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Sandra Wekesa @wekesa_sandra

Intensely busy, best describes Melissa Atieno’s schedule on any typical day.  With patient’s constantly streaming in, as others leave the facility, while her colleagues move around with some sense of urgency, basically conjures how much essential she is to the society.

 Looking at how busy nurses are, especially in the public sector, one gets the sense that they are in business as usual.

But that’s far from it, behind the façade of normalcy, nurses reel under the weight of shortage of personnel, long working hours, long queues and even struggling to make time for family.

“On a normal day, I attend to more than 15 patients. The fact that I work in a referral hospital makes matters worse, because at times the facility can be full, especially on maternity clinical days,” she says.

Due to her schedule, she gets less off days to spend with her children, aged six and nine.

For her, this career is a dream come true, although it has challenging. But far from that she just wishes for a day the county government will prioritise their pay and make sure she receives it on time.

Huge deficit

Having been a nurse for more than nine years, Atieno says one of her biggest problem is career stagnancy. There is just no opportunity of growth in this industry.

It’s not any different for Edgar Munene, a nurse in the private sector who has been in the same position for close to seven years now.

As a dialysis nurse, he seen the hospital grow, but his fate still remains the same.

But the better bit is that they do not get overwhelmed by the number of patients and that they have tools to do their work, unlike his counterparts in public institutions.

“My colleagues always complain thatthey don’t have equipment, or that they cannot handle some diseases because of shortage of personnel.

It just breaks my heart to learn the status of the public hospitals is deteriorating,” he says.

Fortunately for Munene, the hurdles are fewer because they are given an opportunity to air out their grievances to the adminstrator, who handles them immediately.

Seth Panyako, Secretary General, Kenya National Union of Nurses (KNUN), says nursing has made tremendous development over the years. 

For starters, nurses have been able to get to higher education level, such as the masters and PhD.

“There has also been an increase in the number of nurses in the country. Unlike in 2013, where we had only 13,000 nurses, today, over 30,000 nurses are working in the public sector,” he says.

However, one of the biggest challenges the sector still faces is shortage of nurses. World Health Organisation (WHO) says the country needs about 120,000 nurses both in the public and private sector.

“However, we have only 48,000 nurses. This means that there is a deficit of about 83,000 nurses,” Panyako explains.

Annually, about 7,000 nurses are trained, but out of this, about 1,000 leave the country in search of greener pastures. 

According to Nursing Council of Kenya, there are approved 121 institutions that train students on degree, basic and post basic diploma level of nursing and midwifery.

“However, other than the basic training, nurses need to take refresher courses to help them advance.

This is necessary for hospice nurses. Furthermore, they require training on handling of equipment, including protective ones to help them in emergencies such as coronavirus pandemic,” Panyako adds.

But he adds that as a union they are working hard to ensure that health workers can get online training.

“Like in the case of Machakos county, health workers are able to train virtually and this has helped them so much, especially now that the country is practising social distancing.”

In terms of payment, Panyako proudly says it has been improved as nurses have started getting reasonable salaries.

Their allowances have also improved, considering they are first in line to respond to a patient.

Despite the positive developments, devolution is still a challenge. Salary issues have started emerging, forcing nurses to go on strike to be heard. 

“Initially payment was made by the national government and this was easier. But all this changed after we were moved to the county governments.

We started hearing cases of delay in salaries among other grievances,” he says. What’s worse is that some counties treat nurses better than others, thus demotivating the latter. 

Addtionally, employing nurses on contract denies them pension and leaves them with nothing at the end of the contract. Consequently, terms of employment need to be revised.

“Other than that, in some cases, recruitment is done politically, like in the case of Pumwani hospital where they terminated the employment of nurses with five months arrears and employed others, with the same conditions,” says Panyako.

Nurses are  also left out on policy making. 

“There are serious problems when it comes to policy making, yet we contribute about 80 percent of medical issues faced in this country. We are rendered voiceless, yet we are first in line when it comes to response,” he says.

Despite all these problems, Panyako says that the future of nurses is very bright because of the union that works hard in highlighting the grievances that nurses face.