By Caroline Katan
Healthcare services have ground to a halt in major public hospitals across Kwale County following the commencement of an indefinite strike by doctors under the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU).
The industrial action, which officially began on Monday, follows the lapse of a 21-day strike notice issued to the County Government of Kwale.
According to KMPDU officials, the county failed to implement agreements previously reached with the union, despite repeated negotiations and commitments dating as far back as 2020.
“We are at breaking point,” said Dr. Niko Gichana, Chairperson of KMPDU’s Coast region. “Doctors are facing severe challenges that compromise both their professional duties and personal well-being—from delayed salaries, lack of promotions, and poor pay, to the absence of essential benefits like study leave and health insurance.”
As of June 30, salaries for the month of June remained unpaid. Doctors also decried the persistent underfunding of health facilities.
Msambweni County Referral Hospital, the region’s main referral center, has only 15 doctors, despite requiring at least 53 to meet patient demand. In Kwale Hospital, only four qualified doctors are currently serving the entire facility.
“Access to essential medicines and surgical services is severely compromised,” added Dr. Gichana.
“Msambweni Hospital has only one operational theatre, and key departments are overwhelmed. The shortage of personnel is pushing doctors to work for years without leave, leading to fatigue and burnout.”
KMPDU chairperson Coast region, Dr.Niko GichanaÂ
The union accuses the county of reneging on multiple agreements, including a memorandum signed earlier this year, promising to address their demands.
“We asked for a written confirmation of the resolutions we reached. None was forthcoming. Instead, we’ve been met with silence and empty promises,” said Dr. Gichana.
Impact on Doctors and Patients
Dr. Hassan Ahmed Mkuche, a general surgeon at Kinango hospital, described the working conditions as “demoralizing,” especially for specialists. Despite undergoing over a decade of medical training, he says, they are still being paid at entry-level rates.
“Since 2020, we’ve been negotiating. But in the past year, things have worsened—delays in salaries have become the norm, and there’s no progress on salary reviews or allowances,” said Dr. Hassan.
He added that the economic strain has led to family conflicts, mental health issues, and debt burdens among doctors.
“Some of us are unable to pay rent or school fees. When a doctor falls ill, colleagues have to fundraise for treatment. It’s unsustainable,” he noted.
Many doctors, he revealed, are battling stress and depression after working multiple consecutive years without rest. “I’ve gone three years without leave. When you’re the only specialist, you’re on call day and night. Fatigue is affecting patient care.”
Dr. Hassan Ahmed Mkuche
County Government Response
Kwale County Executive Committee Member for Health, Mr. Francis Gwama, confirmed the strike but downplayed its impact, stating that the county has deployed clinical officers to support service delivery.
“There is no cause for panic. Services are ongoing, and emergency cases are being handled in all major health facilities,” said Mr. Gwama.
“We urge residents to continue seeking services, and anyone experiencing difficulties can report directly to me via 0722 537 263.”
He assured the public that negotiations with the union are still in progress and that a resolution would be reached eventually.
CECM health Kwale county, Francis GwamaÂ
However, union officials have warned that without immediate and tangible action from the county government, the strike will continue indefinitely.
“We are no longer accepting verbal promises,” emphasized Dr. Gichana. “What we need now is action.”
Long-Standing Disputes
The doctors’ grievances stretch back to the tenure of former Governor Salim Mvurya (2013–2022), during which multiple pledges were made but never implemented.
Under Governor Fatuma Achani’s current administration, efforts to resolve the issues in early 2024 also collapsed, culminating in the latest 21-day ultimatum.
With the 2024/2025 financial year closing, doctors argue that postponing commitments under the guise of budgetary constraints is no longer acceptable.
“This is a crisis that, if left unresolved, could cost lives,” warned Dr. Gichana. “We urge Kwale residents to engage their elected representatives—Members of Parliament, MCAs—to compel the county government to act. Health is a right, not a privilege.”
