NAIROBI, Kenya — Doctors in public hospitals say they have not been paid, some for as long as six months. They’re furious that they’ve been given faulty protective gear, or none at all. Hundreds of government health workers have fallen sick with the coronavirus, and yet many say their medical insurance was cut in July, just when hospitals became overwhelmed with cases.
The situation in Kenya’s public hospitals is so dire that thousands of doctors, nurses and laboratory technicians in at least three counties walked off the job this month. On Friday, they were joined by more than 300 doctors working in 20 public facilities in Nairobi, the country’s capital, and thousands more across the country are threatening to strike in September if their demands are not met.
The crisis comes as infections are surging, particularly in cities like Nairobi, and intensive care units in hospitals are filling up with coronavirus patients. The pandemic is now straining medical workers to the breaking point in a country known for having one of the better health care systems in Africa, experts say.
“Doctors are not martyrs,” Thuranira Kaugiria, secretary-general of the Nairobi branch of the Kenya Medical Practitioners, Pharmacists and Dentists Union, said in an interview — a line he has since adopted as a hashtag. “Doctors are not children of a lesser God.”
Frustration among health workers peaked after a recent television exposé accused dozens of business leaders and government officials of corruption, alleging that they stole about $400 million in funds allocated to fight the pandemic. The country’s health minister, Mutahi Kagwe, told Parliament the allegations were “just fiction” but later, on Facebook, he promised changes. Some officials have been suspended. Authorities say they are investigating the alleged theft of pandemic-related donations from Chinese billionaire Jack Ma.
Protesters gathered in Nairobi on Friday, calling for those accused to be brought to justice.
While Kenya was able to stem the spread of the virus by locking down early on, health officials have reported 31,763 cases and 532 deaths — a tally experts believe is low because of inadequate testing.
Doctors are demanding quality protective gear, comprehensive medical insurance, salaries paid on time, promotions and compensation packages and exemptions from duty for doctors who are pregnant or who have pre-existing conditions. Union officials have also urged the government to hire 1,000 unemployed doctors to bridge shortages.
Past doctors’ strikes have lasted for months, and this one is open-ended.
Kenya’s Health Ministry did not respond to requests for an interview. But Mercy Mwangangi, chief administrative secretary for the ministry, said in a news conference on Friday that counties have been improving hospital conditions and protective gear, and that the ministry is negotiating with the health workers.
With almost 48 million people, Kenya only has 9,068 licensed medical doctors, according to the Kenya Medical Practitioners and Dentists Council. The country has 537 intensive care unit beds, but only 256 ventilators, a recent study showed.
“Kenya’s health care system has always been one major disaster away from collapsing,” said Dr. Stellah Bosire, co-executive director of the East Africa Sexual Health and Rights Initiative.
Covid-19 has so far infected 700 health workers and killed more than 10, according to the doctors’ union. These include at least 41 positive cases among workers at Kenya’s largest maternity hospital, Pumwani.
Union officials said a public health officer in the northeastern county of Wajir died because he could not get to a facility equipped with oxygen. A nurse in the western county of Homa Bay died of Covid-19 complications days after giving birth.
“There’s a false sense of protection,” he said.
The crippling effects of the walkout are apparent in Homa Bay county, where for 18 days now, 64 doctors and more than 4,000 health workers have been on strike, said Dr. Kevin Osuri Jr., a union official who works at Rangwe Sub-District Hospital, a public facility.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated August 24, 2020
What are the symptoms of coronavirus?
- In the beginning, the coronavirus seemed like it was primarily a respiratory illness — many patients had fever and chills, were weak and tired, and coughed a lot. Those who seemed sickest had pneumonia or acute respiratory distress syndrome — which caused their blood oxygen levels to plummet — and received supplemental oxygen. In severe cases, they were placed on ventilators to help them breathe. By now, doctors have identified many more symptoms and syndromes. (And some people don’t show many symptoms at all.) In April, the C.D.C. added to the list of early signs sore throat, fever, chills and muscle aches. Gastrointestinal upset, such as diarrhea and nausea, has also been observed. Another telltale sign of infection may be a sudden, profound diminution of one’s sense of smell and taste. Teenagers and young adults in some cases have developed painful red and purple lesions on their fingers and toes — nicknamed “Covid toe” — but few other serious symptoms. More serious cases can lead to inflammation and organ damage, even without difficulty breathing. There have been cases of dangerous blood clots, strokes and brain impairments.
Why does standing six feet away from others help?
- The coronavirus spreads primarily through droplets from your mouth and nose, especially when you cough or sneeze. The C.D.C., one of the organizations using that measure, bases its recommendation of six feet on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet. But six feet has never been a magic number that guarantees complete protection. Sneezes, for instance, can launch droplets a lot farther than six feet, according to a recent study. It’s a rule of thumb: You should be safest standing six feet apart outside, especially when it’s windy. But keep a mask on at all times, even when you think you’re far enough apart.
I have antibodies. Am I now immune?
- As of right now, that seems likely, for at least several months. There have been frightening accounts of people suffering what seems to be a second bout of Covid-19. But experts say these patients may have a drawn-out course of infection, with the virus taking a slow toll weeks to months after initial exposure. People infected with the coronavirus typically produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies may last in the body only two to three months, which may seem worrisome, but that’s perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it’s highly unlikely that it would be possible in a short window of time from initial infection or make people sicker the second time.
I’m a small-business owner. Can I get relief?
- The stimulus bills enacted in March offer help for the millions of American small businesses. Those eligible for aid are businesses and nonprofit organizations with fewer than 500 workers, including sole proprietorships, independent contractors and freelancers. Some larger companies in some industries are also eligible. The help being offered, which is being managed by the Small Business Administration, includes the Paycheck Protection Program and the Economic Injury Disaster Loan program. But lots of folks have not yet seen payouts. Even those who have received help are confused: The rules are draconian, and some are stuck sitting on money they don’t know how to use. Many small-business owners are getting less than they expected or not hearing anything at all.
What are my rights if I am worried about going back to work?
The coronavirus isolation centers in the county have been “abandoned,” he said, and patients who test positive are being sent home. The government has yet to call for a meeting with the doctors, Dr. Osuri said.
Kenya’s government was initially lauded for initiating mitigation efforts to curb the virus. But health officials say coordination between the national government and counties isn’t effective, with smaller hospitals left to fend for themselves.
“The ministry of health is like a mother that cut its cord with the counties,” said Dr. Rowena Njeri, a medical superintendent at a hospital in Murang’a County, north of Nairobi.
Dr. Njeri said authorities in Nairobi sent her permeable coveralls, which she only discovered while training health workers on how to use them.
“I felt fear for our health workers,” said Dr. Njeri, who manages 17 health centers and dispensaries with only two regularly-assigned doctors. “There was a sense of doom and uncertainty.”
Dr. Yubrine Moraa Gachemba, an internist and health advocate, said that even though she works at Nairobi Hospital, one of Kenya’s top private hospitals, all doctors are afraid.
“The army that’s fighting the pandemic in Kenya is currently demoralized,” said Dr. Gachemba.