Kenya's public health service has been paralysed for almost a month, that is, ever since the doctors of state hospitals decided to go on strike to demand in the only 'breaking' and vocal manner that the government honour its promises and renegotiate their employment contracts.
The promises, according to the Kmpdu union, which brings together practically all the country's public doctors and has about 7,000 members, concern about a thousand trainees who, after a year of unpaid internship, had been promised employment and grading, with the corresponding salary.
In addition, the unions want to sit down with the government to rediscuss the terms of their contracts.
Normal disputes between workers and employers, one might think, except that in Kenya it often happens that a strike is immediately declared illegal, even though by constitution it is a right, as in many other countries of the world, that the demands of the categories start from the stars and then bargain, and that the representatives of the institutions reply candidly, in this case President William Ruto himself, 'sorry, but we have no money'. According to media reports, the Ministry of Health last month asked for about 5 billion Kenyan shillings, (32 million euro) to start hiring former practitioners, to no avail.

This strike, for the umpteenth time, sheds light on the problem of forced unemployment of so many graduates and qualified staff who have often made sacrifices, with their families, to attend schools in the country and to whom it would seem natural to find work, given the endemic shortage of staff in public facilities. But the shortage of employees is compounded by that of the state budget, which often chooses to invest in other 'strategic' sectors, or is forced to do so. The saying 'the important thing is health' does not seem to apply here.
So the strike has been going on since 13 March, and those who lose out, of course, is the population, and in particular the poorer sections of the population, those who cannot afford to access private healthcare, as is now the case with the middle class and the rich, including foreigners.
Public hospitals, except in rare cases, do not guarantee adequate services, they often have obsolete or non-functional equipment, biblical waiting times, and if lives are saved, they almost always do so thanks to the preparation, willingness and disposition of the staff working there.
In Kenya, however, it also happens that those that are affiliated, i.e. Islamic, Christian or Hindu-inspired hospitals and private facilities dedicated to the needy, are forced to pay under the table for doctors who are members of unions in order to have them on staff. For many of them, therefore, the strike has a double meaning: on the one hand they protest, hoping to gain benefits, on the other hand they do not risk being without pay.

Also because when it is the state that pays, dismissals are already triggered, despite the fact that it is not clear whether the cause is 'just' or not.
In short, a great deal of chaos culminated in a large peaceful demonstration last Tuesday in Nairobi, while in the country's main hospitals, from the queues of the first days of patients, even those who are not serious, we have moved on to the despair and desperation of those who are trying in vain to be treated and of those who have lost a loved one because of the inefficiency. The queues, on the other hand, have for the past week been registered on the border with Tanzania, particularly in the Kilimanjaro region, where thousands of sick people are asking to be treated in the neighbouring country. In Arusha, the city closest to the border where there are hospitals worthy of the name, many clinics are gearing up to receive more patients than normal and charge 'popular' prices to entice their neighbours, while other dispensaries are doing their utmost to provide specialist visits.
Another fact that brings us closer to the African reality, is the return of many rural inhabitants of Kenya, who make up two-thirds of the population, to the practices of yesteryear, linked to traditional medicine, healers and herbalists, if not witchcraft.
Unfortunately, to date, there are no glimmers of hope for this unprecedented situation, due to the length of the union unrest and the firmness of both factions: the union rejected an initial government proposal on raising minimum wages, which was deemed inadequate. On the other side, the government declared that the doctors' demands were exaggerated.