100 DAYS THAT SHOULD NEVER BE REPEATED

My name is Dr. Rowena Njeri

I am a general practitioner

My work station is in rural Kenya

I serve the poorest of poor Kenyans

My life has meaning because I make a difference in someone's life

Providing services I cannot afford

It has been 100 days of total paralysis in the health sector. A very devastating 100 days for Dr. Rowena's patients who need her services most desperately but she, along with her fellow doctors, dug in their heels and said there would be no respite until the government played ball.

As the doctors strike played out, the country was subjected to legal theatrics that left those of us who are not learned friends totally baffled. See, there is a history to this.

In December 2011, Kenyan doctors went on the third national strike, only this time with a lot of confidence, having newly registered a union to handle their labor relations and having signed a recognition agreement with the Ministry of Health. They were totally disenfranchised with their remuneration but had their hearts in the right place. In a 14 point strike notice, their remuneration featured at number 13. The rest was focused on public health care improvement.

The stalemate ended with a solid return to work formula that was three-tied. The first tier was a salary increment based on honoring allowances that covered risks incurred by doctors in practice. This was accepted on condition that the Ministry of Health would sit with the Union and develop a blueprint based on existing policy documents and Union recommendations that would drastically improve health care in the country and this comprised the second tier. The final tier involved the Ministry as an employer sitting down with the Union and coming up with a collective bargaining agreement that would address their engagement.

The first and second tiers were quickly achieved within the set timelines. The CBA negotiations were a different kettle of fish. They were tiresome, drawn out and sometimes downright hostile. Both sides were equally obstinate and it took a whole year to agree on the document. Two key challenges arose with the discussion. The first was the issue of the creation of residency positions. These are remunerated positions for doctors who are in specialty training. The proposal by the Union was that the Ministry should provide for 400 positions to enhance training of specialists and end the current existing slavery that goes on in Kenyatta National Hospital and Moi Teaching and Referral Hospital. The second was in the role of the Salaries and Remuneration Commission (one that had not even been formed at the time) in advising on the remuneration figures that the two parties had agreed upon.

Unlike most collective bargaining agreements, this CBA addressed the needs of the patient by providing a suitable work environment for the doctor who is the service provider. The CBA held the employer to account to ensure that as this doctor, who is adequately remunerated, was able to properly discharge their duties because they had the necessary infrastructure, consumable products, drugs, diagnostics and research-derived evidence to apply best practice.

This document was neatly done and dusted in the year 2012. For over eight months, the Ministry of Health officers did not sign the document, citing one excuse after the other. The lack of response by SRC became the scapegoat. SRC was only constituted after the election in 2013. The commission had to get operational and to respond.

Gitobu Imanyara’s Legal Opinion

Article 41 of the Constitution of Kenya recognises the right of every person to fair labour practices and in particular, the right of workers and employers to form, join or participate in the activities and programmes of a trade union and employer’s organization respectively.  Every trade union and every employer’s organisation has the right (a) to determine its own administration, programmes and activities; (b) to organise; and (c) to form and join a federation. The union or organizations as well have the right to engage in collective bargaining. Article 36 recognises the freedom of association and requires that where any legislation that requires registration of a trade union must ensure that the registration may not be withheld or withdrawn unreasonably; and that there is a right to have a fair hearing before a registration is cancelled.  Trade unions activities are largely significant in two respects – collective bargaining and in strike action. Under Section 57(1) of the Labour Relations Act a Collective Bargaining Agreement is identified as an agreement between an employer or group of employers with a trade union that has been recognized by such employers setting out the terms and conditions of service for all unionisable employees covered by the recognition agreement. Section 59(1) & (2) of the Labour Relations Act provides that a CBA binds all the parties to the agreement and all unionisable employees, even upon resignation of membership. The terms of the agreement are to be incorporated into the contract of employment of every employee covered by the agreement and the same must be in writing and signed by the Chief Executive Officer of any employer or employer association party to the agreement and the General Secretary of any trade union that is a party to the agreement as per Section 59(4) of the LRA.  In this regard therefore, it was for the Ministry of Health to ensure that the said CBA was signed as it is the doctor’s employer. Moreover, the same had to be registered with the Industrial Court under Section 60(1) of the Labour Relations Act within 14 days of conclusion, for it to be enforceable and implemented. The employer (the government herein) was to submit it, but the doctor’s union could submit in case of failure by the government. However, this was difficult since the government had not even signed it in the first place and was relying on the SRC as a scapegoat.

