KUCO chief: Unlawful organ harvesting claims need to be urgently investigated

How do you manage to juggle being a union leader with other roles, such as chairperson of the Health Caucus, Infectious Disease expert, and group leader of African support to the Ebola outbreak in West Africa?

Our laws allow it. To be a union leader, you must be actively working in the sector you represent. I am also a practising clinical officer in government service. The recognition agreement we have with the Ministry permits me time off for union duties without being marked absent. The arrangement works both ways, allowing me to serve in multiple capacities.

What have you achieved so far through the union?

We’ve secured fair representation for our members, signed labour agreements, and achieved various allowances, such as emergency call and health service allowances. Our biggest achievement, however, is visibility and recognition. Before Kuco, very few people understood what clinical officers actually do. Today, it is widely acknowledged that we are the backbone of the health sector — handling everything from diagnosis to treatment decisions and admissions. We’ve also successfully lobbied for the revision of the Act of Parliament. Previously, clinical officers could only study up to diploma level.

Today, we have degree, master’s and even PhD programmes — all thanks to our union’s advocacy. Though clinical medicine began in Kenya in 1928, it wasn’t until 2010 that degree programmes became available. Now, postgraduate qualifications are a reality. Internationally, we are affiliated with the International Academy of Physician Research and Physician Associates. This connects us with similar professionals in 87 countries, including clinical associates in South Africa and physician associates in the US and UK. We are currently working to harmonise curricula across these countries to allow easier mobility for our professionals.

Do you have any rivals as a clinicians’ union?

No. What exists are professional bodies and academic groups, but we are not in the same lane. Even the registrations are different — they are registered by the Registrar of Societies, while we are registered by the Registrar of Trade Unions.

You’ve been vocal about the Social Health Authority (SHA) and its challenges. What, in your view, is its biggest problem?

The main issue is that those entrusted with implementing SHA seem not to understand their roles. Additionally, access to healthcare has been limited for the very people meant to benefit from the scheme. When you restrict access, it forces people to pay out of pocket, exposing them to financial hardship, which defeats the purpose of the programme.

What is your perspective on the financing model of the Social Health Authority (SHA)?

The financing model underpinning SHA is fundamentally flawed. Despite the exchequer allocating approximately Sh4.8 billion to the programme, contributors are finding themselves unable to access services at the most basic level — primary care. This is not only disappointing, but outright illogical.

Take, for instance, dental care. It’s listed in the benefits package with a supposed allocation of Sh2,000. However, beneficiaries are then told that this amount is “subject to availability of funds.” In essence, this means you may be denied care because the budget wasn’t properly allocated — or worse, never existed to begin with. That, to me, is deeply retrogressive. Even more troubling is that Kenyans are now paying more than they did under NHIF, yet receiving less. It begs the question: why are we contributing to a health fund that won’t support us where we need it most?

In my view, the funds collected through SHA should directly support level two facilities, where the bulk of healthcare needs are first addressed. There is absolutely no justification for denying someone dental treatment at a level three facility when they’ve dutifully contributed to the system.

What is your view on the recent reports of human organ harvesting in some hospitals?

This is a deeply troubling issue, and I believe it must be approached with a clear ethical lens. I would look at it in two ways. First, if the organ donation is consensual — where a conscious, informed individual willingly agrees to donate an organ, possibly in exchange for compensation — then the concern shifts to ensuring that such practices are regulated to prevent exploitation and uphold medical ethics. But even then, we must ask: are these individuals acting out of free will, or out of economic desperation?

Ordinarily, organ harvesting occurs posthumously, guided by a donor’s prior consent— where someone, while alive, states that upon death, their organs may be donated to help others. However, where organs are harvested without proper consent, or from vulnerable patients who are not dying, is nothing short of criminal. If someone is unconscious or coerced in any way, this becomes human rights violations and organised crime. Such reports must be thoroughly investigated and those found culpable prosecuted.

You recently signed a return-to-work formula with the authorities. Does this mean the union’s grievances have been addressed?

One major issue was the SHA — specifically discrimination and exclusion. That has been resolved. Our facilities are now recognised and empanelled, with contracting underway. Our practitioners, who had previously been denied pre-authorisation rights, have had those rights reinstated. It was absurd that professionals were denied the ability to practise their trade — something unheard of in many countries.

Promotions and re-designations under the new career guidelines are still ongoing at county level. As for the Collective Bargaining Agreement (CBA), negotiations are complete, and we expect to sign it with the Ministry of Health soon. There is positive progress, and we believe it’s wise to give the process time to deliver results.