Muiruri, Esther Murugi (2017). '“We still remain a developing country”: Analysing the 2016/17 Doctors’ Strike in Kenya from a Capabilities Approach' Paper presented at the annual conference of the HDCA, Cape Town 2017.
On 5th December 2016, doctors in Kenya working in public healthcare institutions went on strike, demanding the implementation of a Collective Bargaining Agreement (CBA) that had been signed in 2013 between the Government and their union, the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU).
Throughout the 100-day strike subsequently called off by the KMPDU on 14th March 2017, following the signing of a Return To Work Formula, doctors articulated, through protest marches, court action, social media platforms as well as television interviews, the benefits of the CBA for all Kenyans. What had initially begun as a labour dispute became a nation-wide call for better equipment and drugs in hospitals, the training and retention of doctors in the public service and a fight for the dignity of all Kenyans.
The quote in the title of this paper is taken from a speech given by the President of Kenya, urging the doctors to remember that Kenya was still a developing country and that their demands for world-class healthcare could not be met immediately. In this paper, I argue that what the doctors in Kenya were ultimately fighting for was the realisation of capabilities, and the freedom of each individual to live a life of their own choosing – Both for themselves as doctors and for the Kenyan citizen. I will carry out an analysis of what I view as the capabilities and functionings the doctors were fighting for. By publicising the CBA, highlighting the clauses that directly impacted on the well-being of Kenyans and recounting their experiences in public hospitals, doctors succeeded in bringing to the fore the conversation regarding the dire state of public healthcare as well as the inequalities present, in comparison to private healthcare.
Through an examination of attitudes and responses to the strike from the Government of Kenya, I argue that the state has failed to appreciate its central responsibility for securing capabilities, and the Central Capabilities in particular. I will show that the problem in Kenya with regard to the provision of dignified healthcare is not a lack of resources, but rather, misuse of, and failure to account for, the available resources, as well as a failure to consider each person as an end in himself. Part of my analysis will also involve a comparison of the quality of healthcare available to politicians and government officials in Kenya, juxtaposed against the quality of healthcare in public healthcare institutions, as a way of bringing out issues of justice and fairness in the opportunities available to each.
Lastly, I will discuss some of the reactions of members of the public in Kenya to the doctors’ strike, the CBA and the role of the media, with a view to assessing our understanding of the extent of our moral and legal obligations in striving for social change and accountability, both as citizens of Kenya as well as citizens of the world.
Throughout my analysis, I will incorporate perspectives and relevant rulings of the courts in Kenya which were involved in giving guidance on resolving the strike.
Method: Normative analysis of the CBA, government statements and official speeches, court rulings, social media posts and other relevant materials.
Key Words: CBA, Dignity, Inequality, Responsibility, Justice