After months of back and forth, the 2013 election rolled in and with it came a new constitutional dispensation and devolution. There was need for closure. The outgoing Permanent Secretary, Mark Bor, being the senior-most government official holding office agreed to sign the document but due to delays, his signature came two days after a new Principle Secretary had been appointed to office. This formed the first bone excuse for the government to refuse to acknowledge the CBA. But truth be told, the government dug this up and dragged it all the way to parliament not necessarily because law was the problem but simply because it was looking for wiggle room to extricate itself from the document.

Gitobu Imanyara Legal Opinion

The question here is whether it was proper and binding to the government to have the document signed by the outgoing Permanent Secretary two days after appointment of a new Permanent Secretary. Should the new Permanent Secretary have signed the same to ensure the government was bound or was the government just trying to cause an illegality by allowing an outgoing Permanent Secretary already out office to sign the CBA. Is a signature of a former public officer binding on the docket the said Public Officer held before termination?

Once signed, the employer had 14 days to register the CBA with the industrial court and start the implementation process. At this time, no one at the Ministry of Health had any time for the document. They were focused on devolution of health and how to pass on the devolved functions to the governors. This was no mean feat. If they had been honest with themselves, they would have admitted that they were facing up to the reality of just how badly health had been mismanaged over the years and how some counties were so badly off, there was nothing much to hand over.

Governors, coveting the perceived fat budget for health, were impatient to take over health functions. They had no comprehension of the liabilities that it carried. Had they even taken a few more months, they would have come to the realization that the budgetary allocation given to them was grossly insufficient. They would have taken the Ministry of Health to task over delayed promotion of health workers and demanded that promotions be completed before handing over the workers. They would have realized that there was a very thorny document that had just been signed that needed execution. But in their short-sightedness, they embraced a ton of problems that would come to haunt them.

The immediate reaction was a December 2013 strike where health workers protested the haphazard devolution of health with neither a health policy, nor a health act in place that would govern the sector. This set off a cascade of county strikes totaling 43 industrial actions in the health sector in three years! Most counties demonstrated a clear lack of understanding of how to manage the function, with wastage of public resources, nepotism, tribalism, and complete lack of understanding of the role played by various cadres of health workers in the system. The Ministry of health made this worse by the imposition of the medical equipment scheme that was obviously not well thought out and poorly executed.

As the discontentment among health workers grew, the doctors were pushed to the edge. They began to put pressure on their Union officials to do something. The officials had spent the better part of two years pursuing diplomatic channels of getting the CBA registered and implemented. They had held meetings with the key stakeholders in the implementation of the document, namely, Public Service Commission, Ministry of Health, Salaries and Remuneration Commission and the Council of Governors. None of these meetings bore fruit. The frustration was palpable. Parallel to this, the Union moved to court seeking to get the Ministry of Health compelled to register and implement the CBA of 2013.

