Koros: Lack of money is the root of all KNH’s problems

For a long time, Kenyatta National Hospital  has been associated with milestones and ills in the same breath. Stories of medical firsts like the separation of conjoined twins are juxtaposed with allegations of negligence, insecurity, overcrowding, long treatment waiting lists and broken down equipment. HealthyNation spoke to CEO Lily Koros, who has been at the helm for the last four years, to find out whether the national referral hospital can be healed.

This is your fifth year as the head of KNH. Anything you are proud of?

I pride myself in a number of milestones during my tenure such as the separation of conjoined twins last year. I have also overseen the establishment of the infectious disease unit, advances in gastroenterology and renal treatment and process improvement through formulation of policies, just to mention a few.

What are you not proud of?

My lowest moments are when KNH is all over the media for all the wrong reasons despite the relentless and tireless efforts of staff committed to providing high standards of care to all patients.

Is it time for Koros to go?

I am serving the second term of my three-year contract which was given upon successful evaluation of my first term in office.There is an established procedure to terminate the tenure of the CEO. Anybody, whether from government or private sector will still follow the laid-down procedure for appointment if they’re interested in the position.

What is the genesis of congestion at KNH?

There are inadequate public health facilities in Nairobi and its environs so we end up providing primary and secondary level of care instead of concentrating on our mandate of providing specialised healthcare on referral basis.

How well does the referral system work?

The referral system is broken. Hospitals at lower levels should act as a filter, but they don’t, so we end up treating patients who do not meet the referral criteria and who should otherwise have been treated at the lower levels. This overstretches us. Patients in critical condition are also brought in without following protocol. The referring hospital is supposed to call to confirm whether the facilities needed for treatment of the referred patient are available. Sometimes that doesn’t happen, putting KNH in a very precarious position.

There were plans to make KNH an in-patient only facility ...

For KNH to be an inpatient-only facility, the referral system must work 100 per cent. More hospitals should be set up in Nairobi  and its environs to handle the surging outpatient needs. In addition, investment in specialised skills should be done to strengthen the capacity of neighbouring hospitals.

Equipment keeps breaking down, why can’t KNH buy new and modern equipment?

There are serious budgetary constraints that hinder our capacity to modernise or acquire new equipment to replace that which was bought as far back as 1969.

There has also been little infrastructure growth at the hospital. Why isn’t KNH expanding to meet growing need?

Funding problems. Expansion requires resources which have not been available for a long time. However, expansion will not solve KNH’s challenges entirely. There has to be corresponding improvement in lower level health facilities so that they can take up their responsibilities and leave KNH to concentrate on specialised services.

What have you done to ensure that patients, employees and visitors are safe, in light of  recent rape allegations?

The hospital has policies that spell out management of security and safety, as well as actions to be taken where there are concerns. Our major challenge has been lack of resources to implement the strategies. We are partnering with government security agencies to beef up security. We are also making arrangements for additional outsourced security to man entry and exit points and expand CCTV coverage. The hospital has not received any rape or attempted rape complaint, but we take every concern seriously and try our best to improve.

What about reports that KNH serves as a bedroom for homeless people and that mentally unstable patients roam the corridors at night?

Kenyatta is a public institution that can be accessed by everyone, but we have guards making frequent rounds to flash out idlers. We are also boosting surveillance.