Scandal of fully-equipped Nairobi hospitals without adequate staff

When immediate former President Uhuru Kenyatta witnessed the groundbreaking for the construction of 16-bed capacity hospitals at Muthua in Uthiru and Kianda in Kibra. [File, Standard] In a move to bolster healthcare infrastructure, the now-defunct Nairobi Metropolitan Service (NMS) built several cutting-edge hospitals across Nairobi, aiming to provide free quality medical services to the city's growing population. While these facilities stand as a testament to progress, the hospitals, despite being fully equipped with modern amenities, are grappling with severe financial constraints and a dire shortage of staff, hampering services. Even the posting of 500 workers previously attached to NMS this week has not addressed the crisis. For instance, Githurai 44 Hospital, which attends to approximately 150 patients per day, has a fully equipped maternity that is not in operation because of lack of staff. Staff at the hospital, who spoke to The Standard on condition of anonymity for fear of victimisation by the county government, said the hospital has 20 members of staff and it needs 20 more to operate optimally. "Some equipment need servicing down and they haven't been repaired. This has hampered service delivery," said a nurse. The facility has only one support staff and medics are at times forced do the cleaning. "This hospital is good and the doctors and nurses do their work but at times they tell us there is no medicine so we have to go buy in chemists which is expensive," Nancy Kamau, a patient at Githurai 44 Hospital told The Standard. James Kimani, who was seeking treatment for stomach issues, said: "I do not have health insurance so in the past, it was difficult for me to access medical care but this hospital changed that because services here are free." At Uthiru Hospital, the situation is no different. A spot check by The Standard revealed that some theatre equipment were moved to Pumwani Hospital after the current county regime took over from NMS. Some staff were also moved to other hospitals. "This has led to a capacity problem so some of our equipment is just idle," said a medic. The hospital attends to between 3,000 and 4,000 patients a month. When then Nairobi Metropolitan Services Director General Mohammed Badi commissioned Githurai 44 Level 3 hospital on July 20, 2022. [File, Standard] The facility, just like Githurai, gets drugs every quarter but they are barely enough. Staff told this writer that Uthiru Hospital has a huge power and waste management problem, hence putting patients and staffs' lives at risk. The facility doesn't have an incinerator and hazardous medical waste can lie uncollected for weeks. To add to the problems, the laundry machine has broken down. "The governor's office is aware of the waste management issues, another medic told The Standard. It offers Linda Mama services but the government "has not settled its bill for a very long time". A faulty X-ray machine has not been repaired despite the county having a department supposed to deal with such issues. The X-ray room has been turned into a store and a fully equipped pediatric ward is not operational due to lack of staff. Medics also told the Standard that some equipment were taken to Mama Lucy Hospital. The dire situation is replicated in all 17 hospitals. Some other hospitals like Gikomba are still under construction. The hospitals, equipped with advanced medical technology and designed to meet the diverse healthcare needs of the community, now face a formidable challenge: the lack of adequate funding. Despite the initial investments in constructing these healthcare centres, sustaining their day-to-day operations and meeting the increasing demands of a burgeoning population has proven to be an uphill task. One of the critical issues stemming from the financial constraints is the difficulty in procuring essential medical supplies. Life-saving drugs, medical equipment, and necessary consumables are often in short supply, compromising the hospitals' ability to provide timely and effective care to patients. Reports suggest that some departments within these hospitals are forced to ration supplies, putting both healthcare professionals and patients at risk. A spot-check at Gatina Hospital revealed that the facility has only 8 nurses yet it should have 14. And like the others named above, it also has a waste disposal problem. "Medical waste has not been collected for the past one year and eight months," a medic said. A toilet meant to serve patients has therefore been turned into a waste disposal unit before collection. The hospital has a huge storage problem, with corridors used to store medical supplies. The facility, according to medics, serves 350 patients per day. It records high assault cases as is the case with Kiamaiko Hospital which also records high diarrhoea cases. "The diarrhoea cases are mostly among children under five years old," a Kiamaiko nurse told The Standard. Gatina's nebuliser also needs servicing. Mercy Ann Anyango, who had taken her infant son for the routine clinic said that the facility has helped her cut down on expenditure on treatment. "Last month my elder son had stomach problems and he was treated here and given drugs, all for free," she said. When former President Uhuru Kenyatta commissioned Gatina dispensary to serve residents of Kangemi and Kawangware. [PCS] Laban Wafula says that were it not for staff at Gatina Hospital he would be dead. "I was attacked by thugs in January and stabbed twice in the stomach and hand. I was brought here for treatment by good Samaritans. The doctors here saved my life. I came back today for a routine check," he said. Kianda 42 level 4 Hospital, which serves more than a hundred patients a day, the situation is the same although the opening of Kibera South Hospital has seen patient numbers reduce. "The distiller is faulty and the X-ray machine is not working despite servicing," said a nurse. A space problem has seen the ultrasound machine and X-ray machine share a room, a situation medics say should not happen because "it affects machine workability." When we asked a nurse about the availability of reagents, she sighed. The theatre is not operational due to lack of staff so equipment idle. Drug supply is not regular enough. The county does it quarterly and not enough. Drugs supplied by the government last a month. A medic said the facility has five support staff but they haven't been paid for a year. "This hospital means a lot to society mainly because services are free. If they had a good supply of medicine, things would be much better. We also wait for long in line to get treatment and when we raise the matter we're told doctors are few," said Andrew Otieno, who was at Kianda seeking treatment for flu. Moreover, the state-of-the-art equipment installed in these hospitals requires regular maintenance and upgrades to ensure optimal functionality. The lack of funding has hindered the implementation of necessary maintenance routines and technological updates, potentially rendering some equipment obsolete or prone to malfunctions. This not only jeopardises the quality of patient care but also poses challenges for healthcare professionals who rely on these tools to diagnose and treat various medical conditions. These facilities are all in informal settlements.

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