Why The Doctors' Strike Is A Missed Opportunity

It is now nearly three months since Kenya’s doctors went on strike. The dispute centers on the Comprehensive Bargaining Agreement the national government and the Kenya Medical Practitioners and Dentists Union signed in June 2013 and which the latter is insisting must be implemented.

The Executive has been at pains to disavow the very agreement it signed and the doctors have had to defend the legality of their strike. The quarrel has caused untold misery in hospitals and drawn in the other arms of government as well as the Central Organisation of Trade Unions and the Kenya National Human Rights Commission. However, for all the sound, fury and chest-thumping, the sick and dying in Kenyan hospitals have little explanation for their calamity. Both sides have privileged spin over substance and confusion over clarity.

The government first claimed the CBA would be too expensive to implement, then argued that the document was not a legitimate agreement anyway since it had not been registered, then that the doctors were not its employees but those of the county governments and it was only playing a “facilitation” role; and finally that the CBA was illegally signed by an illegitimate official on behalf of a Ministry that did not exist.

On its part, the KMPDU has ignored court rulings and orders regarding the legitimacy of the CBA and the legality of the strike it has called; and courted public sympathy by seeking to portray the CBA as the solution to Kenya’s health problems and themselves as warriors for the common good not just for improvements in doctors’ welfare.

These mental gymnastics merit some attention. It is not the first time the government is making offers to its workers to avert industrial action that it later claims are too expensive to implement. Far from it. In fact, it is a tactic the state has developed into something of an art. The same ruse was pulled on teachers in 1997 and again in 2015. The country’s university lecturers are today on strike claiming the government has reneged on a similar promise for a 300 per cent pay rise.

Further, it is strange, to say the least, that the government was unaware that the doctors were not its employees when it signed an agreement with them. The CBA many times refers to the Ministry of Health as the employer, not the county governments. Further, in interviews with this writer, doctors themselves have claimed that their contracts, despite the devolution of health, are still with the Public Service Commission, not with county governments, to whom they say they are seconded. That when, in January, President Uhuru Kenyatta tried his hand at brokering a deal, he left the county governments out of the talks is an indicator of the government’s attempted sleight of hand, as is the idea that it took nearly 4 years to realize the document it had signed and that has been the subject of a dispute in the courts, was fraudulent. In any case, the courts have already declared the signature on the document, if not the document itself, is valid.

Some of the claims advanced by the KMPDU are similarly disingenuous. That the legitimacy of the CBA is problematic cannot be gainsaid. The Labour Court last October ruled that it must be negotiated afresh. A judge has already declared“there is no CBA.” While one can sympathize with the doctors as victims of a government confidence trick, that still does not render it a legally enforceable document. 

If anything, by calling the strike, the KMPDU spurned an opportunity offered by the courts to apply to get the CBA registered in January if talks with government had failed to generate an agreement. In so doing, they put themselves in their current predicament, where their officials have a one-month jail sentence hanging over their heads. Further, even a cursory reading of the CBA will reveal that, contrary to the spin being put out by the union, it is primarily about enhancing the welfare of doctors, not that of their patients. In an interview with Citizen TV in December last year, Secretary General Ouma Oluga stated “categorically” that the strike was about doctors’ suffering, not that of patients.

It is of course obvious that improving the welfare and training of medics as demanded by the CBA will have beneficial effects for Kenyans in general, including in helping to stem the hemorrhage of skilled workers out of the public health system. However, the KMPDU has blown these benefits out of al proportion, with claims such as that implementation of the CBA would end shortages personnel in the hospitals. By Oluga's own numbers, the country has about 8,000 doctors and trains just 600 annually against a requirement of 83,000. That means, even if each and every doctor, including those currently in private hospitals, were employed in the public service, it would still take over a century just to cater for the needs of our current population. The CBA thus does not even begin to scratch the surface.

More than anything, the lies and distortions by both the doctors’ union and the government have denied Kenyans an opportunity to deal the failures in the health system. The problems therein stretch beyond the welfare of doctors and encompass the motives behind the decisions that policymakers in the government have taken. Only by moving beyond the empty spin and honestly addressing the real issues can Kenyans begin to craft a system that works for both our long-suffering doctors and their even more traumatized patients.

What Somalia Can Teach Kenya On Elections And Power Transitions

Incumbents losing an election and graciously conceding is not what most associate with the continent, let alone Somalia. By contrast, the Kenyan experience is rather typical. Here, no incumbent President has ever lost an election. Whether by hook but more often by crook, they manage to cling onto either the end of their terms or their lives, whichever came first.

