147 days without care: Marsabit health crisis deepens as strike leaves patients stranded
Marsabit County Referral Hospital.
What you need to know:
- A prolonged strike in Marsabit has crippled healthcare, forcing patients into risky journeys and preventable deaths.
- Residents face impossible choices as hospital closures push them toward costly, distant, and unsafe alternative.
For 147 days (as of Thursday), much of Marsabit County has been without access to basic healthcare. What began as a labour dispute for clinical officers in the county has now spiralled into what health workers are calling a full-blown humanitarian crisis, measured not just in numbers but also in lives lost, newborns buried, and patients forced to travel dangerous distances in search of care.
A new analysis by the Kenya Union of Clinical Officers paints a grim picture of a health system on the brink of collapse. The data shows a devastating reality, where newborn deaths have surged tenfold. Where two babies died per 1,000 live births before the strike, that number has now shot up to 21 in 100 births.
The data shows a catastrophic drop in patient services. As of February 25, outpatient services had plummeted by 94.4 per cent, dropping from 9,000 patients per month to just 500. Inpatient admissions have fallen by 83 per cent; from 60 to just 10 patients, while theatre cases have dropped from 104 to 60. Currently, outpatient visits, often the first point of care, have nearly disappeared, plunging by 95.5 per cent from about 15,700 visits before the strike to just 700.
Inpatient admissions have fallen by 88 per cent, meaning only the most critical cases are being attended to, often too late. Even surgical services have been crippled, with theatre cases dropping by nearly three-quarters, leaving nurse anaesthetists to shoulder a burden far beyond capacity.
At the same time, entire health facilities have gone silent. Moyale, Kalacha, and Laisamis sub-county hospitals are no longer operational, cutting off thousands from nearby care. In Moyale, patients who used Moyale Sub-County Hospital as a lifeline for outpatient and inpatient care and surgery are now forced to go to private facilities or cross into Ethiopia, navigating uncertainty and delays that could prove fatal.
From Kalacha, the nearest surgical help is over 100 kilometres away along rough, unforgiving roads. For those in Laisamis, the journey stretches even further, to Marsabit town, Isiolo, or Meru, adding cost, time, and risk to already fragile conditions.
According to Halima*, a clinical officer, Moyale Sub-County Hospital, before being declared operational, had been relying on a single nurse anaesthetist to keep its theatre running.
“Now she has gone on leave. Even the maternity department has been closed. With no surgical or maternity services, patients are left with impossible choices and have to seek help in Ethiopia or in private facilities,” she says.
“At Kalacha Sub-County Hospital, there is no nurse anesthetist at all, and clinical officers have not returned to work. Nurses remain on duty, but without clinical officers, they cannot do much. Clinical officers are the entry point to care. If patients are not seen by them, there is no one to attend to them.
“In Laisamis, the pattern is the same. While nurses are still present, the theatre is shut. Patients in need of surgery must now travel long distances to Marsabit County Referral Hospital, back to Moyale, or seek care in private facilities—journeys that often come with dangerous delays.”
The clinical officers started their strike on October 1, 2025, over unaddressed grievances, including failure to implement a collective bargaining agreement (CBA), failure to remit statutory deductions, lack of promotions, lack of medical cover, and chronically delayed pay.
The dispute has played out in court since October last year, with the county government claiming that the strike is illegal and unprotected. “They said our strike is not legal and want us forced back to work, but the court refused. Every time we go for a hearing, there are excuses, documents not filed, and applications missing. It keeps being pushed forward.”
Through the union, clinical officers argued that the strike was a result of the county’s failure to implement return-to-work agreements signed on July 29, 2024, and April 14, 2025, whose execution deadline was September 1, 2025.
A December 10, 2025 ruling directed a 30-day suspension of the strike to allow the parties an opportunity to negotiate in good faith, while cautioning against victimisation or subjection of clinical officers to any disciplinary process or action on account of the strike. However, what followed was intimidation, including halting of salaries and removal of clinical officers from the county payroll.
“Our December 2025 salary was held at the bank. Then from January, we were removed from the payroll. So, we have not received any payment since November,” she explains.
Standoff
Attempts to resolve the standoff have repeatedly broken down. Halima recalls a meeting on March 13 when both sides met to discuss an end to the strike. Promotions were promised, and a return-to-work deal was to be signed days later.
“But on the day of signing, the chief officer switched off his phone, and the county secretary refused to pick up our calls, so it didn’t happen. Up to now, we have been on strike. And now, because we are not on the payroll, even the medical insurance coverage is not working,” she says.
Meanwhile, the true scale of the crisis may be far worse than official data suggests. “With many residents avoiding hospitals altogether, we don’t even know how many people are giving birth at home and losing their babies,” Halima says.
Kuco chairperson Peterson Wachira has termed the prolonged strike a humanitarian crisis. “The employer’s failure to address the legitimate grievances of clinical officers has had deadly consequences for the people of Marsabit. We are not merely withholding labour; the data demonstrates that essential health infrastructure is collapsing and lives are being lost,” he says.
'Nation' reached out to County Secretary Arero Halkano for comment on the progress of resolving the strike and for a response regarding allegations of intimidation, but he referred this reporter to Dr Alamin Adan, the county's chief officer of health services, who neither picked up our calls nor responded to texts messages by press time.
Kuco is now calling for urgent action to stem the deepening crisis. The union is demanding immediate and meaningful dialogue with the employer, insisting that talks must begin without delay to resolve outstanding grievances and restore essential health services across affected facilities. At the same time, Kuco wants all relevant government bodies, including the Ministry of Health and the Council of Governors, to formally acknowledge the severity of the situation and step in to prevent further loss of life.
“We call for an investigation into the massive preventable loss of life and suffering resulting from deliberate inaction over the past 146 days. The lives of Marsabit residents hang in the balance. Every day the strike continues, the death toll and suffering increase,” Peterson says.
“We urge the employer to prioritise human life over bureaucratic inertia and act now. The Kenya Union of Clinical Officers remains committed to a constructive engagement with the county government of Marsabit leading to an amicable resolution of the issues affecting clinical officers and seeing an end to the suffering of the people.”
