Medics: Afya House betrayed us in 500 Dar doctors plan

Christine Wambui, 32, is a licensed Kenyan doctor who graduated in 2014, but is yet to land a job. She is not alone though.

The number of jobless doctors is expected to reach 1,425 by May when the current lot of interns completes the programme, according to the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU).

Last week, the government said it plans to hire 500 Tanzanian doctors in a deal signed with Dar es Salaam to plug staff shortage.

While the spirit behind the move has been lauded, the deal has attracted condemnation from critics who see it as a betrayal to the unemployed medics waiting for a job opening.

Concerned about the portrayal of betrayal in the media, State House, last week came out in defence of the agreement, refuting claims that the over 1,000 doctors the KMPDU cites are readily available for work.

“It is not true that we have imported doctors from Tanzania yet we have our own who are unemployed,” said Health secretary Cleopa Mailu.

“Our doctors get absorbed into public hospitals immediately after clearing medical school. Those who are still ‘tarmacking’, (jobless) are doing so because of their own will, they could have left the public sector to venture into the private sector and things didn’t work for them….”

Dr Mailu spoke last week when he visited the country’s largest referral facility, Kenyatta National Hospital (KNH).

After a mandatory one-year internship, doctors are usually posted to the counties by the Intergovernmental Technical Relations Committee. Dr Wambui interned at the Vihiga County Referral Hospital in Mbale.

Despite the different takes on the pulse of Kenya’s doctor joblessness, both the State and the union are on the same page that there is need to urgently boost staff levels.

On stand-by

During Dr Mailu’s visit at KNH, it was established that the busiest department, the Emergency Unit (Casualty), had only three doctors for the day against the required six working in shifts.

To avoid doctor burnouts, KNH Casualty ought to have at least 35 doctors on standby at any time, according to the hospital’s chief executive, Lily Koros. But as of last week, there were only 14 doctors assigned to the department.

According to the Health ministry’s revised Code of Regulations (2006) on employment of foreigners, the government should not employ non-citizens even on temporary posts if there are skilled citizens.

“In applying for permission to employ a non-citizen, an authorised officer should confirm that there is no citizen with the required qualifications available for appointment,” reads the Code in part.

The KMPDU sees the move by government to get doctors from other countries as a violation of the Code, but said it was okay for doctors from the neighbouring country to agree to work in Kenya at a time when there is there was a huge shortage.

By Tuesday this week, 160 Tanzanian doctors had registered, expressing their willingness to work in local hospitals, according to Tanzania Health minister Ummy Mwalimu.

KMPDU secretary-general Ouma Oluga said that the union had no concerns with the calibre, qualifications or training of Tanzanian doctors.

He, however, said the move was unusual since Tanzania trails Kenya in the doctor: patient ratio and the Kiswahili-speaking nation would further be drained of 500 more doctors.

There are currently 20 doctors for every 100,000 Kenyans compared to Tanzania, which is at 3:100,000, but with a lower absorption rate as compared to its counterpart. Both countries are below the World Health Organisation recommendation of 1:1,000 by 2015.

Kenya has a total of 11,142 active doctors including foreigners on temporary licences. This total includes; medical doctors, dentists and specialists.

Budget constraints

“We wish to inform you that in the last two years Kenyan doctors have struggled to be employed by the government forcing a number to be rejected for what the Health ministry terms as budget constraints,” said Dr Oluga in a letter to Dr Obadia Nyongole – president, Medical Association Tanzania.

Dr Wambui is now worried that her chances of being employed by the government are getting slimmer as a plan to employ more foreign specialist doctors from Cuba gathers steam.

“What’s happening with this government?” she asked. “They (government) are creating unemployment for qualified doctors… what worries me is that my chances of working in this country are reduced by foreign doctors.”

“How many years have I lost just waiting or is it that government wants to hit back at doctors for downing tools?” She asks.

The total cost of educating a single medical doctor from primary school to university (public) in Kenya is at least $65,997 (Sh7 million), according to data from BioMed Central, a UK-based scientific publisher.

In Dr Wambui’s case, having studied in Russia, where training is much better, she stands a good chance of securing a job in a foreign country, but for her passion to offer services to her own people first, she stays put waiting for an opening.

For every doctor who emigrates, a country loses about $517,931 (Sh6 million) worth of returns from investment.

In barely three years, Kenya has lost about 2,500 doctors mainly to the United Kingdom and Australia.