Neglected health guardians: A call to prioritise doctors' welfare

Vihiga county medical practitioners protest outside their Governors offices at Mbale where they are demanding the county government to address their demands on May 16, 2024.  [Benjamin Sakwa/ Standard]

In Kenya, doctors, the guardians of our health, stand on the frontlines of life and death, yet their welfare remains severely overlooked.

While parliamentarians enjoy first-class privileges, the military benefits from robust support systems, and airline pilots extend exclusive perks to their families, doctors—whose expertise safeguards lives—are left to struggle in silence against neglect, poor working conditions, and a lack of institutional support.

Doctors face challenges unimaginable in other professions, from inadequate accommodation and food to navigating emergencies at odd hours with minimal support.

Tragically, these conditions have led to devastating consequences. This year alone, Kenya’s medical fraternity has mourned the loss of doctors to suicide, fatal road accidents, and health complications exacerbated by gruelling work conditions.

The reported death of a diabetic doctor, likely due to hunger-related complications, serves as a chilling indictment of systemic failures within the healthcare system.

Behind the resilience of Kenya’s doctors lies the stark reality of overwork, underpayment, and neglect. The 2017 Collective Bargaining Agreement (CBA) promised fair remuneration and humane working conditions for healthcare workers, but its implementation remains inconsistent.

Doctor interns, expected to learn and provide care under these harsh conditions, are surviving on meager stipends, violating labor agreements.

Financial instability

This financial instability is compounded by long hours that exceed the Kenya Medical Practitioners and Dentists Council (KMPDC) recommendations, leaving many interns emotionally and physically drained.

Basic workplace amenities are often unavailable, with doctors frequently going hungry during long shifts. Stepping away from patients, especially in emergencies, is seen as an impossible luxury.

The impact of neglecting doctors’ welfare extends beyond the medical fraternity—it directly affects patient care. A doctor operating under duress, hunger, or exhaustion cannot provide safe or effective care.

This raises uncomfortable yet critical questions: Has your doctor eaten before diagnosing or treating you? Has your doctor rested before performing life-saving surgery? Is your doctor supported and safe at their workplace to ensure the highest quality of care? These questions underline the urgent need for reform. A well-supported healthcare workforce is crucial for a functional health system.

The struggles faced by young doctors and interns are particularly alarming. Hostile work environments, bullying, harassment, and excessive workloads are systemic issues that need urgent attention.

Interns often work long hours without proper breaks, mirroring the conditions that led to the European Working Time Directive (EWTD) in the EU. Kenya must adopt similar safeguards to protect its young medical workforce.

Delayed payments worsen the financial strain on interns, many of whom graduate with significant debt from self-sponsored education. One postgraduate doctor described juggling hospital shifts and night locums to make ends meet, while another recounted falling asleep during a caesarean section due to exhaustion. These stories underscore the need to address systemic failures that perpetuate burnout and compromise patient safety. To address these issues, stakeholders must take immediate action:

Moving forward

Enforce the 2017 CBA: Ensure fair compensation and humane working conditions for all healthcare workers, with timely placement and payment of interns.

Regulate work hours: Kenya should adopt international standards like the EWTD to establish reasonable work hours and mandatory rest periods for doctors, protecting both doctors and patient safety.

Foster safe working environments: Hospitals must prioritize creating non-toxic environments where doctors feel valued and supported.

Strengthen mentorship programs: Structured mentorship is vital for the professional and mental well-being of young doctors.

Normalize mental health suppor: Accessible mental health resources must be integrated into workplace policies to end the stigma surrounding mental health in the medical profession.

Enhance oversight: Regulatory bodies like the KMPDC must enforce clear guidelines on working conditions and hold institutions accountable.

Silence on the welfare of doctors is no longer an option. The Kenya Medical Association (KMA) has called for reforms to safeguard doctors’ welfare, including addressing toxic workloads, enforcing work-hour regulations, and ensuring fair compensation. The Ministry of Health, KMPDC, county governments, and training institutions must collaborate to protect and support medical professionals.

Let us not wait for more tragedies to act. By prioritizing their welfare, we ensure the future of healthcare in Kenya.

Dr Marion is Secretary General, Kenya Medical Association