Employment and Labour Relations Court (ELRC) on Wednesday gave doctors, Ministry of Health and counties one last chance to settle the stalemate within 14 days. 

Justice Byrum Ongaya said that his order suspending the doctors strike was in place but on condition that the parties commit to meet within two weeks and come up with a solution. 

He declared that if the deadlock persists, he will hear rival arguments to determine whether the strike is legal or not.  

This came as the strike issue became the mythical Tower of Babel with all parties speaking different tongues on who is to blame.

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  Deserted KNH turns into centre for few helpless critical patients
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  Deserted KNH turns into centre for few helpless critical patients
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  Medics insist 11 demands must be met before calling off strike

Kenya Medical Practitioners and Dentist Union (KMPDU) filed an application to punish county governments and the Ministry of Health for allegedly boycotting and storming out of the ‘whole nation’ meetings. 

The meetings were to discuss the bare minimums for the parties to engage. The union also accused the Susan Nakhumicha-led Health Ministry of playing underhand games, including call for last minute meetings.  

On the other, the Ministry of Health and counties pointed an accusing finger at KMPDU claiming that despite Justice Ongaya ordering them back to work, they have remained defiant. 

The Attorney General who is representing the ministry told the court that there should be at least 75 per cent doctors in hospitals as a bare minimum requirement for medics to be on strike. 

The AG pegged his argument on the Labour court’s judgment in 2022 that outlawed doctors and nurses strike unless there is a specified minimum number of medics who are attending to patients. 

A three-judge bench of the Labour court ruled that the law governing essential services in the country allows public employers to determine the classification of employees who must continue to work during a work stoppage. 

They found that the government has the right to dictate the number and names of employees within each classification and the essential services that are to be maintained.  

Justices Monica Mbaru, Jorum Abuodha and Linnet Ndolo directed former Health Cabinet Secretary Mutahi Kagwe and his Labour counterpart Simon Chelugui to come up with regulations within 12 months to ensure that hospitals have personnel during strikes. 

“Industrial action by health workers is not permitted unless there is a known and acceptable formula of ‘minimum service’ retention at every affected health facility. This limitation is in addition to those imposed by the conciliation procedures set by the Labour Relations Act,” the court ruled. 

Doctors argue that first, the ministry and counties should disclose how many medics they have as some services have no one to handle. 

Among KMPDU's demands is to ensure there are enough doctors employed in order to make the bare minimum requirement a reality. 

Justice Ongaya heard that although one doctor ought to take care of 1,000 patients, the current situation is that one doctor takes care of 11,000 Kenyans. 

The union has challenged the government and counties to soften their stance if they want a compromise. In its submissions filed before court, KMPDU lamented that the members were being underpaid. 

According to its comparative study, the union claims the problem lies at President William Ruto’s doorstep, the State House where there is one doctor tasked with taking care of those at the presidency. 

KMPDU claimed that State House paid the doctor less than Sh 863,240 in the Financial Year 2021-2022. Yet in the Collective Bargaining Agreement, the doctor ought to have been paid Sh2.1 million but it was claimed that he got Sh1.3 million. 

The 1,848 doctors under the ministry were said to have been paid Sh27 million less the agreed amount for the same financial year. 

The union said that there is no uniformity in how its members are paid citing the case where a doctor attached to the Directorate of Criminal Investigations (DCI) was being paid more than the agreed amount in the CBA. 

KMPDU has demanded that the government apprehends the police officer who fired a teargas canister at the secretary general Davji Atellah.

The doctors have also demanded refund of the controversial housing levy deducted from their pay.

With all parties claiming to have complied with the court order, and accusing the other of disobedience, Justice Ongaya had to ask them to at least act in a civil manner. 

In court, there was a third voice. The conciliator was tasked to look at what the issues were and at least bring the two warring parties together to make a resolution. 

The conciliator, Kisurulia Kuloba, observed that it was important to end the current strained industrial relations in the health sector. His report is dated March 6, 2024. 

“The country can no longer afford to have strained industrial relations in this critical sector owing to underlying unresolved grievances by the parties,” he said.

In his report, Kuloba singled out six issues that he deemed to be at the heart of the perennial strikes. 

He said that CBA negotiations, comprehensive medical cover, employment of more personnel, provision of adequate protective gear, call allowance and post graduate training and promotion were the main grievances. 

"It is high time these issues were resolved once and for all to bring about industrial piece and harmony in the critical sector,” advised Kuloba. 

On the implementation of the 2017- 2021 CBA, the conciliator observed that there were 48 agreements, and the government and counties were ordered to action all terms and report to the court within 60 days. 

CBA negotiations were to start for the 2021-2025 period but the employers had not given a counter after KMPDU gave its proposal. 

During the meetings, Kuloba noted that doctors raised concern that there were salary delays in some counties. Mombasa and Kisii were called out as being notorious. 

Kuloba said that the issue needed to be sorted out once and for all. 

On statutory deductions, the conciliator's report states that the union did not specify which counties were not remitting the same. 

He also said that although all doctors in the two levels of government were supposed to have comprehensive medical cover, it was unclear how many counties were not complying. 

Employment of all doctors was another thorny issue. Kuloba said that this was not provided in the CBA. He argued that each county and the ministry are responsible for recruitment on the need basis. 

On protective gear, the conciliator said there was a healthcare worker safety policy by the ministry which counties are expected to implement but there was no clarity which devolved units did not have the gear. 

The conciliator found that creation of centralised management of human resources (health services commission) was not in the CBA and therefore needed amendment in the Constitution. 

Call allowance was yet another issue. Kuloba stated that doctors working in universities are employees of the respective institutions and the issue should be dealt with there. 