But a graceful concession from a losing incumbent is exactly what the world witnessed in the Somali capital on Wednesday. The election of former Prime Minister Mohamed Abdullahi Farmajo as the country’s ninth President upheld a rather curious, perhaps unique tradition: Somalia has never re-elected an incumbent as President.

It’s a tradition that goes back to the founding days of the Somalia republic. In its first election following independence and unification in 1960, the popular Aden Abdullah Osman Daar was elected President. Seven years later, he would become the first African head of state to peacefully hand over power to a democratically elected successor -his former Prime Minister, Abdirashid Ali Shermarke.

Now this week’s election in Mogadishu was not, by any stretch of the imagination, one to be emulated. Due to the ongoing terrorist insurgency perpetrated by the Al Qaeda-allied al Shabaab, universal suffrage was out of the question. Instead 135 elders picked 14,000 delegates who elected 275 MPs and 54 Senators who elected the President. The process was marred by allegations of corruption, vote buying and intimidation, which is perhaps not surprising for a country that ranks at the very bottom of Transparency International’s Corruption Perception Index. The head of the country’s police publicly supporting the incumbent and security concerns led to both the shut down oftransportation across the Somali capital and the moving of the election to the airport, which is secured by troops from the African Union Mission in Somalia.

Much of this would be familiar to Kenyans as our own general election looms. Though not as dire as that of our neighbor, our system is not without it controversies. There are credible suspicions of attempts to steal it right from the voter registration stage, with public officials, especially chiefs, illegally co-opted into an effort to help boost registration numbers in areas perceived as supporting the incumbent Uhuru Kenyatta’s Jubilee party. Further, our global corruption ranking is not that much higher (relatively speaking) than Somalia’s and the expected deployment of thousands of police and security agents to safeguard the election speaks not just to the legitimate security concerns in the wake of our invasion of Somalia, but also to the government’s fear of its own people.

President Kenyatta has recently said he is willing to peacefully hand over power if he loses and to his credit, he has already delivered a historical first: in 2002, he became the only losing Presidential candidate from a major party in Kenya’s electoral history to deliver a concession speech. Whether he will remain true to his word remains to be seen, but, as Somalia illustrates, the fact of a chaotic and problematic electoral process need not preclude it.

Somalia also provides an object lesson in the dangers of the ethnic mobilization and military takeover of civilian affairs. Despite being one of only two largely ethnically homogenous sub-Saharan African states, fragmentation along clan affiliation is one of the main reasons the civil war has persisted for so long. Kenya itself had a taste of it in the violence that followed the disputed elections of a decade ago.

Another factor in Somalia’s disintegration was the military takeover that followed the assassination of President Sharmake in 1969. The Siad Barre dictatorship that followed set the country on the path to destruction. Kenyans should therefore be wary of occurrences that diminish civilian control over the military of give it a taste for civilian responsibilities. Thus the decision by President Kenyatta to appoint Gen Chief of Defense Forces Samson Mwathethe to chair a committee overseeing the implementation of government projects should be of concern as should the seeming inability of civilian authorities to hold the military to account following the debacles at Westgate, El Adde and most recently, Kulbiyow.

Somalis are a fiercely independent-minded lot, not as reticent in expressing their opinions as Kenyans are generally perceived to be. “Every man is his own Sultan” is how one 19th century visitor described them. Richard Dowden, Director of the Royal African Society, in 2011 recounted an incident in which a waiter publicly berates a government minister in a restaurant in Hargeisa, capital of the northern breakaway -and far more peaceful- Somaliland republic. Such a scene would be unlikely to be repeated here (except perhaps on our famously noisy online platforms). But maybe we could learn from that waiter the value of confronting, rather than accommodating, our lying and thieving politicians.

Death, Lies and Videotape - Why KDF Must Tell TheTruth About Casualties In Somalia

In the wake of last week’s sacking of a Kenya Defense Forces base in Somalia by the al Shabaab terror group, the Kenyan government’s communications effort have once again come under a spotlight.

The country had just marked the first anniversary of a similar attack on another KDF camp in the Somali town of El Adde in which close to two hundred Kenyan soldiers were estimated to have been killed. Estimated because the government has never released an official tally of dead, injured and captured. Instead, after initially issuing a few statements offering a chronology of events and promising to answer queries later, it has subsequently maintained a studious silence.

This time, after news of the Kulbiyow attack broke on Friday, the KDF initially put out a statement stating categorically that the attack had been repulsed and that the camp had not been overrun. A second statement later in the day asserted that nine soldiers, including two officers, had lost their lives and another 15 had been injured. It also claimed that at least 70 al Shabaab militants had been killed.

