The pain of being a medic in Kenya: My hopeless battle with debt, low pay and suicidal thoughts

Imagine being recruited by the government right out of training to work at the frontline of a deadly pandemic that has claimed millions of lives, with promises of tenure and pension, and other niceties, only for the government to "forget" that you exist once the pandemic is over.

This is the sad story of 29-year-old Diana Wanjiku, a nurse in Murang'a, who says she is now knee-deep in poverty, debt and helplessness.

As if that were not enough, Ms Wanjiku tells the Nation that she is struggling with suicidal thoughts and cannot afford medical treatment.

Ms Wanjiku tells our reporter that she is now hanging on by a thread. This is her story.

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"I have reached a point where I go to work and stare at antipsychotic drugs and then fantasise about overdosing on them.

Sometimes I look at a patient's insulin and think about injecting it under my tongue so that my death will be considered a 'normal' death.

When this thought clouds my mind, I call a certain Red Cross number. When they ask me where I live, I hang up and call again.

My name is Diana Wanjiku, a 29-year-old nurse at Murang'a Level 5 Hospital. I have been battling depression for months.

I have even considered suicide, to be honest.

Things have gotten so bad that I have had to beg a psychotherapist to treat me for free because I cannot afford to pay him.

This is despite the fact that I am employed by the Ministry of Health and the Murang'a County Government.

If anything happens to me, three people should be held responsible: Health CS Susan Nakhumicha, Council of Governors Chairperson Anne Waiguru and Murang'a Governor Irungu Kang'ata.

Let me tell you how it all began.

The year was 2020. It was during the Covid-19 pandemic.

The national government wasted no time in deploying us to the 8,571 sub-counties covered by Universal Health Coverage (UHC).

It was a baptism of fire for me, given the death, helplessness and despair associated with the coronavirus.

I had joined the Ministry of Health immediately after years of training at the Kenya Medical Training College (KMTC) in Nyeri, where I graduated at the top of my class.

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I had hoped to have my life together by the time I was 25, so when I got the call that I had been shortlisted, I knew the time was right to invest and develop.

According to the contract I signed, I was to be paid Sh50,000 a month, which they did whenever they could, but at other times they did not pay us on time, all 8,571 of us.

I had a plan. I'd taken financial literacy courses in preparation for this government job, so I'd know how to manage and invest well.

I had hoped to have finished my studies by now, but it turns out that I cannot even get a study leave approved because, again, the counties say that we are not their employees. When I enquired at the Ministry of Health, I was told that it's only the county that can grant me study leave.

At the time, I was hoping for a better future, thinking that greener pastures had finally appeared.

Since it's well known that government employees receive a risk allowance and better pay, I didn't mind being sent to a rural institution.

In fact, I thought I'd also get a hardship, commuting or housing allowance, but it soon dawned on me that this was not to be.

My first placement was at the Nyangiti Health Centre.

I was living in Kiriaini at the time and couldn't move because of the lockdown.

Travel to and from work would cost me Sh 300 a day and that was when I was working a weekday shift.

It would go up to Sh600 when I was on call at night or at weekends because there were no matatus, so I had to use a motorbike.

Remember, all of us employed under the UHC were on probation from May to around September 2020.

During that time, I had to survive on loans.

The pressure to deliver was immense at the time because we were saving lives day and night.

So I borrowed money, knowing that as soon as the government paid me a lump sum, I'd pay off my debts.

I was shocked!

When the 'lump sum' of Sh50,000 was paid into my account, most of the money went to statutory deductions, including the HELB loan. So, after paying off all my debts, I was left with nothing. 

After a few months on the job, my personal health began to deteriorate; I could not even afford to pay Sh5,000 rent for a single room.

A doctor, after a series of costly tests at Sh8,000 per visit, would conclude that I had ovarian cancer.

In this country, no one talks about how expensive cancer marker tests are.

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This counsellor was very particular about where the tests were done for quality reasons.

I remember on my first visit I spent Sh30,000 on the tests.

NHIF wouldn't cover a penny because the Ministry of Health said my professional group wouldn't allow it.

By 2022, the statutory deductions were off the charts, so my take home was Sh 42,000 against a medical bill of Sh 30,000, my life was completely broken.

This is not surprising because the truth is that they employed us on a 'special salary' which meant no allowances at all.

After the trauma, mental anguish and pain, I later found out that it was a misdiagnosis.

A second doctor found that I had endometriosis, a condition in which tissue similar to the lining of the uterus grows outside the uterus.

I needed my mother's help to get through the first round of treatment as the doctors told me to prepare for surgery.

I was still hopeful that the government would improve things, as I had personally made several trips to Afya House where officials assured me that at the end of the contract I had signed, we would be absorbed and absorbed on permanent and pensionable (PnP) terms.

Around the same time as my visit, it was officially announced that all 8,571 of us on UHC contracts would receive gratuity at the end of the contract.

Sadly, this was a big fat lie.

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In early 2021, I moved to Murang'a town because there was more traffic and it was even easier to hitchhike to work.

I respect truck drivers because they never left me on the road.

I did not care about my safety; I just wanted to make ends meet.

In 2022, my health began to deteriorate again!

At that time, I was transferred to a newly opened health centre in Gatunguru, and I could no longer commute from Murang'a town as I would have to spend Sh500 daily on transport. I had to move again, and as my health had drained me financially, this meant taking out a loan to move, as I was told by Ministry of Health officials that the government no longer offered a relocation allowance.

The district officials told me that we were not their employees and that we belonged to the government.

I was knee-deep in debt and, to make matters worse, my doctor had recommended that I undergo immediate surgery for endometriosis.

That was when the suicidal thoughts started.

Over time the suicidal thoughts got so much worse that I decided to see a psychologist and boy oh boy are they expensive to see.

I remember begging one psychologist to just see me heri nikue nalipa pole pole and I remember her telling me that although she sympathised with me, she didn't do pro bono work.

I had to pay in advance or just pray to God to see me through.

My family had to hold a harambee for me to face the surgeon's knife.

By the time I went into recovery, my contract had ended.

I was forced to return to work a few weeks before my full recovery, because we were told that if we didn't return to work when the contract expired, we would be sacked.

When the contract expired in 2023, we were again left without salaries and, of course, in my case I could not get a loan because I had defaulted on the previous contract.

This time we went without a salary between May and July and then received a month's salary in August and September.

This time I took home 39,000 shillings instead of 42,000 shillings.

We were assured that the arrears would be paid.

Let me tell you about the shock that followed.

The housing levy was deducted at Sh45,000 because they had backdated the deductions by about three months.

My payslip showed a negative amount.

This meant that my nightmare was far from over, considering that I still have a Helb loan to pay off. 

So yes, I'm going to take to the streets until they can hear me, because I am one thought away from leaving this world at the cruel hands of President William Ruto's government.”

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