Why must we beg for the care we provide others? Sick medics plead

In the corridors of Kenyatta National Hospital, where life and death dance in delicate balance, Dr Ndege Chacha moved with purpose each day.

His skilled hands brought new life into the world, but when illness crept into his own body, the system he served so faithfully turned its back on him; a cruel paradox that would ultimately claim his life.

The very professionals dedicated to healing others, and trained to recognise the slightest symptoms in them, often find themselves unable to access medical care when they fall ill.

Without medical cover and with the high costs of seeking healthcare in the country, medics are forced to navigate their deteriorating health on their own.

Early this year, Dr Chacha, a 37-year-old medical registrar training as a specialist in obstetrics and gynaecology at the University of Nairobi’s Kenyatta National Hospital (KNH) campus, fell ill.

Also read: Rest in peace, Dr Daniel Chacha – we failed you

According to reports, he first sought medical care at KNH, the very hospital where he dedicated his time and expertise to saving lives, but couldn’t access care because he wasn’t registered with the Social Health Authority (SHA), and the little money he had was inadequate.

With no option left, he sought care at a local hospital, but his condition worsened. By the time he was referred back to KNH, it was too late, and he passed away on March 14, 2025.

His death sent shockwaves through the Kenyan medical fraternity, igniting a fierce debate and prompting protests. Doctors voiced their anguish over their precarious welfare:

Long hours, immense responsibility, yet often no recognition as employees - and, crucially, no medical insurance.

Their SHA deductions from salaries were often delayed, rendering them unable to access the very healthcare system they served.

The Kenya Medical Practitioners and Dentists Union (KMPDU) stepped forward, demanding urgent reforms in medical training and employment, and advocating for fair pay and comprehensive medical cover for postgraduate trainees and all healthcare workers.

Isolated tragedy

“Dr Chacha’s story was not an isolated tragedy; it was a symptom of systemic neglect that left many healers vulnerable,” said Dr Davji Atellah, the union secretary-general.

However, Dr Emma’s* (not her real name) story paints an even more harrowing picture.

For four years, she has waged a silent war against stage four lung cancer - a diagnosis she has shared only with her closest family members.

“I go to the ward and see patients and put my best foot forward. But the same way I’m treating them is the same way I hope to be treated, yet I don’t have access to that care myself,” Dr Emma confides, her voice steady despite the weight of her words. She has declined to be named for fear of victimisation.

She asked us to remain anonymous, fearing that - even with all the troubles - she may lose her job for speaking out. The transition from NHIF to SHA in 2023 created a perfect storm in Dr Emma’s life. Under the previous system, a standard deduction ensured continuous coverage even when employer payments were delayed.

SHA introduced an inflexible cut-off: if remittances weren’t paid by the ninth of each month, access was denied completely - regardless of the deductions already taken from her salary. This rigid timeline became a monthly sentence when combined with her county government employer’s erratic payment schedule.

“Each month, from the 9th up to around the 19th, I cannot get any care at all, yet my money - about Sh7,000 - has been deducted,” she explains.

The consequences have been devastating. Earlier this year, she desperately needed an MRI as her symptoms worsened. Dr Emma was repeatedly turned away from hospitals despite her critical condition.

“By the time my January remittances reflected, the cancer had spread to my brain, and I was admitted as an emergency,” she recalls.

Released from the hospital on February 10 - just one day after SHA’s payment cut-off - she found herself unable to access follow-up care the very next day.

Even basic tests like a complete blood count or kidney function tests were denied.

“There have been other instances when I was sick and all I needed was something as simple as painkillers, but I couldn’t get them,” she says.

Last year, in 2024, her employer randomly removed her from the payroll for missing a headcount while attending an approved conference.

For three months — September through November - she received no salary and consequently no SHA coverage, forcing her to pay out-of-pocket for her treatments and occasionally rely on her parents to purchase medications.

She was reinstated in December but was never compensated for those months of unpaid work, with her salary arriving nearly a month late, on April 25 - after Easter.

Through it all, Dr Emma continues to work.

“As a doctor, you know when things are very wrong with your health. So you can imagine the anxiety, worry, exhaustion, feeling demoralised and angry. But life goes on,” she says.

