Lamu County residents have not felt the sting of the ongoing nationwide doctors' strike, now in its fourth week. It was business as usual on Lamu Island as doctors held demonstrations in Nairobi on Monday morning.
The strike, led by the Kenya Medical Practitioners' and Dentists' Union (KMPDU), which has over 7,000 members across the country, began on March 15, 2024. They were later joined by clinical officers and laboratory technicians, paralysing health services in public hospitals.
Although patients in other counties have borne the brunt of the strike, health workers in Lamu County continue to perform their duties normally.
A spot check by the Nation at public health facilities in Lamu County revealed that there were no incidents of patients suffering due to lack of services at the facilities.
Ms Rukia Omar, a Lamu resident who visited Lamu County King Fahd Referral Hospital on Monday, said she had only heard of patients suffering due to lack of services as a result of the ongoing strike on television, radio and social media.
"As you can see, I visited this facility today and I was attended to by doctors. We thank our medics in Lamu for their dedication to saving lives no matter what. There's nothing like strike or suffering here. We thank Allah (God)," said Ms Omar.
Hassan Yusuf, another patient, commended the Lamu medics for understanding the state of the health sector in the region, which has suffered from various challenges over the years.
According to Yusuf, Lamu lacks investment in private health facilities, so the public would suffer terribly if medics in public hospitals downed tools.
The Lamu King Fahd County Referral Hospital in Lamu town. It is business as usual at all Lamu health facilities despite the ongoing national strike by health workers.
Photo credit: Kalume Kazungu | Nation Media Group
"If medics go on strike here in Lamu, then that will be the end of many of us. Lamu has so many remote villages and far-flung islands that lack health facilities, right from Witu to Kiunga on the Kenya-Somalia border,” he added.
"Transport is a huge challenge. It's costly as people have to traverse the vast Indian Ocean to reach places with few health facilities. We pray nothing like the medics' strike occurs in this place. It will be hell," said Mr Yusuf.
At Faza Sub-County Hospital in Lamu East, medics have been working as usual.
At Kiunga Dispensary on the Kenya-Somalia border, residents admitted to receiving normal services since the nationwide medics' strike started 24 days ago.
"The only challenge we have here is the lack of drugs. We have to buy most of the prescribed drugs from chemists and pharmacies but all the other services required are being provided. We're not complaining," said Mohamed Kupi, an elder at Kiunga Town.
The Nation discovered that out of the 48 medical specialists, including doctors, and pharmacists among others operating in Lamu, only 14 are taking part in the strike.
Lamu County Executive for Health, Sanitation and Environment Mbarak Bahjaj revealed that almost half of the county's 48 health workers are on contract, while the rest are permanent employees.
Of the 24 permanent staff, only one specialist is paid by the national government, while the rest are Lamu County government employees.
Mr Bahjaj cited patriotism as the main reason why most medics in the county have shied away from joining the ongoing nationwide strike by doctors.
The county health executive also noted that most of the KMPDU's demands on medics, including the payment of doctors' salary arrears arising from the 2017 Collective Bargaining Agreement (CBA), had already been met by the devolved government.
He said that when the Salaries and Remuneration Commission (SRC) issued the circular to increase the salaries of doctors by 10 per cent, the Lamu County government immediately implemented it.
"We only have 14 out of 48 medics here in Lamu that are participating in the ongoing nationwide strike. That means 34 are actively working and this has enabled us to continue to provide services to our people. I congratulate our medics for their patriotism in ensuring Lamu people aren't suffering owing to the strike. They are practising humanity," he said.
"Our medics know very well that Lamu's private health sector hasn't grown to accommodate any emergencies arising. That's why they've ensured there's normal operations in all our over 30 public health facilities across Lamu," said Mr Bahjaj.
Another demand by striking doctors in the country is the provision of adequate medical insurance cover for themselves and their dependents.
They also want the government to address frequent delays in salary payments and to start paying doctors who work in public hospitals as part of their higher degree courses.
Mr Bahjaj said the devolved unit has ensured all the health workers have for years been registered in a comprehensive health insurance cover under the National Hospital Insurance Fund (NHIF) that has enabled them to get crucial services in all hospitals they wanted.
"Now that NHIF is in the process of being changed to Social Hospital Insurance Fund (SHIF), as a county, we are already in discussion to have a private insurance cover for our medics within a two months' time," said Mr Bahjaj.
The health executive, however, appealed to the state to ensure all the grievances of striking medics in the county are addressed.
"Despite our medics providing services as usual in Lamu, we're still worried about the risks of them getting exhausted now that we have 14 of them who aren't working," said Mr Bahjaj.
The Nation also established that other grievances by the medics such as issues to do with study leaves, and working environment, including staff quarters have also been implemented by the devolved government of Lamu.
For instance, between 2015 and 2021, the Lamu County Health Department released about 20 medics who went on study leaves while at the same time getting paid their monthly dues by the county government.
Some have already come back and are still working with the Lamu County government while seven others are finalising their studies locally and abroad.
The devolved government has also built staff quarters within King Fahd County Referral Hospital in Lamu Town, Mpeketoni Sub-County Hospital and Witu Hospital, all in Lamu West.
"We have strived to ensure a better working environment for our medics. We have four new staff quarters at Mpeketoni Sub-County Hospital with only one having been occupied while the rest are vacant.
"Most of our medics are unwilling to reside within those staff quarters. They prefer renting outside as their private arrangements. We have four new staff quarters whose construction is being finalised at King Fahd while another three have been constructed and completed at Witu Hospital with none having been occupied," said Mr Bahjaj.
Other factors that have contributed to the lack of impact of the doctors' strike in Lamu County include the fact that, unlike in other counties, there are no interns in the county's health sector.
This is because most hospitals in the county have not reached the level where they require the services of interns, according to officials interviewed by the Nation.
"Yes, interns are a crucial unit in the medical field but here in Lamu, we have none. We're hopeful that soon, we shall upgrade to enable us to get medical interns," said Mr Bahjaj.
Doctors across the country have vowed to proceed with the nationwide strike, calling for the hiring of more doctors and improved pay for medical interns.
Last week, the Ministry of Health offered to pay medical interns a stipend of Sh70,000, a move that has been opposed by the doctors’ union.
The union insists on the need for the 2017 CBA implemented first and for the interns paid as per the terms of the agreement.
However, Health CS Susan Nakhumicha has maintained that the ministry lacks sufficient funding to pay the amount doctors are pushing for.
On Sunday, President William Ruto asked KMPDU to accept the government's offer on payment of medical interns.
He spoke during a church service at AIC Fellowship in Eldoret, Uasin Gishu County.
"I know we have a situation with doctors and medical interns. I would like to implore them to agree to live within our means. We cannot continue to spend money we don’t have,” the President said.
“We must be honest and tell the truth. We can’t continue to borrow money to pay salaries etc. I want to tell the doctors that we care about them and we also value their service but we must live within our means. We can only afford Sh70,000 because we also want all 1,500 medical interns to be absorbed,” he added.
