By Wasike Elvis 

Doctors in Elgeyo Marakwet County have intensified their ongoing strike, deepening a healthcare crisis that has now entered its third week. The industrial action, led by the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) North Rift branch, has brought most public health facilities in the county to a standstill, leaving residents scrambling for alternatives as basic medical services collapse.

Union officials say the escalation follows repeated attempts to compel the county government to implement a return-to-work agreement signed in 2024—an agreement that ended a previous strike but whose key provisions, particularly regarding promotions and job group placements, have yet to be fulfilled.

“We have been on strike for the last 21 days because the county has refused to implement very clear and simple matters contained in our collective bargaining agreement,” said KMPDU North Rift branch secretary Dr. Kamonzi Mulee.

 “This is not the first time we are facing this issue. In 2024, we had a similar strike over the same concerns, and yet, here we are again.” he added.

Promotions Dispute at the Heart of the Crisis

The central issue driving the strike is the delayed promotion of doctors—a matter explicitly addressed in the 2024 return-to-work formula. The agreement stipulated that postgraduate doctors be promoted to Job Group Q, while senior consultants were to advance to higher grades such as R and S. These promotions were expected to be implemented by November 2024.

“The county has had more than a year to implement these promotions, yet nothing has happened,” Mule said. “We are not asking for salary increases or new allowances. We are only asking that doctors be placed in their rightful job groups as per the agreement.” said Dr. Ismael Aiyabei Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU) chairman North Rift branch.

Doctors argue that the failure to honor the agreement has led to stagnation, demoralization, and career uncertainty. Some doctors who returned from study leave are unsure of their placements, while others with additional qualifications remain trapped in lower job groups, limiting opportunities for growth and further training.

Breakdown in Negotiations and Legal Tensions

Attempts at dialogue appear to have failed. Union officials claim the county government opted for legal action instead of continuing negotiations, a move they interpret as bad faith.

“When negotiations are ongoing and one party rushes to court, it shows they are not interested in dialogue,” Mule said. “It means they do not want to implement what was agreed.”

Doctors insist that previous court processes and conciliation efforts had already taken place, with agreements formally documented. They have vowed to defend their position in court while maintaining the strike.

Dr. Joan Chebii, a physician at a county hospital, noted that initial compliance by the government was temporary. “We initially called off the strike after the 2024 agreement, but the county has failed to implement its obligations. We reached a breaking point,” she said. “The issues are few and clearly outlined, yet they remain unaddressed.”

Governor Accused of Neglecting Health Sector

Union representatives have also criticized Governor Wesley Rotich, accusing the administration of failing to address critical healthcare challenges. Doctors say the government has prioritized legal maneuvers over service delivery, deepening public frustration and endangering patients’ lives.

“This is not just about doctors’ careers; it is about the lives of ordinary residents who rely on public hospitals for essential services,” Chebi said.

The KMPDU has called on county leadership to take responsibility for the crisis, arguing that political posturing and legal disputes should not override the need to deliver healthcare to residents.

Healthcare Services Collapse

The ongoing strike has left Elgeyo Marakwet’s public healthcare system in disarray. Hospitals have been forced to suspend many essential services, and patients requiring specialized care are being referred to facilities in neighboring counties.

This surge in patient transfers has placed additional strain on nearby health systems and increased medical costs for families. Many residents, particularly those from low-income households, face significant challenges accessing care.

“As we speak, most health services in this county are not functioning,” Mule said. “The majority of residents who depend on public hospitals are suffering. Mothers, children, and patients with chronic illnesses are the worst affected.” said the KMPDU North Rift Chairman.

Union Rejects Renegotiation Attempts

Despite the stalemate, the county government reportedly wants to reopen negotiations. The union has rejected this, insisting that the 2024 agreement should be implemented before any further discussions.

“Whatever we agreed in 2024 has not been implemented,” Mule said. “Now they want us to go back and renegotiate the same issues. That will not happen.”

Doctors warn that continued delays could trigger a mass exodus of healthcare professionals from the county, seeking better opportunities elsewhere, further weakening the region’s health system.

Residents Caught in the Crossfire

The strike has not only affected doctors and healthcare workers but also ordinary residents, who are bearing the brunt of the conflict. Many patients have had to travel long distances to access care, with some foregoing treatment altogether due to costs and travel constraints.

Local leaders and civil society organizations have expressed concern about the long-term impact on public health, especially for maternal care, chronic disease management, and emergency services.

“The common mwananchi is suffering due to leadership failure,” Mule said. “Doctors have been clear and patient, but the government’s inaction has pushed us to escalate the strike.”

Uncertain Resolution Ahead

With both sides entrenched, there is little indication that the dispute will be resolved soon. Doctors have vowed to continue—and potentially escalate—the strike until the county government fully honors the 2024 return-to-work formula.

Meanwhile, residents anxiously await a solution to a crisis that threatens not only healthcare delivery but also the long-term stability of the county’s medical workforce.

The county government has yet to issue a comprehensive response to the latest accusations, leaving a healthcare system under immense pressure and residents in growing distress.