Gitobu Imanyara Legal Opinion

As noted earlier, it is upon the Employer to register the CBA as per Section 60 (1) and (2) of the Labour Relations Act. The employer or employer’s organization which is party to an agreement to be registered under this Section shall submit the agreement to the Industrial Court for registration. Under Sub section 2, if an employer or employer’s organization fails to submit the collective agreement to the Industrial court then the trade union may submit it. Whereas the doctor’s union wanted the registration of the CBA the same was with the Ministry of Health which was adamant about registering it without two years having passed without the same having been registered. It was the contention of the trade union that the same could not be effective as per Law requirements without the registration. To hold meetings with the relevant stakeholders and yet ultimately the CBA remained signed by an outgoing Permanent Secretary and unregistered in the Industrial Court was not only a waste of time but also of resources of the doctors and the stakeholders. It was thus the hope of the doctors that by having the Court issue orders compelling the Ministry of Health to register the CBA would solve the predicaments they were already experiencing and prevent further unpleasant engagements between the doctor’s Union and the Ministry of Health. In the meantime, the CBA remained unregistered and could not be implemented by both the Ministry and the doctors. As long as the CBA was not registered the doctors remained on the losing end with them being unable to enjoy the productive legal implications of the same as per Section 59 of the Labor Relations Act.

In 2016, the Union changed tact. The kid gloves were pulled off and the officials asked the membership to prepare for an all out war. The court proceedings in the Industrial and Labor Relations Court were moving on well and on October 6^th, the court ordered the Ministry to sit with the Union and iron out any contentious clauses within 60 days, in preparation for registration of the document. Further orders were given to the Salaries and Remuneration commission to compile their advice to the said CBA within 30 days to allow for the open end of the document to be wound up.

The Union quickly took to knocking on doors seeking meetings with the Ministry of Health to comply with the court’s ruling but the Ministry was not interested. The Union had reached the end of its rope in matters of being civil. It filed a 21-day strike notice to the Ministry of Health. The strike demand was only one: implementation of the CBA 2013.

The Union officials had prepared their members well. The members were angry and determined. They were fully committed to the cause. They wanted their CBA implemented nothing less.

The anger was worsened by a report by the auditor general drawing attention to the Ministry of Health, where approximately KSh. 5 Billion could not be accounted for at auditing. Fingers were pointed to the Principle Secretary, who made things worse by allegedly threatening a newspaper reporter on phone and she recorded the conversation.

Gitobu Imanyara Legal Opinion

By the court trying to involve the parties in resolving the issues amicably before the same had aggravated into more serious issues it was trying to play its role a neutral party and an institution of justice. However, it is more than evident that the Ministry of Health was unwavering to the doctor’s union’s demands and would rather let the members of the unions wander along their corridors as the set time for redress lapsed. It was thus upon the Union to adopt another strategy that would somehow ensure that their demands were catered for. A strike seemed appealing in this instance. The Constitution of Kenya under Article 41(2) (d) provides that every person has the right to strike. Under Section 8(b) of the LRA, a union has the right to plan and organize its administration and lawful activities. In Section 9 of the LRA, the right to participate (employee) and organize (union) lawful activities is non-derogable in every contract of employment. Lawful activities of the union include inter alia, organization and participation in any form of industrial action which relates to conditions of employment. Not all forms of industrial actions are protected. Under Section 80(1) of the LRA the participation in an unprotected action may lead to disciplinary action being taken against an employee, and the employee may also not be entitled to remuneration. To be protected thus Section 76 of the LRA lays out conditions that must be satisfied for the industrial action to comply with the provisions of the Act.

(i)    The trade dispute that forms the subject of the strike or lock-out concerns terms and conditions of employment or the recognition of a trade union

(ii) The trade dispute is unresolved after conciliation; and

(iii)                       7 days’ written notice of the strike or lockout has been given to the other parties and to the Minister by the authorized representative of the trade union or employer.

In regard to the doctor’s union, the union in fact issued a 21 days’ notice of their intended strike to the Ministry of Health for the implementation of the CBA which was in respect of the terms and conditions of employment as required by the Act. Moreover, the doctor’s dispute had tried to be subject negotiations to conciliation by the trying to involve the court and the relevant stakeholders to register the said CBA.

On the issue of corruption in the Ministry of Health, it was unfortunate that the said had to be unveiled yet the Ministry in question was adamant in paying the doctors their dues.

As expected, the Government did not take the notice seriously, right up until 24 hours to the commencement of the strike. There were feeble attempts by the Ministry officials to invite the Union to talks with no real commitment. On Monday 5^th December 2016, the worst doctors’ strike ever to be witnessed in Kenya commenced.

