Declining number of patients in health facilities cause for concern

As the coronavirus crisis rages on, the number of patients seeking services in public and private hospitals has been on the decline.

Private hospitals were the first to raise the alarm last month when they complained that the numbers had dropped so much that some facilities were unable to foot their bills, including paying salaries.

On Sunday, Anglican Church Archbishop Jackson ole Sapit revealed that church-owned hospitals were hard hit and pleaded for government bailout.

Unlike public hospitals which are supported by the government, private hospitals are crumbling under the weight of the pandemic. Like all other corporates, they have been forced to take radical measures to save their businesses.

The big boys in the field are putting on a brave face through pay cuts while the smaller players are outrightly pausing business until ‘things look up’. Unfortunately, working from home is not practical in this kind of enterprise.

So, where did all these patients disappear to? Of course, part of these missing numbers can be accounted for. Accident and emergency departments are receiving fewer patients compared to the period before the pandemic. This is because the number of road accidents have reduced, thanks to the curfew, among other measures.

Diarrhoeal diseases, one of the leading killers in children under five, are also on the decline because of the heightened hygiene measures, and so are upper respiratory tract infections, the leading cause of illness and disease in Kenya. This has also led to a drop in hospital visits.

Declining hospital visits due to reduction in road accidents and hand washing is good news, perhaps the only good news coming out of the Covid-19 nightmare.

But these two cases don’t tell the whole story. There are many other Kenyans out there who are not visiting hospitals. But why?

Kenyans seem to have either suddenly learnt to treat themselves at home, or to live with their pain and suffering for fear of venturing out in search of health services.

There are several possible reasons why people are not going to hospitals. One, some people fear that going to hospital would expose them to the dreaded coronavirus.

Second, there are those who have lost their sources of income and therefore no longer have disposable income to spend on health. Kenyans who have suffered job losses are also unlikely to renew their medical covers if at all they had any.

Third, the lockdown has made it difficult for patients, including cancer patients, who used to get treatment in Nairobi to access the city.

There are of course other factors that are keeping patients at home. But whatever the reason, we should be very afraid. If cancer patients and others with serious ailments cannot get the requisite medical care, we all know the results can be lethal.

This means we are staring at a double tragedy; deaths from Covid-19 and from a myriad other diseases that are not being treated. This should not be the case. Someone somewhere has certainly dropped the ball.

This must change. We must ensure that patients go back to hospitals, and quickly. The government should start by building public confidence in medical facilities, both private and public. That it can do by assuring people, in words and deeds, that a hospital visit won’t expose one to the virus.

The confidence can only come if the government ensures that all medical workers, who are most likely to contract and transmit the virus, are provided with personal protective equipment. In addition, militarisation and criminalisation of quarantine facilities, which has been making some people not to visit hospitals fearing they might test positive and be taken to these facilities, should come to a stop.

Secondly, the government should also ensure that upcountry patients who need treatment in Nairobi are given easy access to the city through ambulances or other means.

Alternatively, the government can organise for devolution of critical health services, such as cancer care, to places where they are unavailable.

It will be a double win if people go back to hospitals; we will avert needless deaths and give the health facilities a dose of life.