Kenya’s healthcare system is facing deep structural problems made worse by poor leadership, political interference and misplaced appointments at the county level, according to Dennis Miskellah, Deputy Secretary General of the Kenya Medical Practitioners, Pharmacists and Dentists Union.

Speaking during an interview on Radio Generation, Miskellah painted a grim picture of how the health sector has become unstable since the devolution of health services.

He said strikes have become more frequent, leadership in many counties is based on patronage rather than merit, and health workers are being supervised by people with no medical background.

“Before devolution, we had like only two or three doctor strikes in this country. After devolution, we have had over 100 strikes,” said Miskellah, noting that Kiambu health workers were already in their 73rd day of an ongoing strike, while Kwale had just concluded another.

“There’s another cycle maturing in MTRH… you give it 14 days, and then it matures,” he added, referring to strike notices that are about to take effect.

Miskellah explained that healthcare is a complex system with 49 different cadres, from doctors and nurses to nutritionists, physiotherapists and lab technicians.

“Healthcare is the only service or product where end-to-end is human beings, from the hospital owner or managers to the doctors to the patient to the relatives. You must really understand what we are getting into,” he added.

The official also blamed many of the current problems on how county governments are run, arguing that most governors treat their five-year terms as opportunities to enrich themselves and reward campaign loyalists.

“These five years, this guy wants to loot. He wants to get money for campaigning. He wants to fight for the seat in the next election. He knows he might not be coming back,” Miskellah said.

The Deputy Secretary General criticised the appointment of unqualified individuals into key positions in health departments, often based on political loyalty rather than competence.

“I have no problem when a governor appoints a retired teacher or campaigner to be a chief officer or a board chairman in the county,” he said.

“But this person wants to supervise somebody who went to school for 15 years. I don’t mean that we are any special as doctors, but this guy went to school for 15 years. He’s now a consultant, then you want me to come to you, some Form Four dropout, to interview me for a job or supervise me? It’s like literally revolving universities and having professors be supervised by retired villagers,” Miskellah noted.

Miskellah said such decisions not only demoralise health workers, but also lead to irrational decisions on salaries, promotions and welfare.

He also mentioned the ongoing frustration over unpaid loans and salary deductions that are never remitted, saying health workers are being pushed into financial distress due to poor county management.