About 2 weeks ago, I met a doctor, one of those that are on strike in Kenya, over dinner and I asked him why they are on strike. You see, I knew they were on strike and I had seen some of the footage in the news, but I really didn’t support them because I didnt know what they were on about. What I knew is that in general, doctors are a privileged lot and them striking at the same time as teachers – well, my priority was going to be with the teachers. I just couldn’t understand why they wanted to be paid more.
Everytime I tried to listen, I was referred to a commission report dubbed the “Mutava Musyimi report” on the state of medical services in Kenya. Made absolutely no sense to me. So I asked Dr. Muriithi to explain it to me like i’m three years old. And he did.
He explained that the few doctors in this land work extremely long hours – routinely even 48 hours, with little to no equipment and facilities. He explained, that especially outside the urban centres, too many people die needlessly because the doctors are forced to work very hard and very long with very little support – and on top of that, they are paid little or nothing – because they are registrars.
I said, “Oh, registrars! Well, most companies don’t pay people to learn on the job…” Dr. Muriithi educated me that a Doctor Registrar is usually persuing his Master’s degree and is already a fully qualified doctor. They can perform surgeries, they deliver babies and so on. They are not student doctors but real actual doctors.
My response to him was to tell him that these doctors are not talking to Kenyans – that they are talking too much to politicians (in political gobbledygook) that they are not helping us the public understand. I basically said to him that my view was that they need to get my mum and grandma pissed off about their plight.
So a couple of questions occured to me:
- Do we pay less in government hospitals for surgeries to be done on us – because they are performed by interns? No.
- Do we get less treatment from these doctors? No.
- What does it say about our country that MPs who work 15 hours a week (not always – and i am an avid Bunge TV watcher) get hundred of thousands of shillings while doctors who keep us alive and teachers who educate our kids are living on scraps? Are we saying that politics is more valuable to us as a society than healthcare and education?
So the Doctors have started the Peremende movement – with which they are telling us in simple terms what the problem is – and now that I understand, I support the peremende movement. Pay our Damn Doctors!
EDIT: I have edited the word “intern” and changed it to Registrar – after advice from Dr. Muriithi and Dr. Ngure (see comments) that interns are under graduates, Registrars are the graduate doctors I mean to refer to.
Well said, @alkags. But – some minor correction. When Linda Afya 2 started, one of the key demands was payment of registrars. Registrars are not interns. They are medical practitioners that have completed internship, gotten licensed, worked a bit and gone back for postgraduate studies. Registrars do the bulk of the work at teaching hospitals – for example, if you are taken to KNH casualty at night [ God Forbid ] and you need surgery, it will usually be a team of registrars doing it. If you are admitted in any public ward, the registrars are the doctors covering the wards.
There have been attempts to claim that the "curriculum time" of a resident / registrar is 80 hours a week, 52 weeks a year. But – tell me – is it fair to ask someone to pay fees ( > KES 250,000 pa ), work them 80 hours a week and insist on not paying them? Every other country pays residents. Our own Aga Khan University Hospital pays residents.
There is a "quality of care" perspective too. Can you reasonably expect a man / woman that has worked > 100 hours a week [ they also do locums on the side to get their daily bread ] to provide optimal care? They are human.
Why does the self sponsored registrar exist? Allegedly, the government sponsors postgraduate education for doctors that have worked for it for three years. Nonsense. First, the waiting lists are > 10 years long. Second – an Afya house fiefdom / personality cult centered around the DMS [ Dr Francis Kimani ] gets to determine who "deserves" to go on study leave, and what areas of study are priority or not ie kujuana. Third – even when doctors are allegedly sponsored by the Ministry, the fees are never remitted to the Universities. For example – this year's budget had KES 200m for settling of fees owed to the Universities, for government registrars. The money went "missing", mysteriously. In summary – government sponsorship of postgraduate training is fiction.
I could go on and on. But – let me wind up by reminding everyone that a registrar or resident is "a fully qualified medical practitioner with a valid practicing license and a few years experience, who has chosen to pursue specialist training." Read and re-read that definition and cross-check it from other online sources.
Dr. Ngure, Thank you for this comment. I shall correct the intern to registrar immediately.
Pay our doctors + better their working conditions – enough said. As a taxpayer I want my money spent wisely and not wasted away. Well written Al.