How Kenyans died during 100-day doctors’ strike

A major hospital has told of the suffering, horrors and deaths of children and mothers like never seen before during last year’s 100-day doctors’ strike.

At the peak of the strike, doctors at AIC Kijabe Hospital say had to select babies most likely to benefit from treatment against those with least chance of survival. The team of 10 doctors paints a sad scenario reminiscent of a war or an epidemic zone; most distressing, hard to forget and never to be hoped for again.

They say elective total withdrawal of health care, including emergency services, has never been reported anywhere else in the world unless in times of armed conflict or epidemics.

The doctors bare their hearts out in a report published on Wednesday April 18 in the journal BMJ Global Health. They tell of how the hospital was affected by the strike of doctors in public health facilities. Due to the high number of patients who turned up at the hospital after closure of government facilities, Kijabe resorted to a mass casualty system where only the most likely to survive were prioritised for treatment.

High-risk pregnancies

“The system involved decisions not to escalate care for children whose outcome was most grim and offer the extremely limited care to others with possibility of better outcomes,” says the study.

The overload, the report says, also saw women with premature labour or high-risk pregnancies miss treatment because more deserving cases were overwhelming.

During the three-month strike period, the Kijabe study led by Mary Beth Adam reports a huge spike in the number of deaths at the hospital.

“In the sick newborn and paediatric medical services, there was an approximate fourfold increase in deaths during the strike and a nearly eightfold increase at the children’s surgical section,”

The doctors approximate a threefold increase in monthly maternal deaths at the hospital during the strike period.

Children presenting at the hospital, with medical or surgical problems, during the strike were up to eight times more likely to die than those reporting during non-strike periods.

To cater for the higher demand the doctors say the hospital opened and staffed additional rooms for sick newborns, because these were the neediest.

At some point though, the report says, the hospital had refused any referral admissions and women coming for deliveries and maternity care.

The Kijabe report says though there are no records, many sick and deserving patients were turned away because the hospital could not cope.

This was further complicated when former Health Cabinet Secretary Cleopa Mailu called on the sick to visit faith based hospitals because a service deal had been brokered.

High death rates

However, at a national health forum organised in Nairobi by the Ministry of Health last month, it emerged the State has since failed to reimburse faith based hospitals which had responded to the government request.

The experience at Kijabe Hospital, the authors say, was hardly unique as it was similar if not worse at other faith based hospitals across the country. They were all characterised by high death rates and overcrowding.

Such a strike, where patients are denied even emergency care, the Kijabe doctors say has never been reported anywhere else in the world unless in times of war, epidemics or disasters. Even in the worst reported cases in the last 40 years, the study says doctors at worst will offer life-saving care such as for sick newborns, C-section and emergency surgery..

The doctors demand that the government address health workers concerns to avert such devastating strikes in future.