Elusive joy for mothers and babies as cartels run maternity down

Saturday September 24 2011

File |  NATION Pumwani Maternity Hospital nurses stopped work earlier this year demanding increased allowances, additional staff, medical equipment and uniforms. A report on the state of the hospital lists low employee morale as a major hindrance to good service delivery.

File | NATION Pumwani Maternity Hospital nurses stopped work earlier this year demanding increased allowances, additional staff, medical equipment and uniforms. A report on the state of the hospital lists low employee morale as a major hindrance to good service delivery. 

By ARTHUR OKWEMBA [email protected]

More than 1,000 children died at the crisis-ridden Pumwani Maternity Hospital in the past year as the City Council facility continued to sag under the weight of mismanagement, low staffing levels, corruption and the absence of equipment, a task force has found.

In the period from July last year to July this year, 13 mothers died in childbirth, while some 253 developed complications and 4,185 gave birth through by Caesarean section. Another 13,000 mothers gave birth normally and were discharged without complication, the report shows.

The task force’s report containing damning findings on the operations at Pumwani Maternity Hospital, and which is likely to shed light on the causes of the high maternal and child mortality at the facility, has been handed over to government authorities for action.

Under-secretary in the ministry of Medical Services, Mr Adan Adan, chaired the task force. Members included Dr Simon Mueke, Dr Izaq Odongo, Mrs Susan Otieno, Mr Manasseh Bocha, Dr Rachel Nyamai, Mrs Anne Njeru, Dr Robert Ayisi, Mr Sylverio Wanjira and Mr Karisa Iha.

Corruption, financial crisis, lack of critical supplies for mothers and babies, mistreatment of mothers, moral and ethical decadence, and absenteeism among doctors, are highlighted as some of the factors that have compromised the quality of services at the hospital.

For the first time, the report attempts to pinpoint areas that seem to have brought the hospital, the third largest and busiest provider of maternal services in Africa, to its knees.

Established in 1926 by the Lady Griggs Welfare League as Lady Griggs Maternity, the hospital caters especially for the poor in Nairobi.

The report brings to light the sorry situation at the hospital where poor expectant mothers go through major difficulties before and after delivery. Only one theatre works full time, resulting in up to 13 mothers who need immediate obstetric attention queuing for up to 24 hours to get emergency C-sections. Delay often leads to death.

City council

There is a shortage of necessary supplies required during and after delivery, and mothers bathe in cold water after the boiler became non-usable, according to the Services at Pumwani Maternity Hospital under the Nairobi City Council, 2011 report.

Only one of the four autoclaves — equipment used to sterilise linen and theatre instruments to prevent infection — is in working condition.

Sometimes the hospital is forced to sterilise the tools at Kenyatta National Hospital to cope with theatre demands or when this machine breaks down.

Only a sixth of the required number of incubators for preterm babies is available, hampering efforts to increase child survival rates.

Workload is more than the 14 doctors and 194 nurses can handle, affecting the quality of services offered as staff struggle to attend to as many mothers and babies as possible. The hospital records between 50 and 100 normal deliveries and eight to 15 Caesarean sections every day.

Staff complained of burnout from the workload, which has had a negative impact on the quality of services delivered and the handling of women who deliver at the facility.

Corruption is also rife at the hospital, with the funds meant for the wellbeing of mothers and babies being misappropriated. Revenue collected from the hospital under the cost-sharing arrangement, for instance, is taken to City Hall for banking. The report says this creates an opportunity for under-banking.

This procedure has affected the delivery and smooth running of services at the hospital, with those