Lack of medical oxygen leaves patients gasping

A man offloads a Medical Oxygen Cylinder at Nakuru Nursing home in Nakuru town on October 30, 2020. [Kipsang Joseph,Standard]

Simon Kirathe knows just how difficult it is to breathe life into someone. Literally. Kirathe narrates how a relative was suddenly taken ill and developed general body weakness and shortness of breath on October 23.

He rushed his ailing kin to a medical centre in Nyahururu town from their Busara village in Nyandarua County. He was examined and treated.

The patient, who also had diarrhoea went back home but his condition worsened forcing him to seek further examination at a private clinic on October 26.

A doctor at the clinic referred him to Nyahururu General Hospital, where he was examined and placed at the facility’s Covid-19 isolation unit.

Swabs for Covid-19 tests were extracted at the unit, but even as they waited for results, the patient's health continued to deteriorate.

Kirathe says a doctor at the unit asked the family to take him to a facility where he could access medical oxygen.

After failing to get an alternative, the patient was referred to Othaya Level Six in Nyeri County. “He struggled with shortness of breath and to save his life, we were forced to move him to get medical oxygen," said Kirathe.

He claims to have contacted health officials in Laikipia and Nyandarua counties who said they did not have medical oxygen.

"Though Nyahururu Hospital provided us with an ambulance to move him, we hired a medical oxygen cylinder at Sh1,500," Kirathe said.

The patient received his Covid-19 results that turned positive on November 2.

Kirathe’s experience shows what Covid-19 patients are subjected to, and raises questions on whether counties and the country has enough medical oxygen.

Oxygen, which was classified by WHO in 2017 as an essential medicine for the treatment of hypoxemia (low oxygen levels in the blood), was finally listed as such in the 2019 Kenya Essential Medicines List, as one of the six inhalational medicines that should be available from dispensaries level.

Processing plant

In a recent media briefing on Covid-19, Health Chief Administrative Secretary Rashid Aman said medical oxygen is a key element in response to the pandemic.

Covid-19 isolation centre at Mogotio sub-County Hospital in Baringo has reported a shortage of medical oxygen.

The wing is supplied with medical oxygen in cylinders from the county processing plant established at Kabarnet Hospital, according to a health employee who requested anonymity for fear of being victimised.

Eldama Ravine, a Level Four Hospital where surgeries are conducted, is also supplied with medical oxygen in cylinders and this is used mostly in theatres.

The employee added that due to lack of proper infrastructure, health workers who have contracted the virus were referred to hospitals in Nakuru, Kericho and Eldoret.

“Our isolation centre does not have adequate supply of medical oxygen nor ventilators. We are therefore worried about patients who require specialised care, or rather in need of emergency services. It is sad that they are likely to die,” said the employee.

Kakamega County has a plant at Kakamega General Hospital that processes and supplies medical oxygen to 13 hospitals across the county.

John Otieno, the county acting chief officer of medical services said 12 Level Four facilities need medical oxygen reservoir tanks and not necessarily plants.

A few facilities also have oxygen concentrators that can convert normal air into oxygen.

“Oxygen processed is piped to the ICU, and others within the hospital wards. Currently, we do not have a shortage of medical oxygen,” said Otieno.

Consumption of medial oxygen at Covid-19 unit at the Rift Valley Provincial General Hospital (PGH) in Nakuru, has also increased in the recent past.

A source at the private entity told The Standard that they are supplying PGH with an average of 55 to 60 cylinders of 60 kilogrammes each, every day, an increase from 25 to 30 litres that used to be supplied before the pandemic.

“Highest consumer of oxygen at PGH is the isolation ward. The number of patients in need of the medical oxygen is overwhelming and the facility converted one of the wards to an isolation unit,” said the source.

High demand

The company also supplies between 20 to 25 cylinders of 60 kilogrammes each to Naivasha Hospital daily, an increase from 10.

However, due to high demand, Naivasha is at times supplied with medical oxygen from the Nairobi plant.

Previously, the plant used to produce an average of 35 cylinders of 60 litres daily, according to a source.

The plant has a capacity to produce between 65 to 70 cylinders of 60 litres every day.

“We are now forced to process oxygen at night to meet the high demand. For example, one cylinder of 60 litres takes an average of 22 minutes to be filled up,” Otieno said.

PGH has an automatic oxygen concentrator launched by President Uhuru Kenyatta, under the Managed Equipment Services, in partnership between the county and national governments in 2016.

But the hospital in-charge Dr Joseph Mburu said since oxygen at the plant is not packaged into cylinders, the management is forced to purchase extra medical oxygen.