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Kenyans face health crisis as a doctor strike enters its fourth month

Jacob Kushner
Special for USA TODAY
Pharmacist Douglas Osoro speaks with a nurse inside the men's ward of the Naivasha Sub-county Referral Hospital, where only a handful of patients remain months after doctors walked out on strike to protest Kenya's failure to implement a 2013 agreement that would have increased their pay and improved conditions in public hospitals. Jan. 30, 2016

NAIVASHA, Kenya —  Nancy Ndirango grimaced in pain as she waited eight hours at a hospital here with a broken right leg, the result of a fall on her way to school. But there was no doctor to see her because they are on strike.

“People can die,” Ndirango, 17, complained. "(The government) should pay them what they’re asking so they can get back to work.”

Ndirango's plight at the eerily empty hospital in this town, about 50 miles north of the capital, Nairobi, is being felt by millions of Kenyans as a national strike by 5,000 public-sector doctors demanding better pay and work conditions enters its fourth month. They walked off the job Dec. 5 to protest the government’s failure to make good on a 2013 agreement to double salaries and hire thousands of new doctors to fill a severe shortage of physicians.

Even when they are working, this nation of 44 million has a critical lack of doctors: just two for every 10,000 people, compared to 23 per 10,000 that the World Health Organization recommends.

Empty beds at the Naivasha Sub-county Referral Hospital, where patients have been turned away because there are not enough doctors working to treat them. Staff say typically the beds would be full of patients. Jan 30, 2016

The few Kenyans wealthy enough to afford private health insurance or pay their medical expenses out of pocket face long waits for care, too, as the country's private hospitals cope with a huge backlog of patients turned away from public hospitals.

Doctors in Kenya earn as little as $1,200 per month in salary and benefits. The low pay forces many of them to seek work as private doctors in Kenya or in Europe or the United States, where they can earn better salaries.

Kenyan activists shout slogans against the country's health ministry as they demand better healthcare service in downtown Nairobi, Kenya, on Feb. 24, 2017.

In the United States, “I have friends who earn about $70,000 a year, said Douglas Osoro, a pharmacist who was in his first year working at the hospital here in Naivasha when the strike began. “Most of the people of Kenya depend on the public sector,” said Osoro. “Why not strengthen the system that serves them?”

“We’re working with a deficit of doctors already,” said Judy Karagania, a resident in opthalmology at Nairobi’s largest public hospital. “And our population is growing so the deficit is likely to increase.”

“Sadly it’s the lower class that’s suffering,” she said.

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A survey of 100 Kenyans last month by the mobile research platform mSurvey found 83% were directly affected by the strike, 74% were unhappy with the state of healthcare in the country and more than half knew someone who had sought treatment abroad due to inadequate services in Kenya.

The problem goes far beyond the pay,” Osoro said. “One medical officer cannot see 100, 200 patients a day.”

Overcrowding can be a matter of life or death. Osoro recalled a case of an intoxicated patient who arrived foaming at the mouth and choking. There was no doctor to attend to him.

“The patient was unconscious. I tried calling the medical officer but they were honestly too busy to attend to that patient.” Osoro said it took 30 minutes to find a doctor who could see him and was able to clear the man’s airway. “The patient could have died.”

Sometimes, they do. Osoro recalls that when he was a resident at a teaching hospital in the city of Eldoret, a 7-year-old child arrived with a severe infection in his lungs. “We would have done fine with an ICU bed," he said, "but we called the ICU department and all the beds were full.”

The child died.

“It was really sad explaining to the mom what happened. We told her that if we had an ICU maybe we could have saved (him),” Osoro said. “It was her only kid. It was frustrating that we couldn’t save one life because of not having the facilities to do so.”

The Ministry of Health said it doesn't have the funds to comply with the 2013 agreement, a defense that outrages many Kenyans in the wake of last fall's disclosure by the corruption-plagued government that an audit of the ministry's budget found $50 million missing.

While government officials are calling for a new labor agreement with the doctors, some of those same officials are benefiting from expensive private healthcare outside Kenya, Osoro charged. “I’ve seen someone struggling to pay drugs that cost ... 60 cents, and then politicians are leaving the country on taxpayer dollars to do even minor procedures,” he said.

Kenyan media lambasted Vice President William Ruto for traveling to South Africa to undergo minor surgery last year, when former President Mwai Kibaki also traveled to South Africa for treatment.

Osoro said his personal savings are growing thin after months without pay, but he called the strike a sacrifice for all Kenyans. “Pay is not as important as having a strong healthcare system in the country,” he said.

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