Doctors label Kirinyaga Hospital a health hazard

The main gate and entrance to Kerugoya County Referral Hospital in Kirinyaga County on June 13, 2019. PHOTO | KANYIRI WAHITO | NATION MEDIA GROUP

What you need to know:

  • Last month, health workers across Kirinyaga county downed their tools citing poor working conditions.
  • In the male medical ward, which has a number of cubicles, there was not a single patient.
  • In early May, there was an outbreak of diarrhoea in the paediatric ward, and staff even stopped eating food prepared in the facility’s kitchen.

There are no activities in the flagship 200-bed Kirinyaga Referral Hospital, located at the entrance of Kerugoya Town.

Two weeks ago, a family from Kabari Village took their kin for an injection for rabies, only for them to be turned away because there was no medic to handle the case. They were forced to seek these services elsewhere.

STRIKE

Last month, health workers across Kirinyaga county downed their tools citing poor working conditions, and vowed not to resume until their grievances are addressed. They accused Governor Anne Waiguru of refusing to reason with them, while the county administration accused them of incompetence.

Two weeks ago, when the Saturday Nation toured the county’s largest hospital — which has been in the news for all the wrong reasons — at lunch hour, we found a handful of health workers, mostly the management team, and patients, with very little taking place.

The outpatient waiting area was almost empty with hospital stretchers stacked in one corner and most of the attending rooms empty.

In the male medical ward, which has a number of cubicles, there was not a single patient while in the male surgical ward, we only found Mr Mutinda Mawili who had a leg injury.

BEANS AND VEGETABLES

Other than Mr Mutinda’s bed, the rest did not have linen; others did not even have mattresses, an indication that very little has been happening at the facility.

Mr Mutinda, who we found having a meal of beans and vegetables, told us that he had been admitted to the ward for two weeks and had been alone all through, adding that although the services there are wanting, he did not have anywhere else to go.

“Though I have been treated, whatever is happening here does not befit the facility’s status. No one is caring for you as it should be and perhaps the kind of service I am getting is only because I am alone. May be if we were more than 10, we would have been left to suffer,” Mr Mutinda said.

How did this 55-year-old referral hospital, which should be the best the county has to offer, get here?

It is the events of March this year that are said to be the straw that broke the camel’s back, leading to the paralysis of all the hospitals in the county after grave issues were allegedly ignored by the executive, led by Ms Waiguru.

HEALTH HAZARD

Doctors at the facility, who spoke on condition of anonymity for fear of being victimised, said that to say working conditions in the hospital are bad was an understatement. As far as they are concerned, the hospital is a health hazard for both patients and staff.

According to a doctor who is in the rank of a medical officer, and who has worked at the hospital for over five years, the facility lacks basic protective gear like gloves, and sometimes medics are forced to ask the patients to buy them.

We found the hospital in a dirty state, from blood-contaminated materials, clogged toilets and sinks, to stinking linen and litter all over.

Things were so bad that in early May, there was an outbreak of diarrhoea in the paediatric ward, and staff even stopped eating food prepared in the facility’s kitchen.

“How can you work in such a hospital? The county management (does not appear) concerned even after some of our colleagues contracted communicable diseases,” the doctor said.

HEPATITIS B

According to Kenya Medical Practitioners, Pharmacists and Dentists Union central branch chair Dr George Moturi, six cases of nurses contracting hospital-acquired infections due to the condition of the facility have been confirmed. Two of them, he said, contracted Hepatitis B.

He also reported a case where a TB-infected mother was housed in proximity to healthy nursing mothers with newborn infants.

Further, the hospital is understaffed, a situation made worse by the recent sacking of casual workers who, according to doctors, would fill in gaps as clerical officers and pharmaceutical technicians.

In addition, the hospital suffers a shortage of key equipment. “The hospital has two theatres but most of the time we manage with just one; when one of them breaks down due to minor issues which can be easily fixed, there is no fast cash for procurement. The laboratory cannot even do basic line tests and so we refer patients to private facilities yet it’s a referral facility,” said another doctor said, adding that theatres were only handling emergency cases.

BOYCOTTED

The hospital also suffers a dearth of leadership since the current team boycotted monthly meetings held to address such issues, allegedly because their recommendations were always ignored by the executive.

The county has been operating without a health executive after Dr Agnes Gachoki resigned in February. Ms Waiguru has since picked Dr Timothy Theuri to take her place, and he has been vetted by the regional assembly.

The doctors and patients’ accounts were corroborated by an internal communication between the facility administrator Mr Seasor Munene and the county executive as well as with the representatives of the health workers, which the Saturday Nation has obtained.

The issues had already been brought to the attention of the County Chief Officer for Health Dr Stanley Ngondi but they were ignored, leading to deterioration.

According to Mr Munene’s letter to Dr Ngondi, the hospital experienced a major power failure which affected main operation centres.

POWER FAILURE

The power failure, which took place on March 31, is said to have damaged a laboratory centrifuge, laboratory incubator and water bath, theatre GA machine, theatre resuscitaire, theatre patient monitor, oxygen plant pump and sockets in the maternity.

This, Mr Munene said, led to an acute problem in the laundry unit, forcing them to rely on Kimbimbi Hospital which also had water issues, and Karatina Hospital which is inadequate, leading to piling and decaying of linen.

Because of this, most patients, he said, were sleeping on mackintoshes, and bed-making had become a problem. Infection prevention at the newborn unit had also become a challenge since where were no gowns for mothers, forcing them to use their own lessos.