The doctors had learnt the Government’s script by heart and sat back as they ticked the checklist one by one. The response expected was:

1. The Government would declare the strike illegal
2. The doctors would be threatened with sacking
3. The Government would move to court to have the doctors ordered back to work
4. Doctors would be expected to disobey the court order
5. The Government would be back to court to file contempt of court charges against the union
6. The Union officials would be threatened with jail and/or the Union would be fined heavily
7. The various levels of Government would begin to issue sacking letters

All these steps came to pass. The Council of Governors (an entity without a single doctor in its employ) moved to court to have the strike declared illegal. The court ordered the doctors back to work and the doctors defied the order, terming it unfair and immediately appealed the ruling.

Gitobu Imayara’s Legal Opinion

Section 77(1) of the LRA provides that a party may apply to the Industrial Court to prohibit the strike or lock-out as a matter of urgency, if the strike or lock-out is prohibited or if the party that issued the notice has failed to participate in conciliation in good faith with a view to resolving the dispute. Failure to attend conciliation precludes allegations of failure of good faith conciliation. The Industrial Court may direct the parties to engage in further conciliation in good faith with a view to resolving the dispute.

As noted in the preceding opinion, indeed the doctor’s union had followed on the necessary steps and given the requisite notice to conduct a strike. In fact, the doctors had been the ones vouching for conciliation whereas the Ministry of Health was jeopardizing the whole process even before the strike kicked off. For the Council of Governors to then wait till the last day of expiry of the 21days notice for them to begin vouching for the declaration of the strike as illegal was both malicious and in bad faith. Indeed the doctors had followed the set provisions of Section 76 of the LRA and thus to declare the same strike illegal was not in order.

Although Section 81 of the LRA deals with essential services as those services that the interruption of which would probably endanger the life of a person or the health of the population or any part of the population. There is no right to strike or lockout in an essential service as per Section 81(3) of the LRA.

Under the Fourth Schedule of the Labor Relations Act, essential services are listed to include among other things Hospital Services which fell under the realm of the doctor’s strike.

Question however, is whether it was in order for the court to declare the strike illegal when in fact the right of the doctors under Article 41 of the Constitution had been violated. Is the Constitution of Kenya not the supreme Law of the Land as per Article 2. To deny the doctors from participating in the strike yet they had done all within their capability to have the CBA signed and registered and even to have talks with the Ministry of Health was unwarranted in a democratic society like Kenya. Article 48 of the Constitution requires access to justice to every person and this indeed includes doctors who under the LRA are prohibited from participating in industrial actions but are however oppressed because of such provision. They had a right to strike and indeed have their grievances addressed especially because they had been in the fore front in trying to engage the government to solve the issue amicably for close to 3 years. As per the LRA they were not allowed to conduct he strike but with the supremacy clause of the Constitution and the jostle they had gone through it was only in the interest of justice that they sought the best option as at then that would force the Ministry of Health to heed to their demands even if such would be a nightmare to the common mwananchi who was in dire need of the health services.

The governors proceeded to issue threats of sacking to the doctors through the media and the doctors dared them to sack them. The angry governors, through the Council of Governors went back to court and the court found the Union officials in contempt of court. Despite the crystal clear ruling, the presiding judge postponed the ruling by a week. On the ruling date, she was away and the matter landed in front of a different judge who deferred the ruling for two weeks, pending the return of the original judge.

The strike completed its first month and stepped into a new year. The Union appeared before court for sentencing in January and were handed a 28-day prison sentence. In a series of postponements, the sentence was repeatedly suspended for over a month. The judge cited giving the doctors more time to call off the strike. In one of the court appearances, the Judge of the High Court of Kenya, infamously lost her temper and in a language unbecoming of the bench, verbally insulted the Union officials.

