fees and resorted to staying at home with severe physical pain.
The discharge summary says Mugure sustained 20 degree burns and 30 per cent inhalation injury. She also developed glottic stenosis—narrowing of the vocal cords—and a tracheostomy tube was surgically inserted in her windpipe, through the neck, to create a hole that helps her breathe.
Her mother Jane Wanjiku, a casual labourer, said Mugure cries all night due to the pain.
“We don’t sleep because she is in so much pain. I am not a doctor nor am I a nurse to handle this case. I wish doctors could go back to work and help reduce her suffering,” she said angrily.
Recently, Mugure's breathing gadget broke and she was taken back to Kenyatta Hospital as an emergency case after two private hospitals demanded too much deposit fee for admission.
"We took her to MP Shah hospital and they asked us to deposit Sh150,000 for her to be admitted," said Consolata Muuru, a good Samaritan who came to her help.
They later went to Nairobi West Hospital, who asked for Sh400,000 deposit, citing that Mugure needed to be in ICU.
"I called Kijabe Mission Hospital and they said they were full to capacity. I was left with no option but to take her back to KNH," said Muuru.
The Kenya Defence Forces doctors at the emergency and accidents unit served her and had her admitted.
"They are doing a good job but the problem is they don't follow the patient to the ward. The moment they are admitted, nurses take over," Muuru said.
Pauline Mugure, a domestic violence victim who was burned by her husband with a kerosene stove at KNH. Photo/Monicah Mwangi
WAITING FOR A MIRACLE
On a normal day at noon, KNH would be a beehive of activities as visitors come to see their patients. It’s different on this day as we walk straight to the entrance. Empty clinic rooms remain closed as abandoned stretchers stand on the corridors. The 1,800-bed capacity wards are scattered, with countable patients waiting for a miracle.
On fourth floor room D, Mugure lies on one of the beds with few other patients. She is groaning with pain. "Nurses have been giving me Panadols, which are too weak for the pain I am in," she said, asking us to get her strong pain relievers.
Another patient in the ward has been here for three months but things have never been as bad as they are now. "They give us food, the nurses are friendly and they bring us painkillers, but there are no doctors," she said. She hoped the government will reach an agreement with the doctors soon to end their suffering.
Purity Munyiri lost her father three weeks into the strike. He had undergone a surgery at KNH but was released when the strike started. "We started shopping for another hospital and all the privates turned out to be too expensive," she said.
They then agreed to keep him at home and get a doctor attend to him from there. "We found it cheaper but we forgot there was no equipment. Dad lost his battle to kidney complications two weeks ago," she said, adding that if doctors were working, he wouldn't have died.
In the fourth week of the strike, Carol Kendi took her husband for chemotherapy at KNH. She knew about the strike but she thought the doctors would make exceptions for cancer patients. "They always told us to miss chemotherapy at our own risk and so I thought they would keep the clinic open for the sake of the patients," she said.
With no money to have chemotherapy administered in a private facility, Kendi travelled back home with her patient and hoped that doctors would call off the strike sooner. She called me two weeks ago to say her husband had died.
MISSION HOSPITALS CONGESTED
The strike has led to congestion in the few mission hospitals in the country and overworking of their staff. A doctor at Kijabe Mission Hospital, who spoke on condition of anonymity, said they have been working day and night since almost all emergency cases in Nairobi and Kiambu are taken to Kijabe.
"It’s been hell. Today, I have done nine surgeries. It’s so tiring and demanding, we are worried we will start making mistakes," he said.
He is a senior government doctor seconded to Kijabe by the Kiambu county. "Though under the government, we decided not to join in the strike," he said.
The doctor added that despite being on duty for the two months his colleagues have been on the streets, he received a letter from his employer to show cause why disciplinary action should not be taken against him for the strike. He has also not received his pay for the two months.
"Doctors at mission hospitals feel both sympathy for the
grievances of their government colleagues and frustration that not even emergency services are
being
provided," said another doctor.
At the hospital's maternity wing, tired pregnant women wait for their turn for elective Caesarian section. For many of them, the wait has been too long. They have to give way for emergency cases.
"I was supposed to have the CS done in the morning and until now (5pm), it hasn't been done," Lucy Wanjiku said.
A volunteer doctor at the facility went to his blog to pour out his heart over what the situation has been like. "Kijabe has never turned an emergency away.
But for the last four weeks, the number of critical maternity, newborn, trauma and medical patients has been overwhelming," the blog read in part.
He went on to narrate how one baby was taken to the facility after trying four other closed (or too expensive) hospitals. "Everyone is tired.
And a little heartbroken that this is happening. Please pray for us," read the blog, titled ‘Caught in the crossfire’.