Isiolo County, Kenya – Bedridden Amina Adan lifts her weak breasts in an attempt to squeeze a drop of milk for her hungry children.
The 37-year-old’s seven daughters and sons, all of whom are younger than 15 years old, surround her narrow bed. They need their mother to be well.
All Adan owns is the family’s one-bedroom village house, made of mud and an iron-sheet roof.
A drought killed most of her livestock; she has no food to feed her children. Her husband left home a few weeks ago with the only livestock that had remained, seeking pasture far away.
And now, a nurses’ strike that began more than four months ago has compounded her challenges of living in a harsh climate with poor infrastructure.
“I started bleeding last Monday,” she says. “I was standing in the house doing my chores and all of a sudden a saw clots of blood dropping down my legs, the bleeding was so heavy that I lost consciousness. My children rushed and called neighbours who came to my rescue.”
The strike by government nurses began in June over pay disputes – a low-paid nurse earns around $200 a month – and has seen the number of mothers dying from childbirth double, children miss out on vaccinations and the return of diseases such as malaria.
Neither ruling President Uhuru Kenyatta nor opposition leader Raila Odinga has pledged to revive the health sector.
“When the strike started in June this year, I had planned to visit a clinic because I had missed my [period] for almost two years. Sadly, nurses went on strike, and I had nowhere to seek help. See, now I cannot walk. I am very weak,” Adan says through tears.
Well-wishers from the neighbourhood took her to Merti Catholic Dispensary. The only public health facility in Merti district was deserted because of the strike.
“At the dispensary, I was charged 1,500 shillings ($14.50). They put me on a drip and inserted a piece of cotton wool in my vagina to help control the bleeding. They referred me to Isiolo for specialised treatment. But in Isiolo, I don’t have money to hire a car, and there is no ambulance here, so I am waiting to die. I have no help coming,” says Adan.
Medical records indicated that Adan could have had a tumour in her cervix, saying she needed further examination and an urgent blood transfusion in a more advanced facility.
But a 240km drive in rough terrain lies between Adan’s village of Manyatta Sakuye and Isiolo town. Only four-wheel drive vehicles can manage the road, which has poor mobile phone coverage.
As he walks through empty corridors, Peter Marete, a clinical officer at Merti Health Centre, confirms to Al Jazeera that most services at the hospital ground to a halt in June.
He attends to the most urgent cases with the help of just two co-workers – a laboratory technician and an administrative staffer. He has to give several children injections for kala-azar, the second largest parasitic killer in the world after malaria.
“As you can see the situation is very bad here,” he says. “These children have come from very far with their parents.
“Kala-azar is a very serious disease and if not treated can be fatal. It is very common in villages here and can only be treated at a public facility like this one.”
Normally, it is nurses who give injections.
“I am very aware of the many cases of patients like Amina who are stuck in the villages because of the strike and have no vehicles to ferry them,” Marete says. “We have no ambulances in the whole of this district, and this puts at risk the lives of patients who need urgent attention.”
Services such as vaccinations, family planning and maternity have closed at his facility.
“This nurses’ strike will have a very big impact on these services because many women are dying in their homes while delivering and no vaccination is going on for the children. I wish the government ends this strike immediately because people here have no alternatives,” he says.
Isiolo County officials, including county deputy governor Abdi Ibrahim Issa, did not respond to Al Jazeera’s request for comment.
As long as these politicians don't access public healthcare, they have no time to push a public healthcare agenda. A very sad situation indeed
More than 25,000 nurses of the Kenya National Union of Nurses demanded in June that the government signs a collective bargaining agreement (CBA), but were turned down. The CBA included requests for uniform and health risk allowances, which officials said would burden the taxpayer.
“Instead of the CBA being signed, it was politicised. The prolonged strike is because the government has been insincere,” says Seth Panyako, Kenya National Union of Nurses secretary-general.
On the coming election, he notes that privileged Kenyans use private healthcare and therefore have no concerns about the public sector.
“As long as these politicians don’t access public healthcare, they have no time to push a public healthcare agenda. A very sad situation indeed,” he says.
The collapse of almost 95 percent of the public health sector has led to outbreaks of diseases such as malaria, Panyako says with concern.
“Our primary healthcare has been broken down. Unless the government takes serious steps, we will see Kenyans continue to suffer.”