Public hospitals struggle to resume services as families blame government

Services in public hospitals were gradually returning to normal even as families who lost their loved ones because of the strike blamed the national government for the paralysis witnessed during the nurses' strike.

The 43-day strike disrupted hospitals in many counties, leading to deaths and suffering of patients who were caught off guard. Families that lost their kin blamed the government for its stand-off with nurses.

For instance, at Kisumu County Referral Hospital (KCRH), Maya Ong’are died after she was abandoned in the hospital ward by nurses. She had been admitted and was under the care of nurses before the strike.

When we visited the hospital on Friday, Maya lay alone in the female ward, connected to an oxygen machine as she struggled with a condition that had progressively weakened her.

Oxygen cylinders stood beside her bed while the small table next to her remained bare. There were no nurses or relatives around her. Two days later, Maya was dead. Maya was admitted to Kisumu County Referral Hospital on March 24 after experiencing severe breathing difficulties.

Her prolonged illness had left her weak and unable to perform many activities on her own. With limited family support, she increasingly relied on friends and hospital staff during her long stay.

Before the strike, Maya had been receiving routine care, including medication, tests, cleaning of her bed and meals, but the industrial action disrupted that routine.

She was left largely dependent on oxygen, with attendants checking on her at different times while essential nursing services remained disrupted.

Her condition was particularly concerning because she could not simply leave the hospital without the equipment and support required to maintain her oxygen needs.

She had hoped to return home if she could obtain an oxygen concentrator, but that option never materialised. Instead, she remained in the hospital until her death on Sunday.

Michael Dimba, Maya's relative, said the family was devastated by her death and blamed the prolonged nurses’ strike for the loss.  He said the government failed to act faster to avoid the deaths and suffering.

“We have lost Maya. It is so unfortunate to lose her life so fast like this. It is all because of the nurses’ strike. If nurses were there, this could not have happened, that is for sure,” Dimba said.

He said Maya had been unwell since her admission in March and that the prolonged hospital stay had taken a heavy toll on the family.

According to Dimba, the family had hoped to take Maya home, but the circumstances surrounding her care made that difficult.

“If nurses were in session, we could even go back with her, but it didn't happen. She was doing everything on her own because she was left desperate in the ward. She was the only one,” he said.

At Makadara Level Four Hospital in Nairobi, nurses have returned in shifts and work has picked up, according to a nurse at the facility.

" I can say the response is good but currently we're not that many because we work in shifts. But at least 80 per cent have responded," the nurse said.

In Machakos, however, only a small number had reported back by Thursday, with the majority still at home, according to nurse James Murimi of Machakos Level Five Hospital.

“Very few, a very slim number have resumed. Majority are still at home and very frustrated,” Murimi said.

Murimi said the frustration stems from what nurses see as a failure to secure the improvements they had demanded during the strike.

He said nurses had wanted the risk allowance raised to Sh20,000 from Sh3,850, but the agreement provides for Sh8,000. They had also sought to have the uniform allowance increased to Sh25,000 from Sh10,000, while the nursing service allowance was expected to rise to Sh30,000 from Sh20,000.

The lower figures agreed on have left some nurses questioning the decision to end the strike.

“It’s so frustrating because Mr Panyako and his team has signed a return-to-work formula that is very vague. It has nothing to really make nurses happy,” Murimi said.

He said nurses should also have been consulted before the strike was called off.

“Absolutely. The nurses should have been consulted before ending the strike,” he said.

Murimi questioned whether the 45 days given to negotiate the Collective Bargaining Agreement would resolve the grievances that pushed nurses into the strike in the first place.

“If you have not agreed on anything with 43 days because we have been on strike for almost 45 days, what is it that is there to really agree on in the next 45 days?” he questioned.

The situation is also different in Siaya, where nurses had not resumed work by Thursday despite the national strike being called off.

Nurse Hamisi Kennedy said their continued absence was linked to separate grievances with the Siaya County Government and not the national strike.