He stated that conciliation proceedings indicated that the current CBA was based on salary or grading structure that had not been approved by the Public Service Commission. However, the counties and the ministry implemented the CBA according to the Public Service Commission structure.  

The conciliator recommended that counties should come up with modalities of ensuring salaries are paid on time and remit statutory deductions. 

Kuloba was of the view that the challenges on the implementation of the CBA were likely to be a thorny affair unless harmonised. By Kamau Muthoni  , The Standard

They were raising a glass to celebrate the official opening of Blackburn’s newest bar when this photo was taken.

A new route for the proposed gas pipeline from Tanzania to Uganda will form part of the discussions between the two countries when the project’s feasibility study is done, a departure from the earlier suggestion of laying the pipes parallel to the East African Crude Oil pipeline.

Ruth Nankabirwa, Uganda’s minister of Energy and Mineral Development, says the two countries have agreed to lay the gas pipes closer to communities to ease access to the product. Earlier proposals had suggested that since nearly all the land for the 1,443km East African crude oil pipeline had been acquired, it would only make sense if the gas pipes were laid side by side in the same corridor. 

This, it was assumed, would relieve the two countries the tedious process of looking for other pieces of land, the huge financial implications that come with compensation hurdles, and reduce the time to build the gas pipeline. But after much thought, the two states have agreed that finding a new route would make economic sense.

“We thought initially that we were going to use the East African Crude Oil Pipeline (EACOP) space and that it was going to be easy. However, the Tanzanian government rightly changed the course of the route because this gas is a finished product, which is needed; so, it cannot bypass communities along the way,” Nankabirwa told Deep Earth in an exclusive interview on the sidelines of the Africa Mining Indaba in Cape Town recently. 

Nankabirwa could not tell when the feasibility study for the Tanzania-Uganda gas pipeline would be completed. She, however, said that the two countries recently instituted two committees – steering and technical – in Dodoma, Tanzania, and assigned them to start on the feasibility study. The study will inform how much gas needs to be piped to Uganda.

Tanzania has nearly 50 trillion cubic feet of gas that it is exploring, which is more than enough to power the entire country and supply more to neighbouring countries. In Uganda, TotalEnergies and Cnooc – the operators of the Tilenga and Kingfisher oil fields respectively– intend to develop gas facilities. Uganda has an estimated 500 billion cubic feet of gas.

This gas, which is expected to be depleted in just eight years, will be used to mainly power the different project infrastructure such as the central processing facilities, the flowlines and the crude export pipeline to Tanzania, among others. A small amount of this gas will be converted into liquefied petroleum gas for domestic consumption.

Many homes in Uganda still use charcoal, which accounts for most of their energy needs. The use of charcoal has placed pressure on Uganda’s forest cover. Official figures place the loss of 72,000 hectares of forest cover annually on firewood and charcoal. This is equivalent to 100,000 football pitches, according to Uganda’s Energy Transition Plan.

Shifting many of these homes to the use of gas is being seen as of paramount importance. It is not the first time that Uganda and Tanzania have discussed plans to build a gas pipeline. Tanzania’s government told Uganda about its interest to sell some of its large quantities of gas to neighbouring countries nearly 10 years ago.

Whispers within the corridors of power offered the view that this was not just about Tanzania selling gas, but a give-and-take condition for participating in Uganda’s oil project through acquisition of stakes in, majorly, the proposed oil refinery. In 2018, the two countries signed a memorandum of understanding to build a gas pipeline, which would run parrel to the proposed East African Crude Oil Pipeline. 

The signing of this MoU offered hope to Uganda’s plans of building its first direct-reduced iron (DRI) plants that will use mostly gas – a healthier form of producing steel without the use of the conventional blast furnace that many environmentalists balk at.

Traditionally, many steel companies in Uganda today are using heavy fuel oil and coal for heating iron ore. Other than the high importation costs for these two energy sources, environmental activists continue to criticise the use of heavy fuel oil and coal due to their high carbon emissions, which are responsible for drastic weather changes such as floods and droughts.

Uganda’s Energy Transition Plan - a blueprint that will guide Uganda to zero carbon emissions by the year 2065 - which was launched in December 2023 during the COP 28 summit in Dubai, UAE, offered a clearer picture of the complexity of building clean DRI plants.

The plan talks of how Uganda, in an effort to reduce the cost of importing heavy fuel oil and coal for steel plants, built two direct-reduced iron plants in Iganga district, which are operated by Tembo Ltd, and another in Masese, operated by Abyssinia Iron and Steel Ltd. While the report said these two plants do not require coal for their operations, it added that they have high emissions.

The Energy Transition Plan adds that after 2030, many steel plants using coal will be phased out in preference for those using gas. That deadline only adds to the pressure for both Uganda and Tanzania to quickly resolve some of the most critical issues for the gas pipeline to be built, one of which will be the route.

In January 2020, the National Planning Authority, with support from the European Commission, released an interesting gas demand report, which offered certain specifics on where exactly a more practical gas pipeline should be routed.

With the proposed construction of a DRI plant in Kabirizi in the western Ugandan district of Rubanda, the report suggests that a gas pipeline from Tanzania should go through the border point of Mutukula, move towards Mbarara industrial park, continue to Rubanda, before also supplying the Kabale industrial park.

Another pipeline can also be routed to the Masaka industrial park before it connects to the existing Bweyogerere, Luweero, Luzira and Jinja industrial parks. Whichever way the gas pipeline is channeled, one thing is clear: Uganda needs it urgently if it is to meet its carbon emission reduction targets. Written by Jeff Mbanga, The Observer