Siaya public hospitals in deplorable condition: report

The Siaya County Assembly has expressed concern over the “deplorable” state of the county’s public hospitals.

REPORT

In a report tabled by the Committee on Health Services and adopted by the assembly last week, the MCAs said there were “glaring gaps across the hospitals visited.”

The report “Report on operational status of hospitals in Siaya County” was tabled even as health workers were on strike over delayed January and February 2018 salaries.

The striking workers discharged patients whose conditions were still deteriorating, a move that enraged senior county officials.

During the campaigns, Governor Cornel Rasanga promised to improve heal facilities and pay health workers.

PAY

County Secretary David Kanundu blamed the national government for delays in remitting money to the county.

"The problem has been brought about by delay in release of money from the exchequer,” he argued.

Mr Kanundu said they received the funds on Tuesday and are working on paying the medics.

Kenya National Union of Nurses Siaya branch secretary Sylvester Ng'anda, Kenya Union of Clinical Officers chairman in the County Silas Oluoch and regional Kenya Medical Practitioners and Dentists Union representative Vivian Wamara said frequent salary delays demoralise workers.

“The delays in salary payments and inadequate funding of the health sector is a major challenge here,” Mr Ng’anda says.

HOSPITAL

The nine-member Health committee chaired by Central Gem MCA Abigael Perpetua Awino visited Madiany, Ukwala, Bondo, Ambira and Yala Sub-County hospitals and Siaya County Referral Hospital.

“On December 19, 2017 at 9.30am, the committee visited Siaya County Referral Hospital.

“The morgue has a capacity of 24 (bodies) but was holding 80 bodies at the time of the visit. There were 40 unclaimed bodies that have been there for two years and procedures to dispose them off are moving at snail speed since bringing the police, courts and hospital together is a challenge,” states the report.

It adds that the mortuary stinks as there is no cold room and “bodies brought by police cannot be embalmed because they (have to) await post-mortem.”

The committee noted that the intensive care unit (ICU), with a five-bed capacity, was equipped “but it is not functioning because the hospital lacks specialised staff.”

RENOVATIONS

In his submissions to the committee, the hospital’s medical superintendent, Dr Geoffrey Mwai, said the mortuary has been earmarked for renovation.

But a cold room and increasing the mortuary’s capacity is not part of the renovation works.

The hospital boss says in the report that the ICU can be operationalised in six hours if “specialised personnel are employed since all equipment are available and only one specialised nurse is in the hospital.”

NEEDS

The committee noted that the financial support the public hospitals receive from the county government does not meet their needs and is also not consistent to enable planning.

“There is general acute shortage of staff across the hospitals and prioritisation in the medical sector is close to impossible since all services rendered are critical,” the report said.

The Siaya County Referral Hospital, according to health officials in the county, has five consultants, four medical officers, six clinical officers and three anaesthetists.

The orthopaedic technology unit at the facility, according to the health report, does not get adequate tools it requires to make crutches and other equipment.

“The County Government was to equip the section with equipment worth Sh2 million but only equipment worth Sh400,000 was supplied,” the report said.

FEES

The tendency to waive hospital fees for non-needy patients on the instruction of “county officials” has been cited as a major blow to the facility’s revenue collection.

Bondo Sub-County Hospital has three clinical and two medical officers despite the high number of in- and out-patients.

The three clinical officers are employed by the county government and the hospital has three examination rooms.

The facility’s outpatient department has no casualty department.

“The morgue has a capacity of 25 without a cold room and the current building functioning as the maternity ward is the surgical ward,” the report said.

The hospital has a bed capacity of 63 and “student nurses administer drugs without supervision.”

CHALLENGES

In the management’s submissions to the committee, they said their ambulances had broken down.

“The boat ambulance serving Ndeda, Oyamo, Mageta and Sifu islands is broken down and no funds for support supervision and the utility vehicle is equally broken down,” the management said.

Madiany Sub-County Hospital in Rarieda has nine medical officers of which only two are employed by the county government while the rest are hired by partners.

“The morgue has no cold room with two employees and a capacity of 16. The hospital has a 23-bed capacity which is “very squeezed. The normal spacing would fit 20 beds.”

THEATRE

The report also states that the post-natal ward at the hospital has three beds, yet 50 to 60 babies are delivered at the hospital every month. It records an average of 15 deliveries a week.                       

“The paediatric ward has a seven-bed capacity. The new-borns and adults share beds and there is no station for nurses.”

The facility’s theatre is wrongly situated in respect to the inpatient department and there is no walkway.

However, the hospital’s management says renovation works have not started since May 2017 when the contractor reported on site to implement the Sh3.7 million project.

FACILITIES

Ukwala and Ambira hospitals have one medical officer each.

In addition, Ambira has five clinical officers of which only one is deployed by the county and the four were brought in by other partners.

The facilities face a financial crisis.

For example, Ukwala, which has an operational cost of Sh12 million per financial year, has only received a Sh1.6 million disbursement.

In Ambira, the facility collects about Sh300,000 each month and banks it to the county revenue account “but this amount never finds its way back to the hospital,” the assembly’s Health Committee was told.

Yala Sub-County Hospital, situated just next to River Yala in Gem, has no running water in its wards except in the maternity ward.

Its mortuary’s overall capacity is 16 bodies but at times stretches to 30.

“It, however, has a cold room with a capacity of eight and looks clean and is odourless.”

REFERRALS

The referral system in the county, the MCAs learnt, has funding problems as well as poor systems of ambulance maintenance.

Another major concern was that there was no designated isolation room in any of the hospitals in the county.

The referral hospital is forced to refer patients to as far as Homa Bay or Kisumu counties for treatment and the county has an insufficiently equipped and staffed physiotherapy unit.

According to the health report, all hospitals in Siaya County wash their linen manually except for the referral hospital, which has a washing machine that is more than 20 years old.

“Solid waste management in the county is at zero level since hazardous waste is burnt in open air emitting poisonous smoke and buried in pits in all hospitals visited.”

“This sadly means that Siaya County has no incinerator and no hospital would pass environmental assessment test because of this serious problem,” the report says.