Learning from Our Physician Comrades in Kenya

December 20, 2024

On May Day, CIR members across the country wore armbands to support the Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU), who were on strike for return of their stolen wages, and more. Along with this action, SEIU, CIR’s parent union, also wrote a letter calling on the U.S. Department of Labor to use its influence to pressure the Kenyan government to do right by healthcare workers. Despite state resistance and even violence, the strike succeeded, with KMPDU praising our solidarity action as instrumental!

Kenya is currently facing a push in healthcare privatization, driven by Western “development” money from organizations like the IMF and World Bank. Inspired by CIR’s success in organizing private hospitals, KMPDU invited a CIR delegation to Kenya for a series of trainings and mutual learning in May. CIR members have always recognized that the struggles of all workers and people across the globe are connected–and that is why we continue the fight for dignity and respect for all. We look forward to our unions continuing to work together!

Dr. Mercy Nabwire is a founding member and National Treasurer of KMPDU. She is completing a masters at Pennsylvania State University and is currently working with CIR in Pennsylvania.

What does KMPDU mean to you? What brought you into the fight?

All around me I was seeing a lot of things that were going wrong. I felt that we were working and the system was silencing us, it was not giving us an opportunity to raise our voices. And if you try to do it as a single person then you’re isolated, you’re treated badly. That is what still drives me. The belief that we have power. I don’t have a lot of power against the system as an individual, but collectively we have so much power to demand change, to transform not just our workplaces, but our lives. That is why I’m passionate about organizing. That’s why I’m constantly organizing.

What would you say to physicians who are nervous about taking action with their coworkers?

What makes most doctors hesitant is this moral question around our role, our responsibility is to save lives fast, before anything else. But in reality, it’s the employer’s responsibility to make sure patients receive care. If the environment has not been provided, no matter how much you do it, you’re not going to do it right. Going on strike is demanding a better working environment which eventually results in better patient care. We must always be ready to deploy this kind of power for very difficult employers who don’t respond. And nobody is going to come and do it for you. Nobody else will strike for you so you get a better working environment. You have to do it yourself—to make that change.

How can our labor movement advance larger struggles for justice?

We can’t look at a worker and restrict our struggles to the workplace. As a worker, I’m a member of a family, a community, and I belong to a larger global community. We must always take these dimensions into consideration in our struggles. Even the people in our society we think don’t belong to the labor movement, they’re workers–basically everyone is a worker. Every struggle that is a societal struggle is a worker’s struggle.

When we transform our conditions of work, we transform our society. When we demand justice in our workplace, we demand justice that is universal. The one thing that’s been unique about our union in Kenya is that our struggles aren’t just limited to getting a pay raise, a promotion, shorter hours; we want a health system that’s responsible, equitable, accessible to every Kenyan.

Understanding S.P.I.T.

What are the benefits of forming a union?

When we come together as housestaff, we have a unified voice for safe working conditions and better patient outcomes. This pandemic has demonstrated that having workplace representation is urgent and necessary. Thousands of residents across the country have organized union chapters and have won historic improvements for housestaff and patients through collective bargaining agreements.

What’s legal? What’s not?

The laws vary from state to state as well as the type of employer you are paid by – private or public.Generally, however, most laws give employees the right to act together to try and improve their working conditions, with or without a union.It is illegal for employees to be fired, suspended, or otherwise penalized for taking part in protected group activity.

Generally, it is illegal for employers to S.P.I.T.:

(Document any activity that may look like this)

Surveil

Administration and department leadership may not conduct unlawful surveillance of employees’ union activity. Identifying, tracking and surveillance of employee discussions about the union or union meetings is illegal.

Examples:

Supervisors cannot inquire about what goes on at union meetings, ask which employees attend the meeting, or even give the impression of such surveillance.

Promise

Administration and department leadership must not directly or indirectly promise any benefits or reward employees for refusing to sign a union card, or for voting against your union. They may not promise a wage increase or give preferential treatment in exchange for refraining from union activity. Encouraging employees to withdraw or repudiate union authorization cards is also unlawful. They may not solicit grievances about working conditions while expressly or impliedly promising corrections if residents do not form a union.

Examples:

“I can get you a job here or give you a good recommendation letter if you don’t get involved.”

Reminder: There is nothing holding management accountable to any promises they make and they do not have to follow through.

Interrogate

Administration and department leadership should not interrogate, or ask, any employee whether or not he or she favors the union, has signed a union card, or has gone to a union meeting.

You can always say you’re not comfortable answering their questions. Remember to ask whether they’ve talked to others, whether they know if they’re allowed to ask, and if they have concerns about residents forming a union and what they are.

Questions they may ask:

Have you heard of a union being formed? Are you involved? Have you been asked to sign a card? Do any of your colleagues have interest in forming a union? Who have you heard union talk from? Do you think you’ll join?

Threaten

Administration and program leadership must not threaten employees with harm or reprisals (economic or otherwise) if they decide to get involved with the union or sign a union card.

Examples:

Administration may not threaten to take away residency spots or current department benefits if the residents decide to form or join a union.

What can we do to protect ourselves?

Despite being generally protected, it is always a good idea to be extra careful:

Remember to be discrete and never seek advice or reveal to management/administration that you are considering unionizing
Refrain from using hospital property – both physical (printers, computers, phones) – and intellectual (email, paging/messaging systems) – in communicating regarding union matters
Be mindful of where and when you discuss unionization with your colleagues – being overheard talking about unions in the hospital “on company time” can be considered “solicitation,” so exercise caution and discretion
As long as you are using personal means of communication such as personal phones, emails, and only talking to other interns, residents, or fellows, the hospital cannot discipline you

Reminder: Forming a union is 100% our legal right and our vote is anonymous.

Learning from Our Physician Comrades in Kenya

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