Striking nurses defy court order

Uasin Gishu County nurses strike over delayed payments and unfulfilled Collective Bargaining Agreement  [Wycliff Kipsang, Standard]

The nationwide nurses’ strike entered a fresh standoff on Wednesday after nurses maintained their industrial action despite a court order directing them to return to work.

The Employment and Labour Relations Court on Monday ordered the Kenya National Union of Nurses and Midwives (KNUNM) to direct its members employed by Mombasa County and the other 46 county governments to resume duty immediately.

Justice Monica Mbaru issued the interim orders after Mombasa County moved to court challenging the strike, warning that continued disruption of health services could lead to further suffering and possible loss of life.

But the order has not brought the seven-day strike to an end, with the union maintaining that nurses will remain out until their grievances are resolved.

A KNUNM official told the Standard that the Council of Governors had not presented anything to the Salaries and Remuneration Commission (SRC) for approval, insisting that the responsibility for resolving the outstanding issues lies with the governors.

“The COG has not presented anything to SRC for approval. The back stops at the CoG. The strike continues,” the official said.

The continued walkout is being felt most sharply in referral hospitals, which are now absorbing patients who would ordinarily have been treated or stabilised at county facilities.

In Kisumu, the region’s largest referral facility, Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) has been grappling with a growing influx of patients from Kisumu, Siaya, Homa Bay and Migori counties.

JOOTRH Director of Nursing Services Teresa Okiri said the hospital had anticipated an increase in referrals when the strike was announced and activated contingency measures to keep services running.

She said admissions had risen across several departments, particularly maternity, emergency, newborn, surgical, paediatric and medical wards.

Okiri said maternity department recorded 44 admissions within the first 24 hours of the strike, significantly higher than the hospital’s normal daily workload.

“The increase has been enormous. We expected more referrals because we are the main referral hospital in the region but the numbers continue to rise every day,” she said.

The pressure has forced nurses, doctors and consultants to work extended shifts, while the newborn unit has exceeded its normal capacity, prompting the hospital to open an additional room and redeploy more nurses to critical departments.

Okiri said JOOTRH was receiving about 50 critically ill emergency referrals daily, with some patients arriving directly from lower-level facilities after failing to receive the required care.

“These are patients who should ideally be referred after receiving initial stabilisation at county hospitals, but because services have been disrupted, many are coming directly to JOOTRH in critical condition,” she said.

For patients, the disruption has meant delays and moving between facilities in search of care.

Steve Ogutu, who was admitted to JOOTRH after sustaining injuries from an animal near Dunga’s Hippo Point, said he first sought treatment at Kisumu County Referral Hospital but waited nearly two hours before receiving attention.

“It took time before I received treatment because there were many patients and very few healthcare workers available. I appeal to both the county and national governments to resolve this dispute because patients are the ones suffering,” he said.

The growing pressure on referral facilities has also raised concern among specialists dealing with maternal and newborn health.

In a statement issued on Tuesday, the Kenya Obstetrical and Gynaecological Society (Kogs) warned that the prolonged strike could expose pregnant women, patients facing obstetric and gynaecological emergencies and newborn babies to increased risks.

The society said emergencies such as postpartum haemorrhage, eclampsia, obstructed labour, ruptured ectopic pregnancy, severe pre-eclampsia and foetal distress require immediate intervention.

“Childbirth does not wait,” Kogs said, warning that newborns may also require prompt resuscitation and specialised nursing care within minutes of birth.

The society therefore called on both the national and county governments and the CoG to urgently engage the nurses’ union and expedite implementation of mutually agreed commitments.

It also urged the union to continue engaging in negotiations while exploring mechanisms to protect emergency maternal and newborn services.

The warning comes as nurses maintain that their grievances remain unresolved.

The union is demanding implementation of the 2017 return-to-work agreement, signing of the Collective Bargaining Agreement, implementation of career progression guidelines and clarity on the employment status of Universal Health Coverage nurses.

The court has given KNUNM 14 days to file its response to the case, setting the stage for further legal proceedings even as the strike continues.

For now, the court order has failed to end the industrial action, while the growing pressure on referral hospitals and concerns over critical services continue to raise the stakes in the nurses’ dispute.