Gitobu Imanyara Legal Opinion

It is evident that the threat by the governors to sack the doctors was a form of intimidation into getting them back to work. Doesn’t the Constitution provide for equal protection of the rights including the doctors?  To try and intimidate doctors into returning back to work yet it is the Ministry of Health that had all through been delaying the resolution of the problem was an act in bad faith. The Employment Act clearly provides for the procedure for termination of employment of all employed persons including those appointed by the government. Indeed the Section 35 of the Employment Act requires that a formal termination notice is given and one month payment in lieu of the termination paid.  To terminate the employment of the doctors without such formal procedure being followed would only lead to more legal tussles between the government and the doctors over unfair termination from employment for exercising their Constitutional right under the Constitution. The same would also have been costly for the government to fathom. Indeed the doctors were not stunned by this directive.

For the court to find that the Union officers were in contempt of Court for not adhering to the ruling to end the strike and further issuing a sentence for 28 days imprisonment and yet the said sentence was being postponed repeatedly only shows that though the Court was willing to have the strike come to an end, it was also trying to exercise its judicial authority and show that they had the authority. However, by so doing the Court was undermining the whole process and pushing the doctors further to the edge. Would it not have been better for the court to recognize that indeed the doctors had played their part of agreeing to have a CBA and that it was the government derailing the process by refusing to register the CBA? The Industrial Court had the authority to direct the parties to engage in further conciliation in good faith with a view to resolving the dispute without necessarily sending the jailing the doctors. By issuing contempt of court orders yet the doctors had only been trying to exercise their Constitutional right was demeaning. The doctors were now being forced to negotiate or face jail yet they had in fact initiated the whole process since the beginning of the agreement to have the CBA.

Finally after three suspensions of the sentence, the Union officials were committed to civil jail. On February 13^th 2017, the seven Union officials were ordered to start serving their 28-day jail term.

There was an immediate massive public outcry. Doctors of all cadres across the country were incensed. They all converged in Nairobi and made their opinion known.

The Kenya medical Association, the professional body that brings together all doctors in Kenya, made a press statement and asked all their members in the private health sector to close down for 48 hours in solidarity with their jailed colleagues. This was in absolute defiance of the elite ruling class who only patronize the private health facilities and consulting offices. The statement being made here was that even though the public sector workforce may be on the street, the private counterparts we in full support as this was a matter of professional respect.

The jailed Union leaders were initially committed to Langáta Women’s prison and Kamiti Maximum Prison. As their outraged peers who were peacefully sharing their disappointment in a peaceful gathering at the Nairobi Railways Club were being dispersed by heavily armed police, the jailed leaders were being dispersed in jails across the outskirts of Nairobi in the dead of the night. In an act that can only be interpreted to denote intimidation, Dr. Evelyne Chege was transferred from Langáta Women’s Prison at 2300hrs to Machakos G.K. Prison while Dr. Daisy Korir was left behind alone. Dr. Tito Ondoro was moved to Ruiru G.K. Prison, Dr. Mwachonda Chibanzi was moved to Athi River G.K. Prison, Dr. Allan Ochanji was moved to Kiambu G.K. Prison, Dr. Oroko Obegi, the Chairman, was taken to Kajiado G.K. Prison while Dr. Ouma Oluga, the Secretary general was left at Kamiti.

To see Dr. Daisy Korir in prison stripes was heartbreaking. Tears flowed freely when her father’s comment on his unwavering support for his daughter made it to social media. Seeing Dr. Evelyn Chege’s mom putting on a brave face for her daughter was unforgettable. The doctors visited Dr. Oluga’s mother in the village just to express their gratitude for what her son was doing for this country. The prisoners may not have slept much in jail but neither did the doctors in their warm beds. They were up all hours on a social media that was closely monitored by the intelligence.

The lawyers had already filed an appeal against the ruling back in January and it was due to be heard on February 15^th 2017. With a huge public uproar and politicians joining in the fray, the Union received legal muscle by way of veteran Senior Counsels James Orengo, Philip Murgor and Mutula Kilonzo Junior to provide much needed support to the existing office led by Edgar Washika.

