#LipaKamaTender: How Kenya’s striking medical workers took control of
the narrative
Posted on December 23, 2016 by George Gathigi
In most labour disputes, the government uses state machinery and the
media to dominate the narrative. But through social media, medical
workers have found a way around this.
Credit: Rick Scavetta, US Army Africa Public Affairs.
Kenya’s medical workers have downed tools to demand a 2013 agreement
is implemented. Credit: Rick Scavetta, US Army Africa Public Affairs.
The ongoing health workers strike in Kenya has taken a new dimension
with medics taking to social networking sites to air their grievances.
In the process they have forged a discussion in the new information
spaces and rallied support for their actions.
Kenya’s medical workers have downed tools to demand the implementation
of a collective bargaining agreement signed in 2013. The unions accuse
the government of breaching the agreement by passing over the
healthcare workers’ payroll onto county governments without
establishing the relevant legal framework for the devolution of
health.
Additionally, healthcare funding across Kenya has been cut from a
recommended 15% of the government’s budget to 2.7%.
Health workers have taken to social media as a way to apply pressure
on the government and to expose the plight of medical professionals as
well as the overall status of health care in Kenya.
The health workers are tapping into a trend that has developed in
leaps and bounds in Kenya over the past decade. This has seen citizens
use social media to express their anger and speak truth to power.
The health workers strike shows how new information spaces can be used
as sites to negotiate, challenge and resist power. It raises the
question of whether social media can serve as a functioning public
sphere within an environment where mainstream media is constrained by,
among others, partisan interests and the bottom line.
How it came about
In the days before the strike, medical workers used the hashtag
#LipaKamaTender (pay it like tender). The phrase has became popular on
social media, and in particular Twitter, as a way to criticise the
current Jubilee administration led by President Uhuru Kenyatta.
Dear Kenyan,
In this Christmas season, don't get sick, we are not paying doctors.
Signed
Ministry of Health #LipaKamaTender
— Sam Gichuru (@SamGichuru) December 22, 2016
We have the capacity and means to sustain a strike for a full
year. We ain't poor, just poorly paid. #DoctorsStrike #LipaKamaTender
— Abi Mwachi M.D (@abimwachi) December 22, 2016
Arresting Doctors Union leaders simply means ALL Doctors have to
visit them in jail..not doing wardrounds! #LipaKamaTender
#DoctorsOnTrial
— Nyashira (@nyashira) December 19, 2016
Kenyatta’s four years in office have been laden with scandals. One of
the latest involves the Ministry of Health. The allegation is that Ksh
5 billion ($50 million) has been “lost”.
There are also allegations that people linked to the president’s
family won tenders to supply mobile clinics and facilities at grossly
overpriced rates. The mobile clinics have been stuck in Kenya’s main
port, Mombasa, for more than a year.
In most labour disputes, the government is able to take the upper hand
by using state machinery as well as the media to influence the
dominant narrative.
But through various engagements on social media, medical workers have
magnified their individual and collective voices to speak about their
own experiences. They have revealed details about their individual and
institutional realities, challenged various ideas and assumptions held
by the public about the medical profession, and tackled questions such
as ethics and industrial action.
By popularising and using the symbolism Kenyans have adopted against
corruption, health workers have located their industrial action within
a broader national debate. Doctors are making it clear that their
demands are not misplaced. If the nation can afford to overpay tenders
and fail to seal loopholes that cause corruption, why can’t it afford
to pay doctors?
Telling their stories
Health workers have revealed their living conditions and the
difficulties they sometimes have saving lives due to the lack of
facilities.
Some have argued that the authorities expose them to dangers about
which members of the public are largely oblivious. Among the issues
they are highlighting are decent pay and benefits as well as shortages
of medical equipment and supplies.
In one Twitter thread, a young doctor told his story about working in
northern Kenya on the Somalia and Ethiopia borders. As the only
qualified doctor in the area he had to single-handedly manage a huge
disadvantaged population. His salary was low and his allowances were
slashed on the grounds that his cost of living would also be low. In
addition, the Ministry of Health refused to transfer him after he was
involved in a road accident and disabled.
Another doctor took audiences back to 2013 when a baby died in her
arms because there was no blood for a transfusion and the equipment to
do blood cross-matching with the parents was out of order:
“After the morning round with my senior consultants in the hospital,
we find an anaemic, gasping, pale as paper and fragile baby. We
proceed to nebulise the baby and put him on oxygen, which is shared
with many patients.”
She could not get blood for the baby and the parents could not afford
to buy blood: “That baby should not have died. No baby should have to
die for lack of equipment. No baby should die for lack of access to
blood transfusion.”
Counter-narratives
One criticism of the health workers strike has been that doctors are
bound to a set of responsibilities under the Hippocratic Oath, and
that their work is a “calling”. Health workers have countered this by
arguing that they have responsibilities, but that they also have
rights.
As Elizabeth Wala, the CEO of the Kenya Medical Association, a
voluntary membership organisation open to all medical and dental
practitioners registered in Kenya, argued:
“[Since] the social contract between doctor and patient is not
considered void under any circumstances, strikes by doctors seem to
raise ethical concerns about their professional conduct. Here it is
vital to consider that doctors in their entirety are human beings
having similar emotions, feelings and more importantly the needs as
those of a common man.”
The cost of living is not different to a doctor as to another citizen.
Bounding them with a social contract does not eliminate these basic
human characteristics.
Others have pointed to options that exist elsewhere. As Ashira
Zephania, an obstetrician/gynaecologist in his third year of practice,
wrote: “The Kenyan doctor can easily make around Ksh 2 million month
salary (an equivalent of US$20,000 compared to as low as US$400 that
some make) if he quits and goes abroad. But he is fighting to stay and
make the system work.”
The health workers strike discourse is more than an industrial
dispute. In debating the status of health in Kenya through social
media, the platform is allowing circulation of information and ideas.
Different positions are put forward, discussed and challenged. Social
media has become a functioning public sphere.
The use of social media has helped to advance the cause of striking
health workers. Through these communication channels they have managed
to mobilise allies to their cause while internally galvanising the
health workforce.
George Gathigi, Researcher, University of Nairobi
This article was originally published on The Conversation. Read the
original article.The Conversation
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