For the last three weeks, the queues at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) diabetes clinic have been long, with the doctors overwhelmed forcing them to call for assistance from other clinics.
The number of patients visiting the facility has surged following the launch of the Universal Health Coverage (UHC) initiative on December 13 last year by President Uhuru Kenyatta under his Big Four Agenda.
UHC is expected to herald the transformation of the country’s health sector that is marred by inequalities because of poverty and lack of medical insurance.
Kisumu, Nyeri, Isiolo and Machakos counties were chosen to pilot the first phase of the programme that targets 3.2 million Kenyans with a full roll-out in all the 47 counties expected by 2022.
The long queues, the tired patients and exhausted doctors have forced the hospital to start another clinic for diabetics on Thursday, besides the Monday one.
Mr Stephen Sewe, the chief officer in-charge of health at the Kisumu County government, said introduction of UHC would save most Kenyans who were suffering before the launch of the programme.
“Poverty had made some people to keep off hospitals and suffer from home but the free health initiative is making them come out resulting to the high number of patients,” he says.
Mr Sewe said that even at level two and three hospitals, patient numbers have surged that the county is working on employing more staff.
He told the Sunday Nation that diabetes, surgical, optical and dental clinics are the most congested at the facility currently.
“The surgical wards were full even before the programme and now that treatment is free including the provision of implants, the number has tripled. As county management, we need to equip the hospitals and employ more workers since the drugs are provided for free,” he said.
Ms Agatha Margaret, from Obunga, a slum in Kisumu Town, is hypertensive and diabetic.
Previously, she was forced to forego food to buy drugs. One needs about Sh2,300 a month to buy the drugs besides bearing the cost of needles for injecting the medicine as well as the periodical testing kits (HD-16).
But with the UHC programme in place, she comfortably and majestically walks to JOOTRH for her hypertensive and diabetic drugs either on Mondays or Thursdays.
“This programme is godsend; our people must appreciate and make use of it by registering in large numbers since the government is spending heavily,” Ms Agatha said.
Mr James Nzioka, a father of a two-year-old boy from Machakos County admitted at Kathiani Hospital, told the Sunday Nation that he had not paid any money for the boy's treatment including X-ray scans on his head.
"My son was admitted yesterday. A head scan was conducted and we have not paid anything. This is a clear indication that indeed the programme is free,” said Mr Nzoka recently.
However, the programme has witnessed challenges ranging from lack of drugs, congestion of patients, lack of blood and delay in the disbursement of UHC cards making some patients to go without the services.
Mr Sewe said that some of the challenges they are experiencing in the programme in Kisumu, in particular lack of drugs, was because the Kenya Medical Supplies Agency (Kemsa) had not supplied drugs.
Mr Eliud Muriithi, the director, commercial services at Kemsa, clarified that some of the drugs that have not been delivered were earlier not being stocked by the agency because county governments preferred purchasing them from outside and since they are slow moving products.
“We have not been stocking some of the ICU products, we just advertised and the tender has been awarded. By next week, all the counties will have the products,” Mr Miriithi said.
Machakos county records the highest number of injuries mostly from accidents occurring on the busy Mombasa-Nairobi highway, lack of blood, which is a necessity, is a bigger problem.
The hospital management disclosed there was a major shortage of blood over the holiday season prompting an appeal for blood donation.
Dr Hellen Nzuki, the Machakos Level 5 Hospital superintendent said with the high number of patients, the demand is high while the supply is low.
“We have little blood as the patients admitted are more than the supply that we have. We are making plans to collect more blood and we will erect a tent in Mlolongo and in churches. The challenge is because of the influx of patients,” said Dr Nzuki.
In Isiolo, the late disbursement of UHC cards posed a challenge since it is the only tool that would identify that one has registered. It is only after registration that a patient can get the services free upon presenting them.
Registration is still ongoing in all public facilities in the four counties.
Health Cabinet Secretary Sicily Kariuki assured that come next week, the challenges would have been settled.
“The journey has been long and we cannot give up when we are just about to finish. The challenges are minor and I am in talks with various stakeholders majorly Kemsa to ensure that the drugs are in the counties by next week,” she said.
President Kenyatta during his address to the nation last week assured Kenyans that the roll-out of the universal healthcare coverage was on course and will be completed as promised by his government.
“So many families across the country are burdened by heavy medical bills because of unemployment, among other things. As the national government, we will help all counties,” he said last week.
“Let us use this as trials and see what is working and what is not within a year. Some counties like Makueni and Turkana have begun rolling out their own programmes, which we will support as the national government,” he added.
So far, the government has installed at least half of the 37 CT scan machines, theatres and intensive care units in 37 counties, lifting the heavy burden of treatment off the shoulders of poor families.
The latest of the counties to receive the computed tomography (CT) scan machines is Kakamega.
And following concerns over the safety of patients and medical staff on the risks of exposure to ionising radiation, the government has assured patients that the new CT scan machines are free from exposure to radiation.
Among the state-of-the-art machines fitted are automatic generator as power backup, an uninterruptible power supply which allows the equipment to keep running in case of electricity outage, cloud imaging devices, laser and thermal printers, CCTV and thermoluminescent dosimeter (TLD) to measure radiation levels patients and medics have been exposed to.
The machines, according to Ms Kariuki, will compliment universal healthcare programmes by the government.
“The government is committed to improving health services to all Kenyans by installing 37 CT scan machines in counties. The machines will help hospitals deal with medical emergencies and reduce referrals,” Ms Kariuki said while launching CT Scan machine at King Fahd Hospital in Lamu County.
Besides imaging services and storage of synchronised patients’ data records in all facilities across the country, the CT scan centre will also aid in early detection of various forms of cancer and other chronic illnesses. Effectively, radiographers and radiologists are able to store patients’ images in the cloud, track request and relay real time status notifications in all centres countrywide linked together and interfaced to the national data centre at Kenyatta National Hospital.
The programme is expected to boost access to medical and minor surgical services, maternal and child healthcare services through the support of elaborate public health education.
UCH is expected to increase access to preventive, curative, rehabilitative and palliative health services at a minimum financial burden.
The programme will also enhance HIV, tuberculosis and malaria treatment in the country. For the public health services, the benefits package include mosquito nets, malaria, and sanitation while that for community services free immunisation, health promotion, and education.
At the facilities for mothers, the Linda Mama programme continues though the name will change since it will be handled by UHC, where delivery is free and mothers would get free commodities including buckets, syringes, and gloves.
Additional reporting by Vivian Jebet and Stephen Muthini.