The Court of Appeal was a totally different ballgame. The Court’s demeanor set the pace for rational deliberations devoid of emotions and theatrics. The court acknowledged the appeal filed before it but in view of the fact that the matter was a public interest issue, ordered that the jailed leaders, famously known as the CBA7, be released from jail with immediate effect, to allow for negotiations that would bring this strike to an end, to continue. Further, the court directed that the release was unconditional, as the union could not be deemed to negotiate fairly with the threat of incarceration hanging over their heads. The negotiations were to take place at the mediation table chaired by the Secretary General of the Central Organization of Trade Unions (COTU).

Gitobu Imanyara Legal Opinion

The doctors were finally jailed and indeed fellow doctors from the private sector also decided to down their tools. Although this was in violation of Article 43(1) (a) of the Constitution on the right to every person having the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care; they were doing so in solidarity with their fellow jailed doctors and on the call of their trade unions. To thus commit the doctors to jail only worsened the situation with both public and private sector doctors failing to provide one of the most essential rights to the Kenyan citizen, that of access to health care services. It was unfortunate that the doctors had to be jailed for a worthy course and especially on a course that was their Constitutional right. There were now no members of the doctors’ trade union to negotiate with the government and thus the ordinary mwananchi remained in destitute with some even dying because of the inability to actualize their Constitutional Right.

On transfers according to Section 30 of the Prisons Act, every prisoner confined in any prison shall be deemed to be in the lawful custody of the officer in charge of the prison. Every officer in charge shall keep and detain all persons duly committed to his custody by any court or according to the terms of the order by which such person has been committed or until such person is discharged by law. By the time the officials were discharged by the courts, it is evident they were not under the officer they were attached hence occasioning the delay in their release.

The decision of the Industrial Court was subject to appeal since the decision to jail the doctors was detrimental to them and the process of negotiations and yet they were they key stake holders in the talks. The Court of Appeal while trying to ensure that the negotiations came to a conclusion and that the lives of Kenyans were saved, decide to exercise its appellate jurisdiction as per Article 164(3) of the Constitution to unconditionally release the doctors. This was wise move especially because courts are supposed to ensure that justice is not only done but seen to be done. By the release of the doctors and referring of the negotiations to mediations, it was evident that both parties would have to ultimately arrive at an amicable solution. Article 159 of the Constitution indeed empowered that Court to refer the same to mediation as it provides that in exercising judicial authority, the courts and tribunals shall be guided by principles of alternative forms of dispute resolution including mediation.

The CBA7 were released from jail the same day but with undue delays as many of the late night transfers were not done as per protocol and therefore a lot of paperwork was missing, incomplete or in the wrong place. Eventually they came out of jail to an astounding welcome celebrations by their own at Uhuru Park, supported by thousands of Kenyans who believed in their cause; family, friends, clergy and the political class.

It was a momentous occasion. Nothing in Kenya has ever brought the medical fraternity together like this day did. They sang, cheered, danced and cried together. They demonstrated how their profession bound them together as they fondly named themselves the 44^th tribe in Kenya. This tore into the propaganda spread by the government communications team pegging the strike on political and tribal motives. Politicians at the podium were shouted down whenever they tried to bring politics to the podium.

This moment of reckoning lasted for the day and it was back to the business of trying to convince an arrogant, bullish government that there was need to reach an amicable agreement. The first week did not go well. The Chair of the mediation, Mr. Francis Atwoli, was not trusted by the doctors though the negotiating team gave it their all. By the end of the week, no deal could be reached. The parties were too far apart, there was too much acrimony, the Cabinet Secretary and the Principle Secretary of the Ministry of Health had their own side shows that led to lack of leadership at the negotiating table and the process could not make much progress.

Seven days later, everyone was back to court and the report by the Chair of the mediation gave a damning report that could easily scuttle the process. The Court of Appeal gave another week with a different round of mediators. Jointly, the Law Society of Kenya and the Kenya National Human Rights Commission took over from Mr. Atwoli. It was a long week with the Chairs doing their best but there was no deal by the next court appearance.

