Anger at young doctors who commit suicide

A gloomy mood gripped a village in Kenya's Rift Valley last week, as dozens of medical trainees joined other mourners in burying a colleague who had committed suicide.

Speaker after speaker lamented the loss of Francis Njoki, a 29-year-old trainee pharmacist, whose family told the BBC of feelings of exhaustion and frustration over the government not paying his salary since he started working as a pharmacy trainee. August.

He is the fifth paramedic to kill himself in Kenya in the past two months due to “difficulties of job stress and lack of responsive insurance coverage,” according to Dr. Davji Attila, secretary of the Kenya Medical Practitioners and Dentists Union (KMPDU). Adding that it was not something the union had recorded before.

The medical authority said there have been five suicide attempts by KMPDU members this year.

There are no figures yet available on the number of suicides nationwide in Kenya this year.

Njoki was doing his training at a public hospital in the town of Thika, near the capital, Nairobi, when he committed suicide last month.

His uncle, Tyrus Njoki, told the BBC that he reported hallucinations and depression due to sleep deprivation.

The uncle added: “He mentioned in his suicide note that delaying his salary for four months was one of the things that exacerbated his psychological illness, and led him to end his life.”

The trainee, the firstborn in his family, was suffering from depression and was receiving treatment, according to the police report.

Njoki was among hundreds of trainees sent to health facilities in August to undertake their mandatory one-year training to qualify.

But the trainees say that they did not receive their salaries during the first four months, due to financial restrictions imposed by the government.

This is despite trainees making up an important part of the workforce in public hospitals – used by many Kenyans who cannot afford private medical insurance.

Trainees constitute about 30% of doctors in the health sector in the state.

They do most of the work in public hospitals, but under close supervision. They are on call, sometimes for 36 hours, and provide most of the health services patients need.

“Like many of his colleagues, Dr. Njoki faced insurmountable challenges in meeting basic needs such as rent and utility bills,” KMPDU said in a statement.

The government has been in a long-running dispute with unions over wages and working conditions for trainees.

The government has proposed reducing the monthly stipend for trainees to $540 (£430).

The union wants it to remain at $1,600 as agreed with the government in 2017.

But President William Ruto said the government could not afford to pay such an amount, and “we have to live within our means.”

“We cannot keep spending money we don’t have,” Ruto said in early April.

After mounting pressure and threats of strike, the government last month released $7.4 million to pay the salaries of more than 1,200 trainees who have not received their salaries since August.

Some interns say they are paid “peanuts.”

“After spending six to seven years of study, we had to wait several months to get training. And then, with all the long working hours, the government decided to pay us peanuts. We are really suffering,” Dr Abdi Addo, a trainee, told BP. C at Mbaghati Hospital in Nairobi.

Dr Adu is among hundreds of young doctors who are torn between leaving the country to look for jobs abroad or abandoning their profession for better paying jobs.

Another trainee, who spoke to the BBC on condition of anonymity for fear of retaliation, said: “I swore to save my life, at the very least, and restore health, at best, but the government is doing everything it can to kill my son.” Enthusiasm and undermining my service department.”

Experts point to the death of Dr. Timothy Ryungu last month as an example of how stressful working conditions are for medical staff.

He was a pediatrician at Kenyatta National Hospital in Nairobi, who collapsed and died at home after a round-the-clock shift; Local media reported that he repeatedly complained of fatigue to his supervisor that day.

The 35-year-old had diabetes and had not taken vacation for two years, according to his family.

An autopsy revealed that Dr. Ryungu died of hypoglycemia, caused by a blood sugar level falling below the normal range. It also showed that he had not eaten anything for more than 48 hours before his death.

In May, the Kenyan government reached an agreement with a medical union to end a 56-day strike, but the main issue of trainees' salaries remained unresolved.

The strike halted operations in public hospitals, and dozens of patients reportedly lost their lives.

Several rounds of talks over trainees' wages and working conditions collapsed.

Last week, the KMPDU ordered all trainee doctors to stay home, issuing a new 21-day nationwide strike notice, accusing the government of reneging on the agreement reached in May.

In September, a 27-year-old trainee doctor committed suicide at Gatundu Level 5 Hospital in Kiambu Central District.

Dr. Desri Mura-Obuoji had just finished a grueling 36-hour shift that had taken a toll on her mental health, according to her co-workers.

They said she also struggled to pay her rent and utility bills.

Dr Mwendi Nthosi, chair of the KMPDU Internship Liaison Committee, blamed financial difficulties and a “toxic” work environment for her death.

Local media reported that during the burial, Obuoji's family asked the government to take responsibility and hold accountable the people who lost their lives.

Other recent suicides noted by KMPDU include Vincent Busire Nyambondi, an intern at Kisii Teaching and Referral Hospital; Collins Kiprop Kosgei, a fifth-year medical student at the University of Nairobi and Keith Makori, a 30-year-old doctor in Kiambu Central County.

Young doctors mobilized on X under the hashtag #PayMedicalInterns to push for better wages and working conditions. They marched to the Health Ministry offices last week to vent their frustration.

“Our doctors and nurses bear the weight of a broken system, but their cries are drowned out by the greed of those in power,” Dr. Kipkosh Cheruiyot Published on the X platform.

Health officials did not respond to the BBC's request for comment.

But in response to rising suicides in September, Health Minister Deborah Barassa said it was a “stark reminder of the silent struggles too often endured by many, including those in the healthcare profession”.

The minister announced plans to deliver “robust workplace mental health programs” for healthcare workers across the country “to ensure support systems are strengthened and those facing challenges do not feel alone”.

Medical experts said many young doctors also suffer “moral injury” or psychological trauma because they feel guilty for not doing enough to treat patients, even though they did their best under difficult circumstances.

“Thinking that you could have done something to save a patient’s life but you couldn’t can lead to feelings of guilt, shame and helplessness, which contribute to mental health problems,” Dr Chibanzi Mwakunda, a psychiatrist, told the Kenyan newspaper The Standard. .

Trainee doctors told the BBC that most medical schools do not adequately address the issue of suicide, leaving new and overworked doctors ill-equipped to deal with traumatic ordeals – and this is exacerbated by poor pay.

One of the trainee doctors said: “A healthy doctor builds a healthy nation. When I feel stressed or depressed as a doctor, I may even forget how to perform resuscitation on a patient, which may lead to them losing their life.”

“A frustrated doctor is a dangerous person to serve you. It has become a thankless job.”

About 1,400 Kenyans die by suicide every year, according to the Kenya National Bureau of Statistics. But some analysts believe the actual numbers may be higher.

Suicide remains a crime in Kenya, where those found guilty of attempted suicide can face up to two years in prison, a fine, or both.

The law has been widely criticized, with some rights groups calling for its repeal, arguing that it further stigmatizes mental health issues and prevents people from seeking help.

“How many doctors will we bury until the government takes action?” Dr. Ado asked.

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