Only luck can see Kenya through the scourge, not doctors

Kenya medical practitioners, pharmacists and dentists union (KMPDU) secretary general Dr Boniface Chitayi (centre), national Treasurer Dr Wambui Waithaka (right) and chairman Dr Victor Ng'ani during a past press conference. PHOTO | FILE

What you need to know:

  • The Sunday Nation has established that all public health institutions save for Kenyatta National Hospital (KNH) do not have isolation wards despite public pronouncements to this effect.
  • The isolation ward at KNH can only handle 40 patients, way too small to cope with an epidemic.
  • On Friday, the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) said even the isolation centre at KNH does not meet standards set by the World Health Organisation.

As the Ebola virus spreads like wild fire across the globe, a weeklong investigation by the Sunday Nation reveals that we have survived this far by sheer luck.

Sunday Nation has learnt that despite assurances from Health Cabinet Secretary James Macharia all indicators on the ground show that Kenya cannot cope with a serious outbreak similar to what has been witnessed in West Africa or even an outbreak of a lesser magnitude due to a poor state of preparedness.

Details we gathered on the ground were corroborated by doctors and nurses we spoke to in the public health facilities during the course of investigations.

The Sunday Nation has established that all public health institutions save for Kenyatta National Hospital (KNH) do not have isolation wards despite public pronouncements to this effect.

Instead of isolation wards, we found holding areas, which are ordinary wards set aside within the institutions to accommodate patients who present Ebola-like symptoms as they undergo screening and monitoring.

On Friday, the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) said even the isolation centre at KNH does not meet standards set by the World Health Organisation.

STATE OF UNPREPAREDNESS

“We know they are in the process of constructing a standard unit, which would be ready in the next two or so months; tell me what will happen should we have an outbreak before then? And can that single facility serve the whole country in case of an outbreak?” KMPDU chairman Victor Ng’ani said.

The isolation ward at KNH can only handle 40 patients, way too small to cope with an epidemic.

A spot check in numerous city public facilities that are under the county government exemplified a state of unpreparedness with doctors and health personnel admitting they would be reluctant to attend to a patient suspected to suffer from the disease because they are ill-equipped.

“The truth is that if a patient was brought here today, none of us would summon the courage to attend to him or her because we are not prepared to do so. Why would I want to risk my life when it is too obvious that I will not help the patient and only end up contracting the virus — do you see any wisdom in that?” one of them asked.

Sub-county hospitals such as Mbagathi, Mama Lucy, and Pumwani, which were meant to decongest KNH, showed no signs of being prepared. The Sunday Nation also learnt that these hospitals had submitted a proposal to the county director of Health Services, Dr Robert Ayisi, towards the setting up of isolation wards.

“We gave the director a Sh32 million proposal to help us put up a standard ward that will enable us handle cases of suspected Ebola,” said Mbagathi Medical Superintendent Dr Andrew Sule. Dr Sule also said they are in the process of training medical personnel on how to handle suspected Ebola cases.

The Public Health Officer in charge of training at Mbagathi, Mrs Margaret Korir, added that they target to train all the staff including security guards, saying they are the first contact with patients going to the facility.

“Health workers must be trained on gowning and de-gowning of personal protection equipment, standard operation of decontamination and isolation according to WHO guidelines,” she said.

With the long bureaucracy within government, the funds are not likely to be forthcoming especially after Dr Ayisi admitted that there is no specific fund City Hall has set aside to deal with Ebola (should there be an outbreak).

PUBLIC OUTRAGE

Mbagathi is one of the hospitals in the city which have received patients suspected to be infected with Ebola virus.

The 25-year-old patient who had been both to Sierra Leone and Senegal, countries seriously ravaged by the virus, was taken there on September 1 with symptoms which suggested he was an Ebola patient. Among other signs; his temperature had hit 39 degrees celsius.

The situation is not any different in border points like the Indian Ocean and Busia where people still cross into the country without proper screening.

National Carrier Kenya Airways and other airlines halted flights to and from the countries affected by the virus only after a public outrage. With panic growing among health personnel over a catastrophe that is only a flight away, KMPDU says it would discourage its members from attending to suspected cases of Ebola unless there are special incentives, proper protection gear and even prospects of compensation in cases of death.

Meanwhile, the Kenya Union of Nurses has advised nurses not to take up employment opportunities in Liberia as advertised by the government.

The union said Kenyan nurses were not trained to handle Ebola cases and going to Liberia would be like signing a death warrant.Speaking in Machakos after a meeting between union leaders and the County Government of Machakos, Secretary-General Seth Panyako said the nurses needed to be trained for not less than three months before they could take up jobs in Ebola-hit countries. “We have seen in the print media the Ministry of Health asking Kenyan nurses to go to Liberia and West Africa to control Ebola. If they must go, let them leave a will behind,” said Mr Panyako.

“Standard precaution like special suits and isolation units must be available before we can step in. We would also seek assurances that should any of our members die in the process, their families will be compensated. Like other members, I have children to take care of; we cannot negate this responsibility on diseases that the state can help prevent like Ebola,” Dr Ng’ani said.

Nationally, Mr Macharia has said, more than Sh600 million has been allocated for the war on Ebola, a figure KMPDU says is a drop in the ocean.

As the state of panic grips the healthcare system, Nairobi chairperson of KMPDU Dr Nelly Bosire said Thursday that a Ugandan lady who presented symptoms related to those of Ebola had been isolated at one of the private hospitals in Nairobi.

PRECAUTIONARY MEASURE

“The woman who had entered Kenya from Uganda met what we call case definition and is the latest to be put in isolation for testing and monitoring,” Dr Bosire said.

According to her, the porous borders as well as what she called general laxity in enforcing safety measures continues to expose Kenya to the epidemic.

“There was an individual from Liberia who was turned at the Jomo Kenyatta International Airport only to find his way back into the country via Burundi. This is so telling about our vigilance,” he said.

Medical Services Director Nicholas Muraguri however insists the country is up to the challenge and has taken all needed precautionary measures.

“As a precautionary measure, the ministry has alerted health workers about the Ebola outbreak in West Africa and has advised them to remain vigilant for unexplained illnesses in those arriving from the affected areas,” Dr Muraguri said.

He says the country’s Rapid Response Team and the Laboratory too had been activated and were on standby.  “We are, therefore, well-prepared to identify and deal with any potential cases of Ebola within 24 hours,” he says.

But according to the doctors’ union, Dr Muraguri and the cabinet secretary have been giving false assurances to the nation.

“Anybody telling you that the country is prepared to deal with Ebola outbreak is deliberately being dishonest or does not understand how the healthcare system works,” Dr Ng’ani said.

Additional reporting by Stephen Muthini