The labour ward at Kenyatta National Hospital (KNH) is handling more than twice its normal capacity. Mothers arrive, some too late. Operating theatres run beyond capacity. The blood bank strains to keep up.
In a statement, KNH Chief Executive Officer Dr Richard Lesiyampe said the hospital has become the main point of care for patients needing urgent treatment as most public health facilities in Nairobi and Kiambu counties cannot operate fully due to ongoing industrial action.
"This has led to a sharp rise in the number of very sick patients arriving at the hospital, many in critical condition," Dr Lesiyampe stated.
"Sadly, some of the mothers and babies are arriving too late, and a few have had poor health outcomes despite the best efforts of our dedicated medical teams. The increased demand for care has also placed immense pressure on essential hospital services such as operating theatres, the blood bank, and diagnostic services. Our staff are working tirelessly around the clock, but resources are stretched to the limit."
Kenyatta National Hospital CEO Dr Richard Lesiyampe, speaks to the media at the facility on August 19, 2025.
Photo credit: Wilfred Nyangaresi | Nation Media Group
Dr Lesiyampe urged all parties to resolve their differences quickly. "Restoring normal operations in Kiambu and Nairobi county hospitals will ease the pressure on KNH and ensure that patients receive care closer to their homes and on time."
Kiambu County doctors have been on strike for over four months. Nairobi County’s nurses, clinical officers, midwives, medical laboratory officers, pharmaceutical technologists, nutritionists, dieticians, and environmental health and public health practitioners have been on a go-slow for about a month.
The Daily Nation recently exposed health challenges in Kiambu County, including 67 new-born deaths from May to September 2025, as confirmed by the county's Chief Officer of Health Services, Dr Patrick Nyaga.
Kiambu County doctors walked out on May 27, citing labour rights violations: chronic salary delays, lapses in medical coverage, stagnation in career progression, excessive working hours, irregular procedural transfers, and illegal halting of union dues remittance.
Doctors report receiving their pay on or after the 17th of the following month. In August 2024, salary payments were delayed by over 30 days.
The county has also been late remitting premiums to the Social Health Authority (SHA). Since the Social Health Insurance Act requires remittance by the 9th of each month, this leaves doctors without access to health services despite having insurance—a violation of the Employment Act.
Hundreds of eligible doctors have faced delays in promotions. Excessive working hours coupled with inadequate staffing have resulted in burnout, rising cases of addiction, and severe psychological strain.
Doctors are being subjected to transfers without following due process as outlined in the County HR Manual and Public Service Commission guidelines. When transfers exceed 40 kilometres, affected doctors do not receive the legally mandated transfer and baggage allowances.
Dr Nyaga refuted claims of a health crisis in Kiambu County, saying the county has hired other doctors and that approximately 90 striking doctors have returned to work.
He said the county had been progressively increasing medical staff even before the strike. "The process of hiring in the public sector is protracted and requires advertisements. These doctors had been jobless for several years as the national government wasn't employing them. They were at the tail end of on-boarding when the strike was called. Many of these specialists were not hired from outside but were trained by the county, which regularly sponsors between 40 and 60 doctors to become specialists. Thirty-nine are currently in medical school."
From left: Kiambu County Referral Hospital Medical Superintendent Penninah Makau, Kiambu County Chief Officer for Health Services Patrick Nyagah and County Executive Committee Health Services Elius Maina address during an interview at Kiambu County Referral Hospital on October 2, 2025.
Photo credit: Bonface Bogita | Nation Media Group
On salary delays, Dr Nyaga said striking doctors have not received salaries for June, July, August, and September because the county is not obligated to pay for services not rendered during a protected strike.
"I am not obligated to pay those on strike. The law stops me from paying anyone who is not working," he said. "The right to strike is protected by law, but that same law also protects the employer's rights. It says the employer is not obligated to pay for services not rendered during a protected strike."
The County Executive for Health, Dr Elias Maina, dismissed the KNH statement, saying Kiambu County hospitals are working and have been receiving referrals from other counties, with no unusual referrals to Kenyatta National Hospital.
"It surprises me," said Dr Maina. "If you look at the letter, it's easy to see its origin—it's unsolicited advice to other counties to engage with KMPDU while claiming there is a surge of patients from Kiambu. Our hospitals have not been making unusual referrals to KNH. However, there are private and faith-based hospitals in Kiambu that could be referring patients to KNH. But we have also been receiving referrals from those same hospitals because we have referral hospitals."
He added: "From the letter you can see the language and spirit is advancing the narrative that KMPDU has been pushing—trying to portray operations in our hospitals as non-functional. There is no health crisis in Kiambu. All our hospitals are working with fully qualified, registered and licensed doctors. The nurses are working, the clinical officers are working. Only a few disgruntled union members have stayed away from work, and immediately they did, we replaced them. We averted a crisis that is not there and exists only in the minds of the union.”
Nairobi health workers cite delayed salaries and withheld arrears, non-implementation of existing resolutions, unfair promotions, and non-implementation of 2024 incremental salary adjustments as ordered by the Salaries and Remuneration Commission (SRC).
Rights of healthcare workers
Nairobi County has also failed to pay gratuity for staff who worked for the defunct Nairobi Metropolitan Service (NMS), and has failed to replace employees who have resigned, died, or retired.
Stephen Muthama, Nairobi branch chairperson of clinical officers, said: "The cumulative effect of these issues has been high staff turnover, attrition and burnout, low morale and productivity among the remaining workforce, interruptions in critical health services across county facilities, and heightened risks of strikes and industrial actions that jeopardize access to care for Nairobi residents."
Kenya Medical Practitioners Pharmacists and Dentists Union’s Secretary General, Dr Davji Atellah (centre), and other union officials address the media at St Luke Hospital in Eldoret City, Uasin Gishu County on July 23, 2025.
Photo credit: Jared Nyataya | Nation Media Group
Meanwhile, KMPDU Secretary General Dr Davji Atellah has announced protests for Kiambu doctors on Monday, October 13, 2025, intended to demand accountability, respect for healthcare workers, and urgent action to restore functional, dignified healthcare systems in Kiambu and across the country.
"KMPDU remains unwavering in its commitment to defending the rights of healthcare workers and upholding the highest standards of service to the nation," said Dr Atellah.