The full Press Release on #KDFKulbiyow incident @amisomsomalia .#Kulbiyow #NgaoYaTaifa #TukoImaraAngani #OnTimeOnTarget #ThisIsKDF #WeAreKDF pic.twitter.com/Y2OOOCo9D4

— Kenya Defence Forces (@kdfinfo) January 27, 2017

Follow up Operational Update Press Release on #KDFKulbiyow. Our Quick Reaction Force soldiers killed over 70 Al Shabaab terrorists.#WeAreKDF pic.twitter.com/nM69Pckpdp

— Kenya Defence Forces (@kdfinfo) January 27, 2017

However, subsequent news reports, some of which claimed to have interviewed survivors of the attack, have raised serious doubts about the veracity of the KDF account. The al Shabaab, who run a pretty sophisticated propaganda machine, initially claimed to have killed over 50 soldiers and subsequently revised that figure upwards. Earlier this week, the group released gruesome pictures purportedly taken after the attack to back up their claims. The Standard newspaper, citing sources within the KDF, also reported that at least 68 Kenyan troops had died. A more detailed account in the Daily Nation also painted a grim picture of the camp being overrun and “pandemonium” as soldiers fled into the bush.

Following these revelations, the KDF and government communications appear to have retreated into silence. No further statements have been issued and, unlike El Adde, there has been no public comment from either their Commander-in-Chief, President Uhuru Kenyatta, or the Chief of Defence Forces, General Samson Mwathethe.

In both attacks, government communications have sought to minimize the scale of defeat specifically by either distorting or keeping mum about casualty figures, details of the incidents and the outcome of any investigations.

But does that matter? Not if you ask the pro-government online army on Twitter. Any attempt to seek clarification is met with accusations of propagandizing for the al Shabaab and having a morbid interest in death counts, as well as patently false claims that militaries across the world never reveal the true extent of their battlefield losses. It is not important to know how many died, so the argument goes, since even one is too many. Telling the truth about casualties, it is claimed, is demoralizing to our soldiers and gifts the terrorists a propaganda coup.

Yet the trouble that the government and the KDF go to to hide them itself demonstrates that the numbers do matter. The fact is, they are not being hidden from al Shabaab but from Kenyans and it is the official silences and mendacity, not the truth, that allow the terrorists’ propaganda to rule the airwaves unchallenged. 

Similarly, the tendency to spin rather than provide accurate information means that KDF accounts of incidents lack credibility. For example, in the aftermath of the El Adde attack, Gen Mwathethe briefed the press on the battle and response. Many of the details he gave, including claims of three suicide trucks, each with the explosive force of the 1998 US Embassy truck bomb as well as "truckloads of suicide bombers", have proven to be either gross exaggerations or outright falsehoods. The same pattern can be seen in the statements issued on Kulbiyow.

Further, as an article by Nyambega Gisesa to be published this weekend in the Daily Nation states, "since Kenya first went to Somalia in October 2011, no single commander has ever been suspended or fired". At the end of his press briefing on El Adde, Gen Mwathethe promised to provide further details once a Board of Inquiry had completed its work. Nothing has been heard from him since.

Into the void created by the KDF's unwillingness to give forthright and credible information steps the al Shabaab propaganda machine, inundating the media and internet with impeccably timed press releases, interviews, caches of (often graphic) photos and slickly produced video footage of incidents. For a while now, it has been clear that Kenya's official communications on its actions in Somalia have been no match for al Shabaab's. And there is a very good reason for this. KDF and government communicators have been preoccupied with the wrong "enemy"- the Kenyan people.

The overriding objective of government communications ever since the debacle at Westgate has been to keep Kenyans from asking uncomfortable questions. Rather than protecting soldiers’ morale or debunking al Shabaab falsehoods as is sometimes claimed, government propaganda has been focused on protecting senior officials' and officers' backsides. Revealing the real extent of deaths risks rousing public anger, stoking uncomfortable questions and demands for people to held to account. 

Yet, questions should and must be asked. Why did the KDF succumb to an attack that was a carbon copy of the El Adde incident, where it had suffered its biggest ever military loss? Why were lessons seemingly not learnt? What are the systemic failures that led to this and who should be held to account? As the Standard editorialized, “losing more than 250 soldiers in 54 weeks in two identical attacks speaks not to the consequence of going to war but the utter incompetence of the high command.”

The numbers matter. They may not tell the whole story, but they do tell an important part of it. The truth matters. The constitution subordinates the KDF to civilian authority and, in the end, its commanders and civilian overlords are ultimately answerable to the Kenyan people. There is an implicit bargain we have with the troops. They will follow orders and risk their lives to defend us and accomplish the mission they are given but we will hold their bosses to account to ensure that those orders and missions are reasonable and that they are properly equipped and facilitated to achieve them. That requires us to have an accurate understanding of the realities they face and the consequences these have. The silence over the needless waste of lives violates that bargain.