When I got into medical school, many people would say to me that I had made it in life. To them, medicine was a big deal because it was somewhat a comprehensive solution to all one’s needs. I’d make a decent living, have respect from nearly all men and attract a quality variety of ladies. And though these were not my primary reasons for joining the profession, I’ll admit that their impressions of the profession were pretty impressive.
In June 2013, a collective bargaining agreement was struck between the government of Kenya and Kenyan doctors concerning among other things higher pay for the doctors; the government didn’t deliver. In December 2016, the doctors took to industrial action starting one of the longest strikes in the history of healthcare. The government made an offer which to me was really generous, but the doctors would take nothing less than they had originally demanded. I could feel the President’s frustration as he delivered a speech in response to the strike. Here is an excerpt
“You have to recognise that we are paying these people and we have offered these people more money than even doctors in the private sector receive. An intern today is being offered more money than a medical practitioner working at Nairobi Hospital, Aga Khan Hospital, Matter Hospital and for working two hours in a government hospital and they run to do private practice in their clinics. This is black mail and we are not going to entertain it.”
About this time last year just before the new interns could take their posts, the ministry of health decided that it did not have enough money to pay interns any more. Men and women working for nearly 16 hours a day seven days a week 48 weeks a year would not be compensated! When I considered what was happening, I thought that what the ministry was proposing was inhumane and tantamount to slavery.
I bring up these two cases because I want us to consider the doctors’ attitudes towards human life when they decide to take industrial action. Is it possible that the Kenyan doctors’ demands were not in keeping with their commitment to preserve human life? And this was at the heart of the president’s frustration. That
“Every doctor swears a solemn oath that they shall do no harm. Continuing with this illegal strike in the face of the enhanced government offer which is on the very edge of affordability and sustainability is to betray that solemn oath. It is continuing to do harm to the same Kenyans who sacrifice in terms of taxes paid, for the training medical doctors receive.”
And in the case of the Ugandan interns, were they so hard pressed that they were rendered incapable of preserving human life; that they were left with no choice but betray that solemn oath to do no harm?
I am writing this while in my room at my community placement centre which is part of my training at medical school. In this placement, students in the faculty of medicine are posted to different health centres in West and South-western Uganda for one or two months. During this placement, we are required to come up with a project to tackle a health need in the community while providing primary health care (PHC) services at the health centre.
Now the project takes up the smaller portion our time here. Most of the time is spent providing PHC services at the centre. However, I am challenged by a colleague who is everything I have never been as a medical student as far as attitude is concerned. He did a diploma in nursing, worked for a few years and is now pursuing a degree in nursing. Despite the low pay and heavy work load, he volunteers more and offers his best quality work. He works harder and longer than any one of us on the team. His primary concern is not the pay, respect or ladies but the welfare of the patients.
I had always thought that doctors were long suffering because they would scarcely take to industrial action. Their commitment to human life would not allow them such luxury. But healthcare is not that simple; that if you put in enough messiahs you will get desirable results. I always tell friends that no matter how good a surgeon you are, if the follow-up of your patients after surgery is poor, many operations will not in fact be successful.
I understand that there are conditions that can cause a health worker to knowingly compromise the life of a patient but if you are a health worker thinking to make such a decision… I mean I don’t know what advice to offer but that all of us, everyday and in every situation should evaluate our attitude towards human life and how we score it against the perks of being in health care.
Featured image: A prospective intern doctor is arrested by the police during last year’s demostrations