Alarm over disease outbreaks in counties amid biting strike

Kenya has been hit by a wave of preventable disease outbreaks as effects of recurrent health workers’ strikes bite.

The current disease outbreak report by the World Health Organisation (WHO) released on Monday shows Kenya reeling under the pressure of serious outbreaks of cholera, measles, Rift Valley Fever (RVF) and dengue fever.

Between January 21 and February 11, Kenya reported 716 cases of cholera to the WHO, mainly in Nairobi, Narok and Kajiado counties.

“Cholera cases continue to be reported in Narok County, with 166 incidents, and Kajiado County, with 425 cases,” the WHO report indicates.

During the period, Nairobi reported a total of 125 incidents of cholera, including 26 confirmed cases.

On January 30, the Ministry of Health, the report states, had notified the WHO of an ongoing outbreak of dengue fever in Mombasa County.

By last week, 325 suspected cases of dengue fever had been recorded, with 173 confirmations in six sub-counties of Mombasa.

Affected sub-counties include Nyali, Jomvu, Kisauni, Likoni, Changamwe and Mvita.

Since the middle of January, 30 human cases of Rift Valley Fever were reported in Murang’a and Nyandarua counties.

“Animal deaths have also been reported in the affected villages,” says the report.

The report also reveals that 335 cases of measles have been reported this year. Wajir has reported 222 cases, Tana River 102 and Kwale 11. Last year, 746 cases of measles were reported in Kenya, an outbreak that has been blamed on declining child immunisation coverage due to health workers’ strikes and low prioritisation by county governments.

While the outbreaks of cholera, measles, Rift Valley Fever and dengue are relatively common in the Horn of Africa, Kenya has by far the highest rates currently.

For example, while Kenya reported 716 cholera cases, in the current bulletin, Tanzania reported just 47 cases, and Uganda 53. While Kenya reported 325 cases of dengue fever, Tanzania reported 38 and none were reported in Uganda. Kenya reported 335 cases of measles, Ethiopia 136 and South Sudan reported 368 cases. No cases were reported in Uganda and Tanzania. Last June, following an outbreak of measles, cholera and chikungunya, the Ministry of Health assured Kenyans it would swiftly bring the diseases under control.

Resources not enough

“The Ministry of Health wishes to assure Kenyans that it will continue to monitor and coordinate response efforts in order to contain and control disease outbreaks in the country,” the director of medical services Dr Jackson Kioko promised in a statement.

Dr Kioko had blamed the outbreaks on inadequate resources to facilitate implementation of effective interventions.

In the first six months of last year, Dr Kioko said 4,954 cases of cholera had been reported in 19 counties across Kenya.

On measles, Dr Kioko said an outbreak in Wajir and Mandera involving 142 patients had been contained.

“This outbreak has since been successfully contained through active case-by-case management and enhanced outreach vaccination services,” said Dr Kioko.

However, by the end of the year, the ministry had reported 744 cases of measles to WHO. Since January, 325 cases have been reported.

The measles outbreak has been blamed on recurrent health workers strikes in the country. The 150-day nurses strike in 2017 was blamed for a 60 per cent drop in child immunisation during the strike period.

Data from 18 referral county hospitals showed that many children missed or delayed getting life-saving jabs during the strike period.

The most affected counties by the strike were Nyandarua, with a vaccination drop of 93 per cent; Kirinyaga 88.6 per cent; Nairobi 87.9 per cent; and Baringo 80.1 per cent.

A detailed study published in June and overseen by Dr Kioko concluded that Kenya is poorly prepared to deal with diseaseoutbreaks and emergencies. The report, published in the journal BMC Public Health, indicated that many public health facilities lacked capacity to respond to cholera and other emergencies.

“Facilities lacked essential materials to respond to a cholera outbreak, including supplies to provide life-saving treatment and capacity to collect and transport specimens for diagnosis,” study revealed.

Kenya is currently experiencing strike by nurses in 17 counties, with some regions reporting a total collapse of the public health system.