Why being admitted at Mandera Referral hospital is staring death in the face

A nurse at Mandera Referral Hospital, Ali Hassan Mursa, attending to a patient in the past. The facility 'lacks' infrastructure to qualify it to operate as a referral hospital, this is according to Members of the County Assembly. FILE PHOTO | NATION MEDIA GROUP

What you need to know:

  • The assembly health committee was tasked to investigate the status of Mandera County Referral Hospital and report back in two weeks after the public decried of increased maternal deaths at the facility, professional negligence, absconding of duties by staff, management wrangles and the deplorable condition of the hospital.
  • Mandera County has the highest mortality rate in the world recording 3,795 deaths per 100,000 live births, more than seven times higher than the national average of 488 deaths per 100,000 live births.
  • The committee observed that the referral hospital has no toilets; the patients are asked to come with mosquito nets on admission; the mortuary is in pathetic situation as it has no coolers and there is inadequate bedding at the maternity wing and that the hospital has no enough incubators.

Mandera County Hospital 'lacks' infrastructure to qualify it to operate as a referral hospital, this is according to Members of the County Assembly.

In a report adopted by the MCAs on Thursday evening, they agreed that, with high consumption rate due to the influx of patients streaming in from the neighbouring States of Somalia and Ethiopia, the hospital is overstretched in service delivery.

The assembly health committee was tasked to investigate the status of Mandera County Referral Hospital and report back in two weeks after the public decried of increased maternal deaths at the facility, professional negligence, absconding of duties by staff, management wrangles and the deplorable condition of the hospital.

The report stated that 24 maternal deaths had been reported at the biggest facility in Mandera in less than three months.

“The hospital reported 3 infants’ deaths, 3 mothers’ deaths and 18 fresh and macerated still births in less than three months, all attributed to inaccessibility to quality maternal health services,” reads the report whose copy the Nation.co.ke has seen.

Other causes of increasing maternal deaths at the facility as per the report are poor health seeking behaviour by the locals, cultural values and practices that do not allow women to be attended to by male health workers and long distances traveled en route the referral hospital.

LACK EQUIPMENT

The report says rural health facilities in Mandera lack necessary equipment such as ultrasound machines to check the foetal well-being and the available health workers neglect expectant mothers.

Mandera County has the highest mortality rate in the world recording 3,795 deaths per 100,000 live births, more than seven times higher than the national average of 488 deaths per 100,000 live births.

This is attributed to poor health infrastructure, unskilled and inadequate workforce and cultural practices that discourages deliveries at the hospitals.

The health committee chaired by Arabia MCA Abdullahi Abdirahaman, noted that Mandera Referral Hospital had seen serious management wrangles that hampered service delivery.

“Despite this house allocating a budget of Sh1.6 billion to health department, the hospital has financial challenges and payment for basic utilities such as water and electricity have not been done to date,” says the report.

Water supply at the facility was cut off two weeks ago forcing relatives with patients admitted there to carry water from home for them or buy from donkey cart suppliers doing business at the facility.

“Essential suppliers of goods and services to the facility have threatened to stop due to lack of payment,” says the report.

The hospital has a pending bill of Sh7 million as it has not paid its suppliers and contractors for the past seven months.

Contractors installing newly purchased machines at the facility and doing renovations stopped their work due to non-payment.

Mr Ahmed Sheikh, the County executive member in charge of health, told the committee on November 19 that the employed staff at the facility have no capacity to operate some of the equipment and machines.

OVERLAPPING ROLES

Mr Sheikh further told the committee that the hospital structure was confusing as the roles overlapped between the manager and the head of operations.

The CEC said the facility did not have the capacity required to take in machines and equipment purchased by the county including the oxygen plant, ultra sound machine and sterilisation machine which none of the staff at the facility can operate.

He said the referral hospital only received Sh1.2 million in the first quarter of 2015/2016 financial year but the second quarter allocation in 2014/2015 was not received from the county treasury which has affected service deliver at the facility.

The referral hospital has 72 nurses against 7 wards, 2 ophthalmologists nurses, 2 psychiatric nurses, one anesthesia, one county focal person and one commodity nurse.

The committee observed that the referral hospital has no toilets; the patients are asked to come with mosquito nets on admission; the mortuary is in pathetic situation as it has no coolers and there is inadequate bedding at the maternity wing and that the hospital has no enough incubators.

DRUG SHORTAGE

The referral facility is also experiencing acute drug shortage since Kenya Medical Supplies Authority (KEMSA) has not supplied them on time and when delivering they fail to consider the placed orders.

In the next 60 days, the MCAs asked the health department to implement their recommendations including abolishing of the offices of the hospital manager and that of operations manager and replace it with medical superintendent through the County Public Service Board (CPSB).

They recommended creation of mobile maternal and child health clinics to reduce the high rates of maternal deaths recorded in the county.

The legislators want a priority given to improving the capacity and capability of the existing facilities in terms of drugs supply and other medical equipment instead of building new facilities.

They also want, within the 60 days, medical doctors to be held personally accountable for any negligence and absconding of duties if any death is reported at the facility attributed to these vices.