Ms Jennifer Wanjiku has cried so much in recent days that she no longer cares to wipe away the tears.
Her husband fractured his hand and skull in a motorcycle accident on February 24, then doctors operated on his hand and ignored his head, and when he died she was slapped with a Sh1.4 million bill.
Now she cannot bury her husband until she clears that bill.
Her tribulations illustrate how hospitals sometimes bring Kenyan families to ruin, and shines a spotlight on Nairobi Women’s Hospital, and the decisions of its doctors in their treatment of 71-year-old Philip Muraya, particularly the decision not to attend to his head injury despite a head scan showing he needed urgent surgery.
The hospital on Thursday refused to divulge details of Mr Muraya’s admission and the circumstances of this death.
“We can only share this information with the patient, next of kin who brought the patient to the hospital, the Kenya Medical Practitioners and Dentist Board, and a court of law upon their request,” Chief Business Development Officer Johnson Mwithi said.
Ms Wanjiku’s tribulations started on February 24 this year at Gacharage, a small village in Kandara Constituency, Murang’a County, when her husband was involved in a motorcycle accident.
Mr Muraya was taken to the nearby Thika Level Five Hospital where he was treated for minor injuries, including a fracture on the arm, and discharged.
Three weeks later, he began complaining of a throbbing headache and the family took him to Kandara Health Centre, where he was also treated and discharged.
“On the night after he was treated at the clinic he started vomiting and became unresponsive,” Ms Wanjiku told the Nation on Tuesday this week.
“I told my children to take him to hospital.”
The next day, the worried family took him to the nearby St Mathias Mulumba Hospital, but doctors referred them to a clinic with computed tomography (CT) scan facilities for a head scan.
The scan, conducted at Thika X-Ray Clinical Services, showed that Mr Muraya had a brain injury, and the family was again referred to a hospital with intensive care unit facilities.
“We took him to Kijabe Mission Hospital on the same day, where he was given an intravenous dextrose drip to revive him,” Mr Muraya’s son Amos Gacheru said.
“However, he could not be admitted since there were no ICU beds. A medic told us he could refer us to a hospital in Nairobi that had ICU beds.
"We agreed to his suggestion and he placed a call to Nairobi Women’s Hospital, which agreed to admit dad.”
That admission was to mark the beginning of the family’s agony as it degenerated into quarrels with medical staff at the facility over the way they were handling Mzee Muraya’s head injury.
“When we visited him the next day, we discovered doctors had only replaced the dressing on his fractured arm but ignored the head injury indicated on his CT scan report.
"They made no mention of the head injury and instead said my dad needed to be put on a life support machine,” Mr Gacheru said.
Doctors told him his dad had developed breathing problems due to severe pneumonia.
“We reminded them of the CT scan findings but they insisted they needed to place him on the machine. Despite our misgivings, we agreed,” Mr Gacheru added.
The machine cost them Sh60,000 a day, and the family asked that Mr Muraya be disconnected from it after two days as they sought to be discharged from the facility.
“A clerk at the hospital told us they would only allow us to move our father if we had a referral letter from another facility with an ICU bed,” he said.
After a long back-and-forth, they were finally referred to Kenyatta National Hospital on March 18, 24 days after Mr Muraya fractured his skull.
However, just as Mr Gacheru prepared to move his father to KNH, a nurse told him the hospital had called to inform them that it did not have a vacant ICU bed.
“Sensing a scheme to keep my father at Nairobi Women’s, I went to KNH, where a nurse showed me two empty beds.
"He, however, told me that we needed to go through a proper referral procedure, initiated at Nairobi Women’s,” he said.
The referral letter they got from the hospital indicated that the patient had been kept off a ventilator machine because his family could not afford it, but did not mention the brain injury at all.
The hospital also asked them to pay at least Sh370,000 of their Sh500,000 bill before transferring their father.
They could not afford it even after fundraising, and so Mr Muraya stayed on at Nairobi Women’s.
On or around March 23 nurses removed the patient’s feeding tube, leaving him to survive on an intravenous dextrose drip.
A doctor informed the family that Mr Muraya’s oesophagus had become blocked.
“The next morning I heard nurses say they had inserted a feeding tube but it had leaked, spilling the contents into my dad’s lungs and causing more complications,” said Mr Gacheru.
By April 5 the bill had climbed to Sh 1 million, and the next day, more than 40 days after the accident, Mr Muraya passed on without any doctor, according to the family, attending to his head injury.
Ms Phyllis Njoki, the fourth born daughter of the Murayas, explained how the hospital broke the news of her father’s demise on April 7.
“We were on what had become a routine visit when a doctor told us he had passed on the night before, at 3am. I went to the mortuary and found his lifeless body still lying on a stretcher, yet to be put in the freezer,” she said.
The bill, they were informed, had risen to Sh1.4 million, but there was something not right about it.
Mr Muraya had, according to the doctor who briefed Ms Njoki, died at 3am, but the family had been billed for procedures that had apparently been carried out long after the death.
“According to the bill, at 3:24pm, a physiotherapist named Dr Hamisi had attended to my father, followed by a Dr Warutere four minutes later, more than 12 hours after the reported death,” Mr Gacheru, who claims the hospital had begun billing their father even before he was wheeled in from Kijabe, said.
“I filed a case in court on April 17 to compel the hospital to release the body for burial, but withdrew before the hearing on April 8 after the hospital said it will not enter into negotiations with us if we were suing it.
"Despite our gesture, done in good faith, the hospital has refused to listen to our pleas and release our father’s body,” Mr Gacheru noted.
The Muraya family, however, said the hospital had not reached out to them to provide details on their fathers hospitalisation, detention, and death.
“Nobody is telling me what happened to my husband and how he died,” a distraught Ms Wanjiku said as she mourned her husband at her Gacharage home.
“Friends and relatives have long given up on coming to console us after realising there are no immediate plans to bury my husband.”