By Human Rights Watch
Published October 23, 2021
Despite significant resources being dedicated to the COVID-19 response in Kenya, the government failed to provide health workers with adequate protective equipment, testing, or other safety measures.
Besides exposing health workers to avoidable risks of trauma, infection, and death, the Government of Kenya’s haphazard, uncoordinated response has hindered the country’s ability to provide timely and quality health care during the pandemic.
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An investigation ordered by President Uhuru Kenyatta in August 2020 found that Kenya had lost Sh7.8 billion (US$70.4 million) meant for COVID-19 response through corrupt tendering, but over one year later, no meaningful changes have resulted from the investigation.
“Kenya’s negligence regarding the safety and needs of health workers in the middle of a pandemic is unacceptable,” says Otsieno Namwaya, East Africa director at Human Rights Watch. “Kenyan authorities should take urgent steps to ensure health workers on the front lines of the fight against COVID-19 are able to work in an environment that would not put them at unnecessarily heightened risk.”
Kenya has 58 000 registered nurses, 12 000 registered doctors and 14 000 clinical officers. Around 18 000 nurses are under government employment and thus went on strike during the Covid-19 crisis period, while 7 200 doctors are working in government facilities nationwide.
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Health workers interviewed by Human Rights Watch said that at first, they did not have any personal protective equipment (PPE) – masks, gloves, or overalls/gowns. When they finally received equipment, there was either not enough or it was of poor quality. They said they did not receive training before being assigned to wards treating COVID-19 patients, greatly undermining their ability to respond in the early days of the pandemic. Fearing for their lives, some health workers said that they would sometimes panic and run away when they encountered people in the hospital with COVID-19-related symptoms.
The lack of support led health workers nationwide to go on strike, with the nurses in at least five of the 47 counties starting the strike in June 2020 followed by doctors and clinical officers in August 2020. The strike spread across Kenya quickly as health workers accused government of failing to address their grievances.
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Research indicates that Kenyan authorities did not deliver on its promise to provide risk allowances; ensure that health workers hospitalized with COVID-19 had access to quality and affordable care; and that funeral expenses for the health workers who die from the disease would be covered.
The doctors and nurses interviewed expressed disappointment that the authorities did not recruit enough staff, despite an available pool of trained but unemployed health workers to manage the expanded testing facilities. They said authorities failed to buy enough kits and reagents to ensure regular testing of everyone, including patients, staff at hospitals, and other members of the public.
One doctor said that the limited availability of PPE made it difficult to observe basic safety protocols, such as regular replacement of PPE or having enough for all times on duty.
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All health workers interviewed said they felt overworked, stressed, and unsupported by the authorities, particularly because the authorities only recruited fewer than 1 000 nurses nationwide on one-year contracts, and underpaid them, and no new doctors to respond to the COVID-19 crisis.
“We were being paid Sh10 000 [$100] per month, which we did not get for six months,” said one such newly contracted nurse. “The authorities gave us no risk allowances, no insurance, no health cover, no PPEs, and then we were placed at the emergency area where we were the most exposed.”
An entry-level nurse at government hospitals earns about Sh51 600 (US$516) per month and other allowances that could amount to almost the same amount. Three union officials said that several health workers attempted suicide due to the stressful work environment.
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The Kenyan government should take urgent steps to ensure that those implicated in corrupt enrichment from COVID-19 funds are held accountable, Human Rights Watch said. The authorities should also identify and address the systemic weaknesses that have facilitated corruption in the health sector and undermined the delivery of health services during the pandemic and beyond.
“The government of Kenya owes health professionals and its global partners corrective actions regarding its poor treatment of health workers,” Namwaya says. “The pandemic is still here, and the grave concerns of doctors and nurses should not be ignored.”