Major county hospitals in dire need of oxygen, report indicates

As Kenya continues to grapple with Covid-19 cases, most hospitals do not have oxygen plants. 

According to an audit report by the Kenya Medical Practitioners and Dentist Council (KMPDC), inadequate oxygen supply and shortage of staff in isolation units are the major challenges hospitals are facing. 

The report, Technical Report on Oxygen and Ventilator Findings, reveal that Kenya has a total of 305 licensed isolation units.

“Data collected reveal that 87 per cent of the facilities have oxygen supply, the most common supply method being the cylinder, which stands at 54 per cent,” reads the report signed by KMPDC CEO Daniel Yumbya.

For example, Kenyatta National Hospital (KNH) has an oxygen processing plant but it is faulty.

Oxygen supply hitches at the hospital have been witnessed for over 20 years, but no action has been taken on establishing a new plant.

“Lack of enough oxygen plant at the hospital is a major problem. This is due to the breakdown of one of the plants serving the patients.

"It was being supported by a foreign non-governmental organisation (NGO), but when they stopped servicing it, maintenance cost became a challenge and it broke down,” noted the report.

Further, there are two units at the hospital with six ICU beds, two dialysis beds and 60 regular beds at its Mbagathi unit.

“There is an urgent need for critical care beds, they have no red liners and are forced to use the yellow ones which they mark as hazardous waste. There is a need for oxygen cylinders at the Mbagathi unit,” added the report.

Through piping

Kiambu County moved its isolation centre from Kiambu County Referral, to Tigoni Level 4, a 300-bed capacity with piped oxygen supply, and an additional 100-bed capacity isolation unit without oxygen supply.

Turkana lacks ICU care and oxygen production services, while Homa Bay County Referral has no oxygen generating plant, but has a BOC tank.

At Siaya County Referral, oxygen is supplied through piping and can only support up to 48 patients.

The report indicates oxygen in most hospitals is mostly supplied through cylinders, which are also in short supply.

The total number of cylinders in Kenya as per the council’s assessment is 1,622. Embu County has the highest number of cylinders at 300.

Iten County Referral Hospital has 40 as are IRC Kakuma Amusait General Hospital, Kamalel Health Center, Siloam Hospital, St Leonard’s Hospital, Unilever Tea Hospital, Nakuru War Memorial Hospital and Homa Bay County Referral Hospital.

Others are Metropolitan Hospital, The Nairobi Women’s Hospital Adams, Komarock Modern Health Centre, Kitui County Referral Hospital, Bishop Urbanus Kioko Hospital, Kangundo sub-County Hospital, Diani Beach Hospital and Samburu County Referral Hospital.

The report, dated July 17, 2021, revealed that the flow rate capacity of piped oxygen, on average, varies between 2.5 to 150 litres per minute.

Kapsabet County Referral, Jaramogi Odinga Oginga Teaching and Referral Hospital (JOOTRH) and Meru Level 5 have a flow capacity of between 480 and 1,500.

The council noted that up to 78 per cent of the facilities are able to dispense oxygen to multiple patients simultaneously. 

The facilities which can dispense oxygen to more than 200 patients simultaneously include Kenyatta University Teaching, Referral and Research Hospital (KUTTRH), MP Shah Hospital and Tigoni Level 4. 

Highly equipped facilities according to the council are KUTTRH and Moi Teaching and Referral Hospital (MTRH).

Ventilator services

Though the availability of oxygen plants is still low, the council noted that overall, the status of oxygen has improved since the first audit exercise in July 2020.

“The findings suggest that health facilities were better equipped and as such, it can be expected that the oxygen and ventilator services can be improved,” added the council.

In addition, 56 per cent of audited facilities have oxygen concentrators, of which 77 per cent are public facilities.

“The total number of concentrators in all isolation facilities is 438.

The total number of concentrators in non-active Covid centers is 10,” the report stated. 

In the one-year assessment done between June 29 and July 17 last year, it was found that only 49 per cent of facilities have ventilators, of which, 63 per cent are public health facilities.

Among facilities without ventilators are Chebiemit sub-County Hospital in Elgeyo Marakwet, Elgeyo Border Dispensary and Kamalel Health Centre in Uasin Gishu; Nakuru Provincial General Hospital Annex, Kapsabet County Referral Hospital, Narok County Referral Hospital, Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu County Referral Hospital, Machakos Stadium Covid Isolation Centre and Mbale Rural Health Training Centre.

Others are Nanyuki County Referral Hospital, JM Kariuki Memorial County Referral, Langa Langa sub-County Hospital, Muranga Level 5 Hospital and Kilifi County hospital.

The council has asked the government to prioritise the installation of piped oxygen and oxygen plants in all the counties.