The Religious leaders gave it a shot. They probably had the hardest time on the table. The pressure was mounting and the President had finally turned his attention back to the national crisis. This was the darkest time on that table. The Union negotiating team was getting exhausted but they remained steadfast. They kept the focus amidst efforts to derail them. The Government kept playing the game of musical chairs, shifting goalposts, leaking sensitive information onto social media despite a gentleman’s agreement to maintain silence until a deal had been sealed. Egos took centre stage and rational thinking was thrown out of the window. Subtle and not so subtle threats were made.

On the morning of Tuesday 7^th March 2017, the parties appeared in court one more time. The religious leaders were worn out from the fray but hanging in there. Two key documents had finally been agreed upon by all parties, the revised collective bargaining agreement and the customized recognition agreements for the 47 county governments to sign and recognize the union along with the national government. The challenge was in the return to work formula which was still highly contentious.

At Court, the progress report was given and the Union prayed that these two documents be signed by all parties as they completed the return to work formula. The bench ordered that the Counties sign the documents and the Union demonstrated willingness to travel to Naivasha where the Devolution Summit was going on and all relevant parties were present.

Gitobu Imanyara Legal Opinion

As noted earlier, Article 159 of the Constitution provides that in exercising their judicial authority, the courts and tribunals shall be guided by among other principles alternative forms of dispute resolution including mediation. Indeed the courts thought that the best way to solve the issues were via mediation so at to get the most viable agreement. To have the Principle Secretary and the Cabinet Secretary showing egos yet they were representing the government and thus needed to work as a team was unfortunate. Moreover, confidential information should not have been disclosed to a person not a party to the negotiations.

No sooner had the court emptied, than the television stations aired a live clip of the president throwing the whole process out of the window! A livid president threatened to sort out the doctors if they did not agree to the government terms. The Chair of the Council of Governors made a mockery of the progress that had been made. He categorically stated that all offers made by government had been withdrawn. The process came to a screeching halt. Angry doctors took to social media to ventilate and their negotiating team sat tight waiting for court the next week.

The teams convened again in court on Monday, March 13^th as directed. The doctors were at the end of their rope. They had felt mistreated and abused and didn’t care anymore which way it went. Suffice it to say, the patience of the Court of Appeal had run out and they were ready to resume the core business of why they were sitting to begin with, which was to hear the appeal against the contempt of court rulings. In a surprise turn of events, the Government side claimed they were willing to conclude the return to work formula. The Ministry of Health Legal Counsel asked for time to read the documents before committing. The Court gave 24 hours. There would be no more extensions.

Tuesday morning bright and early, all roads led to the Courthouse. This was it. We were all out of time. We would either end the strike or every effort put to this moment would go down the drain. The Government said that the return to work formula was almost done and it would be signed and registered in court before close of business of the same day. Doctors sat around their televisions with bated breath.

At 1600hrs, all local stations came alive to the scene at Delta House in Westlands, where the Council of Governors offices are housed. The drama was not over yet, as transmission had to be interrupted as the doctors perused the printed document to find it was not what had been agreed upon. The Government had already solidly declared that they would NOT sign the collective bargaining agreement as long as doctors were on strike. The concession made was that the return to work formula explicitly stated that the county Governments would sign the recognition agreements and then together, both National and County Governments would sign the CBA within 60 days of ending the strike and then start to implement it. As tempers flared and parties traded accusations, the right document was printed and publicly signed to bring to an end a very painful, very bruising 100 days that left us with devastating losses.

If the Government fails to implement the collective bargaining agreement, all the devastation that both the doctors and the public underwent would be in vain. We shall not hesitate to hold them to account for all the lives lost in the quest for better health for Kenyans.

My name is Dr. Rowena Njeri

I am happy the strike is over

I can now get back to the business of taking care of my patients

I am holding on to the promise that government

Will keep its end of the bargain

And implement the CBA

 For the sake of my patients…