Why soldiers have own military hospitals

The soldiers who jumped from a military chopper that crashed during a routine exercise in Kajiado County in June were later airlifted to the Defense Forces Memorial Hospital in Mbagathi, Nairobi.

Of the 23 soldiers on board, 10 died. The survivors were airlifted to the military hospital in Nairobi.

Why weren’t they given first aid in the health facility nearest to the scene of accident?

That soldiers have to use military hospitals is not by accident, sometimes with unintended consequences. Take the example of the 37-year-old soldier who was allegedly attacked by his girlfriend, Violet Asale Emu in Nairobi’s Kahawa Wendani area this April.

The Directorate of Criminal Investigations (DCI) noted that Daniel Omollo Onyango suffered injuries after “his wife cast her teeth through his thumb, chest and shoulder.”

Onyango, who was based in Gilgil, later developed convulsions and his condition deteriorated while waiting for a military ambulance. He died.  

Access to medical care can be a challenge to soldiers living among civilians, especially in case of emergencies, like Onyango’s, in the face of healthcare for military officers being part of government-controlled health economy.

So, why is this the case with soldiers and not the police?

Well, security experts explain that the military carry out critical functions of national security for which a healthy distance with the public is paramount.

Richard Tuta, a security expert, argues that the nature, environment, injury and treatment of soldiers dictate their separation from civilian hospitals worldwide.

Also, treating soldiers in civilian facilities, says Tuta, can make them easy targets from the enemy, considering the “nature of injury sustained by soldiers is different compared to an accident, and such can be used by the enemy to counter-attack. Yet, this is a person who should be returned to the battle field.”  

Tuta adds that privacy in handling injured or ill military officers is another issue, which is why “the military need special hospitals and after-care setup. Any state, therefore looks at the wellbeing of the military.”

By virtue of their roles for country, Tuta argues that there is dimmed trust with civilians, who, if hospitalised with soldiers, might be used “to spy on our army. We have seen cases of people camouflaging as civilians.”

Tuta says soldiers injured in the battle field can, however, be stabilised in any nearby hospitals, before referral to military hospitals as “pros and cons are always looked at in treatment of a military person.”

Edward Wanyonyi, a security researcher, said historically, the military have different health risks and levels of trauma treatment is different from that of civilians, and which should be guarded for safety of the country. “Soldiers cannot be treated in a private hospital because of occupational risk management.”

A retired military officer concurred with Wanyonyi and told Health & Science that soldiers have their own military hospitals mostly for maintaining confidentiality, as “it will not be good if people or the enemy are privy to injuries sustained by soldiers. This is likely to reveal weakness, hence the need for military hospitals,” said the retired Captain.

Military hospitals also serve as preparation grounds when a country is readying itself for war. Thus, it is easy to use military medical facilities to stockpile essential supplies of medicines, first aid kits and extra beds in expectation of casualties away from prying civilians and possible spies.

Military hospitals provide cover for injured soldiers, making it difficult to know the severity on the battlefield as civilian facilities would also make it easy for enemy spies to check mortality rate by a simple count in wards.

Soldiers are also often treated by military medical personnel, says Tuta, and every military camp has someone with medical knowledge, including a general First Aid provider, clinical officers handling clinical examinations, and doctors, who are most times a Major or Captain.

Tuta says Cadets (doctors) as well as others in the health fields recruited in the military are taken for further training for specialisation and that referral systems happens in military hospitals that are clustered as per service demand, but always well equipped.

George Musamali, a security consultant and former General Service Unit (GSU) officer, said soldiers have military hospitals because battle field injuries are different from ordinary ones. Most are thus equipped with medical specialists in, among others, bullet injuries.

“Most soldiers who get treated in military hospitals have a history of bullet injuries, that is why they get airlifted to military hospitals,” said Musamali, adding that cases of ailments like malaria can be sorted in civilian hospitals.

And of the soldier who died in Nairobi’s Kahawa Wendani, Musamali is of the view that he could have been taken to the nearest facility and stabilised before being sent to a military facility for specialised care.

“It is not a must to have a soldier treated in a military facility. It was wrong to waste time referring to this soldier, yet he could have been treated at any nearby hospital.”

Health & Science sought to know, among other issues, the rationale for military hospitals, medical treatment for soldiers living among civilians and why injured soldiers are airlifted to military hospitals without receiving first aid in the nearest facilities, from the Kenya Defense Forces.

Since June, we sent the above questions via the public affairs email - as instructed by the KDF spokesperson, without success by the time of going to press.

Cops and civilians access military hospitals, depending on injuries.

Contrary to popular perception, police officers can also access military hospitals, especially if treatment sought is from a battle field involving civilians, depending on type of injuries. This is common in developed countries like America and Israel.

Military officers can also access public hospitals in cases where theirs are out of reach as “medical ethics do not allow a soldier to be denied admission in a public hospital,” explained the retired Captain.

“The soldier has a right to be treated then arrangements are made for him or her to be picked or airlifted to a military facility,” explained the former officer, adding that military hospitals were not a preserve of soldiers. “Civilians are taken there for either first aid or treatment before being transferred to public hospitals. In fact, some civilian patients resist being transferred because of the efficient medical care.”

George Musamali says: “It is not a must that soldiers get treated in military hospitals, and also, not all cases are handled at such facilities. It is determined by the kind of injury sustained, and need kind of specialised care.”

The perception that civilians are hardly allowed is because admission is restricted to avoid overstretching the facilities is wrong. However, priority is given to emergency cases and patients in critical condition, and often in situations where military hospitals are the only nearest facilities, according to the retired Captain.

In Kenya, a number of colonial era military hospitals have been converted to referral hospitals for civilians. Kenyatta National Hospital is one such. Military health facilities are mostly not far from other civilian hospitals, which is strategically to provide services to civilians if need be.

Military conduct civilian medical operations during emergencies!

Kenyan military medics have been involved in providing healthcare, including fighting malaria and calamities in Tiaty, Baringo County, for instance.

KDF soldier doctors, nutritionists, pharmacists and clinical officers help out during medical emergencies and when patients are in remote areas without access to medical facilities. In 2018, they donated antimalarial drugs through mobile clinics set at Loruk Centre, where they coordinated healthcare services, mostly to children and the aged.   

Hillary Kibet, the Officer Commanding Loruk KDF camp told Health & Science: “KDF medics were sent to Baringo to help fight malaria that is fast killing people. We cannot speak of restoring security when our people are dying because of diseases.”

The soldiers conducted mobile clinics around Kapau, Chesawach, Kongor, Loruto, Kadingding, Chepkalacha, Nudo, Pkait, Mukutani at the boarder of Tiaty and Baringo South, Komolion, Amayan at the boarder of Turkana and East Pokot, Nasorot in Torioko Ward.

Kibet says the programme was conducted under the Civil Military Cooperation Activity after meeting several patients while on duty, including a pregnant woman who was driven to Kapau dispensary in Tirioko Ward, and luckily, he was assisted by Dancan Omwenga, a volunteer. She gave birth to twins but was also diagnosed with malaria.