This is a narrative that Ms Mercy Nyaguthii, who entered the maternity ward as a patient before the health workers downed their tools, confirms.

SHOCKED

She says she was shocked that when she was admitted to the ward and found there was no linen and mothers were being forced to cover themselves with their lessos. “I had to ask my relatives to bring me bed sheets as I wait to be taken to the labour room to deliver,” she says.

The challenges also affected drug storage, which saw some drugs go bad. But it seems the matter was not addressed promptly, despite Mr Munene having provided pictures of women in lessos and of piles of unwashed linen.

Instead, on April 24, Dr Ngondi issued a WhatsApp message to the Kirinyaga County Hospital Management Team ordering the dismissal of county casual workers across all hospitals in the county, citing budgetary constraints.

On the same day, a public notice by the County Secretary terminated services rendered by about 200 casual workers in the health department, 77 of whom were trained in the control of the spread of infectious diseases, saying they had led to the ballooning of the health department’s wage bill.

The Kenya Medical Practitioners and Dentists Board then entered the fray. The board’s chief executive officer, Dr Daniel Yumbya, confirmed that the items which Mr Munene had raised in his April 2 letter were yet to be fixed, and also highlighted more challenges, including inadequate personal contributed to deteriorating of service delivery.

CASUAL WORKERS

It also recommended disciplinary action against Dr Mburu, Munene, the nursing manager Ruth Mwai and Dr Eva Wachuka who is in charge of the hospital’s pharmaceutical unit.

In a letter to Dr Yumbya dated May 15, Ms Waiguru said her team had investigated the claims and taken action. First, she said the facility had been cleaned and the laundry machine repaired, and that a supplementary budget has been revised to cater for incineration facilities as well as additional laundry service equipment.

The deserted corridors of Kerogoya County Referral Hospital in Kirinyaga County on June 13, 2019. PHOTO | KANYIRI WAHITO | NATION MEDIA GROUP

Further, she said some workers were to blame for the mess, and defended the move to sack the casual workers, saying it would save the county Sh3.5 million per month, which would be used to improve operating conditions at the facilities.

Njuki-ini Ward Rep Fredrick Fundi, who is also the chair of the assembly health committee, also said a supplementary budget to cater for 45 new, untrained casual workers at the facility had been provided.

But what has raised concerns is why the county sacked 77 specially trained casual workers only to hire 45 untrained ones, with the governor’s critics saying that if the wage bill was a concern she should have reduced the numbers instead of sacking them all.

SHAMEFUL

Mr Fundi, who described the current health status as shameful, asked the health workers and the executive to end the impasse, saying only the executive can explain the casual workers issue and that the assembly had done its part to save the situation.

But even after the hospital was cleared by the Dr Yumbya-led board, the health workers have maintained that they will not to return to work until their grievances, which they claim have been ignored, are addressed.

Dr Ouma Oluga, who is the Secretary-General of the KMPDU, said the critical recommendation put forth by the medical board on human resource was not addressed in Governor Waiguru’s response.

First, he said, the governor ignored the issues of nurses contracting hospital infections and the victimisation of the hospital management. Further, he said, all cadres of healthcare professionals are forced to work and live in deplorable and life threatening conditions, saying they have persevered even though this has jeopardised their lives and careers.

EMPLOYEE SAFETY

Dr Oluga also said hospitals in the county have laboratories but have not put measures to ensure employee safety, yet infectious human secretions are handled in great numbers, compromising patient care and health workers’ safety.

Meanwhile, despite the county government assertions, the residents of Kirinyaga County continue to suffer the lack of health facilities. Two weeks ago Mr Joseph Muchiri from Kaitheri village in Kerugoya location, suffered a dislocation in his leg allegedly while running errands at his home.

His relative, Ms Mary Wanjeri, rushed him to Kerugoya Hospital for treatment due to its proximity and affordability, only to be forced to take a U-turn at the casualty area after waiting for hours without being attended to.

They were informed there were no doctors to attend to them and therefore there was no reason for them to continue waiting.

With no options, Ms Wanjeri decided to transfer Mr Muchiri who was in much pain to the Anglican Church-sponsored Mount Kenya Hospital which is just a few kilometres away and which is relatively costly compared to the public facility.

STRUGGLED

“What else can I do and I want our kin to be treated? He is in a lot of pain and I cannot let him suffer at Kerugoya Hospital because from what we were informed by the people who we found at the facility, there is no doctor to treat him since all of them are on strike,” Ms Wanjeri told Saturday Nation as she struggled to help Mr Muchiri board a boda boda to ferry him to Mount Kenya Hospital.

As recently as Thursday this week, patients were still suffering the lack of staff and facilities. “We queue from morning to evening and go home without being attended to because there are only a handful workers in the hospitals who can’t be able to handle the huge workload,” said Mr Geoffrey Muthee, who was waiting to be attended to at the Kerugoya Hospital.

INFLUX OF PATIENTS

Besides private hospitals, which many cannot afford, patients have also been forced to rely on the neighbouring Nyeri, Murang’a and Embu counties. Embu health executive Joan Mwende has expressed concerns about an influx of patients from Kirinyaga, a thing which she said had overstretched Embu Referral Hospital to an extent of depleting essential drugs.

The hospital’s chief executive, Dr Daniel Mugendi, admitted that 60 per cent of outpatients seeking treatment there are from Kirinyaga County.

When contacted during the time of our investigation, Ms Waiguru maintained that the facility was operational, and forwarded photos of doctors and nurses serving a few patients.

Additional reporting by George Munene