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Sunday, July 23, 2017

Why employers should be keen on the health of domestic workers

"I was shocked to bump into ARVs in my girl’s belongings."
"I was shocked to bump into ARVs in my girl’s belongings."

WHEN Rose Odhiambo hired a house help early this year, her excitement was evident, as she braced herself for a new life with the latest member of her family.

However, nothing prepared Rose for the hard-hitting reality that would be her predicament after three months stay, as her girl would succumb to what was diagnosed as “multiple organs failure” by medics from various hospitals.

“Sheila* had worked elsewhere in the same capacity, so I had an easy time orienting her to the daily chores in our home and routine household activities,” Rose says as she struggles to hide the evident shock that was Sheila’s sudden demise a couple of days ago.

Like Rose, most domestic employers barely take a keen, deep interest in the health of their employees, oblivious of the dangers they expose themselves to and their loved ones.

Jane Shikunga, a mother of three in Kayole, also got a surprise on her house help's health.

“Some years back, I was shocked to bump into ARVs (antiretroviral drugs) in my girl’s belongings,” she says.

Shikunga and her husband are employed and often leave their children under the care of a nanny, who literally manages the young ones’ lives.

“She would bathe them, nurse them, play with them, cook for them and do almost everything until they retired to bed, most times even before we got back home,” Shikunga says.

While acknowledging that people should not be victimised due to their health status, Shikunga calls for caution to ensure the situation does not degenerate into another catastrophe to unsuspecting family members.

“Recognising their health position only serves to ensure that extra care and protection is taken into account at all levels, which in the end helps in minimising any would-be risks.”

While interviewing her new house help, Felister Wairimu enquired of any health issues and the girl was kind enough to tell her she is HIV+ and on ARVs. She was confused on whether to hire her or let her go. “The confession got me off guard, but her honesty moved me. She would have chosen not to tell me,” Felister says.

After consulting her husband, who is a medic, the two decided to hire the girl, with whom they stayed with for close to a year. “Every month she would take a week day off to go collect her ARVs, which she took religiously,” Felister says.


Rose says although she has hired countless house helps in her 34-year motherhood, nothing prepared her for the sad reality that befell her when Sheila was diagnosed.

She says during her short stay in Naivasha, the tall, well-built teenager from western Kenya had been an outgoing, vibrant and energetic girl, with the zeal to live.

“From the very day I hired her, she seemed to get it, without any struggle, something that created a special bond between us. I was left with the sole role of giving directions and ensuring supplies were available. The rest was hers,” Rose says.

Unknown to her employer and herself, Sheila was battling multiple internal system malfunctions, which had persisted for a long time, with no evident warning signs.

Due to the cost implications of healthcare in Kenya, most house helps are not insured, while their employers enjoy the benefits that accrue from formal employment — organised medical cover.

Unknown to employers, the lack of such cover can easily extend unimagined risks to the entire family as a result of nannies’ ailments, which include tuberculosis, HIV-Aids, skin conditions, waterborne and other non-cardiovascular diseases.

“It starts by accepting house helps as critical members of our families. In this regard, we don’t have to wait for them to show any symptoms before rushing them to hospital,” clinical officer Lucile Shikumi says.

Shikumi is urging families to enhance dialogue and develop an interest in the entire household by adopting routine medical visits, a practice that Rose emphasises.

While visiting Nairobi early last month for a routine medical appointment, Rose opted to travel with Sheila.

“I intended to introduce her to my family members. However, on the eve of our safari back to Naivasha, Sheila complained of stomach and back pain.”

Rose, a nurse by profession, prescribed some painkillers for her girl, who after taking them reverted to her usual lively self.

“Nobody could tell that it was the same person who had earlier been reeling in pain,” says Ainea Onuti, Rose’s nephew.

Unfortunately, Sheila’s painful episodes did not stop upon landing in Naivasha, prompting Rose to refer her to undergo a malaria test, among other examinations. The former came out positive, leading to her being put on anti-malaria dose.

“What shocked us was that instead of her improving, she kept complaining of stomach and back pains. I decided to take her for a complete check-up to ascertain the real problem.”

The results from the tests not only threw Rose into total disarray but also the team of experts working on Sheila, who immediately ordered Rose to rush the patient to Kenyatta National Hospital for specialised care.

“This would later turn out to be one of my longest and most frustrating nights ever, as we had to stay awake and wait for the recommended doctor to come and attend to Sheila. Upon arrival, he sent us back home after prescribing some drugs, claiming the condition was not an emergency.”

According to medical records, Sheila’s kidneys were swollen, her liver had changed colour and she had further developed ascites, the accumulation of serious fluids in the peritoneal cavity. She had cancer that was already at an advanced stage.

“Due to the nature of my work, schedule and health, I was compelled to call her mother to come and attend to her in hospital here in Naivasha, where we had admitted her. However, the mum insisted on going back home with her, as she had to balance between nursing Sheila and fending for her siblings.”

As fate would have it, Sheila battled to the very end and succumbed the very day she was transferred to Western Kenya, having stayed in Naivasha for a mere three months, which Rose describes as blissful.

“Even though my conscience is clear, I wish to call upon especially mothers who rely on house helps, to go an extra mile and spend a few thousands towards (medical) checkups and covers. These small things we take for granted are the very ones we end up paying so dearly for,” Rose says.


In most cases, when a domestic worker falls sick, the first thing the employer thinks about is dismissing her. Legally, employed domestic workers have the same rights and protections as any other worker under Kenyan law.

The Employment Act, 2007, requires that termination of employment, for whatever reason must be through issuing a one-month notice, notifying the labour union or office, paying all accrued leave days and severance pay.

The Kenya Union of Domestic, Hotels, Educational Institutions, Hospitals and Allied Workers (KUDHEIHA) has strongly criticised employers for unfair dismissals of domestic workers, including over sickness.

In case of sickness, domestic workers are entitled to seven days fully paid sick off and seven more days on half pay. Their annual leave should not be less than 21 days. "Domestic workers are managers in their own capacity and deserve respect and decent working conditions. Any unfairness is against human rights," secretary general Albert Njeru said.

By law, employers are supposed to contribute to the NHIF and NSSF on behalf of domestic workers, but only one per cent of employers do it. "The number of domestic workers on any medical cover by employers is worrying," said Ruth Khakame, chairperson of the National Domestic Workers' Council.

Ruth said domestic workers undergo the worst forms of violations in the hands of their employers. "So many girls have been dismissed from work for being sick and we handle such cases on a daily basis," she said.

Kudheiha industrial relations officer Dorcas Mbeke said when they receive such complaints fro the workers, they contact the employer and try to settle the issues at their level. "Some employers however refuse to cooperate and those are the ones we take to court," she said.

Through awareness campaigns, the union, which has more than 16,000 registered domestic workers, is on a campaign to educate domestic workers to take health insurance as a person responsibility and register. ''We hold meetings and ask the existing members to bring us the domestic workers from their flats," Dorcas said.

She said they at times carry out door-to-door visits, which she said is not easy. "Many employers don't want their workers to join a trade union, so it has not been easy."

According to Kituo Cha Sheria, domestic workers are among the most vulnerable groups of workers. "They work for private households, often without clear terms of employment, unregistered and excluded from the scope of labour legislation."

In Kenya and around the globe, domestic workers endure excessive hours of work with no rest, underpayment or non-payment of wages, forced confinement, physical and sexual abuse, forced labour and trafficking.

The International Labour Organisation estimates that children make up nearly 30 per cent of the world’s estimated 50 million to 100 million domestic workers. Women are most vulnerable. In Kenya alone, domestic workers are well over 2 million.

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