Friday, January 6, 2017

What Next After The Doctors' Strike

5 days after the start of the year 2017 and 32 days since the #LipaKamaTender doctors strike started, there is no end in sight even after a State House,Mombasa meeting between the President and KMPDU officials. However a second round of talks is scheduled for later today,Friday 6th January at The Treasury in Nairobi. My hope is that the choice of The Treasury as the venue for the follow up meeting towards the resolution of the industrial action by doctors about the implementation of the CBA duly signed by the same government  in 2013 is a harbinger of good tidings towards the calling off of the strike. Since The Treasury is responsible for authorization of government expenditure, it’s only fair that the press conference announcing the end of the strike be held there. Though it’s not a foregone conclusion that the strike will be called off either with partial implementation of the CBA or with an amendment to it,all I  pray for tonight is a solution .A solution to the deaths, increased catastrophic healthcare expenditure for affected patients and their families and pain and anguish of the poor and the downtrodden of this land having to endue more than a month without medical care.

A solution to millions of Kenyans unable to access care because they are too poor to afford a private health facility or too tired to reach the faith-based facilities that are now bursting at the seams with increased workload and pressure on their limited, philanthropist funded resources trying to alleviate the suffering of the masses.


If I get to hear those words tomorrow morning, my prayers will have been answered and I will regret not having prayed for other things like a BMW convertible and a miraculous six-pack abs. But isorait.I hope sanity prevails and concern for the suffering doctors and patients of Kenya will be listened to and there will be a road-map to a lasting implementation of the CBA so that we do not find ourselves in the same position a few years down the line.

But before the dust to that fierce rumble is over,we seriously need a discourse on our health system and how to run and manage it. Already as it is we should contend with the impact of the doctors strike on the rollback of a number of important healthcare interventions including the free maternity program and infant and maternal health outcomes. Dear God, I pray that this should not be a case of crisis averted, move on.
Lets face it,to some of us #Lipakamatender is not just about the pay packages of the doctors but a reform of the healthcare delivery system.So,it would pain me to see this conversation being reduced to a single issue of doctors pay.We should seek dialogue and a national consultative forum on health system to determine if we accept to make ours a dysfunctional health system that will serve as a case study for how not to run  public health services for even the most banana of republics. The greater concern should be to chart a way forward on how to strenghten our health system to be resilient and responsive to the needs of the citizens.The involvement of World Health Organization (WHO) in formulation of a roadmap to a new health system could be worth evaluating.The debate and discussions should centre around the goal of universal healthcare coverage.The conversation should look at how best to fund the healthcare system,manage and govern it,distribution and service delivery and  and the best approach to human resources management in the new system.We also need to assess how devolution has impacted on the life of the common man and how best to ensure further gains are made.If devolution is instead rolling back the gains of better life expectancy and maternal and child health,it could be a good time to evaluate changing it or even reverting to central health system delivery with some variation.Health system strengthening activities require input and participation of wide range of stakeholders including donor organizations involved in the sector and since health is affected by a number of other determinants, it should truly be a multi-sectoral in nature. If we do not plan to accomplish the above let’s remember we shall be subjecting the Kenyan people to a bad case of deja vu, few years from now.
I wonder why the international and non-governmental organizations have kept mum on the suffering of Kenyans?Maybe its because of the muzzling of NGOs by the government or maybe the life of a Kenyan seeking healthcare is not as important as a post-election victim or refugee resettlement program.But I could be wrong.Even the normally loud Okiya Omtata and stunt activist Boniface Mwangi have been rather muted in all this.So I urge all stakeholders in health including nutrition and human development programs to come together and resolve to support an initiative to reform and save the Kenyan health system.

On the other hand if later today the strike is not called off with a way forward, I will be the grown man wailing on Harambee Avenue in disbelief at the turn of events.All you will have to do is give me a hug and tell me it’s all a dream and it will come to an end soon.But I wont give up and will continue highlighting on the issue nevertheless.


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