Dozens of Kenyan doctors in at least two counties have gone on strike over delayed salaries, inadequate personal protective equipment (PPE) for handling COVID-19 patients, and lack of medical insurance, a union official told Reuters.

Kenya has a total of 30,636 confirmed infections, with 487 deaths, according to health ministry data.

Healthcare workers say they have not been given adequate PPE, but the government has said it has distributed enough to go round.

Doctors in western Homa Bay and central Embu had gone on strike over delayed or missing salary payments, lack of promotion, missing medical insurance and no hazard bonus, Allan Ochanji, vice chairman of the Kenya Medical Practitioners, Pharmacists and Dentists Union, told Reuters.

Doctors who contracted COVID-19 had been forced to pay out of pocket for their own treatment, he told Reuters in an interview.

“We have colleagues who have contracted COVID, they have been in isolation, they have had to foot the bills, despite the fact that they contracted COVID while on duty,” Ochanji said.

Doctors in Nairobi warned on Friday they would go on strike within a week if their demands were not met: Nairobi has by far the largest number of coronavirus cases.

Richard Muga, Homa Bay County health executive, confirmed that health workers’ July pay had been delayed due to a dispute on how to allocate revenues to counties. He said the strike was illegal.

“We have tried to engage the health workers,” he said. “They have not heeded our pleas.”

A nurse in one Homa Bay hospital who did not want to be identified said patients were no longer visiting public health facilities due to the strike.

“Many patients are now going to private hospitals, or doing over-the-counter medication,” he said.

Health officials from Nairobi and Embu counties did not return calls seeking to comment. The health ministry said on Friday that Nairobi County officials were in talks with the doctors.

The ministry of health said eight healthcare workers had died from COVID-19. Ochanji said 558 healthcare workers had tested positive.

Dr. Doreen Lugaliki became the first doctor to die of COVID-19 in July.

This month nurse Marian Awuor, from Homa Bay, died from COVID-19 days after giving birth.