Doctors in Kenya’s private hospitals are stepping up efforts to unionize in response to precarious contracts, workplace surveillance, and profit-driven care models that undermine both workers and patients.

At Avenue Hospital, organizers have completed mapping and identified department leaders, and an Organizing Committee is now taking shape. At AAR Healthcare, progress has been harder. Just 10 doctors hold permanent contracts, while 100 are classified as “independent contractors” and 25 more are hired as short-term locums. This fragmented workforce faces heavy surveillance and commission-based pay, creating a climate of insecurity and competition.

“Doctors here are clear – they want a union,” said a KMPDU organiser. “The system is designed to keep them divided and disposable, but that only makes organizing more urgent.”

The campaigns are part of a broader effort led by the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) and supported by Public Services International (PSI). International solidarity has been critical, with the Dutch federation FNV, US-based SEIU’s Committee of Interns and Residents (CIR), and research groups including CICTAR all contributing to strategy, exchanges, and training.

Earlier this year, PSI-facilitated and funded workshops led by SEIU organisers trained intern KMPDU organisers and inter in organising model, helping KMPDU to pivot toward organising and building capacity. SEIU and PSI also trained 110 regional organizer in Tanzania in a project to build Tanzania's public employee union capacity and Power. Mean while CIR is working closer with KMPDU organisers developing members tracking and data bases.

The Project have also shined a spotlight on the role of international development finance in driving privatization. Investigations by Bloomberg CICTAR, and Oxfam revealed patient neglect at IFC-funded hospitals in Kenya and Uganda – including Avenue Hospital.

In 2024, KMPDU and CICTAR launched a report on Austrian company VAMED, exposing how it received European development finance while extracting profits from Kenya’s public health system. The findings dominated national headlines and undercut government claims that resources are too scarce to pay doctors fairly.

These workplace struggles are unfolding against a backdrop of repeated nationwide strikes by doctors, demanding fair pay, permanent contracts, and adequate public funding. The strikes have highlighted the contradiction of a system where international investors funnel resources into private hospitals while the public system remains underfunded.

The campaigns in Kenya are part of a wider PSI-led program that links organizing and research in Kenya, and Tanzania. With FNV and CIR support, the aim is to build organizing culture by training organizing on the organizing model, grow union density, and building African union power to confront the spread of profit-first healthcare models across Africa.

“This fight is about much more than contracts,” said KMPDU leaders. “It’s about whether healthcare in Kenya will be run for profit – or for people.”