Impunity as rogue doctors operate condemned clinics

Last Sunday, the nation was shocked into an uneasy silence when on prime time, Citizen TV led the day’s bulletin with an X-rated video of a ‘doctor’ allegedly assaulting an unconscious woman.

Unfortunately, such abuses are not uncommon. With a population of 42 million, Kenyan healthcare industry is now seen as a veritable path towards quick riches by quacks and even registered practitioners. To date, registration and enforcement of regulations in the medical sector remain a grey area.

Numerous bodies are responsible for licencing of a wide range of professionals.

The multiplicity of these licencing bodies has inadvertently led to emergence of loopholes that are exploited every so often, leaving an innocent, though a gullible public, at the mercy of rogue psychotic individuals. In mid-July, a small village in Western Kenya encountered fame for all the wrong reasons. A routine vaccination procedure almost turned tragic.

Between December 2014 and June this year, a health worker at Akichelesit and Moding health centres attended to 28 children in a routine government sanctioned vaccination drive.

The aftermath was however far from routine. After the exercise, 28 children suffered paralysis arising from treatment given in the six months between December 2014 and June this year, though those with severe paralysis reported initial complaints after treatment in 2013.

Limited knowledge

“The nurse who treated these children showed limited knowledge on treatment guidelines for malaria in children because Quinine was the wrong drug to give in undiluted format and in case where the malaria was not severe,” Director of Medical Services Nicholas Muraguri said at the time. Dr Muraguri said the nurse had been interdicted and ongoing investigations would further look at knowledge and practice gaps of health workers.

In nearly all of these cases, the culpable person is seldom a qualified medical officer. The Kenya Medical Practioners and Dentists Board (KMPDB) has denied Mugo wa Wairimu, the ‘gynaecogist’ at the centre of Citizen TV expose, as being one of their own. In the recent Marakwet East case, where two children died from a measles jab gone wrong, it has emerged that a sweeper administered the vaccine.

One key question remains: who should draw the line and ensure unlicenced practitioners do not get to an unsuspecting public?

Between June 17 and 19, officers from KMPDB conducted several inspections within Nairobi to ascertain the suitability of some hospitals and clinics to handle patients.

A spot check conducted by The Standard on Sunday on Friday revealed that several facilities that had been ordered closed after the June inspections, are still operating.

We found Set-Light Dental Clinic in Nairobi’s Huruma’s Kwa Chief area open and running. On seeing our vehicle, a woman standing on the only alley to the doctor’s room retracted her steps farther inside and appeared confused when we began asking about the facility.

“I am just a patient,” she said, refusing to acknowledge if the facility is operating. She then shifted her story. “The doctor left for lunch. Wait here, I will call him then let you know at what time he will be coming back.” With that, she locked herself behind a door written ‘Dr’. For about 10 minutes, we could hear murmurs but no one came out to talk to us.

Barely 100 metres away stands Total Community Development Clinic, previously condemned but currently in operation. Located on the first floor of a dimly lit residential building with pitch dark corridors, personnel locked themselves behind a peripheral metallic grill.

Despite several attempts knocking at the door, no one came out to answer our questions. In Roysambu, the door and window of Medlink Healthcare and laboratory stayed ajar as if it was operating. Outside sat a woman and a man who denied any association with the facility. “The owner, the doctor, is out for lunch,” was all they were willing to divulge. We called the number provided for the facility but our calls never went through.

According to a report in our possession prepared by the medical board, the owner of the facility fled and abandoned the premises when he saw inspection officers arriving on June 17.

Shalom medical Centre in Buruburu Phase Five was among the facilities that had been recommended for closure in the June inspection. The board cited lack of licence and display of medicine at the reception (against the board’s recommendation of professionalism) as reasons.

Despite this, it remained open for business, with a man and a woman in lab coats appearing to be the only personnel at the facility.

“Yes, the Buruburu facility is supposed to be closed until I get licencing,” admitted Dr Francis Kenyatta Nyanchungi, the man we had been told owned the facility.

Dr Francis was not available for a one-on-one interview but through a phone call, he said the facility is just one among several he runs going by the same name with the main one located in Nakuru. “I did not know that the man I have entrusted the clinic with kept it operational.”

The man in a lab coat behind the counter of what looked like a chemist, told us he was just an overseer but is not a registered with the pharmacy and poisons board. Identifying himself as Fadhili Mulili, he bore no other kind of medical accreditation.

The curious case of Mugo wa Wairimu is a perfect example of a nonexistent enforcement system.

“Police records show he has a pending case. In November last year, a woman reported at Kasarani Police Station that she had been assaulted at his clinic. She just made a report and never came back with medical records to support her claim,” police spokesman Charles Owino said.

Toothless board?

But the matter was never followed up. “It is hard going forward with a case if there are no complainants or if they go missing. We can only do so much,” Owino said.

And before the TV expose, KMPD had closed down Mugo’s clinic and, according to the board’s CEO, handed him over to police.

“We inspected Prestige Health Care in Githurai 44 on June 17 when we arrested and handed over Wa Wairimu to Kasarani police,” says Daniel Yumbya, CEO of KMPDB.

It has also emerged that on a previous raid to the same clinic, on a case of a patient who had been confined for almost a month for being unable to pay her bill, the board’s officers were forced to retreat after personnel locked themselves in and threatened to burn down the whole building.

Yumbya defended the board saying it is the work of police to make sure facilities which have been ordered by the board to close stay that way. “We did our part as the board; we arrested him and handed him over to police. When and how he was released is for the police to answer,” said Yumbya.

The alleged Mugo’s case is just one. Many more go unreported. Many more lead to more than temporary paralysis. Many lead to deaths, such as those of two children in Marakwet East killed as they sought better healthcare.

How many more quacks fall through these cracks and what ills do they mete out on an ignorant public? A total of 857 cases of medical malpractice have been reported to the KMPDB since 1997. This translates to around 47 cases every year, almost a case a week. Of these, 721 have been determined at Preliminary Inquiry Committee, 15 at a tribunal (national level) and 13 at professional conduct committee.

To lodge a complaint or a case of negligence at the board, a member of the public pays Sh2,000 processing fee but Yumbya says that the fee is usually waived for citizens who cannot afford to pay, adding that the board hopes to do away with the fee as it receives cases.

Of pertinence though is the fact that a majority of Kenyans may not know of their rights to pursue such matters with KMPDB. In fact, outside urban areas, individuals believed to be in the medical field are put on a pedestal and acquire an almost deity status. Access to this kind of justice remains an uphill task for many.