From picket lines to policy: A stand for dignity and change

In December 2016, doctors in Kenya took an extraordinary stand. As Secretary General of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), I stood alongside thousands of colleagues on the picket lines. We were exhausted, physically from gruelling shifts, and emotionally from watching patients suffer in broken hospitals.

Public hospitals had become places of pain. Essential machines broke down regularly, wards were overcrowded, and patients lay on the floor for lack of beds. Our demand was simple: implement the 2013 Collective Bargaining Agreement (CBA). It promised not just fair pay, but more staff, stronger facilities, and a supply of life-saving medicines. It was never only about salaries—it was about restoring dignity to healthcare.

The strike lasted 100 days. Public hospitals ground to a halt. Lives were lost, and that weighed heavily on us. But we believed short-term pain could lead to long-term reform.

Government pushback was intense, even jailing me and six union leaders for defying court orders. Those were dark days. Yet, standing in court in 2017, I felt no regret. We were fighting for doctors and patients—two sides of the same coin.

When the strike ended in March 2017, we had won key commitments. Doctors’ hours were capped at 40 per week, overtime was paid, and long-overdue allowances introduced. Most crucially, the agreement acknowledged that health worker welfare and patient welfare are inseparable. For the first time, we had a blueprint for change.

Eight years later, I now sit on the other side of the table. No longer a union leader, I serve as Principal Secretary for Medical Services. The irony is not lost on me. The doctor who led chants in 2017 now chairs policy meetings. But my mission remains unchanged. Back then, our mantra was simple: patients and providers deserve better. That still guides me today.

My journey from activism to public service has shown how protest becomes policy. Under President Ruto’s Bottom-Up Economic Transformation Agenda (BETA), healthcare is a national priority. My appointment was not a reward, it was recognition that the demands of 2017 were the seeds of today’s reforms.

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I often recall telling doctors outside Kenyatta National Hospital: “Our fight is about oxygen in wards, drugs on shelves, and dignity in hospitals.” Today, that same conviction fuels my work. The reforms we once fought for are now taking shape. Thousands of health workers have been absorbed into permanent, pensionable positions, and salary arrears settled. Hospitals, such as Kerugoya are now referral centres with ICUs and oxygen plants.

The government has deployed 100,000 trained, paid Community Health Promoters, while over 7,000 Universal Health Coverage (UHC) staff have been made permanent. The Social Health Insurance Fund, now income-based, replaces NHIF, with over 26 million Kenyans enrolled and hospitals receiving billions.

Challenges remain—enrolling the informal sector, streamlining reimbursements, and expanding infrastructure. But our direction is clear: healthcare is becoming a right, not a privilege.

If I could speak to my 2017 self, I’d say: “The struggle was worth it—but the work continues.” To Kenyans, I say: health is a shared responsibility. Hold us accountable. Support reforms. From picket lines to policy, our journey continues.

Dr Oluga is PS State Department for Medical Services