With all that is happening in Kenya, our medical interns need to be at their place of work.
I propose a martial plan to allow medical interns to begin their medical internship on July 1 2024.
Background
The court case that the medical interns had filed opposing the SRC circular that proposed to pay them a stipend instead of a salary was postponed to September 2024. It was thought that this case would help hasten the deployment of medical interns but it did not. There is thus a minicrisis of sorts – to start or not to start medical internship?
Medical internship had not started initially because the , The Ministry of Health of Kenya (MOH) had not budgeted for these medical interns. resulting in a delay in posting of these interns. MOH on the other hand blamed the quagmire on Treasury of kenya, whom they accused of not releasing monies meant for medidcal interns. As a result of this ping-pong the posting dates for medical internship were postponed thrice, to September 2023, then February 2024 & then to July 2024. This resulted in a nationwide strike of doctors to push for this posting over and above the issue of the unpaid CBA salary arrears owed to doctors.
During the strike MOH threw a spanner in the works and proposed to/their change the terms of employment for medical interns from employee with all the benefits as negotiated by the CBA to casual laborers to be supported with a stipend of 70,000 KES, a position that made the strike go on for a longer time. This stipend is not acceptable in view of the work that medical interns do. Medical Interns literally run the level 4 & 5 health facilities both day and night .
HOSPITAL ALLOCATIONS
Of note is that the medical interns were already assigned their places of internship by the Kenya medical practitioners and dentist council (KMPDC) and they have already taken their Hippocratic Oath. This was done mid last year.
PROPOSAL
I thus propose that the medical interns report to their assigned stations and begin working as they await the court process to make a judgment on their case. The bigger question would be how would the intense survive without pay?
SURVIVAL PROPOSALS
We, the older generation of doctors have been in such situations before. During my internship we worked for four months without pay but the medical superintendent was very helpful. The hospital provided us a stipend and housing for that period until we got paid and refunded the hospital.
INTERNSHIP BUDGET
The first important thing is that theMinistry of Health (MOH) should prepare two budget lines for the current unposted interns, and for the medical students who are almost completing their medical studies in the various medical schools. We do not want another back log.
LIST OF INTERNSHIP HOSPITALS
The second intervention is to generate a list of all the internship hospitals where they have been posted to do their medical internship. The facilities will be contacted to document the level of assistance they can have for the medical interns.
INTERN HOUSING
Top of the list would be for them to provide group housing for the medical interns. Generally interns’ houses should be within or near the medical facility that is having those medical interns. The hospitals should move quickly to secure these internship housing. In the initial run, the hospitals having facility improvement fund could pay three months deposit for these houses, so that once the interns settle and get paid, they could refund the rents that have been paid in the case that house allowance is included in their pay.
DAILY SUSTENANCE
We have witnessed excellent crowd saucing for finances during their current demonstrations. The same technique could be applied to crowd source finances to maintain medical interns during the period that the court process is ongoing. I propose that manager be identified to receive fans that will facilitate medical in internship both now and in the future, so us to ensure that medical interns are posted immediately they complete their studies and that they do not suffer financial strain while they are helping the Kenyan achieve universal health coverage. The KMA SACCO could also advance the internship loans to the young ones to be refunded when they get paid.
INTERNSHIP COORDINATOR
Each medical facility has an internship Cordinato who would identify issues that may arise during internship. Interns are prone financial distress, medical accident and may even get into alcoholism as a result of work strain. The internship coordinator should be on the lookout for these things.
INTERN MONITORING
The MOH and KMPDC should then set up a monitoring team to see how the interns are faring by doing monthly inspections and provide the report that can be used to improve the process now and in future. The county governments that stand to benefit the most from the services of the medical interns should take a lead in ensuring that they are interns are well taken care of. In the long run the County Governments could set aside a kitty to facilitate internship.
BUDDY SYSTEM
Kenya Medical Association in collaboration with other societies and associations will call upon their members to form a buddy system to provide support for the medical interns in these very difficult times.
BURDEN OF WORK DURING DEMONSTRATIONS
The benefits of having the internship facilities both public and private, complete with the requisite personnel is that in these times of demonstrations, there are likely to be many who require care, and the presence of medical interns provides not only opportunity to ensure that the injured are quickly taken care of, but also to ensure that the medical intense arelearning how to take care of injured patients in situations of emergencies.