Workers’ rights

She calls for counties to uphold their responsibility to pay remittances promptly and respect workers’ rights.

“I generally feel like the SHIF is a very blind system because requests for patients are a lot. I needed an MRI two months ago, but they just didn’t respond - accept or reject. They just left it pending for one and a half months. If you call the hotline, you get no response,” she explains.

Dr Ishmael*, a surgeon from Kiambu County who also asked to remain anonymous, shares similar frustrations.

In March this year, she sustained a shoulder injury and needed urgent overseas surgery.

Though cleared by the Kenya Medical Practitioners and Dentists Council (KMPDC) and the Ministry of Health, SHA stalled the process due to late county remittances.

By April 9, Kiambu hadn’t paid SHA, making her account inactive.

“The money was remitted on April 26 - well past the deadline. Now I’m racing against time before the next cut-off, which is likely to happen. I can’t raise my hand, sleep properly, or groom myself. I’m on heavy painkillers, and further delay risks damaging my hands - my tools of trade,” she says.

She reached out to county HR and SHA but got no help. She’s not alone.

“Why must we beg for care we provide others?”

In a recent WhatsApp group post, a colleague in an emergency was denied treatment because remittances hadn’t been made.

“If you have an emergency, you can’t wait for next week. Yet we can’t access care ourselves. It’s demoralising,” she says. “Those with chronic illnesses are always anxious about missing treatment.”

Dr Emmanuel*, a doctor with almost two decades of service at the Ministry of Health, also painted a grim picture of a healer denied healing.

Suffering from hypertension and asthma, he relies on daily medication and occasional hospital admissions.

“I have to take medication every single day for life to keep my pressure within normal ranges. I’m also asthmatic, so I use an inhaler often during the cold weather, and I get asthma attacks. So I need chronic medication for life. These drugs are available, but they are costly,” he says.

Under the previous NHIF system, his government insurance had worked effectively. But with the transition to SHA, he has been repeatedly turned away from hospitals, told that the government had not remitted funds. Since this is the only comprehensive insurance he had, he has had to go for days without medication because he cannot afford it.

“The NHIF was working quite well. I would get my medication using the cover, but this has since changed. On several occasions, I have gone to hospitals and been rejected. They say the cover does not work. On one occasion, I was told that the government had not remitted the funds, and on another occasion, I wasn’t given an answer. I had to purchase medication out of pocket, spending about Sh10,000 a month,” he says.

Like Dr Emma, there were times when he was unwell, unable to receive treatment, yet still compelled to report to work.

“About a month ago, I was sick. My blood pressure was very high, yet I still reported to work. It makes me feel sad and disappointed because, frankly, these are the services that we offer as doctors - and yet we are not able to access them, and because of reasons that we don’t understand clearly,” he says.

He adds, “If they were to give us options to seek medical insurance from private sector providers, I would get a superior cover. But as it stands, I pay out-of-pocket largely for my medication.”

Dr Bonnke Arunga, a medical officer in Kisumu, questions if he made the right career choice. Despite excelling in school and completing an internship with hope, his career has faced nothing but obstacles.

When SHA replaced NHIF, he lost his job at a private facility. Now, with no cover at work, he buys his own insurance to cater for his family.

“My pay is low. I can’t support relatives or afford emergencies. Many colleagues suffer from burnout, mental health struggles, and financial pressure,” he says.

“During the internship, the government delays payment for months. You’re expected to deliver care, yet can’t afford rent or food.”

Kenya’s doctor-to-patient ratio is 1:17,000 - far from the WHO’s recommended 1:1,000.

The few doctors available are stretched thin, and many lack insurance.

Dr Atellah says more than 1,000 healthcare workers face the same challenge due to inconsistent coverage from counties. Doctors have resorted to fundraising via WhatsApp.

“We have over 80 groups where we contribute to colleagues’ medical care weekly,” says Dr Atellah.

This reality is not just tragic - it’s dangerous.

When those tasked with saving lives are denied their right to health, the ripple effect touches every patient and weakens the entire healthcare system.

*Names have been changed to protect identity