“We would have returned to work today because the union already called off the strike but we are still outside because of our own grievances with the county government of Siaya. The national strike has ended,” Kennedy said.

The differing situations point to an uneven return to work, with some facilities already seeing services pick up while others continue to experience resistance or separate labour disputes.

KNUNM Secretary General Seth Panyako directed nurses to resume duty within 24 hours after calling off the strike on Wednesday.

For nurses such as Murimi, however, ending the strike has not necessarily settled the grievances that led to the walkout.

“The nurses should have been consulted,” he said.

In Mombasa, Steven Wambua also said he lost a relative at Coast General Teaching and Referral Hospitals because of the nurses' strike.

Yesterday, Wambua called on nurses to resume the duty fully to avert more deaths. He said also nurses had the right to strike, the government had a constitutional duty to make sure patients do not suffer.

“Even after the strike was called off, nurses are few in the hospital. I lost a relative who was admitted here partly because there was no nurse to take care of him,” said Wambua.

Yesterday services at CGRH were still slow, as families and patients complained of lack of service or essentials such as drugs.

Some patients said they were forced to look for services in private hospitals, alleging that although nurses had resumed duty, not much was happening in the hospitals.

“Some wards are empty because there are no nurses to take care of patients admitted by doctors. Without nurses hospitals are paralysed," said Geoffry Kamande outside CGTRH.

Meanwhile, Mombasa Governor Abdulswamad Nassir issued appointment letters to over 286 new nurses in what was seen as a move to avoid future paralysis.

He said the recruitment was part of a systematic, planned and sustainable transformation of healthcare in Mombasa following the construction of new health facilities.

County officials, however, said the recruitment of the nurses on contract terms aims to avoid frequent industrial action that has affected service delivery in the county.

“The unionised nurses are unreliable because of frequent strikes. The contracted nurses will alleviate the suffering of patients when the unionised go on strike,” said the official.

In June, during another nurses' strike, Nassir directed the County Public Service Board to recruit 573 nurses on contract to ensure uninterrupted healthcare services.

Nassir vowed that he will not sit back and see patients suffering because of the frequent nurses' strike.

“What we cannot accept is any patient being turned away from hospital,” he said in June, adding that the recruitment of 573 nurses would help bridge staffing gaps created by the strike and ensure continuity of healthcare services.

Nassir said that although it was the nurses’ constitutional right to agitate, it was his constitutional responsibility to ensure hospitals continue serving the people.

The new recruits will be deployed at Mjambere Level 3 Hospital, Bofu Level 2 Hospital and the Likoni Mother and Child Hospital.

Mombasa is also constructing new Port Reitz Level 4 Hospital and the Raila Odinga Kongowea Level 4 Hospital, with plans to put up others in Mikindani, Kisauni and Jomvu Kuu.

At the Kisumu County Referral Hospital, Medical Superintendent Dr Tom Onyango said nurses had started reporting back to work, with patients also returning to seek services.

Dr Onyango said admissions had resumed and services at the casualty department were operating on a normal basis as the hospital gradually recovered from the disruption caused by the strike.

“Patients are coming in and nurses are reporting back to work. Admission is ongoing and casualty services are operating normally,” said Dr Onyango.

The strike had significantly affected operations at the busy referral facility, disrupting outpatient, maternity and inpatient services.

Before the industrial action, the hospital handled an average of 120 walk-in outpatient cases daily, while its specialised clinics attended to about 8,374 patients every month, translating to an average of about 280 patients daily.

The impact was particularly severe in maternity and inpatient services, which depend heavily on nursing staff. The maternity unit normally handles about 290 patients every month, while the hospital records approximately 600 inpatient admissions monthly.

With nurses returning to their work stations, hospital management expects services to progressively stabilise as patients who may have postponed seeking treatment begin returning to the facility.

A spot check at the Vihiga County Teaching and Referral Hospital also showed services gradually returning to normal, with nurses reporting back to work and patients accessing care.