The healthcare crisis in the counties is deepening. The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has issued a 21-day strike notice to the Homa Bay County Government, threatening a total paralysis of services if their "chronic" grievances are not addressed.

The notice, signed by KMPDU Nyanza Branch Secretary Dr. Ochieng Otana, paints a grim picture of a workforce on its knees. Doctors in the county claim they have become "casual laborers" in their own profession, working without pay, promotion, or protection.

The Grievances

• Salary Delays: The most pressing issue is the erratic payment of salaries. Healthcare workers often receive their pay two months late, leading to evictions and financial ruin. "We are treating patients while our own children are being sent home for fees," Dr. Otana lamented.
• The "Ghost Worker" Purge: The union accuses the county of arbitrarily removing members from the payroll under the guise of a "ghost worker" audit. In August last year, dozens of medics were struck off without notice and have yet to be reinstated, despite verified proof of their employment.
• Stagnation: Career progression has ground to a halt. Some doctors have remained in the same job group for over 10 years, earning the same salary despite acquiring Masters degrees and specializations. The union demands the immediate promotion of all eligible staff.

The Human Cost

If the strike proceeds, the impact on Homa Bay’s 1.1 million residents will be catastrophic. The county has high burdens of HIV, malaria, and maternal mortality. A withdrawal of labor by doctors, nurses (KNUN), and clinical officers (KUCO)—who have signaled solidarity—would leave the Homa Bay Teaching and Referral Hospital operating as a shell.

Governor Gladys Wanga is now in a race against time. While she has previously cited delays in Exchequer releases from the National Treasury as the cause of salary arrears, the unions argue that health should be a "ring-fenced" budget priority. "You cannot play politics with life," the strike notice reads. The clock is ticking.