GLANCE FACTS:Lack of funds, personnel, drugs and necessary equipment characterise almost all health centres in the 47 counties as devolution debate rages
The country’s health facilities are in a pathetic state and almost grinding to a halt.
Lack of funds and the resultant scarcity of drugs and other items as well as acute shortage of medical personnel is the tale at many facilities.
The resignation of doctors opposed to devolution of the sector is not helping matters.
Seven public dispensaries In Nyeri County were in total darkness for a month after Kenya Power cut off electricity supply over a debt before the county government paid up their bills last week.
Nyeri County Referral Hospital Medical superintendent Dr Silas Njoroge said that they were facing dire financial constraints as they were yet to receive the necessary funds to run the facility.
Health centres such as Karaba in Mukurweini had not paid their bills for more than ten years.
“We are running the hospital with the money we receive from some of the services we offer and we are slowly accumulating debt,” Dr Njoroge said.
The Nyeri County Executive for Health Dr Gathua Githinji said the county government was currently facing a Sh2billion deficit in its health budget.
In Kitui County, acute shortage of nurses is the main issue. Ineffective service delivery is the order of the day at Level IV hospital where hundreds of county residents turn up every day for medical attention.
Shortage of drugs also forces patients to purchase some medicines from private chemists.
Between 400 and 500 people visit the hospital’s outpatient wing daily for treatment and the shortage of nurses has crippled service delivery in the wards. Consequently, some of the wards in Kitui County’s largest hospital have been closed.
“If we don’t get more nurses soon, then operations in the hospital will grind to a halt,” Ms Loise Kamau, the hospital’s administrator says.
Ruth Koki, the county health executive, says she had distributed medicines to all medical facilities in the region.
In Kakamega County, public hospitals are inadequately equipped and lack basic infrastructure to handle sophisticated medical conditions.
The facilities affected include the Provincial General Hospital, four district and seven sub-district hospitals, 101 dispensaries, 40 health centres, 43 medical clinics, ten nursing homes and one maternity facility. Kakamega Provincial General Hospital is the only referral facility in the county.
The hospitals lack a functional CT scan machine, a High Dependency Unit and an Intensive Care Unit while all district hospitals in the county lack X-ray services, machines and theatres.
“It’s a pity that no single public hospital has an X-ray machine. Patients who require the services are either forced to go to Kisumu or Eldoret,” Kakamega governor Wycliffe Oparanya says.
The county health executive Elsie Muhanda says even though the county government has allocated Sh618 million to improve health facilities, more needs to be done as most are in a deplorable state.
In Kisii, the only two gynecologists deployed by the national government at Kisii Level Five Hospital have to cater for all women seeking reproductive health services.
Those who require scan or X-Ray services have to make do with private services or deal with officers on the ground since the facility lacks critical specialists such as radiologists and optometrists.
Kisii County has over 134 primary health centres with 14 hospitals but lacks basic facilities. Sarah Omache, the county’s health minister, however believes that with devolution and partnership, a number of hospitals will be equipped.
Despite the subsidised price of drugs in government hospitals, a number of them are not capable of purchasing such drugs.
“KEMSA is doing a great job in the provision of drugs but we are yet to start purchasing drugs through our hospital kitty in the devolution programme,” Kisii Level Hospital medical superintendent, Dr Ondari Enock said.
However in Nakuru County, healthcare services at the Rift Valley provincial general hospital in Nakuru town have improved remarkably over the years.
Patients at the hospital say they are happy with improvement of services and the speed doctors and nurses at the hospital respond to patients seeking medical attention at the hospital.
Ann Muthoni from Mau Narok, who is taking care of her sister at the hospital, says the patient was received well. Muthoni says a few years ago patients feared seeking medical at the hospital because nurses were reluctant and did not handle patients on time.
The Rift Valley Provincial General Hospital is expected to be upgraded to a referral hospital after completion of ongoing construction of special treatment facilities.
The nursing officer in charge of the hospital Dr John Ochola said that the hospital which has a total of 800 staff among them 460 nurses and 80 doctors receive about 1700 patients although it has a bed capacity of 120. The patients are from Nakuru, Bomet, Baringo, Laikipia and Kericho among other regions because of availability of facility that handle most diagnosed diseases.
In Embu, the provincial general hospital is operating at a deficit of Sh10 million every month and this affecting provision of medical services. It requires Sh20 million every month to fund its activities but the hospital only collects Sh10 million through cost sharing.
Medical superintendent Dr Gerald Ndiritu says due to the high volume of patients at the hospital, Treasury had budgeted Sh250 million for the facility to run effectively but no money has been disbursed six months later.
BUY OWN DRUGS
Consequently, patients are required to buy their own drugs for most ailments, while the hospital administration fears that electricity might be cut off in mid-December due to a debt of Sh1.5 million.
“We only have the basic antibiotics for the patients. Patients buy specialised drugs from outside the facility because we have no money to purchase expensive medicines and drugs cannot be supplied on credit,” he said.
Embu health executive Joseph Musomi says day to day running of the hospital was not affected as cost sharing fund catered for electricity, water, bandages, food and some drugs.
The state of the 40 public health facilities in Mombasa County is deplorable.
According to Mombasa County health boss Joab Tumbo, the Coast region’s only referral hospital, the Coast General Hospital, has a shortage of nurses, inadequate supply of medicine and the equipment is dilapidated.
“We inherited a health system that had been badly degraded over the years. These facilities are faced with an acute shortage of drugs. We also inherited a debt of Sh100 million at Coast General Hospital. But we are determined to turn things around,” says Tumbo.
He says the county also lacks enough ambulances ‘and those available are poorly coordinated’.
A nurse working at the maternity wing told The Counties, approximately 10 per cent of over 1,000 babies delivered at the facility in a month require incubator services.
The facility currently has only 30 incubators and efforts to purchase new one had hit a snag after the national government cut budgetary allocation to the facility from Sh86 million to Sh36 million at the beginning of the current financial year in June.
Elsewhere Kisumu East District Hospital will be demolished and reconstructed afresh to ease congestion as there has been increased demand for bed capacity.
Kisumu County Director of Health Services Dr Ojwang’ Lusi says they intend to close the facility for between one and two years in order to reconstruct a modern and spacious facility to expand its capacity of 195 beds.
Currently two to three patients share a bed and there is only one delivery bed.
Lusi says the health facility’s proximity to slum dwellings contribute to its influx.
The New Nyanza Provincial General Hospital, Lusi says, has a capacity of 600 beds, Kisumu East District hospital 300 beds, Chulaimbo has 50 beds, Kombewa has 100 beds, Ahero has 40 beds Pap Onditi has 30 beds and Muhoroni has 40 beds.
Other health centres with congestion of patients which will also be elevated to sub-district hospital level are economic stimulus-supported facilities like Manyuanda in Seme, Nyangoma in Muhoroni, Rabuor and Gita.