Behind the white coats: Kenyan healthcare workers battle burnout, grief and neglect

When patients enter a hospital or clinic, they’re often overwhelmed by pain, fear, or worry for a loved one. In those moments, it’s easy to overlook that the healthcare workers caring for them are also human, each with their own challenges, families, and feelings.

Jackline Atieno, a health worker in a busy hospital, has seen this disconnect many times. Despite dealing with personal challenges, like leaving a sick child at home, she shows up every day, often in the hardest conditions, driven by duty but weighed down by emotional and physical exhaustion.

“Sometimes, patients are so focused on their own pain or that of a loved one that they forget others are waiting too. They may not realise that we've been on our feet for hours, trying to help as many people as we can. Even stepping away for a brief moment—just to catch our breath or use the restroom—can lead to frustration. But we understand where it comes from. People are scared, tired, and just want relief,” Atieno says.

It’s a common belief that healthcare workers are unshakable, trained professionals who never falter. But that belief ignores the intense pressure they face.

Atieno describes being pushed to the edge, working long shifts without breaks, managing countless patients, and juggling personal stress, all while being expected to remain calm and compassionate.

Pushed to the edge

“I’ve been so mentally stretched that I’ve felt like I could break. But we keep going because there are patients depending on us, and families too.”

Atieno recounts times when patients have refused care from certain health workers, not because of poor service, but due to personal preference. This puts extra strain on specific workers, increases their patient load, and robs them of time they desperately need for rest or recovery.

In the face of all this, Atieno leans on her support system—colleagues, friends, and faith.

“When I feel overwhelmed, I talk to my coworkers or pray. I ask God for strength. There’s no room to fall apart—you have to keep moving for the sake of your family and your patients,” she says.

Elizabeth Kerubo works tirelessly as a community health worker in Nairobi, where the realities of her job weigh heavily on her heart and mind.

Over the past few months, she has been deeply affected by the struggles of the patients she cares for—many of whom miss their crucial medications, relapse, or tragically lose their lives. Each loss leaves a mark, not just professionally but also personally.

Grieving family

Recently, Kerubo received a distressing call; a patient she had been closely following, battling both tuberculosis and HIV, had passed away. The news struck her hard, but she had no choice but to drop everything and rush to the patient’s home. There, she found a grieving family, overwhelmed and desperate for guidance. Their eyes sought comfort and answers from her, turning to her in a moment of profound sorrow and helplessness.

Despite her fatigue and personal challenges, Kerubo had to step into this painful scene, organising the transfer of the body to the mortuary and supporting the family through their darkest hour.

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• Behind the white coats: Kenyan healthcare workers battle burnout
• grief and neglect

The emotional burden of such moments is immense, compounded by the harsh reality that her pay is minimal and rarely reflects the depth of responsibility she carries.

Financial strain

More often than not, Kerubo finds herself paying out of her pocket to help patients, whether it’s for transport, food, or medication. This financial strain adds another layer of stress to an already demanding role. The constant stream of urgent calls, even when she is managing her own difficulties, can feel overwhelming and exhausting.

“You can be struggling mentally, yet you can’t even afford the mental health services you’re campaigning for. We are paid only a stipend, with no other benefits or insurance, and sometimes that stipend is delayed. It’s really tough.”

Her words reveal the cruel irony of her situation: while she advocates tirelessly for the health of her community, her own mental and physical health often goes unsupported. This gap leaves many community health workers like Kerubo vulnerable, carrying heavy burdens with a little safety net.

On October 24th, 2024, the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) called for urgent improvements to the working conditions of healthcare workers, following the tragic death of Dr Desree Moraa Obwogi.

Obwogi, an intern at Gatundu Level 5 Hospital, was found dead on her balcony, with a rope around her neck. A note discovered nearby cited a highly stressful work environment and personal difficulties as contributing factors. Reports revealed she had endured a gruelling 36-hour shift without food.

In a statement, KMPDU Secretary-General Davji Atellah highlighted the urgent need for a healthcare system that prioritises the mental health of workers and provides fair compensation to prevent exploitation.

“It is a dangerous system that will continue to wreak havoc on the lives of healthcare workers. We must together resist it. We must resist this modern-day slavery and challenge the embedded structural failures that lead to such tragedies. We owe it to Dr Moraa and every healthcare worker in this country to demand work environments that prioritise workers' mental well-being, ensure timely and fair compensation, and hold accountable those who perpetrate abuse and exploitation,” Atellah said.

Tragically, Obwogi's death was not an isolated incident.

On November 27, 2024, Dr Francis Njuki Gachimo, a 29-year-old pharmacist and intern at Thika Level 5 Hospital, was found dead at his home in Kiganjo Estate, Thika, Kiambu County. According to KMPDU, he had been working without pay for three months.

Depression and isolation

These heartbreaking cases represent only a fraction of the pain many healthcare workers endure, battling depression and isolation with little support or someone to talk to. They highlight a growing crisis within the healthcare system, where mental health struggles among frontline workers often go unnoticed and unaddressed.

A study conducted by the Aga Khan University revealed that one in every four healthcare professionals in Kenya shows signs of depression. This comprehensive research titled "Protecting the Wellbeing and Strengthening the Resilience of Frontline Health Workers", was carried out across all 47 counties in the country. The findings indicated that 40 per cent of healthcare workers exhibit symptoms of post-traumatic stress disorder (PTSD).

The study aimed to shed light on the mental health and resilience of frontline health workers in Kenya.

Between January 2021 and June 2022, nearly 4,000 nurses, midwives, and community health volunteers (CHVs) were interviewed to understand their psychological well-being.

Overwhelming workloads

Among the main factors contributing to these mental health challenges were overwhelming workloads, insufficient resources, challenging working environments, inconsistent payment of salaries for nurses and midwives, and the complete lack of salaries for CHVs. These conditions place immense pressure on healthcare workers, affecting both their mental health and their ability to provide quality care.

Healthcare workers continue to face unfulfilled promises and ongoing challenges. Currently, workers involved in the Universal Health Coverage (UHC) programme are on strike, demanding a five-year gratuity payment for their work during the Covid-19 pandemic.

According to their union, some healthcare workers have lost their lives, many are struggling with depression, and yet they still endure uncertainty and instability about their future.

This situation persists even as the world comes together to observe Mental Health Awareness Month, highlighting the urgent need to address the mental well-being and fair treatment of those on the frontlines of healthcare.